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Liberian Health Care Workers Demand Help; Ebola: Protecting the Front Line; Iraq Fights to Dislodge ISIS; Imagine a World

Aired October 13, 2014 - 14:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


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CHRISTIANE AMANPOUR, CNN HOST (voice-over): Tonight: as President Obama calls a special meeting, is it time to rethink how to tackle Ebola?

That's what the CDC says as it leads the fight in America.

And our own correspondent in the hot zone. Nima Elbagir on the medical workers threatening to strike in Liberia.

Also ahead: while all eyes are on Kobani, ISIS storms ever closer to Baghdad and local Sunni leaders now flee for American troops on the front

lines. Former national security adviser of Iraq joins me live in the studio.

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AMANPOUR: Good evening, everyone, and welcome to the program. I'm Christiane Amanpour.

Police have sealed off the house of a Texas nurse after she has become the first case of Ebola spreading within the United States. She'd been

treating Thomas Eric Duncan, who died of the disease last week.

Spain is on edge, too, as a similar case is under investigation there. The latest from the Centers for Disease Control, which leads the fight in

the United States, is that it admits more cases may develop and safety protocols may have to change.

(BEGIN VIDEO CLIP)

DR. THOMAS FRIEDEN, DIRECTOR, CDC: We have to rethink the way we address Ebola infection control because even a single infection is

unacceptable.

(END VIDEO CLIP)

AMANPOUR: While here in Britain today, thousands of health care workers went on strike for more pay as the health secretary warns there is

little doubt, quote, "that Ebola could break out here, too."

Meantime, the worst hit remains Liberia and now doctors and nurses there are threatening an all-out strike. There are not enough of them,

they say; they don't get paid and -- well, they don't get paid enough -- and they're exhausted after trying to combat this disease since April, as

Nima Elbagir now reports for us from Monrovia.

(BEGIN VIDEOTAPE)

NIMA ELBAGIR, CNN CORRESPONDENT (voice-over): Racing through the streets of Monrovia, an ambulance transporting a suspected Ebola case,

inside a scared and helpless patient. He waits and waits and no one comes.

This is the reality of a system on the brink of collapse. Over the weekend, angry health care workers clashed with the Liberian president over

wages.

They've had enough. Hazard pay and improved equipment among the demands. A work slowdown is in effect at two of the city's four treatment

centers and they're threatening to strike as the demands aren't met.

Ambulances have already been turned away here.

UNIDENTIFIED MALE: Ordinarily you have 3,000 deaths. Multiple that by five. So you have 15,000 deaths in the next four weeks if this is not

handled very soon.

ELBAGIR: So given those consequences, why do you still want to strike?

UNIDENTIFIED MALE: I don't want to strike. But the president has to listen to the (INAUDIBLE). They are angry people. You don't want to have

angry people knocking at your door, (INAUDIBLE). So the president has to listen and act very fast.

ELBAGIR (voice-over): An overstretched health care system beginning to crack when it can least afford to. The president personally now asking

health care workers to stay on the job.

Doctors without Borders, MSF, run the city's four treatment centers. The largest in the world. But they are nowhere near full. Not because

people aren't getting sick, the worry is it's because they may no longer be coming full.

UNIDENTIFIED FEMALE: So now we have enough beds. But the system is not good enough and it's taking time to build, rebuild the trust in the

system.

ELBAGIR (voice-over): Trust that they won't be turned away like so many have in the past and that they'll get the treatment they need.

Rebuilding that trust is another layer of complication. And one that could undo what gains have been achieved here.

ELBAGIR: A lot has been said about the international community's response. But these are the men and women who have been risking their

lives and stanching the wounds since the beginning of this crisis and now they're asking that the world does not forget about them.

ELBAGIR (voice-over): Pause, and the ambulance remains, waiting -- Nima Elbagir, CNN, Monrovia, Liberia.

(END VIDEOTAPE)

AMANPOUR: And just as troubling, there were only 2,348 known cases of the deadly Ebola infection ever. That's prior to this latest outbreak.

Now there have been more than 4,000 deaths, almost all of those in Liberia, and more than 8,000 cases.

The U.N. appointed a special envoy on Ebola this summer to coordinate what is a global crisis. And Dr. David Nabarro recently returned from

Liberia and he joined me earlier from Geneva.

(BEGIN VIDEOTAPE)

AMANPOUR: Dr. Navarro, welcome to the program.

DR. DAVID NABARRO, U.N. SPECIAL ENVOY ON EBOLA: Thank you.

AMANPOUR: We've just listened to the rather devastating report from our correspondent in Monrovia that, at this worst of all possible time,

health workers, doctors, nurses, are going on strike there. The president is having to plead with them not to.

How devastating will this be?

NABARRO: That is really serious news. I really -- the health workers in Liberia, Sierra Leone and Guinea are really at the front of the effort

to confront the Ebola outbreak. And I quite understand that, for many of them, it's a devastating moment.

They've seen their colleagues getting sick and in some cases dying and they're finding it very difficult to sustain work. They want to be

properly recompensed for the extra risk that they face and sometimes they feel they're not given what they require to enable them to do the work.

And that leads to this kind of action being threatened.

I hope that they find a solution and it's not going to occur.

AMANPOUR: Meantime, let's talk about the actual state of the disease right now.

NABARRO: Yes.

AMANPOUR: I heard you, this weekend, on the radio say that you hoped that this could be contained within three months.

NABARRO: Yes.

AMANPOUR: Do you still believe that?

And what gives you that hope?

NABARRO: At the moment we see an outbreak that's doubling in its extent about every four weeks. The international community is coming in

with an extraordinary and totally unprecedented response.

Some countries like the United States and United Kingdom are bringing in large numbers of people, both skilled doctors and nurses, but also

people to help with logistics and emergency management. And they're also providing vast amounts of money.

Other countries are coming up with similar big contributions. In some cases like Cuba, large numbers of doctors and nurses as well.

It's with this very intensive support that I believe it will be possible to get ahead of the outbreak. And our estimate, this is the whole

of the U.N. system, is that we should be able to bend the epidemic curve down and start to see the outbreak coming under control by the end of the

year. That's 90 days from the first of October.

AMANPOUR: And what does coming under control mean?

How do you -- how do you identify that?

NABARRO: At the moment, the outbreak curve is increasing exponentially. That means we're doubling every three to four weeks. It's

going up in an upward direction like this and to deal with that, you have to have a very, very large response. What we're waiting for is a time when

the curve reaches its peak and starts to descend. That's coming under control.

Being fully controlled is when transmission completely stops and that will take a bit more time, after the end of this year.

Of course, this is our anticipated result. It's our objective. We do need to make sure that we can get all the resources in place in time to

support the governments with their response. And if anything gets in the way, then it may be difficult to hit that target.

AMANPOUR: Right. And you talk about, you know, the transmission coming down. Today, the head of the CDC's Dr. Frieden has said that they

must break the chain of transmission. Their most important objective is to prevent the spread to Americans. And to do that, they need to stop it at

the source.

NABARRO: Absolutely. Correct, yes.

AMANPOUR: So, a couple of questions then. Already we're seeing unintended, unexpected cases in the United States. One Liberian man has

died; one nurse is affected -- or rather, infected -- and she is being monitored.

If they are having trouble containing it, if they're having trouble with protocols, if they're having trouble -- and now the CDC's saying we

have to totally rethink how we approach the protocols -- in the United States, how on Earth can you get a grip in Liberia, Sierra Leone, Guinea?

NABARRO: Well, I want to stress that there have been several outbreaks of Ebola in the world in the last 40 years since the virus first

appeared. And --

AMANPOUR: But this is the worst, Doctor.

NABARRO: This is far and away the worst one we've ever seen. But I want to stress that when groups are disciplined and apply the protocols

rigorously, the infection rates amongst health workers are very low indeed.

But it's a very difficult virus to deal with. It can get its way through any break in our defenses.

AMANPOUR: Do you think there should be, A, excessive and extensive new special training?

We're hearing from nurses in the United States that they don't really get special Ebola training, just maybe a few things posted on a billboard,

saying do this and do that, a few diagrams about gloves and protective clothing.

And do you think there needs to be special hospitals committed just to this infection at this time?

NABARRO: Well, certainly in the countries that are affected in West Africa, the Ebola outbreak is being dealt with through specialized Ebola

treatment centers, run by teams who are totally disciplined with the application of the protocol and they've been through it time after time

after time. It's super disciplined.

I've watched how they gown up, how they then get -- they take their clothes off after they've been through their period inside the contaminated

area. It's very disciplined. It involves a lot of care.

AMANPOUR: I know you're trying to be optimistic, but we hear right now that Sierra Leone is under -- or rather, overwhelmed by this and is

really feeling defeated by this.

Let me just ask you, finally, there is lots of talk about a travel ban. Again, Dr. Frieden of the CDC said that actually it would make it

worse to have a travel ban from the three most affected West African countries.

Do you believe that?

Do you agree with that and why?

NABARRO: So let me start by your comment that I'm being optimistic. I'd like to say to you that I'm being super realistic. I'm watching this

very carefully indeed.

I've assessed with Tom Frieden and with colleagues in the World Health Organization what is happening and we've come up with a collective view;

Dr. Margaret Chan of WHO perhaps is our main guru on this, about what is needed to get on top of the outbreak.

And, yes, it's going to require an enormous concerted and disciplined effort to do it, but I think also my judgment is realistic in terms of

time.

Now, let's move to the issue of travel bans. People will travel, particularly if they are concerned about a disease like this. They're

frightened. They will cross road borders; they will get onto boats; they will get onto planes. And the real requirement is to test them very

thoroughly before they get onto any form of transport.

If you tried to have a blanket ban, our experience is it doesn't work. All that happens is people try to get around it, they conceal their

movements, they conceal their history and that can actually create a much greater likelihood of going underground. And diseases that go underground,

they're hard to control.

AMANPOUR: On that note, Dr. David Navarro, thank you so much for joining me.

NABARRO: Thank you very much indeed. Good to be with you.

(END VIDEOTAPE)

AMANPOUR: Now a crisis like Ebola can bring out the best in people. It can also bring out the paranoia and the political pandering.

Louisiana, the same state that looked to its neighbors for rescue and relief when Hurricane Katrina devastated New Orleans in 2005 now wants to

prevent the incinerated belongings of Thomas Duncan, who died of Ebola in neighboring Texas, from being disposed of in the state, even though the CDC

says this kind of incinerated waste is not infectious.

After a break, the contagion that is ISIS and the haunting echo of a massacre two decades ago. Could Srebrenica happen again? That chilling

possibility when we come back.

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AMANPOUR: Welcome back to the program.

Now under constant withering fire, the besieged Kurdish city of Kobani still hasn't fallen to ISIS. Airstrikes continue to try to keep ISIS at

bay, but Kurdish leaders and the United Nations are raising fears of a massacre of the remaining 10,000 or more citizens there if ISIS does take

the town.

The special Syria envoy, Staffan de Mistura, recalled that terrible moment in Bosnia 20 years ago. He connected the dots to what's at stake

today.

(BEGIN VIDEO CLIP)

STAFFAN DE MISTURA, U.N. SPECIAL ENVOY FOR SYRIA: You remember Srebrenica? We do. We never forgot. And probably we never forgave

ourself (sic) for that.

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AMANPOUR: More than 8,000 mostly Muslim men and boys were killed, massacred when Srebrenica fell to the Bosnia Serbs in 1995. But even as

attention today focused on Kobani, ISIS is advancing in Iraq, coming to within just 10 miles of the Baghdad airport.

As the U.S. Defense secretary admits, Anbar province is in trouble. So I'm joined now by Mowaffak al-Rubaie, who represents Baghdad in

parliament and he was national security adviser to former prime minister Nouri al-Maliki.

Welcome, Dr. Rubaie, to the program.

DR. MOWAFFAK AL-RUBAIE, IRAQI PARLIAMENT MEMBER: Thank you for having me.

AMANPOUR: So first and foremost, how serious is the threat to Baghdad right now?

AL-RUBAIE: I think the defense around Baghdad is good and it is not - - it's possible they start probing on the western suburbs on Baghdad, but it is highly unprobable (sic) that they're going to penetrate Baghdad

defenses.

AMANPOUR: What about the airport? Because that is a main heart of Baghdad. It's where all business traffic, et cetera, happens. It's not

that far from the center of the city.

AL-RUBAIE: I certainly agree. The -- it's on the far western side of the city, is Baghdad International Airport. And it's on the probably close

range of their fire from Abu Ghraib and the western suburbs of Baghdad.

But I think now we've pushed back the threat from the airport and I think the airport is quite safe --

(CROSSTALK)

AMANPOUR: Really? You're confident of that?

AL-RUBAIE: I'm -- I have no shadow of doubt about that. The 8 million Iraqis who live in Baghdad, they will die to defend their city.

AMANPOUR: Well, you know, with due respect, you've all been saying that about several cities. I know you're special about Baghdad. However,

if you look at our map, look at this line of ISIS dots, just look. It's just relentlessly heading towards Baghdad, Anbar province is under serious

threat.

We're told that the town of Hit, which is near Baghdad, simply the Sunni defenders folded and ran away and ISIS has taken it.

Firstly, can you confirm that to us?

AL-RUBAIE: We lose some, we win some. This is a war of attrition.

AMANPOUR: I don't see where you're winning, sir. It's all lose, lose, lose.

AL-RUBAIE: Not really, no. We're winning and the other province, we're winning in Salaheddine province. We're winning a lot in the

Kurdistan versus the ISIS, this evil Islamic State, they're winning a lot in northern part of the country. So I think we're also -- we manage to

push them from Abu Ghraib, west part of Baghdad, also we made a very good - - a great gain down south of Baghdad in the southern belt of the capital, which is the alatafiesk (ph) and Tarmiyah (ph) and Mahmudiyah. This is --

these are very important areas because they wanted to encircle Baghdad and try to probe from the -- from the west and from the north.

AMANPOUR: Let me ask you this, because we're talking now about Anbar province, the U.S. Secretary of Defense who, after all, their aircraft,

their helicopters are moving in your defense, has said that Anbar is in trouble and has warned again that this is going to take a very, very long

time.

President Obama said something like three years to contain, degrade, destroy ISIS.

Do you believe that it'll happen that quickly?

AL-RUBAIE: I do not agree with the White House assessment that three years is enough to destroy ISIS from Iraq and Syria. I believe this is a

long war and we have to prepare ourself (sic) in a political and social and ideological challenge as well, as well as the security challenge.

This is -- the ideology culture and the narrative of ISIS is so strong and appealing to some of the youth, we have to challenge this. And this is

-- this is ideological war.

AMANPOUR: How long?

AL-RUBAIE: Well, I'm talking about 5-10 years.

AMANPOUR: That's a long, long time.

Now let me play for you a little bit of an interview that the Chairman of the Joint Chiefs of Staff in the United States, Martin Dempsey, made

this weekend.

(BEGIN VIDEO CLIP)

GEN. MARTIN DEMPSEY, CHAIRMAN, JOINT CHIEFS OF STAFF: Mosul will likely be the decisive battle in the ground campaign at some point in the

future. My instinct at this point is that that will require a different kind of advising and assisting because of the complexity of that fight.

(END VIDEO CLIP)

AMANPOUR: So he was clearly -- he was clearly referring to putting American troops and other Western troops on the ground in with the Iraqi

forces. You can hear this chorus rising. The Americans admit that airstrikes won't do the job. Everybody says it won't.

You have heard your own people in Anbar now calling for Americans to help them on the front lines.

Would you accept American boots on the ground?

AL-RUBAIE: We will not accept any foreign boots on the ground from the regional countries or from our strategic allies in the United States of

America.

What we need, what -- see, we have 1.5 million men and their arm in Iraq. What we need is restructuring of our army. We need speeding up the

process of delivery of weapons, the F-16, the Apache, the Bradley, the Humvees and we need also intelligence sharing. We need also to increase

our intelligence capacity by human intelligence, signal intelligence, satellite (ph) intelligence. That's what we need. We need help from our

strategic ally, the United States of America.

AMANPOUR: You're getting a lot of air help and also some other help from them.

I want to --

AL-RUBAIE: We're grateful for that.

AMANPOUR: -- yes, I -- of course you are. I would like to read for you something that a previous commander in the field said recently. And he

wrote it.

"The prime minister" -- to whom you were former security -- national security adviser -- "systematically purged the most capable senior officers

from the Iraqi army and replaced them with Shiite cronies, who were personally loyal to him but were incompetent and under fire proved to be

cowards, as we have seen. They all ran."

How much responsibility do you take for this?

This was your prime minister, you were the national security adviser.

AL-RUBAIE: Well, I stopped serving the prime minister Maliki in 2009. The summer 2009. I served the first --

(CROSSTALK)

AMANPOUR: But do you agree with this?

Do you agree with this?

AL-RUBAIE: Well, it's partly true, partly not, actually, because the -- there are so many fault, structural faults in the building of the Iraqi

army and, indeed, the federal police. And the -- our U.S. allies were part of that -- were part of -- well, they help us in building our Iraqi

security forces. So there are some corruption. There are a lot of lack of discipline, lack of doctrine and there is a lot of political and party

influence.

So there are a lot of problems in the -- that's why we need an overhaul, a revamping of our Iraqi security forces and that will come with

the -- through training, through our strategic allies, the United States of America.

AMANPOUR: All right. Mowaffak al-Rubaie, thank you very much indeed for joining me.

AL-RUBAIE: Thank you for having me, ma'am.

(END VIDEOTAPE)

AMANPOUR: And just when you think the news can't get any darker, a glimmer of hope from a child otherwise trapped in a silent prison of the

mind, but this little girl has broken free with a paintbrush and her imagination. Her remarkable achievement when we come back.

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AMANPOUR: And finally tonight, a dread disease that brings to mind the scourge of the Black Death, religious wars with echoes of the Middle

Ages, the headlines paint a very dark picture indeed.

Now imagine a world where a child who cannot speak or communicate with others has painted a vision of hope and light. These paintings, filled

with color and vitality, might remind you of one of the Impressionist masters. But it's actually the work of a 5-year-old English girl who's

been painting since the age of 3. That would be remarkable enough. But there's more to this prodigy's story.

Iris Halmshaw is autistic. Her parents say when she was 2, she began to show the telltale signs, unable to pick up words or make eye contact

with others. She was soon diagnosed with a condition whose exact cause still remains a mystery.

But while researchers look for answers, Iris has found a way to break through the wall of silence and isolation of autism. She paints. And she

paints, spending as much as two hours with a brush in her hand and her therapy cat at her side.

And the world has taken notice. Her paintings are in demand and available for sale on the Internet. With one in every 68 children now

affected by this baffling and tragic condition, the search for its cause and its cure goes on.

And that's it for our program tonight. Remember you can always see our show online at amanpour.com, and follow me on Facebook and Twitter.

Thank you for watching and goodbye from London.

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