No room at Ebola clinic for dying victims

A treatment center in Liberia cannot cope with the flood of pleading patients, writes Colin Freeman

Like every volunteer who serves with Mé-decins Sans Frontières, Stefan Liljegren joined up to help the sick and destitute.

In 15 years with the agency, he has been everywhere from Af-ghanistan and Kosovo through to South Sudan and East Timor, the hard and often dangerous work compensated for by the knowledge that he is saving lives.

As field coordinator of the organisation's new 160-bed Ebola treatment centre in Monrovia, the capital of Liberia, one of his tasks is to decide which of the sick people who arrive outside the clinic's gates should get treatment.

Such is the scale of the outbreak that for every 20 to 30 new patients the clinic admits each day, the same number are often turned away - despite the likelihood that they will go home and infect their relations.

"This is by far the most difficult challenge that I have ever faced," the 44-year-old Swede said. "Every day I have been faced with impossible choices, and decisions that are inhuman to make. Having to tell someone that they can't come in when they are screaming and begging to do so is an indescribable feeling, especially when you know they may go back to families who might well then get sick themselves."

Outside the clinic an hour earlier, a grisly scene demonstrated Liljegren's point. Resting face down in the mud, an arm crooked over his face, was the body of Dauda Konneh, 42. He had been lying there, dead, since daybreak.

"He was vomiting a lot and had symptoms like Ebola, so we put him in a pick-up truck and took him here for treatment," said one young man outside. "When we got here last night, he was still alive, but the clinic would not accept him. He died at dawn today."

Having dead or dying patients outside the clinic overnight is a regular occurrence.

Once night falls, the hospital does not admit anyone: handling Ebola patients requires extreme care at the best of times, and it would be dangerous to do so in the dark.

The task of removing Konneh's body falls to Stephen Rowden, a Médecins Sans Frontières volunteer from the UK, who leads a team in charge of the safe removal of corpses. "When I started it was maybe a body every two days, now it is daily and sometimes up to five a day," says Rowden, 55.

The clinic, one of three operating in Monrovia, has seen 350 deaths in the past month alone. Since all infected bodies have to be burned, the casualties have exceeded the capacity of Monrovia's crematorium. Médecins Sans Frontières has had to import an incinerator from Europe - normally used for livestock. For an aid agency that prides itself on triumphing in even the most difficult circumstances, it is a depressing reminder of how far there is to go.

The challenges facing the clinic are a snapshot of the wider outbreak engulfing West Africa. On Tuesday, a World Health Organisation study warned that the number of Ebola cases, currently topping 5000, could reach hundreds of thousands by January unless the aid operation was drastically increased.

Nowhere is the problem more acute than in Liberia, where 40% of the deaths have taken place, and where the government health service has been paralysed by Ebola infections among its own staff.

In coming weeks, a 3000-strong US military mission will arrive in Monrovia to build 17 more Ebola treatment clinics.

Inside the Médecins Sans Frontières clinic, those patients fortunate enough to get through the gates are admitted to rows of large white treatment tents.

Only staff clad in the yellow protective gear can enter the "high-risk" wards, where those with advanced stages of the virus are treated.

One patient, Foofee Sheriff, 54, tells how he became infected after attending the funeral of his brother. "We did not touch my brother's body during the burial, we used plastic bags on our hands to make sure that didn't happen," he insists. "But eight days afterwards I started feeling sick."

There is no telling how many more desperate people may soon be pleading at the clinic's gates. "It gets worse by the day," Liljegren said. "How much worse will it get? I have no idea." - ©The Daily Telegraph, London