CONAKRY, Guinea — The Cuban doctors were all fired up and raring to get to work: Fidel Castro had praised their commitment and urged them to work even with American troops who might otherwise be considered the enemy, and President Raul Castro came to the airport to wish them well in their mission to fight Ebola in West Africa.
That was more than two months ago.
In Guinea, where the current outbreak started, 37 Cuban doctors, nurses and epidemiologists hang around a hotel pool, holding daily meetings to bolster their morale, crowding around a computer to learn more about the theory of Ebola treatment, and even trying on their protective suits and masks.
"We really thought we would arrive one day and get to work the next, but the reality is different," Cuban team leader Dr. Carlos Castro told The Associated Press in Conakry, the capital.
Training is the problem, he explained. All 256 Cubans sent to West Africa at the beginning of October had received weeks of instruction at home, including about protective measures and equipment.
They were expected to get another two or three weeks of "immersion" training in an Ebola treatment center working with patients, Castro said.
Guinean officials said language was one of the issues, with the Cubans speaking Spanish and their hosts French.
Up to now, only Doctors Without Borders has trained medical workers in Guinea on how to effectively care for Ebola patients and at the same time avoid getting infected themselves.
By the end of November, 622 health care workers had been infected with the Ebola virus and 346 of them died, according to the World Health Organization.
One of the Cubans in Guinea died less than a month after arriving and celebrating his 60th birthday, but he did not die of Ebola. Jorge Juan Guerra Rodriguez died of a severe bout of malaria, Castro said.
Doctors Without Borders, which has taken the lead in treating patients from the start of the epidemic, long has complained that it is overstretched. Three months ago it urged states with biological disaster response capacity to urgently intervene and "to dispatch trained personnel in their numbers." Last week it warned of an inadequate response "encumbered by serious bottlenecks in terms of staffing."
Foreign governments have focused on financing and building treatment centers, leaving staffing to charities and local health workers who do not have the expertise, the medical group said.
"Training people to safely operate Ebola case management facilities and carry out other necessary activities takes weeks of theoretical and hands-on training ... this bottleneck has created major delays," said the organization.
Doctors Without Borders has been trying to train 12 health workers there every two weeks, but has not always managed this, said Dr. Moumie Barry, who is in charge of training at Guinea's Ebola coordination center.
Guinea is about to open its own training center, using Guineans trained by Doctors Without Borders, and is organizing to train six of the Cuban doctors using two interpreters, he said. Two Cubans already have been trained by the medical aid group. But at this rate, it would take months to train the entire crew.
Twelve health workers from Mali also will train at the Guinea center since Mali does not have any facility to train them, said Barry.
There has also been a delay in deploying Cuban doctors in Sierra Leone, with only about 60 of 165 Cubans there in the field, said Castro, leader of the Cuban doctors in Guinea.
Sierra Leone's Ministry of Health would say only that some of the Cubans there are working while others still are being trained, according to spokesman Sidie Yayha Tunis. He said the Cubans are being trained at a center run by the ministry, and did not mention any language problems though his country is English-speaking.
