This is my life. I wake at dawn after a fitful sleep, unaccustomed to the heat and the noise, waking during the night with a list of problems running through my head.

If I have internet, then I catch up on emails while I await a lift from my guesthouse. Then we work together in whatever office space we can find, covering the tasks in order of today’s priorities, drawing smaller and smaller circles around them until they have disappeared.

Meals are sporadic and always very late. Food is basic in Moyamba, though the Norwegians take pity on us and drop round a box of army rations. In Moyamba there is no running water, so I remain dusty and sweaty during the day.

The Royal Engineers wash in bottled water – Cleopatra-like with Evian in place of ass’s milk – but they have no room for us now. Work continues until fatigue sets in, then to bed and the cycle continues. I have nothing tangible to show for my efforts at the end of the day, just a mind map that hangs over my bed every night like a child’s mobile.

So we are all chronically tired, hungry, smelly and hot. Perhaps it is not surprising that the arrival of a new influx of international staff generates some tensions. Tiredness and uncertainty in our rapidly assembled and unfamiliar team leads to disagreements about how fast we should open, how interventional we should treat and always what sort of protective equipment is best.

The type of PPE, personal protective equipment, to use is the Middle East politics of Ebola. If you trained in visors you believe in visors, in goggles then you believe in goggles. A night's rest and reflection and gentle stroking and we are soon back on course.

Great progress has been made since my last visit to the Ebola Centre in Moyamba.  The site – 8 football pitches in size – is nearing completion, though JCB diggers still race around in a frenetic ballet.

We take beneficiary occupancy from the Royal Engineers and DfID – I’m not really sure what this means, but we have for the first time fenced off buildings and tents that we can access without hard hats and high vis jackets.

We will start unloading our supplies when the World Food Programme delivers them in a couple of days. It’s an unfamiliar world of logistics and facilities management and I have little to contribute.

Progress is happening. The Americans have been threatening to install their donated lab an hour’s drive away at the junction with the main tarmac road – easier access for them perhaps, but it makes no sense for us so we call in another offer and one day later the US embassy comes back with confirmation that they will install it where we want it at the Centre. 

I also manage to recruit a pharmacist. There is only one applicant – fresh out of college, but bright and eager and local, so a 3 minute interview and he has instructions to turn up on Friday ready to stock and prepare for dispensing the centre’s pharmacy.

There is one big missing piece in our Ebola jigsaw.  None of us have ever seen a case of Ebola before.  This is not a good situation with the blind leading the blind when we open in 2 week’s time.  Getting experience is a bit of a Catch 22, and the existing Ebola Centres are too busy to offer practical experience.

So Chris and I are off to Bo – a three hour drive from Moyamba, deeper into the heart of Africa to take up an offer to work on the wards at the MSF Ebola Centre in the town.

At the last minute I manage to hitch a ride on the UN helicopter.  Having never been in a helicopter this gives me an unashamedly boyish thrill as it lands in the middle of the abandoned stadium where the Royal Engineers are based.

The excitement is extinguished suddenly as the staff sergeant explodes with fury that the UN have landed at what is a full military forward operating base. The Russian pilots shrug with Slavic indifference “So vat are you going to do eh?” they reply to the warnings that the army would have been entitled to shoot them down. “There is going to be an international shitstorm” the staff sergeant mutters to me as I grab my bag and leap aboard.  I look forward to the “UK declares war on UN” headlines.

And so we go to Bo. This is one of the most experienced Ebola treatment centres, and while I am starting to feel that I have had more training in Ebola than I had for my entire medical career, I know that my ultimate test is when I enter the red zone.

MORE BLOG POSTS FROM PROFESSOR JOHN WRIGHT