December 09, 2014
The current outbreak of Ebola Virus Disease (EVD) in West Africa is one of the great public health challenges of the still-young twenty-first century. In a few short months, Ebola has infected more than fifteen thousand people and claimed over fifty-five hundred lives, with the vast majority of fatalities in just three countries — Liberia, Sierra Leone, and Guinea.
Despite the toll Ebola has already taken and the broader threat it poses to populations everywhere, the global healthcare community has been painfully slow to respond. As of mid-November, International Medical Corps remained one of only a handful of foreign humanitarian relief organizations treating Ebola patients in the region.
To be sure, operating an Ebola Treatment Unit (ETU) safely and effectively in rural West Africa is no easy task. Any organization taking on the challenge must be experienced in working in remote, difficult conditions. An arduous four-hour journey is required to reach our seventy-bed ETU located on the grounds of a former leprosy colony in Bong County, Liberia, a hundred and twenty miles north of Monrovia. We opened a similar-sized ETU in neighboring Margibi County at the end of November and expect to have a pair of fifty-bed ETUs operational in Sierra Leone by year's end.
Maintaining an ETU of that size requires three critical components: people, supplies, and money. While the majority of our staff are local Liberian nationals, it is a constant challenge to keep a sufficient and steady flow of skilled international medical and technical personnel willing to give up a two-month chunk of their lives to work in a potentially dangerous environment, then risk being ostracized — or even quarantined — upon returning home. To treat Ebola patients effectively, each ETU requires a staff of around two hundred and seventy. At present about 90 percent of the staff are Liberian nationals. We follow a medical staffing ratio of three expatriate and four local physicians, along with eight expatriate and twenty-four local nurses for every fifty patients. Additional staff are required to provide water, sanitation, hygiene, nutrition, and other needs. Ambulance crews pick up suspected cases to isolate them as quickly as possible, then return those who test negative for the virus or who have been successfully treated to their homes. Trained crews also disinfect, protect, and bury the remains of those who succumb to the disease.