Few health facilities exist in Makeni where patients with the deadly virus are suffering without medical attention.
Scores of Ebola-infected patients have been seen suffering without medical attention in one of Sierra Leone's largest cities, as officials report success in fighting the virus following a three-day lockdown.
In the major mining hub of Makeni, Ebola is ripping through, with more than 100 cases reported in the past month alone. The city's authorities have established three "holding centres" since the first cases were reported in August.
Medical officials say that the hospitals are totally overwhelmed.
"The situation is out of our control," Dr Osman Mohamad Bah, director of Makeni Regional Hospital, told Al Jazeera on Monday. "We have seen more than 100-150 cases in the last four weeks."
He said that 99 percent of the cases tested from the city with a population of 112,000 had returned positive.
Al Jazeera visited one holding centre on the outskirts of Makeni, which lies east of the capital city of Freetown, and where there are currently no Ebola treatment or testing facilities. It was said some 48 patients were inside the facility at an abandoned university compound, crowded in halls with makeshift beds.
During the lockdown that ended this Sunday, a team of 30,000 health workers went door-to-door across the country to find and isolate cases of the deadly virus, in an unprecedented government-imposed quarantine measure which it hailed as "largely successful".
"The exercise has been largely successful... The outreach was just overwhelming. There was massive awareness of the disease," Stephen Gaojia, head of the Ebola Emergency Operations Centre, told Reuters news agency on Monday.
Gaojia noted that authorities reached more than 80 percent of the targeted households.
But at the compound in Makeni, which did not have any isolation barriers, nurses were clearly working in high-risk proximity to Ebola patients without essential personal protective equipment (PPE).
Desperately sick women and children lay sprawled on floors awash with vomit, urine and chlorine. Beds were strewn with pills and rags, and smeared with other bodily fluids.
When an ambulance drew up in front of the building, a driver wearing only latex gloves offloaded a mother and a staggering child, who were questioned by a health worker standing three metres away.
Inside Makeni's 'holding centres'
Sick men, women and children admitted to these centres waited to hear back about their Ebola test results - a three-day process in Makeni, as the nearest swab facility is four hours away in the capital capital, Freetown.
With rooms full of ill people vomiting and bleeding on beds, floors and other surfaces, the risk of cross-contamination in these rooms is huge.
It was unclear where suspected patients, identified during the lockdown, were meant to be quarantined before being taken to the nearest facilities in Kailahun and Kenema districts.
"There are simply not enough Ebola centres, the epidemic is moving... Patients arrive at the level of district hospitals in towns which cannot treat them. They are overwhelmed," said Axelle Vandoornick, field coordinator for the Doctors Without Borders (MSF) Ebola case management centre in Kailahun.
MSF, which has a capacity of 80 beds, has taken in 52 patients from Makeni since August, and 28 over the past week, overriding its policy of not taking patients from outside their own district.
Both Dr Bah and MSF have said that there are not enough ambulances dedicated to the transfer of Ebola patients from holding centres to treatment facilities, while many patients are dead on arrival.
Vandoornick says the government needs to allocate more ambulances to the districts to refer the patients to the few case management centres. "We need more Ebola treatment centres. It is good to have promises for these from all over the world but those promises need to be concretised into acts very soon."
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