World's response to Ebola slow, inconsistent, inadequate: Médecins sans Frontières

MSF, though, said the situation was “far from under control” in Sierra Leone, that the “situation is alarming” in Guinea and, while progress was being made in Liberia, there was no room for complacency. “The outbreak is far from over, as a single case can start a localized epidemic,” it said, reporting infection chains starting in remote rural areas with no access to treatment centers or testing facilities.

MSF noted that case numbers had dropped in the Liberian capital, Monrovia, where there was now surplus bed capacity, but added that many international agencies “seem unable to adapt to the rapidly changing situation” with outbreaks in Bong, Margibi, Gbarpolu, Grand Cape Mount, and River Cess counties. In some areas, such as River Cess, patients must travel for up to twelve hours by road to reach a functioning laboratory and a community care center, MSF said.

In Guinea, where, the MSF says, the outbreak started but was “long overlooked by international efforts,” the response was “painfully slow” (see also Adam Nossiter, “Ebola Now Preoccupies Once-Skeptical Leader in Guinea,” New York Times, 30 November 2014) MSF said that Guinea’s Ebola taskforce was improving but that the caseload in November, month on month, was up 25 perent. It added: “New areas are reporting infections and 17 of Guinea’s 33 prefectures have reported cases in the past three weeks.

“Like in Sierra Leone and Liberia, the absence of implementing partners willing and able to manage case management centers and a lack of trained staff have been a bottleneck and the source of large delays.”

Infection is increasing “alarmingly” in Sierra Leone, said the MSF report, and local healthcare workers were carrying the burden. The latest number of confirmed cases in the country is 5,978.

The Guardian notes that the U.K.’s contribution in Sierra Leone has yet to have an impact two months after its aid program was announced. The United Kingdom and China have sent teams to build Ebola centers in

locations including Port Loko, Freetown, and Makeni, the worst-affected of the country’s fourteen districts.

The MSF said the United Kingdom pledged to build and provide resources for an additional 700 beds had yet to be fulfilled. “As of 27 November, only 11 of these beds were operational, and only 28 patients had been treated. While the remaining centers are under construction and scheduled to open soon, they will not be running at full capacity until well into the new year,” it said.

The U.K. government announced plans to build six hospitals, but only one has opened, in Kerrytown, an hour’s drive from Freetown. About 50 percent of the available beds were government-run or run by the armed forces, with another 40 percent run by MSF, the NGO said.

“In the absence of adequate facilities to isolate, diagnose and manage Ebola cases, Sierra Leonean healthcare workers are struggling,” MSF said. “[We are] deeply concerned about contamination of uninfected patients and healthcare workers where staff are not necessarily trained to manage Ebola patients and where infection control measures cannot be assured.”

Referring to Liberia, the NGO said that “MSF teams are still finding that misconceptions about Ebola are widespread and stigma is intense, leading some to avoid seeking treatment or report cases.” The organizations says it found that people who had been in contact with the sick were fleeing into the bush so as not to be traced, fearful of what would happen if they were.