1. This is ELWA, one of Liberia’s biggest hospitals, and home to the capital’s Ebola treatment centers.
Liberia’s assistant health minister told BuzzFeed three weeks ago that the facility had no more room, and symptomatic patients — in other words, contagious patients — were waiting in cars outside. It’s been full ever since.
2. For weeks, the Ebola isolation ward here has been out of space.
This is the original isolation ward, which has been stretched to handle around 30 people. On Wednesday, five patients lingered at these gates, begging to be let in, but there was no room. They waited for more than five hours — until 10 people died, and their beds opened up.
3. With no beds, patients wait under trees for the chance to get medical attention.
Down the road from the original, over-subscribed isolation facility, a dozen people, mostly women, sat outside, in blustery wind and steady, sometimes torrential rain, hoping for a bed.
4. Kona Kupee couldn’t stop shivering.
On Thursday, Kona sat outside her house. Inside, her husband, Alosho Mumbah, had just died. Or so Kona assumed, when everything went quiet, but she was too afraid to go in and check.
Alosho had been sick for a week, and for a week he’d been calling a health hotline that is supposed to take the sick to the hospital or the dead to the crematory. No one came while he was sick. In fact, no one came until Saturday, two days after he died.
The next morning, Kona came to ELWA, terrified Alosho had had Ebola — and that she had caught it too.
5. Across an empty field from where the women waited, Doctors Without Borders is setting up a new isolation facility.
MSF, as the organization is known (a French acronym), was preparing a 120-bed case management facility Sunday morning. It’s the kind of facility that’s commonly called an “isolation ward.”
6. There are 60 beds for patients who suspect they have Ebola, but haven’t confirmed that with test results yet.
It can take several days of persistent calls to get someone to test you for Ebola, and the test results take at least a day to come back. MSF hopes to see more lab facilities in Liberia.
7. There are also 60 beds for confirmed Ebola patients. On Sunday, MSF moved nine people into beds here.
There’s no cure and no proven vaccine for Ebola. A patient’s best shot is to keep hydrated and get to a health center early — a real challenge in a country that doesn’t have enough beds for the sick.
That also makes MSF’s facility a challenge to open. The group admitted 12 patients altogether on Sunday — nine confirmed and three suspected cases — but it has to move slowly, making sure the protocols work, the staff is confident and comfortable, and everything is running smoothly before it operates at full capacity.
8. Every inch of space in a case management center has to be meticulously planned.
The latrines in the MSF facility are larger than usual. That’s because diarrhea is a common symptom of Ebola, and it’s not uncommon for patients to die in the latrine. This space has to be big enough for workers to get bodies out safely.
9. Most confirmed cases won’t survive.
There are somewhere between 20 and 50 survivors of Ebola in Liberia, where more than 700 cases have been reported. So MSF’s facility also needs a space like this — a morgue.
10. Families of suspected or confirmed Ebola patients often struggle with their loved one’s diagnosis. Keeping in touch, by keeping a cell phone fully charged, makes a big difference.
Ane Bjorn Fjeldsieter, a psychologist, worked at MSF’s facility in Sierra Leone before coming to Liberia. In Sierra Leone, she met a woman whose husband had had “high risk contact” — he’d touched the fluids of an infected person.
“He knew he was probably infected,” she said. “He didn’t have any symptoms yet but he started isolating himself in the house. One morning, he got out of bed and said to her, ‘I love you and I know you love me, but I will never share this bed with you again.’”
Miraculously, the man tested negative, and his wife took him home.
11. Kona isn’t going to have that kind of luck.
She didn’t know Alosho and his brother had participated in the burial of a sick relative in the rural north. His brother had died a few days before Alosho. As she sat outside the house on Thursday, describing the daily phone calls to a dozen numbers she and her family had made, she teared up. But she believed her house might still be Ebola-free.
Today, she had no doubt. “It’s just like him. This headache. These knees,” she said, squinting in pain. She wore a wool sweater, wool gloves, and she wrapped herself in wide pieces of fabric. “I’m so cold,” she said, and her body shook uncontrollably.
“I want a doctor. I want some medicine. I want to get in there,” she said, staring at the clinic being built. “I don’t want to die.”
7 p.m. ET — MSF screened the patients waiting under the tree, and those suspected of having Ebola were admitted to the new center, an MSF employee told BuzzFeed.