The departure of many Western development workers from Guinea, Liberia and Sierra Leone, the West African countries hit hardest by
Ebola, has further weakened the region’s understaffed health systems at the very moment they are facing one of the most volatile public health crises ever.
Liberia, population four million, has fewer than 250 doctors left in the entire country, according to the Liberia Medical and Dental Council. Seven doctors there have contracted Ebola, and two of them have died.
“The
locals’ seeing this mass exodus of expatriates has contributed to the
sense that there’s an apocalypse happening and they’re in it on their
own,” said Raphael Frankfurter, executive director of the Wellbody Alliance, which provides clinical services in a diamond-mining district of Sierra Leone bordering Guinea, where the outbreak began.
Mr.
Frankfurter, too, sent his four American volunteers home for fear they
might fall ill. They left behind 160 Liberian staff members. “It’s
certainly not in line with our values, because it’s just such a glaring
inequality,” he said. But “it’s a very scary place to get sick right
now.”
As
an array of international organizations, wealthy countries and
charitable groups gear up to provide desperately needed resources to
fight the outbreak, the absent doctors and volunteers are a reminder of
the daunting practical obstacles.
Many African health workers battling
Ebola are contracting it themselves. At least 170 workers have gotten
the disease, according to the World Health Organization, and more than
80 have died.
Those sickened include Dr. Kent Brantly, an American now recovering in an Atlanta hospital after receiving ZMapp, an experimental drug.
Three Liberian patients received ZMapp
on Friday, according to Tolbert G. Nyenswah, a Liberian assistant
minister of health and social welfare. The patients signed consent forms
stating that they understood the risks of the untested drug, and waived
liability for any adverse effects.
The
doses had been flown into Liberia after appeals from President Ellen
Johnson Sirleaf of Liberia to President Obama and senior American
officials. Its arrival last week lifted morale and “raised the hope of
everybody,” Mrs. Johnson Sirleaf said.
The situation, however, was
volatile. On Saturday afternoon, several hundred people in an area of
Monrovia known as the West Point slum broke through the gates of a
former school that had been converted days earlier into a holding center
for people with suspected Ebola.
Samuel
Tarplah, 48, a nurse running the center, said Saturday evening that the
protesters wanted to shut it down. “They told us that we don’t want an
Ebola holding center in our community.”
He said the intruders stole
mattresses, personal protective equipment, even buckets of chlorine that
had just been delivered. “They took everything.”
Fear
is complicating the huge increase in aid that is needed: food for
people in areas that have been cordoned off; laboratory supplies to test
for the disease; gloves, face masks and gowns to protect health
workers; body bags for the dead; bedsheets to replace those that must be
burned.
Airlines have canceled flights that could have carried in such
supplies, despite assurances from the W.H.O. that properly screened
passengers pose little risk. Positions on aid teams remain unfilled.
Hundreds
of workers for Doctors Without Borders have fought the outbreak since
March. The group’s president, Dr. Joanne Liu, said there was an acute
need for materials as well as for more human resources — and not just
experts and bureaucrats, but also the kind of person who is ready to
“roll up his sleeves.”
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