Aid organizations want to help Ebola patients, but it's not easy. Transporting aid supplies is becoming increasingly expensive, and donations are petering out, as a visit to Action Medeor revealed.

In a 3,000-square-meter (32,300-foot) warehouse in Tönisvorst near Krefeld, employees at the German medical aid NGO are working special shifts. They pull medicine, portable water reservoirs in backpacks, disposable gloves, face masks, and protective clothing for the doctors and nurses in direct contact with Ebola patients from shelves reaching as high as 4 meters (13 feet). They pack the shipment at a hurried pace. Health clinics in Ebola-infected regions ordered the supplies, which are essential for survival. Action Medeor works directly with these partners locally. Among them is the Gerlib Clinic in Paynesville, outside of Monrovia; the clinic is run by a German, Margret Gieraths-Nimene.

"It is unbelievable! Many places are lacking even the simplest things, such as rubber gloves," said Christoph Bonsmann, who oversees all deliveries and the activities of partner International Search and Rescue Germany (ISAR) in his role as pharmaceuticals expert and director of Action Medeor.

The health systems in Liberia, Guinea, and Sierra Leone are completely overwhelmed. "A lot of doctors and nurses got infected and died because they didn't have gloves," said Bonsmann. The Ebola virus is found not only in blood, but also in sweat from infected patients.

Mainly though, the countries are lacking isolation stations where patients who've potentially contracted Ebola can be segregated from the rest of the population.

"As soon as you can diagnose symptoms such as nausea and high fever, you have to react," Bonsmann said. The Ebola epidemic is like an avalanche. One infected person infects an average of 15 others, who in turn each infect 15 others if the chain is not broken. "Effective isolation is absolutely essential."

He and his team have managed to finance two isolation stations with a total of 44 beds. They're due to arrive in Liberia next week and are to be erected in Monrovia and be fully equipped and ready for use by the end of September.

Dwindling donations

The delivery of the two isolation stations almost didn't happen. According to Action Medeor spokesman Bernd Pastors, many well-known organizations - even at the national level ­- reneged on commitments or failed to respond to desperate pleas for assistance. In the end, the Else Kröner-Fresenius Foundation shouldered the entire 460,000-euro investment ($590,000) alone.

"There's a certain amount of donor fatigue in Germany in the face of the sheer number of crises in the world at the moment," said Pastors.

But the main problem in containing the crisis is not down to hesitation on the part of several governments; rather, it emerged at the highest possible level.

"The World Health Organization reacted too late and didn't give proper credence to warnings from organizations such as Doctors Without Borders," said Pastors.

Bonsmann agrees. Nor are the two men at the Action Medeor the only ones to level such an accusation. Many aid agencies have confirmed the slowness of the WHO to respond to the crisis. The fact that the UN institution only had a third of the financial resources needed at its disposal and had to raise funds to cover the main part of its operations has also been a distinct disadvantage. "We lost valuable time that can now only be made up with a tremendous effort," Bonsmann said.

An intensifying fight

On the desk of medeor manager Bonsmann are the most recent situation reports from UNICEF. They illustrate the dramatic changes. Where in late August a sum of six million dollars was needed for medical care to help fight Ebola, just ten days later, in September, the number had climbed to 75 million.

Additionally, where NGOs like Action Medeor were recently able to secure air freight prices of $3 per kilogram, today that number is 10.

"Today, for 8.5 tons of aid that we're sending, we now need $70,000 instead of $20,000," Bonsmann says. Just two airlines, he says, fly to the Liberian crisis region. The wages demanded by remaining aid workers in Ebola airs have also doubled since the cases of infection began increasing significantly.

Playing against time

Problems are compounding quickly. Working alongside Action Medeor are other groups from various aid organizatinos: Doctors Without Borders (MSF), or the German organizations Medica Mondiale and "World Hunger Aid" (Welthungerhilfe).

Bonsmann still sees problems, though. The number of Ebola patients requiring beds and assistance rises daily. Current demand for beds, according to WHO, is at least 1,000.

"In reality, right now there are just about 220 available," he said. Many people, worried they'll be infected by Ebola, no longer go to the medical centers, not wanting to spend the potential final days of their lives isolated from their families.

Other families are refusing to take in relatives from Ebola crisis regions, Bonsmann says. If people infected by Ebola are no longer being absorbed by treatment centers due to a lack of available space, then people die on the open street, often remaining there for days. Adding to the difficulties is the fact that, with every transmission, Ebola changes slightly.

The mutation is in progress, but no medical personnel can say whether the virus is becoming more dangerous."

Now, the hope is that the German government's additional, 10-million euro contribution can be distributed by the WHO quickly and efficiently.