title: Bending the curve: force health protection during the insertion phase of the Ebola outbreak response.
abstract: After >10 years of enduring operations in Iraq and Afghanistan, Defence Strategic Direction is returning to a contingency posture. As the first post-Afghanistan operation, in September 2014, a UK Joint Inter-Agency Task Force deployed to Sierra Leone in response to the Ebola virus disease (EVD) epidemic in West Africa. The aims were expanding treatment capacity, assisting with training and supporting host nation resilience. The insertion phase of this deployment created a unique set of challenges for force health protection. In addition to the considerable risk of tropical disease and trauma, deployed personnel faced the risks of working in an EVD epidemic. This report explores how deployed medical assets overcame the difficulties of mounting a short-notice contingent operation in a region of the world with inherent major climatic and health challenges.
authors.affiliation: Department of Infection & Tropical Medicine, Birmingham Heartlands Hospital, Birmingham, UK Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: Mark S
authors.identifier: http://orcid.org/0000-0003-4840-5093
authors.initials: MS
authors.lastname: Bailey
authors.affiliation: Headquarters 2nd Medical Brigade, York, UK.
authors.forename: K
authors.initials: K
authors.lastname: Beaton
authors.affiliation: Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bowley
authors.affiliation: Department of Orthopaedics, James Cook University Hospital, Middlesbrough, UK Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
authors.forename: W
authors.initials: W
authors.lastname: Eardley
authors.affiliation: Emergency Department, James Cook University Hospital, Middlesbrough, Cleveland, UK.
authors.forename: P
authors.initials: P
authors.lastname: Hunt
authors.affiliation: Garrison Medical Centre, Catterick Garrison, North Yorkshire, UK.
authors.forename: S
authors.initials: S
authors.lastname: Johnson
authors.affiliation: Anaesthetics & Critical Care, James Cook University Hospital, Middlesbrough, UK.
authors.forename: J
authors.initials: J
authors.lastname: Round
authors.affiliation: Academic Department of Critical Care, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Tarmey
authors.affiliation: Department of Cardiology, Royal Gwent Hospital, Newport, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Williams
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000962:Antimalarials / Q000627:therapeutic use; D001733:Bites and Stings / Q000517:prevention & control; D004777:Environment; D058872:Epidemics; D005759:Gastroenteritis / Q000517:prevention & control / Q000628:therapy; D006282:Health Personnel; D018882:Heat Stress Disorders / Q000517:prevention & control / Q000628:therapy; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007302:Insect Repellents / Q000627:therapeutic use; D057148:Insecticide-Treated Bednets; D007306:Insecticides / Q000627:therapeutic use; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000517:prevention & control; D008887:Military Medicine; D008889:Military Personnel; D009032:Mosquito Control / Q000379:methods; D000067393:Personal Protective Equipment; D012749:Sexually Transmitted Diseases / Q000517:prevention & control / Q000628:therapy; D012807:Sierra Leone / Q000453:epidemiology; D006113:United Kingdom; D014944:World Health Organization
chemical_list: D000962:Antimalarials; D007302:Insect Repellents; D007306:Insecticides