In two Land Rovers, one fitted out as an ambulance, a small team of humanitarian workers last week headed deep into Sierra Leone’s jungle. After hours on deeply rutted paths that could barely be called roads, they stopped at a village that had seen ten reported cases of Ebola.
With the consent of the village chief, the team fanned out across the community, asking at each hut if anyone was feeling ill or had made contact with the earlier patients. At one, they found a mother nursing a seven-month-old, even though she had experienced bouts of bloody diarrhea and a fever of 102°F—possible signs of Ebola. A quick conversation revealed that the mother had recently attended the same funeral as the ten patients.
The aid workers knew right away they had to get the woman away from her village. It would improve her chances of recovery, even though those chances hovered at only about 30 percent. And it would protect her baby and husband, and the entire community, because Ebola is easily passed through bodily fluids such as diarrhea, vomit, and blood.
But that didn’t make taking the woman away any easier.
“If you’ve got a mother crying, her baby crying, her husband crying, her grandmother crying, and the mother in desperate need of medical care, that’s a very difficult situation,” says Gabriel Fitzpatrick, an Irish infectious disease doctor who helped make the difficult decision to take the mother from her community to an Ebola hospital in Kailahun, a several hours’ drive away.
Despite tears, the family didn’t put up much of a fight. The terrors of the fever were already well known to the village.
“Nobody wants to split up a family,” says Fitzpatrick, who works for the humanitarian group Médecins Sans Frontières (MSF), also known as Doctors Without Borders. But “if you let the mother stay there, the outcome is more people will be infected.”
In West Africa, where history’s worst-ever Ebola outbreak has sown terror in countries with virtually no health care infrastructure of their own—Liberia, Guinea, and Sierra Leone—foreign health care workers like Fitzpatrick have been an essential part of the response since spring, when the disease began to spread rapidly.
The World Health Organization announced this week that another, unrelated outbreak began late last month more than 1,500 miles (2,414 kilometers) away in the Democratic Republic of the Congo after a pregnant woman ate infected meat. There are 24 suspected cases of Ebola in the northern part of the country, including 13 deaths.
In West Africa, so far the virus has claimed more than 1,500 lives—about half as many as are known to have been infected. Entire families have been wiped out. Medical care for other diseases, trauma, and childbirth—scant before the Ebola crisis—has evaporated. In the three hardest-hit countries, there are one or two doctors for every 100,000 people, and most are in cities, according to the World Health Organization.
The disease has struck health care workers, locals and foreigners, with particular force. At least 240 have fallen ill and 120 have died since the outbreak began last December, according to the WHO.
Such losses “deplete one of the most vital assets during the control of any outbreak,” WHO said in a press release this week.
Many more have fled in fear. “The loss of so many doctors and nurses,” the press release said, “has made it difficult for WHO to secure support from sufficient numbers of foreign medical staff.”
International aid workers have been crucial in making up the difference, says Sophie Delaunay, MSF’s executive director. The international aid group runs Ebola clinics throughout the affected region, including the 80-bed facility in Kailahun, where Fitzpatrick has spent the last month.
Photographer Samuel Aranda traveled earlier this month to Kailahun, a small town near Sierra Leone’s borders with Guinea and Liberia, population 30,000, for National Geographic, shooting portraits of caregivers and photographs of affected communities. “The landscapes here are littered with destroyed buildings and burned houses that were abandoned and looted during the civil war,” Aranda says.
He describes the MSF hospital there as well organized, with an incredibly dedicated staff.
On Tuesday, WHO announced it was temporarily pulling its own workers out of Kailahun, after one became ill with Ebola.
Médecins Sans Frontières has received a small but steady flow of volunteers from Europe, the United States, Canada, and Australia, as well as other nations. “I’m surprised to see the number of people who really want to put their expertise at the service of our patients,” Delaunay said in an interview, “and who actually are ready to stand by the patients.”
The group has more than1,800 staff members responding to the Ebola outbreak in Guinea, Sierra Leone, Liberia, and Nigeria, 184 of whom are foreign volunteers. WHO has deployed 424 people so far, foreign and local, including doctors, public health workers, epidemiologists, and logistics experts. The U.S. Centers for Disease Control and Prevention, meanwhile, recently announced that it would send 50 staffers to help fight Ebola in West Africa.
More trained medical staff are desperately needed, largely to relieve those already worn out by the battle, Delaunay says. But she wants only volunteers who understand the dangers Ebola presents and who know how to work safely with protective gear. Anyone who doesn’t can quickly get infected—and pass the disease on to others.
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