Ebola: nobody knows what to do

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Monrovia - Jean-Pierre Veyrenche, in charge of building Ebola treatment centres in Monrovia for the World Health Organization, says fear is keeping international aid experts from joining the battle against the west African outbreak. “No one knows what to do” to handle the wildfire spread of Ebola in Liberia's densely populated capital, Veyrenche told AFP in an interview, stressing that humanitarian workers were all “learning” as they go along. But he said that with “simple measures”, medical staff could protect themselves and “get work done” - and that Liberia, like its Ebola-struck neighbours, remained in dire need of trained international workers. Of the four west African nations affected by the Ebola outbreak, Liberia has been hit the hardest, with 3 458 people infected - more than half of the total number of cases. Of those, 1 830 have died, according to a WHO count released on Saturday.

Q: How would you describe the state of the Ebola crisis in Monrovia?

A: The situation is out of control since the epidemic continues to grow... Here we have a country emerging completely broken from a civil war. There are only a few dozen Liberian doctors left. The need is glaring Ä especially for healthcare personnel. And the need isn't being met with the arrival of foreign aid workers, who don't know how to manage such a huge epidemic in an urban environment.

Q: But can humanitarian organisations learn to manage this crisis?

A: Learning - that's what we're all doing. Because no one knows what to do. What's even worse, what's missing is hard data Ä like the true number of (Ebola) cases. The figures being released are just for the cases that have been officially counted. I believe many people are just burying their dead at home, in their gardens.

Q: How do you see events unfolding?

A: I am not optimistic about the immediate future. We're facing a lack of outside support, and a broken-down state trying to do what it can with what it has - which is not much. For me there's no doubt the number of cases will explode in the upcoming weeks and months.

The rainy season is on its way, and the mosquitos will be coming out. Then we'll see an explosion in the number of cases of malaria. This is not going to be easy: there's a risk of mixing up malaria and Ebola, since the symptoms are similar.

Q: You are in charge of the construction of Ebola clinics. Explain exactly what this entails.

A: My job is to set up 500 beds. I think I'll be done in a month. There are a lot of technical issues to consider - how a plot of land is laid out, how big and how accessible it is.

You need 5 000 square metres (5 400 square feet) for a 100-bed clinic - not easy to find in a big city like Monrovia, with marshy terrain. And the heavy rains are an enormous obstacle, as is the high water table which makes it impossible to dig latrines and is forcing us to build septic tanks out of concrete.

Q: What are some of the other problems you're dealing with?

A: We're having to deal with the problem on a social level of getting local populations near Ebola treatment centres to accept them. Even though there is no risk to the neighbouring area, I understand that it scares them.

Q: How would you evaluate the humanitarian response to Ebola in Liberia?

A: There are very few humanitarian organisations on the ground, compared to other crises... I think people are scared, that's how I interpret it. No one knows how to deal with Ebola in an urban area, and in such numbers.

But the international humanitarian community must act. There are ways of working here. You can't get Ebola from stepping off the plane onto the tarmac...

By taking relatively simple measures, and applying them rigorously, work can get done. It's important to avoid too much stress or exhaustion which can lead people to be less attentive.

We need people to come train others who are from here. You can't bring in 5 000 medical workers from elsewhere. I can understand why people aren't coming, but by taking simple measures, it's possible to work here.

Sapa-AFP