If you think the fight against Ebola is going well, here’s a grim new number: 537.
That’s how many new infections were reported in Sierra Leone in the past week. It’s the highest weekly tally in any country since the West African outbreak began.
International governments and aid groups have scrambled to open Ebola treatment centers in the country. But, because of safety concerns, many of these centers are accepting only a fraction of the number of patients they were built to serve.
In the meantime, most sick people are being directed to makeshift, government-run centers. Some of these are simply schools or other government buildings repurposed into a “community care center” — a place for people with Ebola symptomsto be isolated.
Baimaur Laminangbatu, who heads up a chiefdom of several hundred villages in Sierra Leone’s rural north, is helping transform a school into one of these care centers.
The facility is a lot more basic than the full-fledged treatment clinic down the street, which was built with funding from foreign governments, including the U.S. That facility has sophisticated in-ground plumbing and sanitation system.
Here at the school, workers are digging a big hole in the ground. “Those are the toilets for the suspected cases to use,” Laminangbatu says.
The treatment offered at the care center will be limited — medication to bring down a fever and rehydration salts that patients can drink with little help or supervision. In contrast, at some treatment centers, patients are getting intravenous drips for fluid replacements and sponge baths.
Still though, Laminangbatu and his team have stood up this community care center in a matter of days. The facility is remarkably simple. In one room, there are eleven metal cots.
“This place was a classroom,” Laminangbatu says. A chalkboard on the wall still has a lesson written on it. “My name is Hawa. I’m a girl. I’m 4 years old,” Laminangbatu reads off the board.
These community care centers — and larger holding centers — were originally conceived of as temporary triage posts. Health officials intended them to be places where people who might have Ebola could be isolated while they waited for an Ebola test result. If the test came back positive, then a person would be sent onto a proper treatment facility.
But right now, there’s no better place to go. So sick people are getting stuck at these triage centers.
It’s better than nothing, Laminangbatu says. “If we allow those sick to be in the community, Ebola will spread,” he says. “And all of us will die.”
But a few miles down the road, at a holding center, I met Dr. Corrado Conceda, with the aid group Partners In Health. He thinks it’s unacceptable that so many Sierra Leoneans will have to die while waiting for the international response to scale up.
Why should people here get a lower standard of care than Americans or Europeans, Conceda asks? “Everybody deserves the same level of care,” he says. “That should always be our goal and our guiding principle.”
Conceda has begun turning this existing holding center into a full-fledged treatment facility, with IVs. He’s also bringing in medical workers from overseas and trainers in a matter of days, not weeks.
And Conceda totally rejects idea that Ebola has to be such a deadly disease. “Ebola kills so many people here [in Sierra Leone] because there’s not the resources to take care of patients properly,” Conceda says.
As soon as possible, he wants to start using start using lab tests to monitor organ function and tweak electrolyte levels — the tools that American and European hospitals have been using to support their Ebola patients.
“Let’s bring the tools, and then the mortality rate will go down,” Conceda says. “There’s no reason why it couldn’t be 20 percent, or 10 percent, if you diagnose patients early enough before they’re sick.”
The key to getting there, Conceda says, is to maintain that moral outrage — that sense that as long as people are dying, what you’re doing is never enough.