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.
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 need of a 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 eyebrow with her hands. “We tried calling an ambulance days ago, but nobody ever came.”
D.J. manages a faint smile. Seven of the 30 beds made available Saturday morning were vacated by survivors. The rest had died.
Liberia needs more than one million protective suits and other gear such as gloves and boots in order to properly fight the epidemic.
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 (WHO). 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. It is very hard to find recruiters due to this.
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.
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.
“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.
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.