In the Ebola-stricken west African nation of Liberia, conditions facing health and aid workers on the frontline sound eerily post-apocalyptic.
Sanitation is lacking, there is no garbage collection, food distribution has become difficult and access to clean water is extremely poor.
Frontline: Aspen Medical has a clinic in Liberia to help with primary healthcare.
Borders are closed in some areas and there are checkpoints in others. In some smaller villages, deeply held beliefs about the handling of bodies and suspicion about the virus run strong.
For aid and health workers, it can be dangerous and confronting work and there is no definitive answer as to when the world’s worst-ever Ebola epidemic will end.
Inside Aspen Medical’s clinic in Liberia.
For the past several months, workers from a Canberra-based medical company have been on the frontline providing care in a developing nation which has seen its health system buckle under the enormous weight of the Ebola outbreak.
“Most Australians would just be staggered if they went over there and saw what the health workers are putting up with to be able to deliver those really vital services, and all of those health workers are really just doing an outstanding job in what is a very difficult situation,” said Glenn Keys, chief executive of Canberra-based Aspen Medical.
Aspen Medical had already set up a clinic in the capital Monrovia several months ago, before the Ebola outbreak.
But as efforts turned to the Ebola outbreak that was gripping the west African nation, primary healthcare became an unintended casualty of a medical crisis unlike any other in modern memory.
“Everybody is still going through the rest of their lives while the Ebola outbreak is happening – people are still having car accidents, they’re having heart attacks, children are still getting ill,” Mr Key said.
“There’s still quite a large need that I think is forgotten, which is that you still need to be able to provide primary care to the population while Ebola is being treated.
“One of the things that is very sad is that the public health system in Liberia has almost collapsed under the weight of the Ebola outbreak.”
And so companies like Aspen Medical have stepped in to help meet that forgotten need.
“The local hospital, the JFK Medical Center, is almost inoperational due to the Ebola demand, so we’re seeing a large number of non-Ebola patients that are all just of the primary healthcare issues that you would want addressed if you lived there,” Mr Keys said.
He said Aspen was also talking to aid organisations and other countries about providing support for the Ebola epidemic and had been asked by the United Nations to provide extra staff in Ebola treatment facilities.
The Ebola crisis has created a challenging environment for workers on the ground. More than 6500 people across five West African countries have been infected and 3091 have died, according to the UN health agency.
Guinea, Liberia and Sierra Leone are three most affected countries and face enormous challenges in stopping transmission and providing care for all patients.
“People are seeing a range of things that really can be very confronting,” Mr Keys said.
“I think everybody is really learning as we’re going, because I don’t think we’ve ever seen anything quite like this in recent times.
“Our staff are being very careful – they’re doing a lot of infection control procedures, they’re doing a lot of management of patients. If we find patients that have fevers, which is the first indication of Ebola, then we direct them towards the treatment facilities.
“It is challenging for our people in our clinic. We have to make sure we’re managing the clinic, we’re treating our people, we’re forwarding Ebola patients to the appropriate facility and that we’re not infecting our clinic, which would then remove it as a treatment facility.”
For the half of dozen Aspen Medical staff currently stationed in Liberia, the work is not without its risks.
One of Aspen’s doctors contracted Ebola while working at JFK Hospital and helping to treat another infected doctor. He is one of the fortunate ones and has since recovered.
Co-ordinating efforts to control the outbreak is no easy feat and requires a mammoth logistical effort, which highlights why an international approach is needed, Mr Keys said.
“If the US government is going to open 1700-bed hospitals around Liberia to treat Ebola, the UK government is putting a 400-bed facility into Sierra Leone, you can imagine the number of people to fill those is thousands [and]the numbers of staff,” he said.
“With that you’ve got to provide accommodation, water, showers, food and kitchens, security.
“The logistics tale behind this to support even one 100-bed hospital is enormous and the country doesn’t have that infrastructure.
“If we think what happened in Queensland during the floods and what was required by the Queensland government and Australian government to assist in that, imagine going to a country where they don’t have that logistics network, they don’t have manufacturing and all of the food networks
Should the Ebola epidemic eventually be controlled, will still have left its scar on afflicted nations for a long time to come, Mr Keys said.
“Nobody has seen anything like this in recent times and certainly MSF [Doctors Without Borders] and the UN and the WHO are talking in the region of a minimum of six months to be able to get this under control,” he said.
“The country was already a developing nation and still requiring enormous abilities to move ahead, but this has just set the country back so far by the fact that there’s no sanitation going on, there’s no garbage collection happening, there’s little food distribution, there’s very poor access to clean water.
“Really what this shows is that it requires an international effort. And if we are going to do this, it is going to take everybody. No one country, the US or even the UN, can do this on their own. Everybody is going to have to chip in to provide those services.”