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           'Collateral' Death Toll in Ebola Outbreak Expected to Soar

   by Reuters

   Deaths from infectious diseases like malaria, diarrhea and pneumonia
   are likely to soar in West African countries where a vast outbreak of
   Ebola has crushed health systems and killed nurses and doctors.

   Specialists on deadly diseases say deaths from malaria alone, which
   even before the Ebola crisis killed around 100,000 a year in the West
   Africa region as a whole, could increase four-fold in Ebola-hit
   countries as people miss out on life-saving treatments.

   ''Even at this point, said Professor Chris Whitty of the London School
   of Hygiene and Tropical Medicine in London, in  countries facing the
   worst of the Ebola outbreak, "many more people are dying of other
   things that are not Ebola."

   As the epidemic continues, these so-called "collateral" deaths --
   including from complications in childbirth and chronic conditions such
   as heart disease -- will rise as the clinics and health workers who
   would normally treat them are overwhelmed.

   Children at great risk

   Carolyn Miles, head of the international charity Save the Children,
   said children under the age of 5 -- of which there are an estimated 2.5
   million living in the affected areas -- are at great risk, both from
   Ebola and knock-on effects including the psychological stress caused by
   parents and relatives dying.

   "The health services of West Africa have to a very large degree broken
   down," said Jeremy Farrar, director of the Wellcome Trust international
   health charity. "That means care of women in childbirth, of people with
   malaria, of people with conditions like diabetes and mental illness are
   all suffering.

   "That will have huge secondary consequences way beyond Ebola, no matter
   how bad this epidemic becomes," Farrar said.

   The World Health Organization's (WHO) latest update said the Ebola
   virus has killed almost 3,000 people in the West Africa outbreak, which
   began early this year in Guinea and has spread to Liberia, Sierra
   Leone, Nigeria and Senegal.

   The United Nations health agency said at least 208 health workers in
   the region have been killed by Ebola, from a total of 373 so far
   infected with the virus.

   Jimmy Whitworth, the Wellcome Trust's head of population health, said
   the crisis might cause malaria deaths to quadruple to around 400,000 in
   the coming year, with patients too afraid to come to clinics for fear
   of contracting Ebola, and therefore not getting anti-malarial drugs and
   care.

   'Ripples' from crisis are 'worrying'

   Deaths from diarrhea and pneumonia, some of the biggest killers of
   children in sub-Saharan Africa, will also rise, he predicted, as will
   deaths of women in childbirth. Routine immunization programs will grind
   to a halt, putting children at higher risk of diphtheria, polio and
   tuberculosis.

   "The ripples from this crisis are very worrying," he told Reuters. "The
   hospitals are full of Ebola patients and there is not space for any
   other type of patient, and in health clinics, there are essentially no
   staff any more."

   Sierra Leone -- one of the countries worst hit by the Ebola epidemic --
   "even at the best of times had just about the worst maternal mortality
   ratios in the world," Whitworth said. "We're at a very low base, and
   now even that is being eroded away."

   The WHO's director-general Margaret Chan said last week her agency was
   acutely aware that in the three hardest-hit countries there are high
   numbers of deaths from causes other than Ebola.

   "The size of this 'emergency within the emergency' is not precisely
   known, as systems for monitoring health statistics, not good to begin
   with, have now broken down completely," she said.

   She argued, however, that these deaths should not be classed as
   "collateral damage."

   "They are all part of the central problem: No fundamental public health
   infrastructures were in place, and this is what allowed the virus to
   spiral out of control."
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References

   1. http://www.voanews.com/content/ebola-outbreak-west-africa/2463177.html