In July, reported cases of Ebola appeared to be decreasing in Conakry, Guinea’s capital and the first major city to be affected by the ongoing outbreak in West Africa. Of late, however, there appears to have been a massive spike in new cases, and Doctors Without Borders/Médecins Sans Frontières (MSF) is now caring for more than 120 patients—85 of whom are confirmed to have the virus—in its two case management facilities in the country, in the cities of Conakry and Guéckédou.
The Donka Ebola management center in the Ministry of Health hospital complex in Conakry has been particularly badly affected. The facility admitted 22 patients on October 6 alone, 18 of them from the Coyah region, 50 kilometers [30 miles] east of Conakry. There are now 62 patients in the Donka center, which has 60 beds, and staff are rushing to add 14 more beds to the facility.
The Donka center has been able to respond to previous peaks by adapting its capacities. But with the arrival of so many new patients—including children—the center is stretched to the limit of the physical space where it is located.
Stephane Hauser, MSF field coordinator at Donka, noted that case numbers have increased steadily since the end of August: “Right now there are three transmission chains in four neighborhoods of Conakry. With this new chain in Coyah, whose origins we don’t know at the moment, and the ones in Forecariah and Dalaba, which are known but not well-understood, we risk becoming overwhelmed.
“Since the beginning we’ve adapted by scaling up,” he continued. “But renovating the site to increase available space may simply not be enough.”
At the moment, more than 130 people are working around the clock at the Donka treatment center. Their work has clearly had an impact: out of the 220 confirmed cases admitted since the center opened, 105 have recovered.
Today, however, the medical and sanitation teams, worn down by several months of exhausting work, must be reinforced in order to guarantee the quality of care. “Our teams are showing incredible dedication,” says Hauser. “Faced constantly with death, sometimes even those of their own colleagues, and working in difficult conditions—not one person has quit.”
To relieve some of the pressure on its teams, MSF is actively training others who can step in. The teams have carried out training sessions for health care workers with the Ministry of Health and the water and sanitation personnel of local organizations like the Guinean Red Cross, who are expected to start working in other health facilities. But faced with the high number of patients currently needing care, these people will remain part of the team at the Donka facility for now.
“I am really concerned that one day I will be forced to make the decision to turn patients away because of a lack of space,” concludes Hauser.