“It’s pretty scary,” said Alexis Moens, a Doctors Without Borders logistician who was helping to set up the new, more secure isolation ward for Ebola patients.
“This is a dangerous place,” said Mr. Moens, adding that he washed his hands 50 times a day.
“There’s no system; there’s no isolation,” he said. “You make mistakes here, you get infected.”
So many patients, nurses and health workers have died in the government hospital that many people in this city, a center of the world’s worst Ebola epidemic, see it as a death trap.
Now, the wards are empty in the principal institution fighting the disease. Ebola stalks the city, claiming lives every day, but patients have fled the hospital’s long, narrow buildings, which sit silent and echoing in the fading light. Few people are taking any chances by coming here.
“Don’t touch the walls!” a Western medical technician yelled out. “Totally infected.”
Some Ebola patients still die at the hospital, perhaps four per day, in the tentlike temporary isolation ward at the back of the muddy grounds. But just as many, if not more, are dying in the city and neighboring villages, greatly increasing the risk of spreading the disease and undermining international efforts to halt the epidemic.
“People don’t die here now,” said the deputy chief of the hospital’s burying team, Albert J. Mattia, exasperated after a long day of Ebola burials. “They are dying in the community, five, six a day.” Mr. Mattia was particularly disturbed that many of the bodies his team were putting in the ground had come from outside the hospital, thwarting attempts to isolate patients and prevent them from passing the disease to others.
“It’s very, very dangerous, very hazardous; it is contributing to the Ebola dead,” he said as his two deputies nodded glumly in agreement. “You go to the wards, there are no patients.”
Containing the virus in Kenema — one of the nation’s largest cities and a gateway to an area of the country where the disease is rampant — is critical to taming the epidemic’s deadly advance across PARTS of West Africa. More than 930 people, including over 280 here in Sierra Leone, have died since the outbreak was first identified across the border in Guinea in March.
Since then, Sierra Leone has been hit with more cases of the disease than any other nation — 691 out of 1,711 at last count — and the hospital in Kenema quickly became a focal point in the effort to grapple with the epidemic when the government set up a treatment center here for cases in the region.
International health officials have concentrated intensively on the hospital in the last several days, training healthcare workers, preparing a more secure isolation ward, establishing the rigorous separation of zones — low risk, high risk — that characterizes the tightly sealed Doctors Without Borders Ebola facilities elsewhere in stricken West Africa.
But it is a tough struggle, and the recent history of the hospital looms. More than 20 health care workers at the hospital have died trying to battle the disease over the last several months, including nurses, support staff and the country’s leading doctor.
“There’s a perception in the population that it is a dangerous place,” said Philippe Barboza, an epidemiologist who heads the World Health Organization team here. “ ‘The farther one is from the hospital, the better,’ ” said Mr. Barboza, summing up the widely held sentiment. “Even to have a meeting here is difficult.
Elsewhere in the region, the battle against the disease is equally difficult. Dr. Fazlul Haque, the deputy representative of Unicef in Liberia, said health workers were struggling to keep up with the rapidly growing number of cases. Some hospitals are closed, he said, in part because health workers are afraid of getting sick — 63 health workers in Liberia have been infected so far, he said, with more than 30 deaths.
In the past week alone, about six medical staff members at a Catholic hospital in the Liberian capital, Monrovia, and 23 health workers in Bong County were infected, he said.
Liberia’s president, Ellen Johnson Sirleaf, declared a state of emergency this week, calling it necessary “for the very survival of our state and for the protection of the lives of our people.” The government has already quarantined some communities, including parts of western Liberia to stop the spread of the virus from Sierra Leone.
Dead bodies have been appearing on the streets and in houses throughout Monrovia, with people staging roadblocks to ensure that health workers remove them. But with hospitals closed in the capital, it was unclear how many of the victims had died of Ebola, or from other causes. A health worker said his burial team, one of twelve, picked up seven bodies in Monrovia and surrounding areas on Thursday alone.