Sunday, September 28, 2014

U.S. Troops Battling Ebola Get Off to Slow Start in Africa
Body of Ebola victim being removed.
Rare Military Effort Comes as Concerns Mount Over Epidemic's Expansion

By DREW HINSHAW in Robertsville, Liberia, and BETSY MCKAY in Atlanta
Sept. 28, 2014 8:06 p.m. ET

The American military effort against history's deadliest Ebola outbreak is taking shape in West Africa, but concerns are mounting that the pace isn't fast enough to check a virus that is spreading at a terrifying clip.

On Saturday, a handful of troops from the Navy's 133rd Mobile Construction Battalion led a bulldozer through thigh-high grass outside Liberia's main airport, bottles of hand sanitizer dangling from their belt loops.

They had been digging a parking lot in the East African nation of Djibouti this month when they received a call to build the first of a dozen or more tent hospitals the U.S intends to construct in this region. The soldiers started by giving the land a downward slope for water runoff—"to keep out any unwanted reptiles," said Petty Officer Second Class Justin Holsinger.

While this team levels the earth, superiors hash out the still-uncertain details of the American intervention here.

The epidemic is showing signs of gaining speed—6,574 cases had been reported officially as of Sept. 23, with 3,091 deaths. Those fatalities are more than double the number of both a month ago. The actual number of cases is believed to be three or four times as high. Had no international aid come, the Centers for Disease Control and Prevention said, the number of cases in Liberia and Sierra Leone might have soared to 1.4 million by mid-January.

On Sunday, meanwhile, the National Institutes of Health said it is preparing to care for an American doctor who was exposed to the Ebola virus while volunteering in Sierra Leone.

"There is no argument the disease is out in front of the response," said Ken Isaacs, vice president of programs and government relations for Samaritan's Purse, who as an expert in humanitarian assistance is leading who is leading the relief organization's Ebola efforts in Liberia. In terms of response, he added, "where we are today is where we should have been 60 to 90 days ago."

A local health official checks the temperature of a newly arrived U.S. soldier at the airport in Robertsfield, Liberia, as other troops disembark. Glenna Gordon for The Wall Street Journal
Now, some help has arrived, partly in the form of a rare—if not unprecedented—U.S. effort. They will level swampy grassland, unload supplies and build tents, then train thousands of nurses from Sierra Leone and Liberia to treat Ebola.

The epidemic in Liberia and Sierra Leone will likely worsen until 70% of Ebola patients can find room in a treatment center or other setting where they can't transmit the disease to others, the CDC said. Currently, just 18% do so, it said.

On Sept. 16, President Barack Obama ordered 3,000 U.S. soldiers into West Africa. In a speech at the United Nations on Thursday, Mr. Obama criticized the international response thus far and said other donors—governments and organizations—need to step up quickly with aid.

"Right now, everybody has the best of intentions, but people are not putting in the kinds of resources that are necessary to put a stop to this epidemic," he said. More nations urgently need to contribute goods and services like health-care workers, equipment and air transport, he said.

Several countries and organizations have donated money and technical assistance, from the World Bank to Cuba, which is sending 165 doctors, nurses and other health specialists to the region. But more is needed, particularly because the health systems in Liberia, Sierra Leone and Guinea have been overwhelmed.

Other help is beginning to arrive. On Sunday morning, a privately contracted 747 cargo plane landed with 2,016 rolls of plastic sheeting from the U.S. government, one of the materials needed to build an Ebola clinic.

It would take hours to unload the plane, the crew said. Liberia's airport, built in 1942, had just three small forklifts. U.S. Air Force personnel will also have to repair the runway, or for the time being, just paint it so planes don't land on parts in disrepair.

"Some companies would rather go to Afghanistan than come here," said the plane's loadmaster, Felix Curtis.

In the cockpit, a nervous first officer was wearing surgical gloves, a medical mask on his seat. He shared a pen with a Liberian, then darted to the bathroom to wash his hands: "Am I going to be OK?" he asked.

The files on most of Liberia's Ebola cases are stored in three-ring binders on a shelf in an abandoned World War II-era chimpanzee testing lab, filled with bats. That is where the U.S. Army Medical Research Institute of Infectious Diseases conducts blood tests for Ebola. A small three-ring binder holds all the case files from April 15 to Aug. 12. A binder twice that size holds the files from just five days in late September.

"Well," said Alec Hail, the doctor who supervises the testing. "That's remarkable."

Even with the U.S. response, the CDC fears thousands more lives may still be lost. New centers are filling up as quickly as they are built. On Sept. 21, the World Health Organization opened its second clinic in Monrovia, Liberia's capital. By evening, every bed was taken.

"I don't think we can open them any faster," said head clinician Anne Deborah Omoruto Atai. Near the doctor's office, a fierce rainstorm was flooding part of the clinic.

Meanwhile, the embattled Liberian government is struggling to manage a response to the disease. Last week, an official at the health ministry—the focal point for the Ebola effort—died of Ebola.

Other workers abandoned the building, which on Thursday was being sprayed with chlorine. The next morning, the chief medical officer placed herself under 21-day quarantine, on concerns that she had been exposed.

That situation has created a desperate groundswell of support for the U.S. military mission here. "We want the U.S. Army to take over this entire situation," said Sarka Weah, among a group of men watching the naval unit bulldoze the field.

"Yes!" screamed the others.

The clinic will only hold 25 beds, and not for ordinary Liberians: just health workers. U.S. officials hope it will entice other countries to send their own nurses and doctors.

"It's hard to know where all they'll come from," said Frank Mahoney, who heads the CDC's Ebola response in Liberia.

This month, the U.S. Agency for International Development helped Liberia's government convert an unused conference room in a telecommunications building into a war room. The U.S. aid agency had 12 tables wooden built, helped restore running water to the toilets and brought in filing cabinets from the U.S. Embassy, said people involved that effort.

Last Tuesday evening, James Dorbah Jallah, the national coordinator of Liberia's Ebola Task Force, sat in the war room trying to get bottled water delivered to an Ebola clinic that had run out.

"It's not possible," said the supervisor of the government's motor pool over speakerphone. "Everybody's gone home."

Write to Drew Hinshaw at and Betsy McKay at

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