Doctors Without Borders: We've 'Reached Our Ceiling,' Maxed Out Ebola Aid Resources

Doctors Without Borders: We've 'Reached Our Ceiling,' Maxed Out Ebola Aid Resources

* Medecins Sans Frontieres has quintupled capacity since August

* Organization has 600 beds, 3,000 staff in West Africa

* But WHO sees 5,000 to 10,000 new cases a week in early December

By Robert-Jan Bartunek

BRUSSELS, Oct 15 (Reuters) - Medecins Sans Frontieres, a medical charity that has been at the forefront in the fight against Ebola in West Africa, said it was reaching its limit and urgently needed other organizations to step up the efforts against the deadly disease.

The organization currently operates six centers in Guinea, Sierra Leone and Liberia, with a total of 600 beds. Its personnel on the ground have grown from about 650 at the start of August to about 3,000 currently.

"We have increased our capacity a lot," said Brice de le Vingne, director of operations for MSF, which is also known as Doctors Without Borders. "Now we have reached our ceiling."

De le Vingne called on other actors, such as governments and international organizations, to up their game.

"They are deploying as we speak, but we still don't see the results on the field," he said. "The speed of the deployment is still lower than the speed of the epidemic, and that is problematic."

The Ebola epidemic is still spreading, and projections show there could be 5,000 to 10,000 new cases a week in early December, the World Health Organization said on Tuesday.

De le Vingne coordinates missions for MSF and oversees a facility in Brussels that trains volunteers heading for the affected areas. It is the only such training center in Europe, although others, operated by different organizations, are set to open in Geneva and Berlin.

Medecins Sans Frontieres has been accumulating expertise in fighting Ebola outbreaks since 1995. Protocols have been developed on such crucial issues as disinfecting nurses and doctors after they've been in contact with the sick.

At the Brussels training center, a group of trainees were being taught on Wednesday how to enter an Ebola field hospital and how to leave without infecting themselves. They learned how to carefully remove layer after layer of a thick protective suit, repeatedly washing their gloves in a chlorine solution.

All the trainees, whether doctors, nurses or psychologists, have been on missions with MSF before. But working at an Ebola field hospital is particularly challenging.

Already sweating under rubber aprons and face masks on a relatively chilly afternoon, they were reminded by the trainers that Africa will be much hotter, with temperatures at 30 degrees Celsius (86 degrees Fahrenheit) or more.

"We limit the number of times that we suit up and go into that actual high-risk zone where the patients themselves are to just a couple of times a day, so as not to risk over-heating," said Paul Brockmann, one of the trainees who will head out to Sierra Leone on Friday.

The psychological and physical stress is one of the reasons training missions are limited to about six weeks per turn, though some have gone on more than one turn.

Even with the strict protocols, one of MSF's Norwegian staff members was diagnosed with the disease in early October. The organization said it was investigating the incident.

"I'm a bit scared of what I will be seeing, because I know that there's a lot of human suffering that I will be witnessing, and I'm also scared for out staff," said Carla Uriarte a psychologist who is set to leave for Sierra Leone in November.

"I know that some of our local staff died, not necessarily because they get infected in the center but because they are part of the community so that is the part that scares me the most." (Reporting by Robert-Jan Bartunek; Additional reporting by Miranda Alexander-Webber; Editing by Larry King)

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Before You Go

Ebola is highly infectious and even being in the same room as someone with the disease can put you at risk
Not as far as we know. Ebola isn't contagious until symptoms begin, and it spreads through direct contact with the bodily fluids of patients. It is not, from what we know of the science so far, an airborne virus. So contact with the patient's sweat, blood, vomit, feces or semen could cause infection, and the body remains infectious after death. Much of the spread in west Africa has been attributed to the initial distrust of medical staff, leaving many to be treated at home by loved ones, poorly equipped medics catching the disease from patients, and the traditional burial rites involving manually washing of the dead body. From what we know already, you can't catch it from the air, you can't catch it from food, you can't catch it from water.
Cancelling all flights from west Africa would stop the spread of Ebola
This actually has pretty serious implications. British Airways suspended its four-times-weekly flights to Liberia and Sierra Leone until the end of March, the only direct flight to the region from the UK. In practice, anyone can just change planes somewhere else and get to Britain from Europe, north Africa, or the Middle East. And aid agencies say that flight cancellations are hampering efforts to get the disease under control, they rely on commercial flights to get to the infected regions. Liberia's information minister, Lewis Brown, told the Telegraph this week that BA was putting more people in danger. "We need as many airlines coming in to this region as possible, because the cost of bringing in supplies and aid workers is becoming prohibitive," he told the Telegraph. "There just aren't enough seats on the planes. I can understand BA's initial reaction back in August, but they must remember this is a global fight now, not just a west African one, and we can't just be shut out." Christopher Stokes, director of MSF in Brussels, agreed: “Airlines have shut down many flights and the unintended consequence has been to slow and hamper the relief effort, paradoxically increasing the risk of this epidemic spreading across countries in west Africa first, then potentially elsewhere. We have to stop Ebola at source and this means we have to be able to go there.”
Temperature screening at airports is an effective way to stop those who have the disease from travelling
The screening process is pretty porous, especially when individuals want to subvert it. Wake up on the morning of your flight, feel a bit hot, and you definitely don't want to be sent to an isolation booth for days and have to miss your flight. Take an ibuprofen and you can lower your temperature enough to get past the scanners. And if you suspect you have Ebola, you might be desperate to leave, seeing how much better the treatment success has been in western nations. And experts have warned that you cannot expect people to be honest about who they have had contact with. Thomas Eric Duncan, the Ebola victim who died in Texas, told officials he had not been in contact with anyone with the disease, but had in fact visited someone in the late stages of the virus, though he said he believed it was malaria. The extra screening that the US implemented since his death probably wouldn't have singled out Duncan when he arrived from hard-hit Liberia last month, because he had no symptoms while travelling.
Border staff should stop people coming in to the country who are at risk
LEON NEAL via Getty Images
They're not doctors, and it's a monumental task to train 23,500 people who work for the UK Border Agency how to correctly diagnose a complex disease, and spot it in the millions of people who come through British transport hubs. Public Health England has provided UK Border Force with advice on the assessment of an unwell patient on entry to UK, but they can't be expected to check everyone.
Screening at British airports should be implemented to stop unwell people coming in from affected areas
As mentioned before, the UK, especially London, is a major transport hub. Unlike the US, most of those coming from west Africa will have crossed through Europe, so infected people could be coming from practically anywhere, not just flights directly from those countries. This would require the UK to screen every returning traveller, as people could return to the UK from an affected country through any port of entry. This would be huge numbers of low risk people, at vast, vast expense.

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