CHARLOTTE, N.C. -- The hospital in Liberia where three American aid workers got sick with Ebola has been overwhelmed by a surge in patients and doesn't have enough hazard suits and other supplies to keep doctors and nurses safe, a missionary couple told The Associated Press on Wednesday.
The latest infection -- of Rick Sacra, a doctor who wasn't even working in the hospital's Ebola unit -- shows just how critical protective gear is to containing the deadly epidemic, and how charities alone can't handle the response, they said.
Nancy Writebol and her husband, David, called for reinforcements during the AP interview, which followed her first news conference since recovering from Ebola disease. They work for North Carolina-based SIM, the charity that supports the ELWA hospital in Monrovia, Liberia.
About 250 staffers at the hospital use thousands of disposable protective suits each week, but that's not enough to fully protect the doctors and nurses who must screen people entering the emergency room or treat patients outside the 50-bed Ebola isolation unit, they said.
"We don't have enough personal protective safety equipment to adequately be able to safely diagnose if a patient has Ebola. So they are putting themselves at risk," David Writebol said.
Sacra, 51, a doctor from suburban Boston who spent 15 years doing missionary work in Africa, felt compelled to return to Liberia despite these challenges. As soon as he heard that Dr. Kent Brantly and Nancy Writebol were sick, Sacra called and said "I'm ready to go," SIM President Bruce Johnson said.
Sacra's job was to deliver babies at the hospital and take care of patients who were not infected with Ebola. He followed all the protocols to protect himself, said Will Elthick, the group's operations director in Liberia.
But Sacra got infected nonetheless by the virus that has killed more than 1,900 people and sickened 3,500 in five West African nations.
The disease is spreading faster than the response in part for lack of protective gear, said Tom Kenyon of the U.S. Centers for Disease Control and Prevention. At least $600 million is urgently needed to provide these tools and extra hazard pay so that more doctors and nurses are willing to risk their lives, the World Health Organization said Wednesday.
Health care workers at other West African hospitals have gone on strike demanding more protections, the Writebols said.
"They see colleagues who have fallen. They don't want that to happen to them. But they are saying, 'I can't go to work safely until there is personal protective equipment available -- the right gear, the right procedures in place. And then, if they don't go to work, are they going to get paid?" David Writebol said.
The Writebols left Charlotte for Africa several years ago; David helped with the hospital's technology while Nancy helped dress and disinfect people entering and leaving the Ebola unit at ELWA, which stands for Eternal Love Winning Africa.
Liberians were already struggling to survive when they got there, but with Ebola it's chaos -- the number of patients is surging, finding food and supplies is more costly, schools are closed and people with common injuries or even mothers in childbirth can't get care.
Ebola has "overwhelmed the supply chain," David Writebol said. "They can't get equipment in because there aren't any regular flights coming in. Same thing with aid workers from the international community. There are only a limited number of seats available to come into Liberia. ... That's one of the biggest problems -- getting medicine, protective gear and supplies for health care workers who are there."
Nancy Writebol said people who showed up at the emergency room with symptoms were ushered into triage. But health workers were sometimes exposed as they screened patients who may not have known or advertised that they were carrying the virus.
And sometimes, the sick would leave before finding out if they had Ebola. "Those are the people you really worry about going back into the community, because if they are sick with Ebola, it will ultimately spread," she said.
Sacra immediately got tested for Ebola after coming down with a temperature, his brother Doug Sacra told the AP. Like his colleagues he also went into isolation to avoid spreading the virus.
Some other doctors haven't been so rigorous.
The WHO announced today that a doctor in southern Nigeria was exposed by a man who evaded surveillance efforts, and then in turn exposed dozens of others by continuing to treat patients after he became ill. Then he died, and his family and church members followed their funeral traditions by laying their hands on his body.
Now his widow and sister are sick and about 60 others in the city of Port Harcourt are under surveillance.
Sacra, who left his family at home for this latest trip to Africa, was in good spirits Wednesday and able to send emails, Elthick said. That could mean he's physically well enough to be evacuated.
His wife, Debbie, said in a statement that she's focusing on her husband, but she said "Rick would want me to urge you to remember that there are many people in Liberia who are suffering in this epidemic and others who are not receiving standard health care because clinics and hospitals have been forced to close.
"West Africa is on the verge of a humanitarian crisis, and the world needs to respond compassionately and generously," she said.
It's not clear where Sacra would be treated in the U.S. Experts say any fully-equipped hospital that follows safety protocols could prevent an American outbreak while caring for an Ebola patient. But there are four high-level isolation units designed especially to handle dreaded infectious diseases.
The largest is at the Nebraska Medical Center in Omaha, which was told to prepare to receive a patient, but they were told the same thing before Brantly and Writebol were evacuated instead to Emory University Hospital in Atlanta, medical center spokesman Taylor Wilson said Wednesday.
The other two units are National Institutes of Health facilities in Maryland and Montana.
Meanwhile, health care workers in Africa are dealing with the impossible every day.
"To watch so many people suffer and die was horrendous. It was horrible some days," Nancy Writebol said.
"But, to be able to encourage their families and to come alongside families that are grieving, there's hope in that. And, to be able to see a survivor? I mean, oh my goodness. To watch that little boy walk out as a survivor and then to see another child who survived and then to hear -- even today -- that 12 walked out, that's what it's about."