Deep in the rain forest, down a dirt road with potholes that swallow four-wheel-drive vehicles, is a tiny point of light in the darkness that Ebola has brought to Liberia.
The Bong Ebola Treatment Unit is a modest collection of blue tents, connected by gravel paths, near the site of a former leper colony. But when the camp opened Monday, it provided the first 10 beds for Ebola victims in this rural county four hours from Monrovia, where 183 people are known to have been infected with the virus since July, and 81 have died. Most people believe there are many more victims.
Until now, any of Bong County’s more than 325,000 residents who showed symptoms of Ebola had to find his way to the capital or another treatment center in Foya, six to seven hours away. Many people just stayed home, hoping to survive the virus on their own. But with 60 more beds planned, two pickup trucks that serve as ambulances and scores of trained Liberian staff, the Bong center is now making a small contribution against the most deadly Ebola outbreak on record.
“There was an acknowledgment on the part of many of the actors in the response that there was a need for a facility in the middle of the country,” said Sean Casey, the Liberia emergency response team director for the International Medical Corps (IMC), which is running the center. “Every week that we don’t open new facilities, we create the need for several more. It’s just a self-perpetuating problem.”
After coming under fierce criticism, the international community is scaling up its response to the Ebola crisis. The United States this week launched a $750 million effort to establish treatment facilities with 1,700 beds in Liberia. The U.N. Security Council voted unanimously Thursday to create an emergency medical mission to respond to the outbreak, with an advance team in West Africa by the end of the month.
The Bong center is a small initiative, built for $170,000 by the nonprofit group Save the Children. But it is a godsend to rural villagers.
Elijah Kollie, 13, was living with his aunt and uncle, a health worker, in Kakata when the uncle died of Ebola. Four days later, the aunt died, followed by their 24-year-old son. Neighbors refused to take in Elijah, and he set off for a health clinic in Totota, about 35 miles away, accompanied by his father, who could not touch the boy. After an all-night journey hitching rides and walking, Elijah was picked up by the IMC ambulance team at the clinic, where health workers had determined he had symptoms of Ebola infection.
Workers disinfected the waiting area where Elijah had been sitting for 24 hours with another suspected patient, then followed the boy to the truck, carefully spraying each spot where his yellow rubber sandals had touched the ground.
“I leave it to God,” said Elijah’s father, Sulon Kollie, after his boy boarded the truck. Nearby, his mother and another aunt and uncle wiped tears from their eyes.
James Dahn, a farmer in the village of Knuckles, lives in a mud-walled home with a roof of thatched palm leaves. He began vomiting and feeling achy, telltale signs of Ebola, and called the county’s hot line, which sent a Bong treatment center ambulance to him. Keeping their distance, workers questioned him about how he might have contracted the virus. Dahn, 32, said he had been staying in a home in another village where a person died and two others fell ill. He moved back home, but not soon enough.
His wife said she moved out when Dahn began showing symptoms of Ebola infection. Workers disinfected the tiny home inside and out with a strong chlorine solution, spraying the thatched roof and even the clothes Dahn had left behind. Gbanyan Khakie arrived at the center on a motorbike with his younger brother, Nanfarr. Both were infected. Had they developed symptoms a week earlier, the brothers would have faced the uncertain prospects of finding a bed at treatment centers in Foya or Monrovia. But on Tuesday, they were the third and fourth patients at the new facility.
This aid does not come cheaply. The U.S. Agency for International Development is footing the $1-million-a-month bill, Casey said, and the center’s staff of 15 foreign nationals and 84 Liberians had to be trained. Water, sanitation and infection control systems were established, along with a supply chain for items such as chlorine and protective gowns for workers.
The stress of the job means that most workers must take time off after four weeks, so a continuous labor supply is essential. Arrangements had to be made to drive blood samples to labs in Monrovia for testing.
“There’s an incredible amount of planning and training and just action that goes into setting up a facility,” Casey said.
No one knows whether treatment increases a patient’s chances of survival. Anecdotally, it appears to be the case, here and elsewhere, “but there is not good scientific evidence that shows that,” Casey said.
But now that the clinic is operating, with seven patients as of Thursday, Bong County can begin to address some of its Ebola cases and help curb the spread of the virus by isolating the sick.
“I think there’s a clear need for an enormous response here,” Casey said. “Our concern at this point is that we’re just the humanitarian community and we’re not sure how . . . the response is going to get on top of the epidemic.”
Bernstein reported from Monrovia. Samwar Fallah in Bong County and Lena Sun in Washington contributed to this report.