* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Who would want to do their job at high risk of infection in searing heat, with sickness and death all around?
Athalia Christie has viewed the unimaginable. Her eyes have the look of a person scarred.
She has just returned from Liberia, where as deputy for global health at the U.S. Centers for Disease Control and Prevention she was part of a team in August assessing how the United States can respond to the Ebola epidemic in West Africa. She visited hospitals and clinics.
"Children were crawling among the sick. People were lying outside waiting to get in. Morgues were full and they could not burn bodies fast enough," she said.
"Any delay in delivering aid to control the spread of Ebola in West Africa will be devastating," she told a poverty conference in Washington on Friday organised by the U.S. development agency, USAID.
Building the clinics and hospitals pledged by the United States and Britain is not enough, aid experts working in West Africa said. What is critical now is to get more trained staff to help bring the infection rate under control. Without more people on the frontline, the virus will continue to spiral out of control.
But conditions there are gruelling. Ebola is transmitted through body fluids, and the death rate for those who contract the disease averages 53 percent, scaring off volunteers. Over 2,500 people have died this year, mostly in Liberia, Sierra Leone and Guinea with a few cases in Nigeria and Senegal - the worst-ever outbreak of the hemorrhagic disease.
Reported infections are 5,000 but suspected to be two or three times higher, and the rate is doubling every 10 to 21 days, according to the World Health Organisation.
Workers in contact with infected people or materials must wear five layers of protective clothing from head to toe in heat that tops 100 degrees Fahrenheit.
To encourage healthcare workers in the region to return to work, the World Bank this week released grant money to governments for higher salaries, hazard pay and death benefits for their families should they die.
CREATIVE STRATEGIES
Private donors also are starting to step in. The Paul G. Allen Family Foundation has given money and is helping with air transport to get supplies to the region, said its co-manager Dune Ives.
USAID has a tent city in Monrovia where 500 people a week are being trained, said Nancy Lindborg, USAID assistant administrator. While the training is not medically complicated, it requires utter discipline so that nothing is touched that might be infected, she said. Staff must practice the routines over and over before they are deployed into hospitals.
Few medical professionals are actually needed – only 40 out of the 230 people required to staff a 100-bed facility. But experts said there is a severe shortage of workers to dispose of bed linen, wash down walls and equipment with chlorine, and make sure there are enough body bags.
Some frontline medical groups have adapted the World Health Organisation's best practice for treatment because they have too few staff. Less-experienced workers are at a far higher risk of needle pricks if they are inserting intravenous tubes, so needle usage is minimised.
David Olson, medical director for Doctors without Borders, said oral hydration is "completely reasonable" instead of IV kits if a person can hold down fluid, and their stomach and intestines are not in shock. It also lowers the risk of spreading the disease via needles, he said.
Ciaran Donnelly, acting vice president for the International Rescue Committee, called for more reliance on community care, especially in rural areas far from clinics. Rather than travelling and infecting more people, the sick can be isolated in their homes and treated by a family member.
Often that is a death sentence for both. But the options are shrinking rapidly.
"We need to be willing to try new strategies that are not ideal and not optimal. We have to be creative," said Christie.
She returns to Liberia next week.
Our Standards: The Thomson Reuters Trust Principles.
