September 2014 – AFRICA — I wake up each morning – if I have managed to sleep – 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. I am supervising the suspect tent, which has room for 25 patients who are likely to have Ebola – 80-90% of those we test have the virus. We administer treatment for malaria, start patients on antibiotics, paracetamol, multivitamins, rehydration supplements, food, water and juice while they wait for their results. Sometimes people have arrived too late and die shortly after arriving. In one afternoon last week I watched five seemingly fit, healthy, young men die. I gave the first a bottle of oral rehydration solution and came back with another for the second. In the half a minute or so in which I had been away the first man died, his bottle of water spilt across the floor. The four others followed in quick succession. We sometimes have to hold back tears but try to offer patients all the comfort that we can – especially if they are in their last moments. I cannot spend as much time as I would like with each of them due to the intense heat of the personal protective equipment and the sheer number of patients.
My colleagues in logistics are doing a fantastic job of building new extensions and hopefully, in the next week, we will increase our capacity further still. In the meantime, we are only open to admit patients for a couple of hours each day before all our beds are full again. Once admitted, patients spend 10-14 days with us, and if their body beats the virus – and they have three days in which they do not show symptoms – we perform another test to see if they have fully recovered. Unfortunately, people die before they even reach our centre. It is a difficult and dangerous procedure to remove a body from a vehicle and the team often has to do this many times a day. We have been forced to order an incinerator from Europe because the local crematorium cannot cope with the number of bodies. Each day this week patients have recovered – in the early stages there were no survivors whatsoever. Yesterday seven people went home, including a young man who had painted the inside of one of our tents red when he arrived because he was bleeding so profusely. Our team had thought he had no hope of survival. It is lovely to see the patients going home with their certificate of discharge, though most have lost family members or friends, and can face stigma upon their return. I believe MSF is doing a fantastic job, but we are only able to care for a minority of the people in Monrovia who have Ebola. We also work in the north of the country, but every county is now reporting cases and we have absolutely no capacity to respond.
It is extremely sad to see the indifference of the international community with regards to this epidemic. It is great to see an added interest and investment in research for vaccines, but we urgently need experts who are physically present and more structures on the ground here in west Africa, where the situation continues to be catastrophic. The author is an aid worker for Médecins Sans Frontières who wished to remain anonymous. –Guardian