As the United States deals with its first case of Ebola, the disease continues to ravage western Africa:
As the Ebola epidemic intensifies across parts of West Africa, nations and aid agencies are pledging to respond with increasing force. But the disease has already raced far ahead of the promises, sweeping into areas that had been largely spared the onslaught and are not in the least prepared for it.
The consequences in places like Makeni, one of Sierra Leone’s largest cities, have been devastating.
“The whole country has been hit by something for which it was not ready,” said Dr. Amara Jambai, director of prevention and control at Sierra Leone’s health ministry.
Bombali, the district that includes this city, went from one confirmed case on Aug. 15 to more than 190 this weekend, with dozens more suspected. In a sign of how quickly the disease has spread, at least six dozen new cases have been confirmed in the district in the past few days alone, health officials said. The government put this district, 120 miles northeast of the capital, Freetown, under quarantine late last week, making official what was already established on the ground. Ebola patients are dying under trees at holding centers or in foul-smelling hospital wards surrounded by pools of infectious waste, cared for as best they can by lightly trained and minimally protected nurses, some wearing merely bluejeans.
“There’s no training for the staff here,” said Dr. Mohammed Bah, the director of the government hospital here. “The training is just PowerPoint. It is very difficult to manage Ebola here.”
In recent weeks, the world has vowed to step up its response to the epidemic, which has been spreading for more than six months. The United States has sent a military team to neighboring Liberia with plans to build 18 treatment centers to prop up the broken health system. The British have promised to build field hospitals in four urban areas in Sierra Leone, including this one. The French are setting up a treatment center and a laboratory in Guinea. The Chinese have sent scores of medical personnel to the region and have converted a hospital they built outside Freetown into a holding center for Ebola patients. The Cubans have pledged to send more than 400 doctors to help battle the disease in the region.
But little of that help has reached this city. The dead, the gravely ill, those who are vomiting or have diarrhea, are placed among patients who have not yet been confirmed as Ebola victims — there is not even a laboratory here to test them. At one of the three holding centers in Makeni, dazed Ebola patients linger outside, close to health workers and soldiers guarding them. The risk of infection is high, the precautions minimal. Patients are kept at the holding centers, receiving a minimum of care, until space opens up at a distant treatment center.
There’s more at the link, but what it makes clear is that these nations are ill prepared to deal with the disease even at its current outbreak level, and would likely be overwhelmed even more if the outbreak expands as some estimates have predicted. The United States and other nations are sending help that is mainly focused on building hospitals closer to where the outbreaks are so that patients don’t need to be transported further, thus raising the risk of the epidemic spreading. Whether that will be enough to help start to stem the tide of infection is unclear, but what is clear is that even if this ends relatively soon many of these nations are going to be feeling the impact well into the future.
