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As Ebola Rages, Poor Planning Thwarts Efforts As Ebola Rages, Poor Planning Thwarts Efforts
(about 7 hours later)
KERRY TOWN, Sierra Leone — On a freshly cleared hillside outside the capital, where the trees have been chopped down and replaced with acres of smooth gravel, the new Ebola treatment center seems to have everything. There are racks of clean pink scrubs and white latex boots, bathrooms that smell like Ajax, solar-powered lights, a pharmacy tent, even a thatch-roofed hut to relax in. KERRY TOWN, Sierra Leone — On a freshly cleared hillside outside the capital, where the trees have been chopped down and replaced with acres of smooth gravel, the new Ebola treatment center seems to have everything. There are racks of clean pink scrubs and white latex boots, bathrooms that smell like Ajax, solar-powered lights, a pharmacy tent, even a thatch-roofed hut to relax in.
But one piece is missing: staff. The facility opened recently with a skeleton crew. Now, in an especially hard-hit area where people are dying every day because they cannot get into an Ebola clinic, 60 of the 80 beds at the Kerry Town Ebola clinic are not being used.But one piece is missing: staff. The facility opened recently with a skeleton crew. Now, in an especially hard-hit area where people are dying every day because they cannot get into an Ebola clinic, 60 of the 80 beds at the Kerry Town Ebola clinic are not being used.
It is like this with a lot here: good intentions, bad planning. Aid officials in Sierra Leone say poor coordination among aid groups, government mismanagement and some glaring inefficiencies are costing countless lives.It is like this with a lot here: good intentions, bad planning. Aid officials in Sierra Leone say poor coordination among aid groups, government mismanagement and some glaring inefficiencies are costing countless lives.
Some officials argue that the whole response system seems to be begging for a McKinsey & Company, or some other troubleshooter, to rush in and problem solve.Some officials argue that the whole response system seems to be begging for a McKinsey & Company, or some other troubleshooter, to rush in and problem solve.
Ambulances, for example, are being used to ferry blood samples, sometimes just one test tube at a time, while many patients die at home after waiting days for an ambulance to come.Ambulances, for example, are being used to ferry blood samples, sometimes just one test tube at a time, while many patients die at home after waiting days for an ambulance to come.
Half of the patients in some front-line Ebola clinics do not even have Ebola, but their test results take so long that they end up lingering for days, taking beds from people whose lives hang in the balance and greatly increasing their own chances of catching the virus in such close quarters.Half of the patients in some front-line Ebola clinics do not even have Ebola, but their test results take so long that they end up lingering for days, taking beds from people whose lives hang in the balance and greatly increasing their own chances of catching the virus in such close quarters.
Even after patients recover, many treatment centers delay releasing them for more than a week until there are enough other survivors, sometimes dozens, to hold one huge goodbye ceremony for everyone — again, keeping desperately needed beds occupied. “I just wanted to get home and see my wife,” said Suliman Wafta, a recent Ebola survivor treated nearby. “But I had to wait eight extra days.”Even after patients recover, many treatment centers delay releasing them for more than a week until there are enough other survivors, sometimes dozens, to hold one huge goodbye ceremony for everyone — again, keeping desperately needed beds occupied. “I just wanted to get home and see my wife,” said Suliman Wafta, a recent Ebola survivor treated nearby. “But I had to wait eight extra days.”
The latest Ebola numbers are ominous. This past week, Sierra Leone reported almost 100 new cases in a single day, nearly double the number just 10 days before — and those are only the confirmed cases, which health experts say may be a third of the total. At this rate, the swelling roster of the gravely ill will far outstrip even the most optimistic projections for new hospital beds.The latest Ebola numbers are ominous. This past week, Sierra Leone reported almost 100 new cases in a single day, nearly double the number just 10 days before — and those are only the confirmed cases, which health experts say may be a third of the total. At this rate, the swelling roster of the gravely ill will far outstrip even the most optimistic projections for new hospital beds.
The recriminations are beginning to fly, especially against Britain, which, in a carve-up of Ebola-afflicted countries, is the international power taking the lead here. “Why are the British here? To end Ebola, or party?” read a headline in a local newspaper. It added, “While their American counterparts are working hard to end Ebola in Liberia, our so-called colonial masters are busy living the life of Riley.” The recriminations are beginning to fly, especially against Britain, which, in a colonial-style carve-up of Ebola-afflicted countries, is the international power taking the lead here.
“Why are the British here? To end Ebola, or party?” read a headline in a local newspaper. It added, “While their American counterparts are working hard to end Ebola in Liberia, our so-called colonial masters are busy living the life of Riley.”
British officials say that is not true, and that the 800 or so soldiers deployed here, who are building new treatment centers and training medics, are not allowed even a beer. “We’re working from 7 a.m. to 10 p.m., seven days a week,” said Maj. Simon Reeves, a spokesman.British officials say that is not true, and that the 800 or so soldiers deployed here, who are building new treatment centers and training medics, are not allowed even a beer. “We’re working from 7 a.m. to 10 p.m., seven days a week,” said Maj. Simon Reeves, a spokesman.
A big question people here are beginning to ask is whether the American military, which has sent 2,400 troops to Liberia, has any appetite to come to Sierra Leone. Many aid officials say the Pentagon’s role in building treatment centers, establishing mobile blood labs and ferrying Ebola supplies around Liberia has helped slow the epidemic there.A big question people here are beginning to ask is whether the American military, which has sent 2,400 troops to Liberia, has any appetite to come to Sierra Leone. Many aid officials say the Pentagon’s role in building treatment centers, establishing mobile blood labs and ferrying Ebola supplies around Liberia has helped slow the epidemic there.
An Obama administration official in Washington said that no decision had been made to shift American troops from Liberia to Sierra Leone or send in large numbers of reinforcements, but that “nothing is off the table.”An Obama administration official in Washington said that no decision had been made to shift American troops from Liberia to Sierra Leone or send in large numbers of reinforcements, but that “nothing is off the table.”
Like others, the official kept citing the “Brits’ primacy” in Sierra Leone — a reference to how, several months ago, Western powers divided Ebola responsibilities in West Africa along historical lines, with the United States helping Liberia, a nation founded by freed American slaves in 1822; France helping a former colony, Guinea; and Britain helping its own former colony, Sierra Leone.Like others, the official kept citing the “Brits’ primacy” in Sierra Leone — a reference to how, several months ago, Western powers divided Ebola responsibilities in West Africa along historical lines, with the United States helping Liberia, a nation founded by freed American slaves in 1822; France helping a former colony, Guinea; and Britain helping its own former colony, Sierra Leone.
According to several other American officials, the Pentagon was not enthusiastic about getting involved in Liberia in the first place and is resistant to going deeper into the region.According to several other American officials, the Pentagon was not enthusiastic about getting involved in Liberia in the first place and is resistant to going deeper into the region.
“They basically said, ‘We know conflict, but we don’t know Ebola,’ ” said one American official in West Africa. The military is also tired from fighting two long wars, the official said. “They basically said, ‘We know conflict, but we don’t know Ebola,' ” said one American official in West Africa. The military is also tired from fighting two long wars, the official said.
The Pentagon press secretary, Rear Adm. John F. Kirby, said the Defense Department was continuing to “monitor the spread of Ebola,” and was “mindful that it doesn’t just exist in Liberia.” In the next month, it will send two mobile blood labs to Sierra Leone to help reduce the bottlenecks caused by delays in testing.The Pentagon press secretary, Rear Adm. John F. Kirby, said the Defense Department was continuing to “monitor the spread of Ebola,” and was “mindful that it doesn’t just exist in Liberia.” In the next month, it will send two mobile blood labs to Sierra Leone to help reduce the bottlenecks caused by delays in testing.
Many aid officials in Sierra Leone said they crave a more effective command structure. The government runs a national emergency center, but aid officials said that with scores of foreign experts, government delegations and private charities flocking here, coordination was still messy, with many gaps and overlaps. It is extremely difficult, they said, to get even the most basic information, including how many treatment centers exist.Many aid officials in Sierra Leone said they crave a more effective command structure. The government runs a national emergency center, but aid officials said that with scores of foreign experts, government delegations and private charities flocking here, coordination was still messy, with many gaps and overlaps. It is extremely difficult, they said, to get even the most basic information, including how many treatment centers exist.
There are also growing questions about corruption, with the government announcing recently that it had found 6,000 “ghost medical workers” on its payroll, even as real Ebola burial teams and front-line health officers say they have not been paid in weeks.There are also growing questions about corruption, with the government announcing recently that it had found 6,000 “ghost medical workers” on its payroll, even as real Ebola burial teams and front-line health officers say they have not been paid in weeks.
Nothing, though, has raised more eyebrows than the new Kerry Town Ebola clinic, about a half-hour’s drive from the capital, Freetown. The clinic is an impressive campus of blue and white buildings lined up in perfectly straight rows, with all the orderliness of a military camp. It remains quiet, though, without enough trained nurses or hygienists to operate safely at anywhere close to capacity.Nothing, though, has raised more eyebrows than the new Kerry Town Ebola clinic, about a half-hour’s drive from the capital, Freetown. The clinic is an impressive campus of blue and white buildings lined up in perfectly straight rows, with all the orderliness of a military camp. It remains quiet, though, without enough trained nurses or hygienists to operate safely at anywhere close to capacity.
Several aid officials said that the Sierra Leonean government had been in a rush to open the clinic, but that the aid group tasked with running it, Save the Children International, had never run a critical-care field hospital. The rows of empty beds have led to some nasty finger-pointing.Several aid officials said that the Sierra Leonean government had been in a rush to open the clinic, but that the aid group tasked with running it, Save the Children International, had never run a critical-care field hospital. The rows of empty beds have led to some nasty finger-pointing.
Save the Children officials said the government had “begged” them to run the clinic. The government said Britain had made the decision. And the Britons said they had had no choice because no one else wanted the task.Save the Children officials said the government had “begged” them to run the clinic. The government said Britain had made the decision. And the Britons said they had had no choice because no one else wanted the task.
The Save the Children officials said Saturday that they had asked for eight more Ebola patients per day but were receiving only one.The Save the Children officials said Saturday that they had asked for eight more Ebola patients per day but were receiving only one.
“That place is like a boat without a captain,” a senior international aid official said. “Everybody’s rowing in different directions, and the boat doesn’t move.”“That place is like a boat without a captain,” a senior international aid official said. “Everybody’s rowing in different directions, and the boat doesn’t move.”
The British military said that it was close to completing several other clinics, but that it would take time, just as it did in Liberia, to turn the crisis around here.The British military said that it was close to completing several other clinics, but that it would take time, just as it did in Liberia, to turn the crisis around here.
Usually, in big emergencies where many people are in desperate need, the United Nations Office for the Coordination of Humanitarian Affairs plays a huge role, dividing services into clusters and then coordinating the work of private aid groups within each cluster. Ensuring “a coherent response to emergencies” is its raison d’être. Usually, in big emergencies where many people are in desperate need, the United Nations Office for the Coordination of Humanitarian Affairs plays a huge role, dividing services into clusters and then coordinating the work of private aid groups within each cluster. Ensuring “a coherent response to emergencies” is its raison d'être.
All across the refugee camps and war zones of Sudan, Central African Republic and the Democratic Republic of Congo, to name a few, are legions of young aid workers scrambling around in vests stamped with “OCHA,” as the office is known. But in Sierra Leone right now, there very few are seen. “I have no idea why OCHA isn’t doing this, and I think OCHA has no idea why they’re not doing this,” said Michael von Bertele, the global humanitarian director for Save the Children.All across the refugee camps and war zones of Sudan, Central African Republic and the Democratic Republic of Congo, to name a few, are legions of young aid workers scrambling around in vests stamped with “OCHA,” as the office is known. But in Sierra Leone right now, there very few are seen. “I have no idea why OCHA isn’t doing this, and I think OCHA has no idea why they’re not doing this,” said Michael von Bertele, the global humanitarian director for Save the Children.
One United Nations official, who was not authorized to speak publicly, said OCHA defined the Ebola crisis as a “systemic medical issue.” “Corporately, this is not a humanitarian emergency,” she said, but conceded that most aid agencies viewed it as one.One United Nations official, who was not authorized to speak publicly, said OCHA defined the Ebola crisis as a “systemic medical issue.” “Corporately, this is not a humanitarian emergency,” she said, but conceded that most aid agencies viewed it as one.
The United Nations still seems to be struggling with how to respond to one of the biggest international health crises in decades. After a lackluster start by the World Health Organization, Secretary General Ban Ki-moon established a separate Ebola mission in September to speed up the international response and cut through some of the typical United Nations bureaucracy.The United Nations still seems to be struggling with how to respond to one of the biggest international health crises in decades. After a lackluster start by the World Health Organization, Secretary General Ban Ki-moon established a separate Ebola mission in September to speed up the international response and cut through some of the typical United Nations bureaucracy.
Anthony Banbury, the head of that mission, said the United Nations was helping with crisis management and that OCHA had sent “a number of information officers” to the region. He also said that the Sierra Leonean government was handling coordination “very effectively.”Anthony Banbury, the head of that mission, said the United Nations was helping with crisis management and that OCHA had sent “a number of information officers” to the region. He also said that the Sierra Leonean government was handling coordination “very effectively.”
Many Sierra Leoneans find that laughable, but some said that because the government had declared a state of emergency, they had to speak carefully.Many Sierra Leoneans find that laughable, but some said that because the government had declared a state of emergency, they had to speak carefully.
“Everybody knows there are huge gaps,” said Ibrahim Tommy, a human rights campaigner in Freetown. “But nobody can say anything.”“Everybody knows there are huge gaps,” said Ibrahim Tommy, a human rights campaigner in Freetown. “But nobody can say anything.”
Several journalists and intellectuals have been summoned to Parliament recently to defend their work, and last month a prominent radio host was locked up for 11 days after he asked some questions about the government’s Ebola response. A government spokesman said that the radio host had been jailed for other reasons, without specifying them, and that there was no repression in Sierra Leone.Several journalists and intellectuals have been summoned to Parliament recently to defend their work, and last month a prominent radio host was locked up for 11 days after he asked some questions about the government’s Ebola response. A government spokesman said that the radio host had been jailed for other reasons, without specifying them, and that there was no repression in Sierra Leone.
The journalist, David Tam-Baryoh, called the experience terrifying. “The government is getting very edgy,” he said.The journalist, David Tam-Baryoh, called the experience terrifying. “The government is getting very edgy,” he said.
When asked what grade he would give the government for its handling of Ebola, Mr. Tam-Baryoh giggled nervously.When asked what grade he would give the government for its handling of Ebola, Mr. Tam-Baryoh giggled nervously.
“Well, if I wasn’t in the country,” he started to say. “But I don’t even want to say that. The powers of emergency could be wrongly used, to put it mildly.”“Well, if I wasn’t in the country,” he started to say. “But I don’t even want to say that. The powers of emergency could be wrongly used, to put it mildly.”