Sierra Leone doctors call for better Ebola care for colleagues.

As Ebola rages through Sierra Leone, local health workers are among the hardest hit. Data from the US Centers of Disease Control and Prevention show that nearly 200 health staff (different cadres) were infected between May 23 and Oct 31 this year. According to media reports, 12 doctors are among the country’s health worker cases, ten of whom have died. In early December, the Junior Doctors Association of Sierra Leone (JUDASIL) staged a strike, calling on authorities “to hastily facilitate the establishment of a specialised treatment centre for health workers”. Sierra Leone already has an Ebola treatment unit designated for health-care workers, which opened last month, but local doctors are blocked from accessing it. Staffed by British Army medics, at the British-built Ebola treatment complex in Kerry Town, the 12-bed health-care workers’ unit only accepts local health-care workers from UK-funded Ebola treatment facilities, according to a letter from British authorities titled “Access Criteria for Kerry Town 12-bed Facility” that The Lancet has obtained (appendix). UK Department for International Development senior press officer Angela Balakrishnan confirmed that the health-care workers’ unit is available for British and Sierra Leonean health-care workers who work at “a UK-supported facility”. Most Sierra Leonean doctors and all of the country’s junior doctors work at government hospitals, so they are ineligible for admission. Junior doctor Ibrahim F Kamara who is on JUDASIL’s executive told The Lancet that he thinks the British misled the country about their intentions when they described the facility they were going to build. “We’re disappointed”, he said. By contrast, the 25-bed unit that the American military built for health-care workers infected with Ebola in Liberia accepts any international and Liberian health-care workers. Staffed by the US Public Health Service Commissioned Corps, the Monrovian Medical Unit has provided care for 16 patients since opening its doors in early November, including six who recovered from Ebola and two who were never infected, according to the Lieutenant Commander Kate Migliaccio of the Commissioned Corps.