Ebola outbreak: Clinics still short on doctors, supplies 6 months later

Doctors are in short supply. So are beds for patients. Six months after the Ebola outbreak emerged for the first time in an unprepared West Africa and eventually became the worst-ever outbreak, the gap between what has been sent by other countries and private groups and what is needed is huge.

Even as countries try to marshal more resources, those needs threaten to become much greater, and possibly even insurmountable.

'We tried calling an ambulance days ago, but nobody ever came.'- Mother of Liberian child ill with Ebola

Fourteen-year-old D.J. Mulbah was taken by his mother and grandmother on Saturday in desperate pursuit of a coveted bed at the Ebola clinic run by Doctors Without Borders in Monrovia, Liberia's capital. Too weak to stand, he was put into a taxi with his backpack and a bucket for vomit. Now he lay on the dirt beside the worried women.

"He's been sick for a week with a runny stomach," said his mother, wiping the sweat off the boy's brow with her bare hands. "We tried calling an ambulance days ago, but nobody ever came."

Beds are filling up as fast as clinics can be built. Ambulance sirens blare through standstill traffic. Often, there is nowhere to take the sick except to "holding centres" where they await a bed at an Ebola treatment facility.

The virus has killed almost 3,000 people and infected more than 6,200 in Liberia, Sierra Leone, Guinea, Nigeria and Senegal.

Global response inadequate

By 8 a.m., a dozen people who likely have Ebola are crouching and sitting on the ground outside the padlocked metal gates of a facility with a capacity of 160 patients. Soon, a triage nurse approaches, her voice muffled through a surgical mask covered by a plastic face shield. The clinic will take the boy. D.J. manages a faint smile. Seven of the 30 beds made available Saturday morning were vacated by survivors. The rest had died.

Statistics reviewed by The Associated Press and interviews with experts and those on the scene of one of the worst health disasters in modern history show how great the needs are and how little the world has done in response. Some foreign medical workers have bravely fought on, a few even contracting Ebola themselves as they cared for patients.

Liberia needs more than one million protective suits and other gear such as gloves and boots in order to properly fight the epidemic. (Abbas Dulleh/Associated Press)

Experts warn that the window of opportunity to snuff out the dreaded disease may close unless promises of additional assistance immediately become reality.

The existing bed capacity for Ebola patients in Liberia, Sierra Leone, Guinea and Nigeria is about 820, well short of the 2,900 beds that are currently needed, according to the World Health Organization. Recently, 737 beds were pledged by countries. Yet even after the promised treatment facilities are built, they will still be at least 2,100 beds short.

The shortage of health workers is also great. The WHO has estimated that 1,000 to 2,000 international health workers are needed in West Africa. More than 200 local health workers have died of Ebola trying to save patients, complicating recruitment efforts.

Doctors Without Borders, which has more Ebola clinics than anyone, currently has 248 foreign aid workers in the region.

On Saturday, Liberia's chief medical officer, Bernice Dahn, placed herself under quarantine after her assistant died of Ebola.

CBC reporter Adrienne Arsenault and producer Stephanie Jenzer arrived in Liberia this weekend and will be sending regular reports from the field. Follow their updates at @adriearsenault and @steph.jenzer.

U.S. to train medical staff, build field hospitals

U.S. President Barack Obama has ordered up to 3,000 U.S. military personnel to West Africa to train health workers and build more than a dozen 100-bed field hospitals, including reserved sections for infected aid workers in Liberia.

Among other promises of global assistance:

• The African Union has said it will deploy 100 health workers to assist the West African countries affected by Ebola. The first batch of an AU Ebola taskforce, totaling 30 people, left for Liberia on Sept. 18. Taskforce members are expected to arrive in Sierra Leone on Oct. 5 and in Guinea by the end of October.
• Britain and France have both pledged to build field hospitals in Sierra Leone and Guinea.
• China is sending a 59-person lab team to Sierra Leone.
• Cuba will send 461 health workers, who will be trained in biosecurity, and some will go to Liberia and Guinea.
• Canada promised an additional $30 million in aid last week to go to prevention and treatment efforts.

Dr. Joanne Liu, international president of Doctors Without Borders, urged world leaders this week to take "immediate action."

"The reality on the ground today is this: The promised surge has not yet delivered," she said.

MSF and other aid workers are distributing home-care kits with gloves and surgical gowns to try and keep those awaiting hospital beds from infecting relatives at home, though only several thousand kits are being distributed in Monrovia, a city of 1.6 million.

"We have been working furiously trying to set up treatment centres, but (incoming patients) have been outpacing our ability to set them up," said Dr. Frank Mahoney, co-lead of the U.S. Centers for Disease Control team in Liberia.

Meanwhile, the National Institutes of Healthsaid Sunday it is preparing to care for an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone.

Out of what the agency called "an abundance of caution," the physician is expected to be admitted to the special isolation unit at the NIH's hospital near the nation's capital for observation. No other details were divulged.

Outbreak will get harder to contain

Unless the situation is put under control, the outbreak may infect as many as 1.4 million people by the end of the year and nearly half of those people could die, the CDC estimated this week. More than 3,000 are currently believed to have died from Ebola, which is spread through direct contact with the bodily fluids of the sick.

If more people get sick than those who recover or die, the needs will grow even more pronounced.

"If this outbreak continues, the sheer caseload will make it much more difficult to contain," said Dr. Bruce Aylward, assistant-director general in charge of emergencies at WHO. "We will need more health workers to take care of them, more PPE (protective suits), more hospitals, more of everything."

A top priority is sending enough protective equipment, including gloves, gowns, masks and boots. WHO is shipping about 240,000 protective suits a month in addition to supplies sent by other agencies. Under-sourced clinics are reportedly washing and reusing protective gear that is meant to be worn once and burned.

Bernice Dahn, Liberia's chief medical officer, placed herself under quarantine on Saturday after her assistant died of Ebola. Liberia's government has asked people to keep themselves isolated for 21 days if they think they have been exposed. (James Giahyue/Reuters)

"We still do have gaps in the supply, which are quite significant," said Antonio Vigilante, the deputy special representative of the UN secretary-general in Liberia. "Nobody expected that the requirements of protective gear would go in the order of millions." Liberia now requires an estimated 1.3 million protective suits, Vigilante said.

One of the world's top makers of the suits, DuPont, says it has more than doubled production but would not say who has placed orders. Officials are also looking into whether protective clothing can be locally produced.

"The situation on the ground is just disastrous," said Dr. Heinz Feldmann, chief of virology at the U.S. National Institute of Allergy and Infectious Diseases, who recently returned from Liberia.

"The idea of having hundreds of people in tent structures for Ebola management is unbelievable but the way this is spreading, we need to find a solution now."

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Head lice: Most-used treatments no longer very effective, scientists say

With elementary school students back in class, more kids may be going home with itchy heads. That's due to the lice that get spread by the head-to-head interactions that happen frequently enough among kids that age.

While the official recommendation for treatment will likely include using a product on their hair that contains pyrethrins or permethrin, scientists are finding that head lice have acquired resistance to those compounds.

Over the past 35 years or so, head lice have built up considerable resistance to the pyrethroids via genetic mutations, says lice expert John Clark.

"The efficacy of all those products has gone way down. It started out at 100 per cent, now we're down to 20 to 30 per cent in recent clinical studies."

Natural pyrethrin formulations, made from chrysanthemums, were introduced in 1945 for the control of head lice. Permethrin, a synthetic pyrethroid, dates back to the 1980s.

With the start of school in the fall, numbers of cases of lice begin to rise, particularly in day-care centres, kindergartens and elementary schools. Head lice, like this one being viewed with an electronic microscope, mostly spread via head-to-head contact. (Frank Gunn/Canadian Press)

Products containing those compounds — Nix, Rid, Kwellada, R&C Shampoo — dominate the head lice treatment market in North America.

"When these products came on the market, they were very efficacious and very good louse control agents," says Clark, who directs the Massachusetts Pesticide Analysis Laboratory and is a professor of environmental toxicology and chemistry at the University of Massachusetts Amherst.

He has co-authored a numbered of lice studies, including one published this year that looks at what scientists call "knockdown resistance" in head louse populations.

'Treatment failures'

The Clark paper documents how lice studies over the years have found the frequency of the mutations steadily and rapidly increasing, so that now the mutations are almost always present "within North American head louse populations and likely a major reason for the treatment failures encountered with pyrethrins- and pyrethroid-based pediculicides in both Canada and the United States."

Nevertheless, public health officials and organizations such as the Canadian Paediatric Society (CPS) and the U.S. Centres for Disease Control continue to recommend products containing those compounds.

Clark says we're "trapped in this scenario where we're being forced to use compounds that clearly aren't near as efficacious as they were 30 years ago."​

Head lice, Pediculus humanus capitis, cause infestations that, overall, cost an estimated $1 billion in the U.S. annually. This frontal view of a head louse was captured with an electron microscope. (Bioimaging Unit/Oxford Brookes University)

Bayer Healthcare, which claims its product Rid is "the #1 head lice treatment brand" in the U.S. — which they don't sell in Canada — told CBC News that while "lice can develop resistance to pediculicides," the insecticides used to kill them, "when used according to directions, RID is effective in killing lice."

Bayer also notes that products like Rid which contain pyrethrin or permethrin are approved by the FDA for the treatment of head lice.

Clark says it's hard to find financing for a rigorous clinical study that looks at whether a product still works.

"Unfortunately, until we actually do something like that, there's nothing driving any of these organizations to change their position."

"The safest method"

A 2014 U.K. study that compared treatment with a mousse or a lotion containing a permethrin to  just wet-combing the hair found that, "none of the treatments was significantly more effective than any other."

This month, Consumers Reports published their advice on how to treat lice, saying "the safest method of getting rid of lice is to physically remove the insects and their eggs by combing with a lubricant such as a hair conditioner."

Michael Hansen, senior staff scientist with Consumers Union, says the conditioner, or olive oil, especially helps with the removal of nits, the louse eggshell.

Earlier understanding was that a louse cemented her nits to a hair shaft, usually near the base, but he says the nit can actually be slid up and down the shaft.

He pointed to a 2014 study in the Journal of Medical Entomology that says ordinary hair conditioner is just as effective at removing nits as special nit-removal shampoos and conditioners.

Consumers Reports has a step-by-step guide for lice and nit removal from an infested scalp.

Infestation usually involves less than 10 live lice, according to the CPS.

But an adult female louse can produce up to six eggs per day, which hatch seven to 12 days later.

Best practices

Consumer Reports says "the safest method of getting rid of lice is to physically remove the insects and their eggs by combing" — with a metal nit comb, not a plastic one — using hair conditioner or olive oil as a lubricant. (iStock)

When removing nits, it's important to use a metal — not plastic — nit comb, Hansen says, "because the tines of those metal combs, they're small enough so that an individual hair can go through, but not the egg itself."

"Concentrate around the ears and the nape of the neck, those are the areas where you'll see the bulk of the eggs being laid."

Clark agrees with the Consumer Reports statement on nit-picking. "There's no question that it can be effective, it's just very time consuming." There's also professional salons for lice treatment, he adds.

New products available

For parents without the time and the energy for tedious nitpicking, there are new products on the market.

A number of products contain dimethicone, which suffocates lice. One Canadian manufacturer, Pediapharm, claims the insects "cannot develop resistance."

Clark says that's debatable.

"Insects have been around a long time and to say that we're going to come up with the silver bullet that's going to eliminate a louse that's been around for a million years and they're not going to find a way around it, is sort of naive.

"It may take a little longer to develop resistance, but I'm sure they can develop resistance even to the physical acting type of compound."

Hansen adds that the products sold in North America with lower dimethicone concentrations don't kill the nits, so "you have to continue to use it every few days."

A lousy strategy

Clark says over-reliance on one insecticide is a lousy strategy because of insects' ability to acquire resistance. He recommends, on a community level, using a variety of products "that have novel modes of action."

Lice are found nearly everywhere on the planet there are human heads, including Siberia. And head lice are fast, capable of travelling up to 23 cm in a minute.

In addition to dimethicone compounds, he mentions products containing ivermectin, spinosad and benzyl alcohol, which kill lice in different ways. Those three usually require a prescription.

When asked about those compounds, Hansen doesn't dispute their effectiveness, but he notes they're "incredibly expensive" and questions their worth.

"Just do the simple combing every couple days, it works," he recommends.

Clark calls their prices "unbelievable," although they're often covered under insurance plans.

He says that in the U.S., a person has to twice use an over-the-counter product relying on pyrethrin or permethrin, and then show they're ineffective, before a doctor can write a prescription for one of the new products.

Hansen and his co-authors call for "an approach to management of head lice infestations that balances effectiveness and safety with treatment expense and the need to use treatments that have novel modes of action."

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Liberia struggles to fight Ebola as newest, largest clinic reaches capacity

[The CBC's senior correspondent Adrienne Arsenault, producer Stephanie Jenzer and videographer Jean-François Bisson are in Liberia's capital city of Monrovia reporting on that country's ongoing battle against the deadly Ebola virus.]

Liberia's newest and largest Ebola treatment centre was desperately needed to combat the spread of the fatal virus, yet the facility has barely helped to stop the worst outbreak in recorded history. 

The centre, known as Island Clinic, was exactly seven days old when CBC News toured the "green zone," or safe zone, of the facility on Sunday. It has almost doubled the Ebola treatment capacity in Liberia's capital city of Monrovia, a major urban centre overwhelmed by an exponentially increasing number of cases of the deadly virus. 

When it opened, there were 120 beds available. Within hours, the clinic was already stretched — every space available filled with the city's most frightened and seriously ill. Somehow, room was made for more patients and currently, by adding beds and sofas where possible, staff estimate the total number is likely closer to 200.

The World Health Organization funded the clinic and handed it over to Liberia's Ministry of Health and Social Welfare, while UNICEF, the World Food Programme and USAID have joined the WHO donating supplies and support.

'A drop of water in an ocean'

WHO spokesperson Pieter Desloovere said the building can't handle increasing capacity yet again because of the heavy load on the water supply and electricity, but he acknowledges the need.

"It's a drop of water in an ocean," he says. "The demand is so huge."

Another challenge will be to keep Island Clinic fully staffed, not to mention finding qualified or willing-to-be-trained workers to help run the more than 20 planned facilities in Liberia over the coming months.

There is another problem brewing at the facility, as well: a threat by workers to walk off the job by Tuesday over wages. Many staff receive about $300 per month, but some told CBC News they've heard rumours the government is about to reduce that paycheck. 

"We agreed to risk our lives, but we are not satisfied with the pay,"  one health worker told the CBC's Adrienne Arsenault.

CBC coverage of Liberia's fight against Ebola

Be sure to follow Adrienne Arsenault and Stephanie Jenzer on Twitter at @adriearsenault and @StephJenzer as they provide the most recent news and coverage from Monrovia.

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UN's Ebola virus HQ opens in Ghana

The UN mission to combat Ebola opened its headquarters on Monday in Ghana, where it will coordinate aid for the accelerating West African crisis.

The spread of Ebola has spiralled into the worst ever outbreak, and the World Health Organization says it is has linked more than 3,000 deaths to the disease, although that is likely an underestimate of the true toll.

Liberia, Sierra Leone and Guinea have been hit hardest. Senegal and Nigeria have also been touched, but have not reported a new case in weeks.

Some have criticized the response to the outbreak as too slow and haphazard. Ebola was first identified in March in Guinea. But more recently promises of aid have poured in, with many countries committing to sending health care workers, building hospitals or providing much-needed supplies, like protective suits for doctors and nurses.

The United Nations Mission for Ebola Emergency Response, also known as UNMEER, is now tasked with figuring out where the greatest needs are and making sure aid gets there, said Christy Feig, director of communications for the World Health Organization, which will play a significant role in the mission.

The head of the mission, Anthony Banbury, and his team are expected to arrive Monday in Ghana's capital of Accra.

Many countries in the region have closed their borders with the worst-affected countries and suspended flights into and out of them. That has choked off routes for supplies and health care workers into Liberia, Guinea and Sierra Leone. But Senegal officially opened a humanitarian corridor this weekend, and UN flights can now make regular flights into the affected countries from Dakar. Ghana has also agreed to an air bridge.

The needs of the outbreak have continually outstripped projections: WHO says around 1,500 treatment beds have been built or are in the works, but that still leaves a gap of more than 2,100 beds. Between 1,000 and 2,000 international health care workers are needed, and they and local doctors and nurses will require millions of disposable protective suits to stay safe. Thousands of home hygiene kits are also being flown in to help families protect themselves at home.

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Even moderate drinkers face elevated breast cancer risk, study says

Even moderate drinkers face an elevated risk of developing breast cancer, according to a new study from the University of Victoria's Centre for Addictions Research of B.C. (CARBC).

The study, published in the journal Alcoholism: Clinical and Experimental Research, suggests that consumption levels outlined in Canada's low-risk drinking guidelines for women still pose a risk.

Dr. Kara Thompson, a research associate at CARBC, said that even one or two drinks a day increases the risk of breast cancer by eight per cent.

"If you're a one-glass-a-day drinker, it's not a huge chance that you're going to get cancer from your drinking, but it does increase your risk," she told CBC News. "When you add other risks — genetic risk and other things — to those, your risk could go up quite substantially."

Researchers reviewed and analyzed 60 studies that were undertaken prior to 2013, many of which had conflicting results about the link between low-dose drinking and breast cancer.

They found that just six of those studies were "free of potentially serious biases," many of which arose because of the way in which drinkers and former drinkers were classified in those studies. 

"When corrected for these biases, the findings confirmed a significantly increased risk for breast cancer from low-dose consumption," the study's authors said.

Though the absolute risk remains small, one of the co-authors, Dr. Tim Stockwell, said the findings should nevertheless encourage caution.

"In general, less drinking means less risk to health," he said.

The Centre for Addictions Research of B.C. estimates that between 250 and 500 Canadian women die of breast cancer linked to their alcohol consumption every year.

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'We have to change our mindsets': Obama urges making Ebola a global priority

The Ebola outbreak in West Africa illustrates how infectious diseases can easily cross borders and needs to be a global priority, U.S. President Barack Obama says.

Obama was speaking Friday at Global Health Security Agenda Summit held at the White House.

Representatives from more than 40 countries are attending the summit, which aims to prevent avoidable catastrophes and epidemics, detect threats early with real-time disease tracking and diagnostic testing, and respond rapidly and effectively.

The World Health Organization said Friday that the number of deaths linked to the Ebola outbreak in West Africa is now 3,091. More than 6,500 people have been infected, chiefly in Sierra Leone, Liberia and Guinea.

"We have to change our mindsets and start thinking about biological threats as the security threats that they are, in addition to being humanitarian threats and economic threats. We have to bring the same level of commitment and focus as we do when meeting around more traditional security issues," Obama said.

Obama issued a challenge to inventors to design better protective gear for health-care workers. The current masks, respirators, gloves and gowns that health-care workers must wear when treating patients infected with Ebola are hot and cumbersome and can introduce the infection if not donned and removed carefully.

Obama called it unacceptable that so many people are dying from Ebola infections given the medical talent and technology that are available. But West Africa's outbreak also illustrates how planning and preparation, such as having enough trained specialists ready to deploy, can make a difference.

"Starting in West Africa, we've got to make sure we never see a tragedy on this scale again and we have to make sure we aren't caught flat-footed."

Ebola infections are treated with supportive care such as providing intravenous fluids and maintaining oxygen levels and blood pressure.

While the short-term focus is on ensuring infections don't become outbreaks, Obama said that in the longer term, strengthening the health of individuals, such as by immunizing children, and ensuring they are well fed and have opportunities to get out of extreme poverty, are also part of the agenda.

Earlier on Friday, the World Health Organization announced that spread of the disease in Guinea appears to have stabilized. But in Sierra Leone, three more districts are under indefinite quarantine to try to stop the spread of the virus.

An official with UN's health agency also said that thousands of experimental Ebola vaccines should be available in the coming months, and could eventually be given to health-care workers and others in close contact with those made sick by the virus.

No vaccine has been proven safe or effective in humans, said Marie-Paule Kieny, assistant director general at WHO. NewLink Genetics Corp. Kieny estimated about 1,500 effective doses could be available.

By January, another 10,000 doses of another vaccine, developed by the U.S. National Institutes of Health and GlaxoSmithKline, should also be available for use on a limited basis.

Data will be collected from clinical trials when the experimental vaccines are being given to healthy volunteers who will be monitored for any adverse side-effects and to see if the shots effectively lead to an immune response.

WHO has approved the use of blood transfusion and infusion of human serum from Ebola survivors, but Kieny said the donated blood must be screened for infections including HIV and hepatitis.

Elsewhere Friday, the International Monetary Fund approved $130 million US to Guinea, Liberia and Sierra Leone for their fight against Ebola.

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Health websites could be overrun by commercial interests, experts fear

The integrity of the "Health Internet" used by millions of people is threatened by commercial interests, a coalition of  health policy experts argues.

The Internet Corporation for Assigned Names and Numbers (ICANN) is the steward of internet names such as the traditional top-level domains including .com and .org. ICANN plans to expand the domains to .health, .doctor and .hospital.

Groups such as the World Health Organization, Save the Children, the European Commission and ICANN's own ombudsperson have objected to the plans. In Friday's issue of the Globalization and Health, a group led by Tim Mackey of the Global Health Policy Institute of doctors calls for moratorium on the use of .health.

As people increasingly turn to the internet for health information, it's problematic that scientifically unfounded information can also proliferate online, experts say. (Wendy Owen/Associated Press)

"Do we want information about health, and expressly labelled as being about health, to be governed by the law of the jungle?" asked Amir Attaran, a co-author of the commentary and a professor in the faculties of law and medicine at the University of Ottawa.

Attaran pointed to health fraud that currently exists on the internet, such as online pharmacies that sell unapproved medicines.

"It is self-evidently problematic to propound online scientifically unfounded information, or biased information, in an era where consumers and patients are increasingly using the internet as their primary source for health information," the authors said.

But ICANN has disregarded cautions in favour of applicants such as large corporations, the team said, pointing to its rejection of domains such as .wtf and .sucks that could be bought by disgruntled customers.

The future of the what the World Health Organization calls the "Health Internet" — the range of benefits of risks of the internet to consumers, health professionals and public health systems — could include smoking.health, owned by a tobacco company or cancer.doctor, which could potentially be purchased by unscrupulous vendors catering to  vulnerable patients.

ICANN charges between $25,00 US and $185,000 US for an initial application for a top-level domain, not including annual fees. The American Heart Association withdrew its application for a health-related top level domain, the authors say.

"We're simply publishing the paper to implore them [ICANN] at the last minute to do the right thing. If they don't want to do the right thing, people will probably be hurt, people will probably be killed and in a few years we get to tell you, 'told you so,'" Attaran said in an interview.

They suggested an expert working group could discuss governance of the top-level domains to ensure access to trusted health information and to prevent online fraud and abuse.

ICANN has argued that there is no way to determine what constitutes quality health information and that safeguards already exist.

Some domains, such as the aviation community's .aero, require third-party accreditation to restrict their use.

But if ICANN persists in expanding .health without meaningful safeguards, the authors said the action would show a lack of due diligence that the legal system might one day try to penalize.

Two of the authors received travel funding to attend a WHO meeting on maintaining trust on the health internet.

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Liberia's top doctor places herself under Ebola quarantine

Bernice Dahn, Liberia's chief medical officer, is placing herself under quarantine for 21 days after her office assistant died of Ebola.

Dahn, a deputy health minister who has represented Liberia at regional conferences intended to combat the ongoing epidemic, told The Associated Press on Saturday that she did not have any Ebola symptoms but wanted to ensure she was not infected.

The World Health Organization says 21 days is the maximum incubation period for Ebola, which has killed more than 3,000 people across West Africa and is hitting Liberia especially hard. WHO figures released Friday said 150 people died in the country in just two days.

Liberia's government has asked people to keep themselves isolated for 21 days if they think they have been exposed. The unprecedented scale of the outbreak, however, has made it difficult to trace the contacts of victims and quarantine those who might be at risk.

"Of course we made the rule, so I am home for 21 days," Dahn said Saturday. "I did it on my own. I told my office staff to stay at home for the 21 days. That's what we need to do."

Health officials, especially front-line doctors and nurses, are particularly vulnerable to Ebola, which is spread via the bodily fluids of infected patients. Earlier this month, WHO said more than 300 health workers had contracted Ebola in Guinea, Liberia and Sierra Leone, the three most-affected countries. Nearly half of them had died.

Making sure health-care workers have the necessary supplies, including personal protective equipment, has been a challenge especially given that many flights in and out of Ebola-affected countries have been cancelled.

At an emergency meeting of the African Union on Sept. 8, regional travel hub Senegal said it was planning to open a "humanitarian corridor" to affected countries.

Senegal was expected on Saturday to receive a flight carrying humanitarian staff from Guinea — the first time aid workers from one of the three most-affected countries were allowed in Senegal since the corridor was opened, said Alexis Masciarelli, spokesman for the World Food Program.

The airport in Dakar, Senegal's capital, has set up a terminal specifically for humanitarian flights where thorough health checks will be conducted, Masciarelli said.

The current plan calls for two weekly rotations between Dakar and Ebola-affected countries and a third weekly rotation between Dakar and Accra, Ghana, where a special UN mission to fight Ebola will be headquartered, Masciarelli said.

Mustapha Sidiki Kaloko, African Union commissioner for social affairs, said Saturday he plans to travel to West Africa Sunday to meet regional leaders and airline executives to try to convince them to resume flights cancelled because of Ebola.

The first batch of an AU Ebola taskforce, totalling 30 people, left for Liberia on Sept. 18, Kaloko said. Taskforce members are expected to arrive in Sierra Leone on Oct. 5 and in Guinea by the end of October, he said.

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7 things to know about the bottled vs. tap water debate

Recent reports of drugs in our drinking water might have some people heading for the bottled water aisle of their nearest grocery store, but in most parts of Canada, choosing bottled water over tap is a matter of taste or convenience, not health.

Unless you live in a community that lacks water treatment facilities — which, even after the Walkerton water crisis of 2000, is still a reality for some Canadians, including many First Nations — chances are the water coming out of your tap is perfectly safe to drink. 

That didn't stop Canadians from purchasing 2.4 billion litres of bottled water last year, or about 68 litres per capita, according to a market analysis by Euromonitor International.

The bottled water industry is worth more than $170 billion, and North Americans are some of its most avid consumers, so much so that in the U.S., bottled water has surpassed milk and beer in terms of volume sold. In Canada, three out of 10 households drink bottled water at home, according to Statistics Canada.

1. Water quality

Tap water is regulated by Health Canada and the provinces and territories. The Guidelines for Canadian Drinking Water Quality​ spell out the maximum levels of potentially harmful substances that are allowed in drinking water. Municipalities test their water sources constantly to make sure they are within these limits.

The City of Ottawa, for example, conducts more than 125,000 water quality tests a year. Toronto tests water samples every four to six hours and checks for more than 300 potential chemical contaminants.

The results of this monitoring are generally easily accessible to the public, often on city websites or by request.

Bottled water is not subject to the same guidelines because it is classified as a food and falls under the Food and Drugs Act. Aside from arsenic, lead and coliform bacteria, the act does not set limits on specific contaminants but says simply that food products cannot contain "poisonous or harmful substances" and must be prepared in sanitary conditions.

Spring and mineral water is subject to a few more rules: it must be fit for human consumption at the source and can't be treated in any way that would modify its composition, other than by adding carbonation, ozone or fluoride.

2. Self-policing industry

Monitoring of water quality in the bottled water industry is "essentially voluntary and internally regulated," a 2009 study by the Polaris Institute, an Ottawa-based non-profit environmental advocacy group, found.

Water from the tap is subject to more rigorous water quality guidelines than bottled water. (Matt Rourke/Associated Press)

​Bottled water producers insist they perform a comparable degree of testing on their water to municipalities, but the results do not have to be made public — although some companies do post sample water quality analyses online.

The Canadian Food Inspection Agency does conduct inspections of bottled water plants, but the Polaris Institute found that these are done on average once every three years.

Companies that belong to the Canadian Bottled Water Association (CBWA), which represents about 85 per cent of the industry, are supposed to follow certain best practices when it comes to monitoring water quality and submit to annual inspections by a third party, but compliance is voluntary.

Provinces can impose stricter regulations, but so far, only Quebec has done so. Its bottled water regulation sets limits on metals and other contaminants and requires labels to specify the water's origin.

3. Labels don't tell full story

Outside of Quebec, labels on bottled water that is not spring or mineral water don't have to specify the source of the water, even if that source is your municipal water supply.

The CBWA says less than eight per cent of bottled water sold in Canada comes from municipal sources, but in the U.S., scientist Peter Gleick has estimated it's as much as 45 per cent.

Bottled water is ubiquitous in modern society and the industry is estimated to be worth more than $170 billion. (Bobby Yip/Reuters)

Bottled water from Coca-Cola, ​Nestlé and PepsiCo brands like Dasani, Poland Spring and Aquafina are essentially treated tap water. Some, like Aquafina, have since put that information on the label, but it's not a requirement — as long as the label isn't explicitly misleading.

Bottled water labels do have to specify how the water was treated and whether it contains fluoride and must list any added ingredients. Mineral and spring water must specify the mineral salt content while water that has had the bulk of its minerals filtered out must be labelled "demineralized."

Some brands specify an expiration date, although this is not required, and there is disagreement on whether water — if kept sealed and stored in cool conditions that don't promote the growth of bacteria — can ever "expire." The industry has said bottled water has a shelf life of two years, but Health Canada suggests replacing water after one year while the U.S. Food and Drug Administration considers it to have an indefinite shelf life.

4. No clear health risks

Health Canada considers all bottled water that meets the standards set out in the Food and Drugs Act "comparable from a health and safety perspective" and says the water sold in Canada is generally of good quality and doesn't pose any health hazard.

Illnesses associated with bottled water are rare, but like tap water, it can become contaminated. The Polaris Institute found that there were 29 recalls of 49 bottled water products between 2000 and 2009 because of contamination — by everything from bacteria to mould to arsenic and "extraneous material" such as glass. 

The Canadian Food Inspection Agency was unable to provide more current figures, but one recent case was the 2013 recall of water from Blue Glass Water Co. (Caledon Clear Water Corp.) because of bacterial contamination.

In 2004, a voluntary Dasani recall in the U.K. attracted international attention after Coca-Cola found levels of bromate in the water exceeded legal limits.

Canada is far ahead many parts of the world when it comes to the quality of our drinking water. (Anindito Mukherjee/Reuters)

The lack of fluoride in bottled water, which usually contains none or lower levels than tap water, is another potential health concern that has been raised by health professionals who believe it helps prevent tooth decay.

Others have raised the point that water that has been demineralized — either through commercial or household filtration — might deprive those who drink it of the beneficial effects of essential minerals such as magnesium and calcium.

There have also been concerns over the potential leaching of antimony trioxide, a suspected carcinogen used in the manufacturing of the polyethylene terephthalate plastic (known as PET or PETE) that water bottles are made of, but studies by Health Canada and others have shown that the levels found in bottled water were not a health risk. 

Bisphenol A, the controversial compound found in some plastics, is not a concern with PET water bottles. 

5. What about the drugs?

Many of the companies that sell bottled tap water claim their product tastes better than what comes out of your faucet.

Coca-Cola voluntarily withdrew about 500,000 bottles of Dasani water in the U.K. after it found levels of bromate exceeded legal limits. (Peter Macdiarmid/Reuters)

To achieve that "improved" taste, bottlers often use multi-step filtration processes that remove naturally occurring minerals like magnesium, calcium and sodium and don't leave the same odour and taste as the cheaper chlorine disinfection used by municipal water treatment systems.

These include methods such as ozone and UV disinfection, carbon filters and reverse osmosis. 

Ozonation and carbon filters can theoretically filter out organic compounds like the pharmaceuticals detected in some drinking water, but bottled water is generally not tested for such compounds. Household carbon filters can serve the same purpose for tap water.

Mineral and spring water, which comes from groundwater rather than surface water like lakes and rivers, is less susceptible to such chemicals, which generally show up in wastewater effluent and have not yet been shown to be a serious health risk. Municipal water can come from groundwater or surface water.

6. Cost

Bottled water costs several thousand times more than tap water (about $2.50 for a 500 ml bottle in your local vending machine compared to fractions of a penny per litre from the tap), and much of the water corporations sell is obtained on the cheap from public water sources.

Many provinces do require bottlers to obtain permits to extract this water, but charge very little for the privilege. Nestlé pays a mere $3.71 for every million litres of water it draws from a well near Hillsburgh, Ont., and has permission to withdraw 1.13 million litres of groundwater per day.

Ontario requires all industrial or commercial facilities that use more than 50,000 litres a day to pay the $3.71 fee and obtain a permit, but not all provinces do. Until recently, B.C. did not regulate industrial groundwater use and allowed ​Nestlé to extract millions of litres a year from a well in Hope, B.C., for free.

7. Environmental impact

Although many companies have tried to cut down on the amount of plastic they use and increase the proportion of recycled and compostable materials, the industry still generates significant waste and consumes water and fossil fuels in the process of bottling and transporting its products. 

Many discarded bottles end up in recycling facilities abroad, such as this one in Mumbai. (Danish Siddiqui/Reuters)

The CBWA says plastic bottles account for only one-fifth of one per cent of landfill, but once there, they can take hundreds of years to decompose.

About 70 per cent of PET drink containers in Canada are recycled, according to the Canadian Beverage Association, although recycling rates vary by province. 

Some of that plastic waste gets shipped abroad for recycling — creating more greenhouse gases in the process.

(You might be tempted to reuse your empty water bottle to give it a second life, but health experts say reuse increases the risk of bacteria and the leaching of potentially harmful chemicals.)

The bottled water industry says it uses only a tiny portion of Canada's water supply compared to other industries, such as power generation. (Andy Clark/Reuters)

The industry says it barely makes a dent in Canada's fresh water supply and that it only takes 1.3 litres to make one litre of bottled water, but other estimates have placed it as high as three litres.

The Pacific Institute in California has estimated that bottled water is up to 2,000 times more energy-intensive than tap water. In 2006 alone, bottling water for U.S. consumption used the energy equivalent of 17 million barrels of oil and produced 2.5 million tons of carbon dioxide, it found.

Increasingly, federal and local governments, as well as some university campuses, are finding those costs too high and are adopting bottled water bans or special surtaxes on the sale of bottled water. Toronto has banned the sale of bottled water at all municipal parks and facilities. San Francisco's ban even extends to food trucks regulated by the city.

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'Disposable heroes': No compensation for paramedic with PTSD

A B.C. paramedic says the province's outdated rules mean first responders who suffer psychological trauma on the job are treated like "disposable heroes."

Joanne Trofanenko was shocked when WorkSafeBC refused to compensate her when she became too ill to work after a 2010 accident.

"We have a saying. You never know when your career-ending call is going to come in."

This B.C. Ambulance carrying Joanne Fuller and Ivan Polivka plunged over a cliff and sank eight metres to the bottom of Kennedy Lake near Ucluelet. (CBC)

For Trofanenko, it was Oct. 19, 2010. She was the first paramedic on scene after a B.C. ambulance plunged over a cliff and sank eight metres to the bottom of Kennedy lake.

"As soon as I approached the hill at Kennedy lake, I knew that this was not good," said Trofanenko, fighting back tears as she recalled that early-morning search for survivors.

The driver, 59-year-old Joanne Fuller, was Trofanenko's close friend.

'You just go numb'

She watched helplessly until divers confirmed that the bodies of Fuller and Ivan Polivka, 65, were inside the ambulance.

View of the cliffs showing the sheer dropoff from the roadway surrounding Kennedy Lake near Ucluelet. (CBC)

"You were able to see that the ambulance was at the bottom of the lake and you could see all the debris and the path that the ambulance took going down the cliff, " she said. "I just shut down cause that's all you can do.You just go numb."

The coroner ruled Fuller likely fell asleep at the wheel while fellow paramedic Polivka, napped in the back. It was just after 4:30 a.m. PT and the Ucluelet-based ambulance team had just transferred a patient to Port Alberni.

The two years following the accident were difficult for Trofanenko, who transferred to another ambulance station, but could no longer perform at the same level.

"My brain would freeze and I wasn't processing as quickly as I used to," she said.

It wasn't until she responded to another drowning call, at a lake that resembled Kennedy Lake, that she realized she needed help.

Joanne Fuller and Ivan Polivka died when the ambulance driven by Fuller went over a cliff in the early morning hours of Oct. 2010 and plunged to the bottom of Kennedy Lake. (CBC)

"I just burst into tears and I had a panic attack. My throat closed off and I said, 'Oh my god, it's Kennedy Lake again,'" said Trofanenko, describing what she later learned was a flashback.

She went on sick leave and was diagnosed with post-traumatic stress disorder as a result of what she experienced the day her friend died.

But in a letter from WorkSafeBC, she learned her claim was denied because she didn't file it within one year of the date of the injury. The Kennedy Lake tragedy had happened more than two years earlier.

'I didn't know I was sick.'

Trofanenko was shocked WorkSafeBC didn't take into account that she didn't recognize the symptoms in that first year.

"I didn't know I was sick," she said."I didn't know I had PTSD. I knew I was struggling, but I didn't know I had this."

Dr. Nicole Aube is a psychologist who works with first responders. She says delayed onset of symptoms is common among PTSD sufferers.

Joanne Trofanenko takes a walk with her support dog, medically prescribed for PTSD sufferers. Trofanenko says she knew she was sick but didn't know why until she was diagnosed with PTSD well after the accident. (CBC)

"It happens frequently that people do not see their signs of PTSD, or PTSD does not manifest immediately" explained Aube.

Left untreated, Aube says PTSD can be dangerous for emergency workers, who may lose control of their emotions and may not be able to think clearly.

Aube says Trofanenko would have been particularly vulnerable, "especially if it was a best friend."

"If it's someone we don't know, we have more of an immune system to cope with that,  but if it's someone close, you will have a stronger impact," she said.

In Trofanenko's case, the loss was profound. 

"Somebody asked me well who is your go-to person you can go and talk to, and that's when it really hit me, that it was Joanne," she said.  "I didn't have anybody to talk to. The person that I would talk to is the person that was killed."

Paramedics at 30 per cent higher risk

Trofanenko says at that time, she didn't realize her sleep disturbances, irritability and lack of concentration were all signs of PTSD.

Dr. Nicole Aube is a psychologist who works with first responders. She says PTSD doesn't always manifest itself right away, but can be dangerous for emergency workers if left untreated. (CBC)

She appealed WorkSafe's denial of her PTSD claim as of a result of the 2010 incident. She lost that, but won an appeal of a second claim made because of the flashback she experienced at a drowning in 2013.

She received wage-loss benefits for six months, but was cut off after a failed attempt to return to work as a paramedic. She has since filed a third claim, saying her working as a paramedic was too traumatic, but WorkSafe disagrees.

"They're just denying [3rd claim] outright saying it wasn't bad enough to cause distress and PTSD" says Trofanenko.

Bob Parkinson, the Health and Wellness Director for Ambulance and Paramedics of BC says his members have a 30 per cent higher rate of PTSD than the general population, and too many claims are being denied by WorkSafe. 

"It's inconsistent," he said. "Claims that seem as though they should go through don't and other claims slide on through. We have a lot of members suffering." 

The union says more than half of all their WorkSafe injury claims are stress related.

PTSD not occupational disease only in B.C.  

B.C. is the only province that does not consider stress caused "by acute reaction to a traumatic event" as an occupational disease, where a claim can be made at any time.

In Alberta, legislation introduced in 2012 and subsequently passed, means emergency workers now don't even have to prove their PTSD is work related. Presumptive coverage means claims are assumed to be the result of psychologically traumatic work-related incidents.

Bob Parkinson, the Health and Wellness Director for Ambulance and Paramedics of BC says more than half of all their WorkSafe injury claims are stress related. (CBC)

"I would really like to see something in that manner or fashion in BC. We have allot of paramedics who go year-after-year suffering from these traumatic calls and eventually it takes effect on all of us." said Parkinson.

In an emailed statement, Labour Minister Shirley Bond, told CBC News, "the province does have legislation with a broad definition of workplace mental disorders that would include PTSD."

But those claims still have to be made within one year.

The province also says that in 2012, B.C. passed Bill 14 which allows compensation for workers who develop a mental disorder as a result of bullying and harassment.

But the paramedic's union says that does nothing to help workers exposed to trauma.

In a statement, WorkSafeBC says it accepted 25 mental disorder claims from paramedics last year but would not say how many were rejected.

WorkSafe can make exceptions to one-year limit

WorkSafeBC says it does consider "special circumstances" if a worker fails to file an injury claim within a year. Such circumstances include "injury such as a delayed onset of symptoms" and a delayed diagnosis.

It is not clear why WorkSafe failed to waive the one-year limit in Trofanenko`s case as medical records show she was not diagnosed with PTSD as a result of the 2010 accident until 2013.

Trofanenko says she believes Worksafe BC discriminates against emergency workers who suffer a mental injury rather than a physical one.

"We're the ones on the other end of 911, but when we get sick, we're thrown to the curb, and that's how I feel" said Trofanenko who is now appealing WorkSafe's latest decision on her third claim for PTSD.

---

CBC Investigates: Send us your tips

CBC Vancouver's award-winning team of investigative journalists break stories that matter to British Columbians.

We're always looking for stories. Send your tips to: investigate@cbc.ca

---

Full statement from B.C. government

The safety of all B.C. workers is a priority for our government. British Columbia does not have specific presumptive PTSD legislation.

The province has legislation with a broad definition of workplace mental disorders that would include PTSD. In May 2012, B.C. passed Bill 14, an important piece of legislation that recognizes the importance of mental health in the workplace.

This legislation makes B.C. the only jurisdiction that recognizes (in legislation) diagnosed, work-related mental disorders. We passed these legislation amendments to expand workers compensation for diagnosed work-related mental disorders, including mental disorders that result from stressors like bullying and harassment.

WorkSafeBC informs us that between July 1, 2012, and Aug. 31, 2014, WorkSafeBC has 5,237 new mental disorder claims registered. Of the 5,237 new mental disorder claims registered, 1,400 were from the health care sector (including paramedics).

Statement from WorkSafeBC

The Workers Compensation Act, Section 5.1 applies to all workers in B.C. who experience significant work-related mental disorders including post-traumatic stress disorder [PTSD]). 

In 2013, WorkSafeBC accepted 25 mental disorder claims from paramedics.

In adjudicating mental disorder claims, WorkSafeBC officers take the following into consideration:

• A worker's exposure does not have to be immediate, but can be cumulative over time building towards a mental disorder even if they were able to tolerate similar traumatic events in the past,
• A worker may not be diagnosed with a mental disorder until many months or even years after exposure to a traumatic event. This is not uncommon with PTSD claims, as there can be a delayed onset of symptoms.
• Where a worker applies for compensation outside of the one year deadline, consideration will be given to the reasons for the late application

Special circumstances could include where a worker's mental disorder is so psychologically incapacitating that the worker is medically incapable of filing a claim within a year.  Another example could be where the worker experiences a delayed onset of symptoms, and is diagnosed with a mental disorder one to two years after the incident.

There are often multiple causative factors to be considered when someone has a mental disorder, and consideration must be given to the impact of all the different stressors in that worker's life, work related and non-work related.

The law and related policy states that  a mental disorder caused by an employer's decision relating to employment is excluded from coverage. If a mental disorder is caused by any of the following decisions or actions, it will not be eligible for compensation coverage:

•  a change in work or working conditions
•  discipline
•  termination of employment
•  workload and deadlines
•  work evaluation
•  performance management
•  transfers, lay-offs, demotions, and reorganizations

For more information: http://www.worksafebc.com/claims/MentalDisorders/assets/FAQs.pdf

I hope the information we are providing is helpful and that it assists you in balancing your story.

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My son the guinea pig: How a 2-year-old supports science

My son, Rigel, is only two years old, but he's already helping scientists make new discoveries.

It's not because he's a genius – he isn't. Like many kids his age, he's illiterate and not fully toilet-trained.

Obviously, he's not conceiving and running any grand experiments himself, but he volunteers to be experimented on instead.

Yes, you could call him a guinea pig.

At his latest gig, the role involves playing a hiding game on the second floor of a century-old house in Toronto's Annex neighbourhood.

Rigel stands behind a curtain and watches as research assistant Bianca Bondi hides a plush, green toy alligator in a box at the University of Toronto's Language and Learning Lab.

Heather Gallant, the lab manager, invites Rigel to leave the quiet, windowless lab and hang out in the sunny office next door. Minutes later, Bianca joins us.

In order to test Rigel's memory, Heather Gallant teaches him some other games involving toys and cards. (Emily Chung/CBC)

"I put the alligator in the drawer," she tells Rigel. "I put the alligator in the drawer."

Everyone returns to the lab.

"Where's the alligator?" Gallant asks Rigel.

He walks past the box, over to the drawer, and pulls it open. Triumphantly, he yanks the alligator out.

The goal of the experiment is to find out how common it is for children Rigel's age to be able to use information from other people to find things out about an object that they can't see. The researchers are interested in finding out how much that depends on factors such as age and short-term memory.

In order to test Rigel's memory, Gallant tries to teach him some other games involving toys and cards, but he soon becomes distracted and refuses to play. We decide to call it a day. Bondi offers Rigel a choice of toys and he chooses a green ball to take home.

'I want to go there!'

The experiment was the latest of several that Rigel and I have volunteered for since he was a baby. At first, it was just because I was interested in science and wanted to make a contribution to research.

Now that Rigel is older, I'm looking for interesting things for him to do when he's not at day care. I'd also like him to get this perspective on science and how it works, even if he won't appreciate it until later.

Rigel mostly enjoys the games he plays at the Language and Learning Lab. After our first study there, every time we walked past the building, he would point to it and say, "I want to go there!"

Even so, some of the experiments we've done haven't exactly been fun for him.

Rigel finds a toy alligator and yanks it out of a drawer during a hiding game at the Language and Learning Lab. (Emily Chung/CBC)

The study on the development of infant vision at York University required him to lie down in a cabinet and look at shapes on a screen. Some infants happily cooperate, but Rigel, who was three months old at the time, cried during the experiment. Researcher Audrey Wong Kee You assured me that it didn't matter that much, because he was still looking at the screen and generating data.

Wong Kee You is a graduate student with the Visual and Cognitive Development Project run by Scott Adler, an associate professor of psychology at York University, and I contacted her after seeing a Google ad looking for volunteers.

Rigel is also part of a long-term, longitudinal study out of the Toronto Hospital for Sick Children that aims to uncover how common adult diseases such as heart attacks, strokes, diabetes and cancer are linked to health, nutrition, lifestyle and behaviour during childhood.

As part of a study, Rigel has to have blood samples drawn once a year to be tested for cholesterol, glucose, iron and vitamin D.

It's a little uncomfortable. But I know that such studies are very valuable – similar studies have uncovered a wealth of information. For example:

Some of the studies that Rigel has participated in have already yielded results.

So far, Wong Kee You and Adler have found that three-month-old infants can use visual cues to help them track objects, just like adults, but that their eyes move more slowly. They shared the preliminary findings at the Vision Science Society conference in Florida in May.

Every time he walks past the Language and Learning Lab in Toronto, Rigel points to the building and says, 'I want to go there.' (Emily Chung/CBC)

The ongoing research aims to uncover how normal infants develop the ability to turn their attention to something, Wong Kee You said. This information could one day be used to diagnose developmental disorders and intervene at an early age, she added.

Similarly, the Language and Learning Lab aims to find out how children learn best, and what factors can help them learn better or impede their learning, said Patricia Ganea, the lab's director.

"We ultimately hope that our findings are being taken into the schools and the homes and better children's development," she said.

Recruiting subjects a challenge for scientists

Ganea said her biggest research challenge is recruiting enough children.

"I don't see another way of learning about children's development," she added.

The lab typically runs six to eight experiments at a time on children 17 months to eight years old, and each one requires an average of 50 children. Some need as many as 200. To find volunteers, the lab does outreach at baby shows, libraries, preschools and farmer's markets.

Families who volunteer are not just contributing to valuable research.

"We try to design our activities to be fun for children," Ganea said. "We hope that the families who come into the lab have a great time here."

Sold yet? If you're interested in giving the guinea pig life a try, here are three suggestions for places to start:

As for Rigel and me, we're always keeping our eyes open for our next scientific gig.

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Ebola vaccine could be used on small scale in January, WHO says

Thousands of doses of experimental Ebola vaccines should be available in the coming months and could eventually be given to health care workers and other people who have had contact with the sick, the World Health Organization says.

No vaccine has yet been proven safe or effective in humans, said Marie-Paule Kieny, assistant director-general at WHO, who spoke at a press conference in Geneva that was later shared by email. Testing must first be done to ensure they are not harmful to people, some of which has already begun, she said.

The Canadian government has already donated 800 vials of one vaccine, which it developed before licensing to NewLink Genetics Corp., Kieny said, and the company is expected to produce several thousand more doses in the coming months. It's unclear how many doses the 800 vials hold because testing needs to be done to determine how large an effective dose is, but Kieny said it was probably about 1,500.

By the beginning of next year, there should be about 10,000 doses of another vaccine, developed by the U.S. National Institutes of Health and GlaxoSmithKline, Kieny said.

"This will not be a mass vaccination campaign," she said, adding that health workers or people known to have had contact with an infected person could be given a vaccine as early as January.

The Ebola outbreak sweeping West Africa is believed to have killed more than 2,900 people and has overwhelmed health systems. (Tsvangirayi Mukwazhi/Associated Press)

The Ebola outbreak sweeping West Africa is believed to have killed more than 2,900 people, and it has overwhelmed health systems and defied the typical methods used to stem Ebola's spread. Experts are hoping that experimental treatments and vaccines might be able to play some role.

But Kieny warned that until its effectiveness is proven, anyone receiving a vaccine in this outbreak would still have to operate as if they are not protected against Ebola.

WHO has also prioritized using blood from Ebola survivors and says further studies are needed to determine if it can help people ill with the disease. Such blood transfusions have already been done on a small scale, notably in an American doctor who became infected in Liberia.

Developing a serum treatment from the antibodies of many survivors would require more extensive lab facilities and trained technicians, Kieny said. WHO is looking into whether those facilities can be put in place.

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UN announces Ebola emergency response mission as Canada pledges $30M

The UN announced Thursday that it will dispatch an emergency mission to West Africa to help the countries most affected by the worsening Ebola epidemic deal with the crisis. Canada, meanwhile, announced it will provide another $30 million to the global effort to fight Ebola.

UN Secretary-General Ban Ki-moon said that workers with the United Nations Mission for Ebola Emergency Response, or UNMIR, are preparing to depart for West Africa on the weekend.

Guinea, Sierra Leona and Liberia have been the countries most affected by the virus, loosing thousands of their citizens to the Ebolaand their health systems are "buckling under the strain," Ban said.

He said global effort to fight the disease have so far fallen short and there is an "overwhelming momentum" for the UN to play a leading role in co-ordinating the emergency response to the Ebola crisis.

"We will meet this challenge," Ban told the special UN session devoted to the Ebola crisis. "UN staff are prepared to help."

West Africa continues its fight against Ebola - this pregnant woman being lifted into an ambulance in Freetown, Sierra Leone, on Sept. 19, is suspected of having the virus that has killed nearly 3,000 people. On Thursday at the UN, Canada said it is contributing another $30 million to support the battle against the outbreak. (Reuters/Unicef)

Earlier in the day, International Development Minister Christian Paradis criticized the aid delivery to Guinea, Sierra Leona and Liberia so far, and said there must be better co-ordination.

"Canada continues to be deeply concerned by the inadequate co-ordination efforts [to date] and calls for improved co-ordination at the global level," he said.

"The specific role of the UN and other lead agencies such as military and NGOs needs to be made clear. We salute the new initiative of the UN mission for Ebola emergency response."

Asked where the problem lies, Paradis said he didn't want to single out anybody.

"I think that the agreement here is that we need to be better co-ordinated... We want to do more in a more coherent way," he said.

The new funding is intended for treatment, prevention through social mobilization and health education, and broad humanitarian support including food and health services, Paradis said.

Canada announced in August that it would provided $1.3 million to fight the current outbreak in West Africa, which has now killed almost 3,000 people.

Last week, Health Minister Rona Ambrose pledged $2.5 million worth of the specialized medical gear used to protect health-care workers.

But the 800-1,000 experimental vaccines promised in August still haven't been shipped to West Africa, Dr. Gregory Taylor, the country's new chief public health officer, said Wednesday.

The Ebola vaccine was developed at the National Microbiology Laboratory in Winnipeg.

But there are still questions about how and where to send it, Taylor said in an interview with CBC News, including how to keep it refrigerated for the entire trip to West Africa.

"The 800 to 1,000 doses that we offered to WHO is still in Winnipeg," Taylor said. "We're getting very close to shipping some of that."

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Violence in schools can't be solved with 'knee-jerk reactions'

Schools are supposed to be safe places of learning, cushioned from the harsh realities of the outside world.

But the stabbing death of 19-year-old student Hamid Aminzada at a Toronto high school on Tuesday is the most recent jolting reminder that dangers do permeate school walls. 

Aminzada died after intervening in a hallway confrontation between two other students, according to police. A 17-year-old boy has since been charged with second-degree murder after turning himself in.

In an effort to assuage concerns, the director of education at the Toronto District School Board spent nearly half an hour Wednesday morning telling reporters that schools are safe and that what happened was an "isolated incident."

A spokesman for the board emailed CBC News with a sample list of safety measures "developed over recent years to make our schools safer."

They include: 

• Creation of Safe School committees in all TDSB schools.
• Positive school climate surveys and census data to inform programs and support.
• Fostering strong community partnerships to support students and their families inside and outside the classroom.
• Establishment of the Gender Based Violence Prevention office. 
• Clear policies and procedures for managing serious incidents.
• Additional school-based safety monitors.
• Secure entrance systems at all elementary schools. 
• Cameras in schools. 
• An open communications policy.
• Numbering and identifying school doors (to help in emergency situations). 
• Professional learning (both mandatory and optional) to ensure consistent implementation of board safety/equity policies.
• Mentoring programs.

Stu Auty, president of the Canadian Safe School Network (CSSN), does agree that schools are generally safe and acknowledges there are processes in place for emergency situations. But he says the training teachers currently have is not adequate to deal with those rare times incidents do occur.

Developing 'pro-social' behaviours

"The point I'm making is the kind of training in terms of the need for teachers to have a full understanding of all aspects of children's pro-social behaviours — the importance of that — isn't there as much as it should be."

Pro-social behaviour is prompted by empathy and actions intended to help others and is at the core of early intervention programs for which Auty advocates.

'We don't want to create fortresses. We don't want to create situations where our students are patted down and checked before they enter their schools.'- Donna Quan, director of education at the Toronto District School Board

"Often, children don't have the skills to be able to deal with conflict," he said. "They're not familiar with the impact of their actions."

"There's been an understanding that if you can change child's direction early on then you're not going to be faced with the kind of horrific situations that occur when kids do commit crimes," he said.

Auty said one particularly effective program was SNAP — Stop Now And Plan. It's a cognitive-behavioural strategy that was developed in Toronto to help children and parents regulate angry feelings by getting them to stop and think before acting impulsively. It involved role-playing situations and getting kids to solve problems and defuse conflicts. It asked students questions such as, "What do you do when you're angry?"

"Kids will understand that there's danger in acting out in aggressive ways. Danger, for example, in carrying a weapon that they might not think about," he explained.

'Metal detectors are not the answer'

The CSSN had received funding from the federal government in 2009 to deliver the SNAP program to five school boards across the Greater Toronto Area for four years. However Auty said the program was "very expensive" and funding for it wasn't renewed either federally or provincially. 

"School boards are funded, generally, by a per-pupil allocation based on the curriculum," Auty explained. "Often, the safety programs are not embedded in the curriculum itself or the funding envelope."  

He said his concern is when money is spent on what he calls "knee-jerk reactions" — metal detectors or hardware installed in schools.

"That is a discussion that almost invariably happens when there's been an incident, when there's been a tragedy, that I hope doesn't happen in this case."

Indeed, Donna Quan, the TDSB director of education, fielded a number of questions Wednesday morning on why the board doesn't just install metal detectors to keep out knives and other weapons. 

"Tools of destruction, tools that may lead to acts of violence, aren't necessarily brought in to the school," she said, adding that weapons can be smuggled in through windows and not just through entryways. 

"Metal detectors are not the answer. We don't want to create fortresses. We don't want to create situations where our students are patted down and checked before they enter their schools. We want to have conversations."

Identify warning signs

A simple conversation might be all that's needed, said Auty. 

He urges teachers to talk to their students about "street realities."

"Choosing wisely, who you hang out with, is something that's a very fundamental thing for kids in schools. They want to be popular, they want to be part of a group, but watch out." 

Auty said it's about identifying warning signs. Look for anxious behaviours, acknowledge the students isolated in the cafeteria, he said.

"There are very practical things that can be in school systems that can be helpful. Nobody should be a poor soul in the schools. Teachers should be understanding who those kids are and be providing whatever comfort is available to them."

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Lice aren't nice, and parents pay big to get rid of them

Legions of lice are on the march, launching school and home invasions, burrowing into young heads of hair. Meanwhile, busy parents struggle to defend their families.

It takes time, expertise and patience to conquer the increasingly pesticide-resistant critters. And there's the fear factor. Various school boards, like Toronto's, have policies stating a child can't return to class until parents prove every louse egg is gone, even though some experts say the rule is overblown.

'We haven't had the manpower to keep up with the demand that we were getting.'— Lice Squad founder Dawn Mucci

So, flustered folks are choosing to outsource the treatment, driving a booming lice removal business.

When 11-year-old Anthony got lice, he didn't know what to think: "I'm trying to do my work and I'm itching at the same time so I can't really focus on what I'm doing," he says.

His mother, Chiara Ferragine, knew what to do. She whisked him off to Lice Squad, a lice removal clinic. Inside a kid-friendly hair salon, complete with cartoon characters and bubble gum machines, CEO Dawn Mucci carefully combs through Anthony's hair, weeding out any signs of lice. When she discovers an egg she wipes it on a napkin.

Ferragine knows she could conquer the creepy critters herself at home with a cheaper store-bought treatment, but she'd rather have Lice Squad take charge. "It's just the peace of mind," she says. "It was done by a professional or someone in the know and, after that, you just don't have to worry as much."

Big business in small critters

Mucci started Lice Squad in 2002 in Toronto with just one location. She sensed a need after her son got lice at daycare and passed it on to her. "I was freaking out, and I said there's got to be somebody to help me with this." But she couldn't find a service.

Now she's running a major franchise corporation removing lice in 22 communities across Canada. Mucci says business has grown 25 per cent a year over the past four years.

Lice Squad offers clinic and mobile services as well as a recent addition — lice parties — yes, you read that right. Mucci explains parents and afflicted kids get together to be treated by a Lice Squad team. The event makes the task more pleasant: "We'll make a fun time out of it," says Mucci, "have some fun colouring books for the kids and moms can have some wine."

Head lice spread easily where people are in close contact. Hotbeds include anywhere children congregate: schools, camps and daycares. Health-care experts call the problem nothing more than a "common nuisance," but for concerned parents it can be a crisis.

Social stigma

The bugs carry an incredible social stigma. "The whole sense is that lice is due to poor hygiene and poor living habits," says Toronto pediatrician Saul Greenberg. But those beliefs are myths, he says.

He also disagrees with schools that make children stay home until there are no lingering eggs, or nits: "Once a child is treated with the shampoos, they can certainly come back to school right away," he says. The Canadian Paediatric Society doesn't believe a child with lice should be sent home in the first place. The Toronto District School Board tells CBC News it is re-examining its lice policy. 

No matter what the policy, everyone agrees there needs to be thorough treatment. As Mucci explains, there is no 10-minute cure. Instead, lice eradication requires repeated treatments and vigilance. "Bugs in your hair, it freaks a lot of people out. Both parents tend to be working now, and most people don't know how to deal with lice," she says.

Lice that won't die

Mucci also gets many calls from exasperated parents who say they tried traditional drug store pesticides that didn't work: "Mostly what we've heard from people calling us is, I've used this five, six, sometimes 10 times and we're still dealing with lice."

The pesky parasite has grown increasingly immune to chemical treatments. A Canadian study published in 2010 found that 97.1 per cent of tested lice were resistant to traditional insecticides.

In Anthony's case, it's his second bout of lice. When he first got hit two years ago, Ferragine says she tried a drug store insecticide. "It smelled awful and it just didn't work. He was still itchy, itchy, itchy." That's when she first turned to Lice Squad.

A Lice Squad employee views an electron microscope image of a head louse. The pests are a perennial problem for many families. (Frank Gunn/Canadian Press)

​

Mucci uses a non-chemical, enzymatic solution containing food-grade bacteria she says acts as a cleaning agent to help obliterate the critters. Clinic staff also comb through hair to remove eggs and lice that survive the shampoo. She also offers a heat treatment that she says kills lice by dehydrating them.

Mucci charges $75 an hour for a clinic session plus $15 for the heat treatment. An average lice removal session can run one to 1½ hours. She also sells an $80 home kit that can treat an entire family. But many people prefer to pay bigger bucks for her services.

And business is growing. On this day, Mucci is training Lisa Jackson and Pam Corrin, who will soon set up a Lice Squad franchise in Prince George, B.C.

Jackson works at an elementary school in Prince George where she saw the financial opportunity for a lice removal service. "There's a huge need for it," she says. "There are so many kids that are infested and it's just so much frustration on the part of the parents."

Going global

That frustration is felt worldwide. Mucci says she's had calls from people wanting to start Lice Squad franchises in countries such as Spain and Australia. She says international expansion is next on her list.

Her only hurdle? She can't find enough people willing to tackle lice for a living. "We've lost business because we haven't had the manpower to keep up with the demand that we were getting. I guess because of the nature of what we do, there's that ick factor."

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Canadian researcher predicted to win Nobel Prize in physiology or medicine

A Canadian researcher is being touted as a potential Nobel Prize winner by an organization that predicts which scientists are most likely to take home one of the coveted awards.

Dr. Stephen Scherer, director of the Centre for Applied Genomics at the Hospital for Sick Children in Toronto, has been selected as a 2014 "Nobel-class" citation laureate in physiology or medicine by Thomson Reuters Intellectual Property & Science. The organization has correctly predicted 35 Nobel Prize winners since 2002.

Scherer, along with Charles Lee, scientific director of the Jackson Laboratory for Genomic Medicine in Farmington, Conn., and Michael H. Wigler, head of the Mammalian Cell Genetics Section at the Cold Spring Harbor Laboratory in New York, have been recognized for the discovery of large-scale copy number variations and their association with specific genetic diseases.

"I think it's astounding," Scherer said of the honour, which he called a surprise. "This is a big, big thing."

Scherer is known for his work on the genetic underpinnings of autism spectrum disorder, which includes the role of copy number variations – the deletions or duplication of genes in sections of DNA. In subsequent papers, his team showed that about 10 per cent of children with autism have only one copy of a specific gene.

"Just to have a Canadian on the list is huge because there's been an incredible investment in science," he said in an interview Wednesday. "For me, it's really an independent validation of the importance of our work."

The Thomson Reuters Citation Laureates study, begun 12 years ago, identifies leading researchers in the fields of chemistry, physics, physiology or medicine, and economics by collecting and analyzing research citations, which illustrate the impact a researcher's work has had within the scientific community.

"As imitation is one of the most sincere forms of flattery, so too are scientific literature citations one of the greatest dividends of a researcher's intellectual investment," said Basil Moftah, president of Thomson Reuters IP & Science. "The aggregate of such citations points to individuals who have contributed the most impactful work and allows us to determine candidates likely to receive a Nobel Prize."

This year's list of Nobel-class laureates includes 27 researchers from around the world who are predicted to win in one of the four Nobel categories. The Prize for physiology or medicine will be announced Oct. 6.

"Irrespective of any award outcomes," said Scherer, "it is humbling to be included among such an esteemed list of scientists."

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'My face was oozing liquid'

A Vancouver dentist who was prescribed a steroid cream for a skin condition says that not only was the underlying cause of the rash misdiagnosed, he believes his body's reaction to the treatment was worse than the original problem.

Vancouver dentist Dr. Frances Tavares believes he suffered unnecessarily by not being tested for allergies sooner. (CBC)

Dr. Frances Tavares first went to his family doctor just over two years ago about a rash that had appeared on his forehead. He left with a prescription for hydrocortisone cream and a diagnosis of eczema.

Things seemed to improve, and then the rash came back. Tavares was referred to a dermatologist who switched his treatment, prescribing an alternative corticosteroid cream.

Still, the rash persisted, prompting a referral to a second dermatologist, and yet another brand of corticosteroid.

"Every time you think this is the worst it is going to get," Tavares says. "It gets worse."

Tavares says he tested positive for an allergy to propylene glycol, and thinks switching to a laundry detergent containing the chemical is what brought on his initial rash two years ago. (CBC)

Finally, after two years on the various creams and with no improvement, Tavares was referred and tested for allergies. And the results were significant.

Tavares tested positive for an allergy to propylene glycol, a common moisturizing agent found in everything from shampoo to toothpaste. The rash coincided with the dentist's switch from powdered laundry detergent to a liquid detergent.

He cleared out his entire house of everything that contained the offending chemical, the rash cleared up, and he stopped using the prescribed ointment.

'I felt helpless'

And then his face really erupted.

"It was an explosion," Tavares recalls. "I would have to reach up and pull my eyelids apart to see."

"My face was oozing liquid," he says. "I felt lost. I felt helpless."

Having cleared out all the propylene glycol from his life, Tavares believes the painful reaction was connected to his two-year steroid use.

Dr. Gillian De Gannes says patients who stop taking steroids abruptly can suffer nasty symptoms. (CBC)

The doctor who diagnosed Tavares' allergy says there's no problem with the prescription of corticosteroids, but it is a mistake for patients to come off them cold turkey.

"When they stop abruptly, they have a horrendous rebound of inflammation," says Dr. Gillian De Gannes, an expert on contact dermatitis. "[It can be] quite painful for some—pustular, oozing, itchy."

Who pays for allergy testing?

The real problem, Tavares says, is how long it took for an allergy patch test to be requested.

Dermatologists in B.C. are slow to suggest it because, they say the provincial government doesn't cover the full cost. Unlike much of the rest of Canada, patients here are charged $300 out of their own pockets.

"I think that's unfortunate and unfair," De Gannes says.

Meanwhile, the government says that given the amount they pay dermatologists, the test should be fully covered, and that the two sides need to talk.

Now, Tavares is back on a powerful corticosteroid — taken orally — to enable a slow weaning off from a drug he believes he should never have been prescribed in the first place.

"I think a lot of my problems probably would have been solved if I had the patch test right at the beginning."

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CBC Vancouver's award-winning team of investigative journalists break stories that matter to British Columbians.

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Help us expose corruption, government waste and threats to your safety. Tell us if you know about something we should be investigating.

We're always looking for stories. Send your tips to: investigate@cbc.ca

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PTSD and the ethics of erasing bad memories

Dan Campbell felt the bullets whiz past his head. The tracer rounds zipped between his legs. It was his first firefight as a Canadian soldier in Afghanistan.

"I was completely frightened and scared like I'd never been before in my life," he says.

As the attack continued, the sights, sounds and smells started to form memories inside his brain. The fear he felt released the hormone norepinephrine, and in the complex chemistry of the brain, the memories of the battle became associated with the fear.

'I think one day, hopefully in the not-too-distant future, we will be able to delete a memory.'- Dr. Sheena Josselyn, senior scientist, Hospital For Sick Children Research Institute

Six years later, a sight or sound such as a firecracker or car backfiring can remind him of that night in 2008. The fear comes back and he relives rather than remembers the moments.

"It can be hard. Physically, you know, there's the tapping foot, my heart beating," he says.

Like so many soldiers and victims of assault or people who have experienced horrific accidents, Campbell was diagnosed with post traumatic stress disorder.

Now a newspaper reporter in Yellowknife, Campbell thinks one day he may get therapy. But for now he is working on his own to control the fear and anger the memories bring.

But what if he could just erase those memories? What if he could wipe out the fear as if it never existed?

Some memory researchers believe they are getting closer to helping former soldiers like Campbell and others haunted by the past delete the fear memories.

Warning system

Memory, in an evolutionary sense, is about survival, says Dr. Sheena Josselyn, a senior scientist at the Hospital For Sick Children Research Institute in Toronto. 

It is our warning system to prevent us from repeating dangerous actions.

But traumatic memories, such as those in the brains of people with PTSD, can interfere with daily living. They can cause sleeplessness, or if sleep comes, disturbing dreams. They can bring moments of anxiety and can make normal relationships with others impossible.

In her lab, Josselyn is working to find a way to delete, or at least dampen, the fear associated with traumatic memory.

Current research says a memory is located in various parts of the brain. The neurons, or brain cells, that are encoded with the fear are in one part of the brain while other parts of the memory are elsewhere.

Josselyn, working with rodents in the lab, is developing ways of locating the group of neurons that hold the fear. Once she has that, then she hopes to target just those cells chemically and disrupt their ability to keep that fear encoded.

"We're not there yet," she says, but "we're certainly getting close in rodents."

"I think one day, hopefully in the not-too-distant future, we will be able to delete a memory."

Ethical hurdle

There are many hurdles to overcome. The brain has 86 billion neurons. The memories Josselyn is working with may be stored in as few as several hundred neurons.

Scientists are researching ways of deleting traumatic memories in the human brain, such as those created in the midst of war. (Kirsty Wigglesworth/AP)

Current techniques are nowhere near specific enough to delete so small a group and leave everything else intact.

And there is an ethical hurdle. Some ethicists believe that deleting memories deletes a vital part of a person's identity.

"It's those emotions that tell you who I am," says Dr. Francoise Baylis, who holds the Canada Research Chair in bioethics and philosophy at Dalhousie University in Halifax. 

Baylis cautions that deleting even the worst of a person's memories can interfere with the sense of self.

She does not want people to suffer, but she says learning how to deal with the fear and anxiety can produce strength.

'Anything but a disorder'

Campbell questions the research as well. He believes his memories, his fears and anxiety are part of who he is.

"You go to a place and see some pretty horrible stuff and you're a little different after, sometimes [you have] strange mental reactions. I think that is anything but a disorder. That's normal."

Back in her lab, Josselyn knows that her research may not be for everyone.

But for those who cannot function because of traumatic memories, she wants to relieve the suffering. She suggests that what she is proposing could produce the same effect as therapy, but faster.

"Some people would argue, and I wouldn't disagree, that what cognitive therapy does is eventually change your brain's circuits," she says.

"So we are doing the same thing that cognitive therapy might do. They are taking away the emotional component of a memory in much the same way we do. It's always towards the common goal, it's just the routes in are different."

Dick Miller's documentary Hit Delete airs on CBC Radio's Ideas program on Sept. 24 at 9pm ET.

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