Why Abbott Doesn't Put Medical Boots On The Ground

There are many threats that face Australia.

Some are economic, such as the global financial crisis that toppled world banks in 2008. Some are political and military, such as terrorism or the aggression of sovereign states. Some are environmental, such as the radically warmer climate future Australians must grapple with.

The kind of threats a government considers important, and moves to respond to, tells us a lot about the ideological inclinations of that administration.

And nowhere is that truer than in Australia, where Tony Abbott’s contrasting responses to terrorism and viral epidemic have provided a telling commentary on his government’s priorities.

When Islamic State emerged as a dangerous military upstart in Syria and Iraq, the Abbott government moved quickly. IS represents nearly everyone’s idea of bad guys: trans-national religious fanatics who specialise in high-profile atrocities.

Within weeks of news of IS’s discomforting success against the disintegrating Iraqi army, the Australian government had announced a new military intervention in the region. Super Hornet strike fighters and special forces troops would be sent to the region, to assist both the legitimate government of Iraq and the rather less recognised regional forces of Kurdistan.

Even before the announcement of a new war on terror, a different and perhaps even more alarming threat was developing in Africa: Ebola.

This menace rode not the red horse of war, but the white horse of pestilence. Rather than the “pure evil” of Islamic State, Ebola was a different sort of threat: the barely animate killing machine of a lethal virus.

The Abbott government’s response to Ebola could not have been more different. What’s interesting is the progress of its arguments, and the very different frame via which it attempted to justify its inaction. For months, it pretended there was no threat: that Ebola, although undoubtedly tragic, was not after all an incipient threat to faraway Australia.

When it did act it sent money, rather than a fully-fledged medical response. This was despite the repeated pleas of Medicines Sans Frontier which, in the absence of sophisticated public health infrastructure in West Africa, has played the major role in attempting to contain the epidemic.

MSF told anyone who would listen that money was not the object. What was required was the sort of on-the-ground emergency response that only a nation-state could resource and deploy: logistical support, field hospitals, trained doctors and nurses, medical supplies, generators and HAZMAT suits.

“Let's be very clear,” MSF Australia’s Paul McPhun told AAP back in September. “It's not MSF's role nor should it be to substitute the responsibility of the Australian government or any other state in addressing this.”

But Foreign Minister Julie Bishop had an answer: Australia could not evacuate or properly treat any doctors or nurses that became infected with Ebola virus. Therefore, it would not be safe for Australia to send a team. “We have advised any Australians that are working in west Africa to ensure their employer has evacuation and contingency plans in place,” Bishop explained.

Meanwhile, the virus spread. Tens of thousands have been infected and many thousands have died. The World Health Organisation estimates there are more than 13,000 confirmed or suspected cases across six countries.

Although infection rates appear to be declining in Liberia and stabilising in Guinea, they are still increasing in hard-hit Sierra Leone. “In all three countries, transmission remains persistent and widespread, particularly in the capital cities,” the WHO warns.

This week, the Abbott government finally moved to strengthen its tardy response to the crisis, pledging a further $20 million to fund private health provider Aspen Medical to staff and operate a British-built medical centre in Sierra Leone. That centre won’t be up and treating patients for another month.

The Abbott government has maintained the delay was due to the time it took to secure a northern hemisphere guarantee for the repatriation and treatment of any Australian medical personnel, should they become infected. That guarantee finally arrived this week, from the United Kingdom.

But today it has been revealed that Australia was offered a similar guarantee three weeks ago by the European Union. Exactly why the government didn’t take up the offer, or why it has dallied so long on its Ebola response, has yet to be explained.

Perhaps the real reason is rather simple: the fact that Ebola is an inanimate virus, rather than a gun-toting terrorist.

In the Abbott government’s hierarchy of threats, infectious disease simply ranks lower than terrorism and religious extremism, whatever the objective size and lethality of their relative threats.

Tony Abbott himself pointed this out in yesterday’s media conference. “I stress, this is a health emergency,” he told journalists.

“It's not a military emergency, for instance, which is why we have contracted a private health provider to do this, which is in keeping with our response to other overseas health emergencies such as cholera in our region. It's entirely in keeping with those sorts of precedents.”

In other words, the Prime Minister is making it clear that health emergencies are simply less important than military emergencies. In the case of a terrorist group in Syria and Iraq, Australia is quite prepared to send fighter jets, cargo planes and special forces troops. In the case of an epidemic in Africa, a third-party response by a sub-contractor is apparently enough.

Why is the Abbott government so keen on military intervention, and so reluctant when it comes to medical response? One reason is clearly that, in the kinetic and combative world-view of the Prime Minister, viruses simply aren’t as big a threat. This is curious, as it seems obvious a global pandemic, such as Avian influenza, poses a bigger threat to Australia’s health and economy than any number of IS-trained terrorists.

But there is a second reason for the government’s reluctance to send a medical response to West Africa: we don’t have the capability.

The government’s prevarication on Ebola reveals a worrying truth about Australian national security. When it comes to non-military threats such as infectious disease, the Australian Defence Force simply doesn’t have an adequate or ready response.

As security expert Adam Kamradt-Scott pointed out in an article for the ABC back in October, the ADF has a relatively small medical corps, with only 254 military doctors as of 2013. The ADF doesn’t have a large, internationally deployable field hospital it could send to an epidemic outbreak. Our vaunted C-17 cargo planes might be good for dropping supplies to the Peshmerga, but they can’t be configured for medical transport Nor do we have any hospital ships, unlike the US Navy (although the Navy will improve its medical facilities when the Canberra-class troop transports come online later this decade).

In summary, Kamradt-Scott wrote “the ADF has very little capability to respond to disasters of this type.” In fact, our military relies heavily on Australian civilian medicos and hospitals, and the ADF’s front-line medical facility in the event of a northern emergency remains Darwin hospital.

Field hospitals and army doctors aren’t cheap; then again, neither are Air Warfare Destroyers and Joint Strike Fighters. But Australia has always prioritised traditional war-fighting over softer, non-military threats.

As a result, when epidemic strikes, we don’t have the ability to respond.