As well as a flood of patients, the only working Ebola treatment centre in Sierra Leone has to deal with rumours of organ harvesting and infected patients who hide, says Anja Wolz, an emergency coordinator at the Médecins Sans Frontières (MSF) Ebola treatment centre in Kailahun, Sierra Leone.
What is the situation at your treatment centre in Kailahun?
We have a capacity of 80 beds, but in the last 6 weeks, we have seen 260 patients, of which 170 have been confirmed to have Ebola. We've had 89 deaths and 36 patients who have recovered.
We are also working on health promotion – informing people about the virus and how to prevent it. There is a lot of misinformation out there, so we train community health workers and traditional healers, but there are still people with Ebola who are hiding.
Why are people with Ebola hiding?
They are afraid. We've had 89 deaths at the centre. People think that, because there is no treatment available, they will come here to die.
There are a lot of rumours that we are cutting off heads. Or that we are taking organs and selling them. At the same time, some people are saying that Ebola does not exist.
So the outbreak might be worse than we think it is, because there are infected people unaccounted for?
It's an important point. The epidemiological system is not functioning here. We should be tracking survivors and people with the virus. If we could see where they are going, we could react, and inform those villages about Ebola. But we only have four epidemiologists here, so this is really difficult.
What would make it possible to track infected people?
We need epidemiologists. We need experienced doctors. We need health staff and infection control staff. We need a greater social mobilisation effort. We also need more money. The World Health Organization has said it has a $100 million plan, and will send more experts, but we haven't seen anything in the field yet.
What's the atmosphere like in Kailahun?
Here in the city, people are more open about Ebola, and are seeking treatment. But there are real problems with isolated communities. For example, three weeks ago, a team from MSF visited a community that doesn't believe Ebola exists. They had carried out an unsafe burial of someone who had died from the infection. Traditionally, here, you undress the person, wash, clean and dress the body and then kiss the body without any protection.
To do a safe burial, you have to be protected, and you need to disinfect the body with chlorine solution, put it in a body bag and bury the corpse in a 2-metre-deep grave.
The MSF team did saliva tests, and found two people with a high virus load. Since then, our centre has received more than 30 patients from the village, all of whom attended this unsafe funeral. It's sad, because so many people have been infected, and so many people have died.
Why are people saying Ebola doesn't exist?
These villages are completely isolated – they have no internet, and not even network coverage for a mobile phone. When the health workers come by, the villagers think what they are saying is not true. Instead, we are now asking Ebola survivors to go to these villages, to tell the truth about what is going on.
What is the most difficult thing about your work?
The problem is too big. It's out of control. At the moment, we are the only functioning case management centre for Sierra Leone.
And we are nearly completely full. Every week there is a new village of cases coming.
People are starting to understand how big the problem is now, because a lot of people have friends, family and colleagues who have died from Ebola. The president has visited our centre. On Monday, Sierra Leone held a stay-at-home day, for people to reflect on Ebola and pray.
Are you afraid of contracting Ebola?
At MSF we have strict controls. The safety and security of our staff and patients is of the upmost importance. Everybody who works with us in the centre receives training, and if they don't respect protocol, their contract is terminated. We have full personal protective equipment – gumboots, overalls, two pairs of gloves, a mask with a hat and goggles. No part of the skin is exposed. We haven't had anyone infected so far in Kailahun, and we are very proud of that.
I personally have a lot of respect for Ebola. If I was to say I was worried or scared, I would be in the wrong job.
How are you coping personally?
It is difficult. You see a lot of people dying. But on Sunday we discharged nine survivors. This gives you your power back. You know you are doing your best. You say, OK, I know why I am here.