September 2014 — AFRICA – Like every other volunteer who serves with Médecins Sans Frontières, Stefan Liljegren joined up to help the sick and destitute. In 15 years with the agency, he has been everywhere from Afghanistan and Kosovo through to South Sudan and East Timor, the hard and often dangerous work compensated for by the knowledge that he is saving lives. His latest mission, in Ebola-hit Liberia, offers rather less job satisfaction. As field coordinator of MSF’s new 160-bed Ebola treatment centre in the capital, Monrovia, one of his tasks is to decide which of the sick people who arrive outside the clinic’s gates should get treatment. Such is the scale of the outbreak that for every 20-30 new patients the clinic admits each day, the same number are often turned away – despite the likelihood that they will go home and infect their relatives. “This is by far the most difficult challenge that I have ever faced,” the 44-year-old Swede told The Telegraph during a brief break from his work in the sweltering humidity of Liberia’s monsoon season. “Every day I have been faced with impossible choices, and decisions that are inhuman to make.
Having to tell someone that they can’t come in when they are screaming and begging to do so is an indescribable feeling, especially when you know they may go back to families who might well then get sick themselves.” Outside the clinic an hour earlier, a grisly scene demonstrated Mr. Liljegren’s point. Resting face down in the mud was the body of Dauda Konneh, 42. He had been lying there dead since daybreak. “He was vomiting a lot and had symptoms like Ebola, so we put him in a pick-up truck and took him here for treatment,” said one young man outside. “When we got here last night, he was still alive, but the clinic would not accept him. He died at dawn today.” When The Telegraph mentions this to Mr. Liljegren, he nods. Having dead or dying patients outside the clinic overnight is “a regular occurrence,” he says. The reason being that once night falls, the hospital does not admit anyone: handling Ebola patients requires extreme care at the best of times, and it would be dangerous to do so in the dark.
The task of removing Mr. Konneh’s body falls to Stephen Rowden, a British MSF volunteer from Danbury, Essex, who leads a team in charge of the safe removal of corpses, which are sprayed with chlorine-based disinfectant first. “When I started it was maybe a body every two days, now it is daily and sometimes up to five a day,” said Mr. Rowden, 55. “I have never seen this amount of bodies before. It sounds callous, but you just have to switch off emotionally.” No amount of “switching off”, though, spares the MSF staff from the wider scale of the fatalities around them. The clinic, one of three now operating in Monrovia, has seen 350 deaths in the last month alone. Since all infected bodies have to be burned, the casualties have exceeded the ability of Monrovia’s local crematorium to cope. MSF has had to import an incinerator from Europe – normally used for livestock – to assist. For an aid agency that prides itself on triumphing in even the most difficult operating circumstances, it is a depressing reminder of how far there is to go. –Telegraph