H.E. Dr. Sinéad Walsh:

I thank the Deputy. That is a very interesting question and it does not have a straight answer. Ebola started in the remote rural areas because Ebola appears to be a disease that comes from interaction between humans and the natural environment in ways that, in the past, we have not been used to. There are a lot of important issues around how we manage natural resources and forests. Ebola in Congo, Uganda, Sierra Leone and Liberia really did come from that interaction of humans with forests in ways they did not previously have to interact - maybe people now are pushed into needing different resources due to other challenges, economic and otherwise. That is one of the long-term issues we need to pay attention to. Ebola started in the rural areas. In some ways rural areas are very difficult to deal with because of the remoteness. It is very hard to get social mobilisation and ambulances out to people. The urban areas ended up being affected worse in some ways because of population density and the spread within the households. That has been really challenging. In both countries a lot of the big numbers were in Monrovia and Freetown because of the slum communities. Ebola is all about two things: isolating people and burying people safely. It is impossible to try to isolate someone where eight people live in a room in a slum in Freetown. That leads us back to the response - "Can we get an ambulance there within four hours rather than within 48 hours." It is an interesting question.

I do not know if anybody has yet done any analysis of the numbers and whether urban or rural populations have been more disproportionately affected. We will probably get all those details later. However, they have definitely been badly affected in different ways because of different challenges in the different environments.