The $22-million, 25-bed field hospital the Pentagon has pledged to build in Liberia to combat the Ebola epidemic is being set up "to treat health care workers," a Pentagon spokesman said Tuesday.
Michael D. Lumpkin, the assistant secretary of defense for Special Operations/Low-Intensity Conflict, spoke on a call with several journalists.
Nancy Lindborg, the Assistant Administrator for the Bureau for Democracy, Conflict and Humanitarian Assistance of U.S. Agency for International Development, which leads the U.S. government response on Ebola, clarified on the call that the health workers for whom the facility is meant are foreign health care workers, not Liberians.
"The goal is to provide assurance for health workers" who have or might volunteer to go to any of the affected countries. Liberia, Guinea and Sierra Leone have been the worst hit, and Nigeria is seeing its small number of cases rise, as the death toll hit nearly 2,300 on Friday.
Health workers, both local and international, "have been extremely courageous and that's everybody from the technicians to the nurses to the doctors," Lindborg said.
Lindborg said that the facility is being set up for foreign health workers, not domestic health workers. A press officer later reconfirmed the plans to BuzzFeed News by telephone.
International health agencies, from the World Health Organization (WHO) to Doctors Without Borders (which goes by the French acronym, MSF), agree that the lack of personnel is a major obstacle in responding to the outbreak.
But until Tuesday's press call, no one understood the Pentagon's pledge, announced Monday, to be limited to foreigners — and if it the 25-bed facility were slated to serve Liberians, health workers wondered how such a small facility, with sophisticated trauma triage that has little to do with Ebola treatment, would be relevant.
Field hospitals are "very much surgery oriented; there are a lot of theaters and high intensive care," said Dr. Ian Norton, who is coordinating the foreign medical teams coming into Liberia and who had just returned to Monrovia after a week of fundraising. "It isn't as relevant for general Ebola care."
Norton didn't know at that time about the Pentagon's pledge. (And no one knew, today's press call, that the facility was reserved for foreign health workers.)
When Norton was informed by BuzzFeed News about the $22 million, 25-bed facility, he laughed.
By contrast, MSF expects to spend $39 million this year on Ebola response in Guinea, Sierra Leone and Liberia. The group has taken the lead in setting up treatment centers, which many public health experts consider the most important step in an Ebola response. The executive director of MSF-USA told BuzzFeed News, before the press call, that a 25-bed facility — even if it admitted Liberian patients — barely scratched the surface of what that country needs.
"We don't need 25 beds. We need 1,000 beds, yesterday," Sophie Delaunay, executive director of MSF-USA, said. "If this is the only offer that is going to be practically implemented on the ground, it's paltry in the face of all the needs."
USAID insists that it is contributing to the building of 1,000 beds — including with this 25-bed field hospital — but did not provide specifics about funding, location or staffing despite repeated phone and email requests.
Delaunay added that any pledge of beds without adding staff is "highly insufficient."
The WHO estimates that for every 100 beds in a facility, 200 staff are needed — 100 health care providers, and another 100 support staff who clean latrines, wash laundry, and disinfect health care workers leaving treatment tents, among other duties.
Lindborg said that USAID has pledged $10 million to support the African Union's promise to deploy 100 African health workers — 25 doctors, 45 nurses, and other support personnel — in the four affected countries (including Nigeria). No timeline for the deployment has been given.
"It's quite incomprehensible that there is such a disconnect between the clear needs that we see as front line responder[s]" and the latest U.S. government response, Delaunay said.
Jeremy Konyndyk, the director of the Office of Foreign Disaster Assistance, which is overseeing the U.S. response to Ebola in Liberia, later said on Twitter that the hospital will serve both foreign and local health care workers. The deputy press director for USAID, who moderated the call, did not dispute BuzzFeed's original story in an email to the reporter immediately following publication of the story. USAID has refused repeated requests, by email and telephone, for a follow-up interview. Konyndyk also did not reply to multiple requests for a follow-up interview.