1 Dec 2014

Why aren’t Britain’s Ebola centres in Sierra Leone ready?

The British government’s flagship Ebola treatment centre in Sierra Leone is running at only a fraction of its capacity as it continues to face challenges.

Kerry Town, Sierra Leone

The facility in Kerry Town, run by Save the Children on behalf of the Department for International Development, was opened almost a month ago. But only 20 beds are operational out of its 92 bed capacity.

Read more: Is British Ebola hospital in Sierra Leone up to the job?

The centre is the first of six being constructed across the country, worth £230m in total, with the aim of rolling out 700 beds and providing direct medical care to up to 8,800 patients over six months by mid-December. Apart from Kerry Town, facilities will be built at Port Loko, Makeni, Moyamba and two more centres in Freetown.

UK constructing treatment centre in Sierra Leone


UK constructing treatment centre in Sierra Leone. Credit: DFID

Kerry Town

A spokeswoman for Save the Children said the organisation was attempting to “scale up” gradually, but the process had been “complicated”. She said: “We always knew, and said publicly, the running and management of the Ebola treatment centre in Sierra Leone would be complicated and challenging.”

There have some been challenges with the operational build at Kerry Town which is not surprising. Save the Children

Speaking to Channel 4 News, she added: “Scaling up has to be done properly, safely, and with clinical advice. We expected to be at 30 beds at this stage, and we are at 20 and are admitting and discharging patients every day. This means that we will not always have 20 patients. We aim to open another 10 beds in the next fortnight.

“There have some been challenges with the operational build at Kerry Town which is not surprising, we have built and set up a very complicated medical facility in little more than nine weeks. There were a lot of challenges on the site, and inevitably these only emerge as we start to put pressure on the infrastructure. In order to operate safely we have to put these things right, we can’t do it after we have filled up.”

Save the Children hopes to be at full capacity by mid-January, but is aiming to reach the target by Christmas.

Cuban health workers in Sierra Leone

The first members of a team of 165 Cuban health workers arrive at Freetown’s airport to help the fight against Ebola in Sierra Leone, on 2 October.

World Health Organisation Director General Bruce Aylward praised Sierra Leone for “doing all things right” to tackle the virus, which has killed more than 1,500 people, despite admitting that only 40 per cent of cases had been isolated in the country. He said: “That capacity (to treat Ebola) at the district level is strong and getting stronger in Sierra Leone, and that’s why I think the prognosis is actually very good.”

Port Loko

Jonathan Edgar, chief operations officer for GOAL, told Channel 4 News that the facility in Port Loko was on target to open mid-December.

Mr Edgar, who is travelling to the country, said the Sierra Leonean health ministry would be handing over the centre with 100 beds this weekend. He said: “It will be difficult, and incremental at first.

We are apprehensive, but we have mitigated and looked at all risks possible. Jonathan Edgar

“It will really depend on the patients’ needs…but hopefully it will be filled before January.

“It will depend on the first week of it being dynamic. We are apprehensive, but we have mitigated and looked at all risks possible.

“We only have one objective, which is to fill the centre. It is unprecedented in terms of the scale.”

Moyamba

Dr John Wright, working with French organisation Solidarite to open a centre in Moyamba, said that £500m should have been invested into Sierra Leone, Liberia and Guinea in 2012, to stop the spread of the epidemic. The opening of the centre is scheduled for an initial capacity of 50 beds, with a potential increase to 100 in early 2015.

They were plunged into the deep end, without any opportunity to learn to swim. Dr John Wright

The Bradford-born public health activist wrote on his blog, that the facility in Kerry Town was “plunged into the deep end”. He said: “Kerry town started from scratch in a bespoke, but untested Ebola treatment centre. They were plunged into the deep end, without any opportunity to learn to swim. Their first month of operation has involved an enormous challenge of adapting their facility to the needs and demands of their patients.”

Freetown

EMERGENCY’s second Ebola treatment centre in Freetown is also expected to provide 100 beds for patients. Responding to Channel 4 News, it said it was attempting to ensure that there were sufficient staff and that they were “thoroughly trained”:

With more than 130 new cases of Ebola reported over the weekend in the west African region, the challenges faced by organisations on the ground grow day by day.