STEVE INSKEEP, HOST:
Let's face it; Americans are paying less attention to Ebola. The drama of a handful of cases in the United States seems to have ended for now. Also, the U.S. election is over, leaving politicians less reason to hype the danger. But if you're in Sierra Leone in West Africa, this is more than a cynical tale. Last week alone, 537 new infections were reported in that country. That is the highest weekly tally in any country since this outbreak began. International governments and aid groups are scrambling to open treatment centers in Sierra Leone, but that is not easy. NPR's Nurith Aizenman reports.
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BOB BONGOMEEN: And what is PPE?
UNIDENTIFIED RECRUITS: Personal protective equipment.
NURITH AIZENMAN, BYLINE: Bob Bongomeen is instructing 23 recruits in a critical skill, how to stay alive while working in an Ebola ward. We're soldiers, he says. The chlorine spray are bullets. The protective suit...
BONGOMEEN: That is our armor, the defense that we use to stop any infection.
AIZENMAN: Bongomeen's a sanitation expert, brought in from Uganda for this new Ebola treatment center in Sierra Leone's rural north. It's been built by the aid group International Medical Corps with foreign funding. The local men and women sitting in a ring of folding chairs around Bongomeen have been hired to work as cleaners.
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BONGOMEEN: What fluids could we easily get in contact with?
UNIDENTIFIED RECRUIT #1: Sweat.
UNIDENTIFIED RECRUIT #2: Stool.
UNIDENTIFIED RECRUIT #1: Vomit.
UNIDENTIFIED RECRUIT #2: Saliva.
BONGOMEEN: Saliva, blood...
AIZENMAN: The stool, vomit, blood of someone with Ebola is highly infectious. It's why hundreds of health workers treating Ebola patients have gotten sick themselves. And it's the reason International Medical Corps has been taking things slow. Their facility is designed to treat 50 patients. For now, they're taking in 10. They open Monday, and they want to phase up safely.
BONGOMEEN: The safety and protection protocols is the one thing that we don't negotiate with. There's not so much room to play with that.
AIZENMAN: This is something you hear a lot in Sierra Leone right now. Ebola has been surging through the capital and northern districts since September. Yet, it's taking the international community weeks to build and full open promised treatment centers. In the meantime, most sick people are being directed to makeshift government-run centers like this place.
BAIMAUR LAMINANGBATU: So can I just take you along the building now?
Baimaur Laminangbatu heads a chiefdom of several hundred villages. We meet in one of them, in front of a one-story, yellow cement building surrounded by jungle.
So this place is normally a school?
LAMINANGBATU: It was a school, yes. It was closed because of the Ebola. Now we are using it as an Ebola holding center.
AIZENMAN: The chief has asked some neighborhood teenage boys, who have no school to attend for now, to hack away brush to clear a path for ambulances.
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AIZENMAN: The care on offer is limited. Officially, these holding centers are supposed to be triage outposts. But with the real treatment centers so backed up, many people may end up dying here. Effectively, the main function of this place seems less to help people than to prevent them from infecting others.
LAMINANGBATU: If we allow that sick to be within the community, it will spread. And all of us will die.
AIZENMAN: Nearby, another holding center is being expanded.
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CORRADO CONCEDA: Well, this is the entrance to the red zone.
AIZENMAN: Dr. Corrado Conceda is with the aid group Partners in Health. And he says this idea that Sierra Leoneans have to die while the international response scales up, it's unacceptable. He asks, why should people here get any lower standard of care than Americans or Europeans?
CONCEDA: Absolutely, everybody deserves the same level of care. That should always be our goal and our guiding principle.
AIZENMAN: Conceda has begun by helping to turn this existing holding center into a full-on treatment facility, using IVs and bringing in overseas staff and trainers in a matter of days, not weeks. He says there's no time to build from scratch. And he totally rejects the idea that Ebola is such an exotic, unbeatable disease that it has to kill so many people.
CONCEDA: No, no, no. I mean, it does here. But it does here because there's not the resources to take care patients properly.
AIZENMAN: As soon as possible, Conceda wants to start using lab tests to monitor patients' organ function and tweak electrolyte levels, the things American and European hospitals have been using to support their Ebola patients to such great effect. The key to getting there, he says, is to maintain a sense of moral outrage. As long as people are dying, what you're doing is never enough. Nurith Aizenman, NPR News.
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