Turning away the Ebola dying

A US announcement on 16 September to send 3,000 troops to help tackle the Ebola outbreak in Liberia was welcomed with relief by health workers, who are losing the battle to contain the disease.

Some 57 percent of Liberia's 2,407 cases have broken out in the past three weeks, according to the World Health Organization (WHO), a transmission rate that is vastly outstripping health workers' ability to treat patients safely. Health professionals have had no choice but to turn away the sick and the dying.

Pierre Trbovic, an anthropologist from Belgium working with Médecins Sans Frontières (MSF) at the ELWA Ebola Treatment Centre, one of two in the capital, Monrovia, was forced to turn patients away: He had no choice - the centre was full and could not safely admit more patients.

"The first person I had to turn away was a father who had brought in his sick daughter in the trunk of his car. He was an educated man, and he pleaded [with] me to take her, saying while he knew we couldn't save her life, we could save the rest of his family from her. At that point I had to go behind one of the tents to cry," says Trbovic in a written testimony.

Other families pulled up in cars, let the sick out and drove off, abandoning them. One mother tried to leave her baby on a chair hoping that doctors would have no choice but to care for the child.

In streamed the patients, "but there was nothing we could do. We couldn't send them anywhere else - everywhere was, and still is, full."

Health workers are already completely overwhelmed by the brutal job of providing palliative care for Ebola sufferers: Each morning dead bodies must be body-bagged, and blood, faeces and vomit cleaned from the ward - and if they take on more patients, they risk lowering their safety guard which could prove fatal.

As of 7 September, the Ministry of Health and Social Welfare estimates 165 Liberian healthcare workers have contracted Ebola with just under half of them dying.

Slow international response

MSF President Joanne Liu, in a speech to UN member states in Geneva on 16 September, blamed a lethargic international response for the spiralling crisis.

"Sick people are banging on the doors of MSF Ebola care centres because they do not want to infect their families and they are desperate for a safe place in which to be isolated. Tragically our teams must turn them away. All for a lack of international response," she said.

MSF is running two treatment centres in Liberia with a 300-bed capacity, and the government a third, but up to 600 additional experts and 10,000 local health workers will be needed to contain the virus, estimates WHO.

In a welcome turnaround, the US has announced it would open up 17 treatment centres and train health workers across Liberia in a military-led operation.

Sleeping among the dead

Ebola survivors IRIN spoke to said they are inordinately grateful to have received the life-saving care, but that conditions in the centres are uniformly poor, with dead bodies, vomit and faeces all around.

Mohammed Sheriff, from Lofa County and now living on the outskirts of Monrovia, has just been declared Ebola-free after 21 days having been treated at Foya hospital. While recovering, he saw many friends and acquaintances stream into the centre but "it was impossible to help them when they were sick," he said.

The conditions there were terrible, partly due to the ravaging nature of the disease which in the current outbreak is killing about half of its victims. "Sometimes you wake up and you're lying down between two dead bodies. Sometimes you move your mattress and the next place you go you will meet another dead body there," he told IRIN.

Patients in the isolation wards are passed food and water from afar, but there is often not enough available and they receive a meal just once a day, they told IRIN.

An MSF aid worker wrote in The Guardian: "I wake up each morning. wondering if this is really happening or if it is a horror movie. In decades of humanitarian work I have never witnessed such relentless suffering of fellow human beings or felt so completely paralyzed and utterly overwhelmed at our inability to provide anything but the most basic, and sometimes less than adequate, care."

Better pay, insurance needed

Nurse Wedor Geleh, at JFK hospital in Monrovia, told IRIN national healthcare workers need better incentives to keep up the brutal work.

"Health care workers have been a major target [of the disease] - especially nurses and doctors. If you want JFK to be a national referral hospital, people will continue to pour in. But what is the motivation for me as a nurse that, in case something happens to me, my family will be provided for?"

Geleh has no health insurance if her family gets sick. She earns US$325 a month.

Nurses and doctors are demanding medical insurance and better wages. The government has agreed to pay doctors US$1500-20000 per month as of September, according to the Ministry of Health.

The current Ebola outbreak is the worst the world has ever seen, with 4,963 reported cases thus far and 2,453 deaths as of 13 September, according to WHO.

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