Ebola: Doctors Without Borders Shows How to Manage a Plague

The more serious the emergency, the more likely he’ll hear about it late on a Friday. That, at least, is what experience has taught Hugues Robert-Nicoud, a disaster response expert for Médecins Sans Frontières, also known as Doctors Without Borders, or simply MSF. On a budget of €952 million ($1.2 billion) per year, MSF runs a volunteer collective of 30,000 physicians, nurses, logisticians, and locally recruited staff that functions as an independent ambulance corps and a kind of MASH unit for those in need. So on Friday, March 14, when his cell phone displayed a Swiss country code after 10 p.m.—he was on the road in Tokyo—Robert-Nicoud braced for the worst.

For years, MSF had been running a malaria control center in Guéckédou, a city in the West African nation of Guinea, two miles from the border with Liberia. Two days earlier, the Guéckédou clinic had received a report from the Guinea Ministry of Health detailing eight unexplained deaths in the region. At first, it sounded a lot like Lassa fever, which was bad enough, though when treated aggressively with Ribavirin, a proven antiviral, Lassa is usually not fatal.