Last month, the United States made two promises to Liberia.
On Sept. 8, Obama pledged that the U.S. would construct a 25-bed hospital outside Monrovia, the capital, to treat health care workers. They've been bearing the brunt of the outbreak: In Liberia alone, at least 188 health workers have been infected and 94 have died.
Then, on Sept. 16, Obama announced a massive response to the outbreak, involving thousands of U.S. troops on the ground to train health care workers, deliver relief supplies and build 17 Ebola treatment centers for the general public.
At the time of the announcement, Obama stressed that time is of the essence. "It's spiraling out of control. It is getting worse. It's spreading faster and exponentially," he said at the Centers for Disease Control and Prevention in Atlanta. "Today, thousands of people in West Africa are infected. That number could rapidly grow to tens of thousands."
Yet progress on the hospitals has been slow.
As NPR's Jason Beaubien reports from Liberia, a month later, workers are still spreading gravel on the construction site of the 25-bed hospital. Standing on the side are dozens of locals looking for work.
Without health care workers, the hospital won't be able to open its doors. NPR's Nurith Aizenman is in Anniston, Ala., where officers from the U.S. Public Health Services, who will run the hospital, are supposed to get trained by CDC.
Right now, she tells Morning Edition's Steve Inskeep, only eight of the 65 people needed are there.
"Quite a number of [officers] are being delayed for all sorts of reasons," she says. "I'm told not all of them have passports, they have to get all the vaccinations that you need to work in West Africa — so they're not scheduled to get this training for another two weeks."
And this round of training is just the preliminary three-day course. "There's more training to come," she says.
At this rate, the earliest the hospital can open its doors for business is possibly around the end of October — about seven weeks after the hospital was promised.
"Maybe that is a reasonable amount of time to staff up a hospital from scratch," Aizenman says, "but reasonable amounts of time are a luxury that we don't really have in this outbreak."
The 17 other treatment units that Obama promised are also under construction, though Beaubien reports that the U.S. military expects those to be fully operational in 60 to 90 days.
Our photo gallery checks in on the progress of these projects.
STEVE INSKEEP, HOST:
The West African nation of Liberia faces questions on a far larger scale about health care workers. The United States is now helping to build a 25-bed hospital in Monrovia, the capital, specifically for people who care for those with Ebola. Let's start our coverage of this with NPR's Jason Beaubien. He's in Monrovia. Jason, what are you looking at right now? What have you been seeing?
JASON BEAUBIEN, BYLINE: So I'm currently at a construction site of what is going to be an Ebola treatment center going up quite rapidly right downtown, in downtown Monrovia. There's also another facility out by the airport which is this U.S. hospital - this 25-bed U.S. hospital that is going to only treat health care workers who have gotten infected when they were treating people in facilities, like the one that is being constructed right around me at the moment.
INSKEEP: OK. So there's construction of a hospital that you're looking at, which is for Ebola patients, construction of a different hospital for people who care for them. Now let's talk about why there would be a separate facility with NPR's Nurith Aizenman. She's in Anniston, Alabama, which is where American personnel are being trained to run that second facility. Nurith, why would there be a second facility?
NURITH AIZENMAN, BYLINE: Yeah. The administration pledged to build this second facility nearly a month ago, on September 8, even before they revealed their broader response plan. And the idea is to address one of the major challenges of this outbreak, which is that so many of the health care workers who are taking care of Ebola patients are getting sick themselves. In Liberia alone, 188 health care workers have gotten infected and 94 have died, and this is a country that does not have a lot of trained medical workers to spare. And just as importantly, their deaths are discouraging thousands of additional health care workers who are needed in Liberia from signing up to help. So setting up this special hospital is the U.S.'s way of reassuring workers, of telling them if the worst happens, you'll be taken care of.
INSKEEP: And who are the people who are being trained to do that where you are in Alabama?
AIZENMAN: So it's going to be run by personnel from the U.S. Public Health Service Commission Corps. They're under the Surgeon General, and they're all public health professionals. But - and here's the catch - they need to be trained to provide Ebola care, and that process is taking time.
As you said I'm here in Anniston, Alabama, where the CDC is providing this training. It's not just for the government workers, but also for medical professionals who are going to Liberia with NGOs. And only eight of the people who will ultimately be running this hospital for health care workers are at this week's session; they're the only ones to get trained so far.
INSKEEP: Given the scale of this story, that doesn't seem like a lot of people.
AIZENMAN: Right. So it's going to take roughly 65 officers of the Public Health Service to run the hospital, but quite a number of them are being delayed for all sorts of reasons. I'm told not all of them have passports. They have to get all the vaccinations that you need to work in West Africa. So they're not scheduled to get this training for another two weeks, and this is just a preliminary three-day course; there's more training to come.
There's a lot that goes into running an Ebola ward safely. So to get this hospital open for business, we're looking at possibly the end of this month at the earliest, and that would be about seven weeks since the hospital was promised. And maybe that is a reasonable amount of time to staff up a hospital from scratch, but reasonable amounts of time are a luxury that we don't really have in this outbreak. Just in the time since the hospital was proposed, we've already seen the number of Ebola cases in Liberia more than double.
INSKEEP: OK. So that's where the training stands. Let's go back to Jason Beaubien. You briefly described the construction, Jason, but how does the construction stand?
BEAUBIEN: So, you know, the U.S. has promised to build 17 other hospitals on top of that one hospital that we're just talking about. And they have broken ground on one of them so far - 1 of these 17. You know, they're saying that there could be 4,000 U.S. troops that are involved in this overall effort. Well, right now they've only got 256 of them on the ground here.
There's some criticism that things are moving slowly, but talking to military officials here, they're saying - U.S. military officials - they're saying that, you know, the weather has been a real problem. It's been the rainy season. It's been very hard to get construction going. And they're also saying this is a sovereign nation here; they can't just drop hospitals out of the sky and, you know, plump them down somewhere and all of a sudden they're working. They have to work with the local government, and that's slowing things down.
INSKEEP: You're educating me on something here. You're saying it is U.S. troops who are actually doing the construction in Liberia?
BEAUBIEN: Yes. Its U.S. troops that are basically overseeing it. They are working with local contractors to do the actual - like, run the bulldozers and things like that. But it's Navy Seabees who are out there right now sort of organizing these sites, getting them prepared. And then they're going to be actually setting up the tents that these Ebola treatment centers will be in.
INSKEEP: How long will it take them to be up and running on the scale that they want to be?
BEAUBIEN: They're saying it's going to be 60 to 90 days before these full, 17 hospitals that the U.S. has promised is going to be up and running.
INSKEEP: So let's talk about what that means in real terms. And let's be fair, 60 to 90 days to get hospitals up and running, that's actually quite a short time. But aren't there projections that within a few months, we could be looking at - if things do not change - a vast number of Ebola cases in West Africa?
BEAUBIEN: Yes, absolutely. And this also comes back to health care workers as well. I mean, the hospital that I'm standing at right now - they're about to finish it this week, and one of the questions is as soon as they do get it constructed, they don't yet have the personnel to run this. And that's also going to be an issue at the U.S. hospitals. The U.S. is going to build these facilities; they are not going to be providing care there; that is going to have to be done by somebody else. It's not going to be U.S. soldiers or U.S. personnel providing personal care to the Ebola patients there. So that is going to be challenge down the road in terms of getting those actually up and running as effective Ebola treatment centers.
INSKEEP: Jason, thanks very much.
BEAUBIEN: You're welcome.
INSKEEP: That's NPR's Jason Beaubien in Monrovia. And we've also been talking with NPR's Nurith Aizenman who's in Anniston, Alabama, where Americans are being trained to treat Ebola health care workers in that facility in Liberia. Nurith, thanks very much.
AIZENMAN: You're welcome, Steve.
INSKEEP: And you can see for yourself how the hospital construction is going in Monrovia in a photo gallery, which you can find at npr.org. Transcript provided by NPR, Copyright NPR.