WASHINGTON — Dr. Sara Stulac trained for moments like this, when a deadly outbreak required her medical expertise and her global experience.
But Stulac, deputy chief medical director at Boston nonprofit Partners in Health, faces the wrenching decision about whether to assist in West Africa’s Ebola-ravaged regions with a 16-month son at home.
The need is clear: Partners in Health has hired around 100 short-term clinicians but will require at least 500 more in the next few months. Like many health professionals, Stulac must balance her desire to help some of the world’s poorest combat a virulent disease with the danger of contagion and the prospect of quarantine.
“My whole career, so far, has been to be there and acting where the greatest needs are,” said Stulac, also an associate physician at Brigham and Women’s Hospital. “I’m torn about it every day. But what if I found out on the way home I’m automatically quarantined and couldn’t see my child?”
Stulac’s concern highlights the unprecedented challenge organizations face as they recruit health care workers to combat an epidemic that can require more than a month away from home, modest compensation, and a 21-day quarantine upon return. Controlling the disease in West Africa — the key to preventing its spread elsewhere — is heavily dependent on nonprofit groups and their volunteers.
President Obama was flanked by white-coated doctors and public health professionals on Wednesday as he applauded the dedication of health care workers “on the front line” in West Africa and rallied for greater assistance.
“The world needs you now more than ever,” he said, referring to volunteers as heroes, and as examples of “what is possible when America leads.”
But the difficulties remain vast.
World Health Organization officials estimate 1,000 international health professionals and 20,000 local workers are needed to staff planned Ebola treatment centers in affected countries. World Bank president Jim Yong Kim on Tuesday pleaded for an additional 5,000 doctors and support staff to target the disease.
And while about 3,700 volunteers have signed up to assist through the US Agency for International Development, many will not have the required skills.
“One of the greatest needs in Ebola-affected countries remains qualified health care workers,” said Lisa Hibbert-Simpson, a spokeswoman for USAID, which has set up a website to help link volunteers to nonprofits.
“There’s also a high burnout rate for the medical workers involved in the response,” she said, “so it’s absolutely critical we have a pipeline of trained and skilled personnel who are on deck and ready to go.”
The Obama administration is sending nearly 4,000 troops to build makeshift hospitals and transport cargo, although they will not interact with Ebola patients. Nearly 70 Public Health Service officers are arriving this week, and more than 90 employees from the Centers for Disease Control and Prevention already are deployed.
The Public Health Service officers will work in a new field hospital, created to ensure health care workers receive proper medical treatment.
Recruitment has moved more slowly than has been the case in previous international disasters.
“After the Haiti earthquake, we saw thousands,” said Margaret Aguirre, the International Medical Corps’ head of global initiatives. The Ebola crisis first drew “little more than a handful.”
Recruiting has proved difficult, she said, partly because the disease is so potent and rare. The group requires 10 days of training and at least six weeks of service. A 21-day quarantine in some states could mean months before a person gets back to his or her life.
“It’s just too prohibitive for some to take that much time off work,” Aguirre said.
International Medical Corps counts about 35 international workers in West Africa and around 280 people from Liberia and Sierra Leone.
Doctors Without Borders, one of the best-staffed health groups in the region, has 3,200 people in West Africa, 300 of them from outside the region. The organization has enough people for current programs, but its officials fear what might happen if the epidemic continues to spread.
Efforts to recruit volunteers were complicated last week when Governors Chris Christie of New Jersey and Andrew Cuomo of New York announced they would impose a 21-day quarantine on health care workers who worked with Ebola patients. They altered restrictions this week after Kaci Hickox, a nurse who worked with Doctors Without Borders in Sierra Leone, called her quarantine inhumane.
“I sat alone in the isolation tent and thought of many colleagues who will return home to America and face the same ordeal,” Hickox wrote in The Dallas Morning News. “Will they be made to feel like criminals and prisoners?”
Now back in Maine, Hickox has vowed to take the issue to court if the state tries to quarantine her. Governor Paul LePage said Wednesday that he was seeking legal authority to enforce the quarantine if Hickox did not abide by a voluntary one. She shows no symptoms.
Obama did not mention state policies in his remarks, but he said no travel ban or quarantine would allow the United States to “hermetically seal ourselves off.”
The World Health Organization warns the outbreak could grow to 10,000 new cases a week, making assistance that much more necessary.
“I don’t remember such strident calls for help in Africa as we are seeing now,” said Irwin Redlener, director of Columbia University’s National Center for Disaster Preparedness. “Our obligation morally and practically is to really help flood that area with perfectly trained health care volunteers.”