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In West Africa, Health Care Infrastructure Crumbles With Ebola Deaths

MELISSA BLOCK, HOST:

The president of Doctors Without Borders, Dr. Joanne Liu, has been sharply critical of the weak and late international response to Ebola. And she worries that now U.S. attention has been distracted by the few cases here at home when a massive response is needed to the epidemic raging in West Africa. Doctors Without Borders has decades of experience on the front lines fighting Ebola in Africa. But Doctor Liu told me the scale of this outbreak is unprecedented.

JOANNE LIU: Before our biggest centers were about 30 beds, 40 beds. Now, we are at 200, 250 beds. There's nothing like this that we've been faced with before. But by the fact of having such big centers, we are contracted on a daily basis to numerous cases of death. And being confronted with death on a daily basis, it's absolutely distressing, if not traumatizing, for our staff. Since the case fatality rate is between 50 to 70 percent depending when people are presenting, it means that in a center of 200 beds, you can imagine how many people you will have to - I will have to say take care and accompany towards their last journey. So that is absolutely distressing. The other thing that we've never done before is building crematorium - that, as far as I'm concerned, MSF has never done that. And we're so upset by that. I keep telling myself, MSF, Doctors Without Borders, we are meant to save lives and ensure people will live, but not take care of dead bodies.

BLOCK: With so much focus on Ebola right now in West Africa, what's happening with regular care, the work that you would ordinarily be doing in terms of infectious disease or delivering babies, anything like that?

LIU: Right now what we're facing - it's the collapse of health care infrastructure. Right now, the WHO data is saying that there were about 400 health care staff infected in the region, half of them have died. I think these are underestimated figures. So what we are facing right now is the fact that we don't have enough staff - medical staff - to run medical facilities. And in some places where we can still run medical facilities because there were so many people who were infected or because there are still some currently people infected, it became a vector of infection to the population. So now we are facing what we call the emergency within the emergency, it's the access to basic health care. And right now, we are facing the ridiculous situation that someone might not die of Ebola, but might die of malaria that is easily treatable or an HIV patient doesn't have access for his anti-retroviral medicine for the last few weeks, if not the last few months. So this is a disastrous situation in terms of basic health care access.

BLOCK: It does seem that Doctors Without Borders is able to set up treatment centers quite quickly - much more quickly than it's, for example, taken for the U.S. government to set up treatment centers in Liberia. What are you doing that makes you more nimble than big government response?

LIU: I think that it's the fact that we have done it before. So we have some of the know-how. On the other end, I think that people are overinflating how complex it is to open and run an Ebola center. What it needs, actually, is organization, discipline and a fair amount of courage for people who are going to be working in it. But it's not that complicated, so I think that somehow today, people are a bit paralyzed by fear.

BLOCK: Dr. Liu, thanks so much for talking with us.

LIU: Thank you, bye-bye.

BLOCK: That's Dr. Joanne Liu. She's the international president of the aid group Doctors Without Borders. She spoke with us from Barcelona. Transcript provided by NPR, Copyright NPR.

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