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Sun August 24, 2014

Aid Workers In Short Supply As Ebola Grips Liberia

Originally published on Wed August 27, 2014 8:51 am

Sheldon Yett is UNICEF's lead man in Liberia. Over a long career he's been in the thick of all sorts of crises — wars, earthquakes, epidemics. He's seen firsthand how, when disaster strikes a poor country, aid workers and experts from all over the world flood the zone.

But with the Ebola epidemic, almost no one is answering the call.

"I'm astounded by how difficult it has been to get the partners we need," Yett says. "People are afraid. I can't convince my own staff to come. It's extremely, extremely difficult. We need skilled, qualified people here."

With the number of Ebola cases in Liberia now topping 1,000 and many more cases thought to be unreported, the need for international support has become acute. Liberian officials and aid groups say they desperately need health workers and experts in disease management.

"The effects of this outbreak will be with us for many, many, many months to come, and we need qualified people here, and we need the funds to address it," Yett says. "The needs are enormous."

But something about this virus — maybe the fact that it's so deadly, or maybe it's the images of health workers putting on full-body protective suits to avoid getting infected — seems to have unnerved the sort of experts Liberia needs.

Hunting For Doctors

One of biggest shortages has been in care centers for people with Ebola. Last weekend the aid group Doctors Without Borders opened a new center in Monrovia with 120 beds. They were filled almost immediately. The United Nations is promising to help add another 500 beds — but not for another six weeks, and it's still on a hunt for doctors.

"The biggest concern has been, as long as I've been here, is to get international staff with Ebola experience," says Lindis Hurum, Doctors Without Borders emergency coordinator for Monrovia. "That's what's been stopping us."

She says they've already brought in every available person they can. But they don't actually need that many more international experts to expand the treatment centers, just enough to train the Liberians who would do most of the work.

Even though working with Ebola patients is extremely dangerous, Brett Adamson, coordinator of the new Doctors Without Borders center, says he's had no problem finding Liberians willing to step up.

"It was quite surprising, considering the number of health workers that have died, and so they've been amazing," Adamson says. "We recruited 50, 60, 70 staff in a day."

'We Need Brave People'

One of the new hires, Amos Togba, helps disinfect gear and equipment at the center. He says he knows the risks.

"Well, yes, I have some fear, but I have to be brave to do it," Togba says. "That's the only way we can attack the virus. We need brave people to do it."

Then there are the jobs that aren't hazardous, but are nonetheless essential.

Liberia's government recently set up an Ebola hotline for people to call with questions or ask for help. Barkue Tubman, who runs a public relations firm, helped set up the center with a Facebook call-out for workers.

On hiring day, Tubman says, "We walked out the gates and we saw about 1,000 people in pouring rain," she says.

It's rainy season here, and when it comes down, it really comes down. Tubman says they had to turn hundreds of people away.

Liberians are also at forefront of the work that experts say is the real key to quashing the outbreak: going door-to-door through every community to find out who is sick, help them get tested, and encourage those who came in contact with a sick person to stay away from others during the 21 days it takes to find out if they've been infected.

Barely Making A Difference

Joyce Kilikpo does this by delivering supplies such as rice, salt, cooking oil and sanitary pads to people under quarantine. Kilikpo, executive director of the aid group Public Health Initiative Liberia, makes these runs every day in partnership with an NGO called Action Aid. But she feels like she's barely making a difference.

"We say, 'Sorry for everything that happened,' " Kilpo says. "There are a lot of people that are not getting food, and what we are doing is just a drop in the ocean."

Experts also say the information being gathered by people like Kilpo is of limited use, unless it's fed to people with direct experience coordinating disease emergencies. That expertise is missing, too.

Hurum says she thinks experts don't step forward because they fear they would be putting themselves in immediate danger, which is not necessarily true. The reality, she says, is that working in Liberia during this outbreak is a lot like working in any other disaster.

"There's a lot of things you can do in this response that [are] not high-risk," she says. "You do not have to put on that astronaut equipment that you see in all the pictures to respond to this crisis."

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

LINDA WERTHEIMER, HOST:

This is WEEKEND EDITION from NPR News. I'm Linda Wertheimer. With the number of Ebola cases in Liberia now topping 1,000 and many more cases thought to be unreported, the need for international support has become acute. Liberian officials and aid groups say there is a desperate shortage of supplies and personnel. They need health workers and experts in disease management. But as NPR's Nurith Aizenman reports, recruiting those workers is a challenge.

NURITH AIZENMAN, BYLINE: Sheldon Yett is UNICEF's lead man in Liberia. Over a long career, he's been in the thick of all sorts of crises - wars, earthquakes, epidemics. And he's seen firsthand how when disaster strikes in a poor country, aid workers and experts from all over the world flood the zone. But this time, almost no one's answering the call.

SHELDON YETT: And I'm astounded by how difficult it has been to get the partners we need. It's - people are afraid. I can't convince my own staff to come. It's extremely, extremely difficult. We need skilled, qualified people here.

AIZENMAN: Something about this virus - maybe the fact that it's so deadly, or maybe it's those images of health workers putting on full body protective suits to avoid getting infected - seems to have unnerved the sort of experts needed here.

YETT: The effects of this outbreak will be with us for many, many, many months to come. And we need qualified people here, and we need the funds to address it. The needs are enormous.

AIZENMAN: One of the biggest impacts has been on care centers for people with Ebola. Last weekend, the aid group Doctors Without Borders opened a new center in Monrovia with 120 beds. There were filled almost immediately. The United Nations is promising to help add another 500 beds but not for another six weeks. And they're still on a hunt for doctors. Lindis Hurum is the Doctors Without Borders emergency coordinator for Monrovia.

LINDIS HURUM: And the biggest concern has been - as long as I've been there - is to get international staff with Ebola experience. That's what's been stopping us.

AIZENMAN: She says they've already brought in every available person they can. But they don't actually need that many more international experts to expand the treatment centers - just enough to train the Liberians who would do most of the work. Even though working with Ebola patients is extremely dangerous, Brett Adamson says he's had no problem finding Liberians willing to step up. He's coordinator of the new Doctors Without Borders center on the outskirts of Monrovia.

BRETT ADAMSON: It was quite surprising considering the number of health workers that have died. And so they've been amazing. Most of these - we recruited 50, 60, 70 staff in a day.

AIZENMAN: One of the new hires is Amos Togba. He helps disinfect gear and equipment at the center. He says he knows the risks.

AMOS TOGBA: Well, yes, I have some fear. But I have to be brave to do it. That's the only way we're going to attack the virus. Only brave people will do it.

AIZENMAN: Then there are the jobs that aren't hazardous, but are also essential.

(SOUNDBITE OF PHONE RINGING)

UNIDENTIFIED MAN: Good afternoon. Ebola Call Center, how may I help you?

AIZENMAN: Liberia's government recently set up a hotline for people to call in with questions about Ebola or to ask for help. Barkue Tubman helped organize the center with the Facebook callout. She runs a public relations company, and here's what she saw on hiring day.

BARUKE TUBMAN: We walked out the gates, and we saw about 1,000 people in pouring rain.

AIZENMAN: It's rainy season here. And when it comes down, it really comes down. Tubman says they had to turn hundreds of people away. Liberians are also at the forefront of the work that experts say is the real key to quashing the outbreak - going door to door through every community to find out who's sick, to help them get tested and to encourage those who came into contact with the sick person to stay home away from others during the 21 days it takes to find out if they've been infected.

Joyce Kilpo does this by delivering supplies to people under quarantine. On this day, she's bringing rice, salt, cooking oil and sanitary pads to a woman who lost five members of her family.

UNIDENTIFIED WOMAN: Thank you.

JOYCE KILPO: We are so sorry for everything that happened.

AIZENMAN: Kilpo makes these runs every day in partnership with an NGO called Action Aid. But she feels like she's barely making a difference.

KILPO: There's a lot of people that not getting the food. And what we are doing is just, I mean, a drop in the ocean.

AIZENMAN: Experts also say the information being gathered by people like Kilpo is of limited use unless it's fed to people with direct experience coordinating disease emergencies. That expertise is missing here too.

Hurum of Doctors Without Borders says the failure of enough experts to show up this time is all the more distressing because it seems to be based on a misconception that they would be putting themselves in immediate danger.

HURUM: There's a lot of things you can do in this response that is not high risk. You do not have to put on that astronaut equipment you see in all the pictures to respond to this crisis.

AIZENMAN: The reality, she says, is that working in Liberia during this outbreak is a lot like working in any other disaster. Nurith Aizenman, NPR News, Monrovia. Transcript provided by NPR, Copyright NPR.

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