The week slips seamlessly into the weekend. No one rests in the Ebola response teams. We visit our second Ebola Centre. This time in Laka, nearer to Freetown than Kerrytown, run by an Italian NGO called Emergency (great name).

Emergency have a small Ebola Centre but will be moving next door to brand new, UK-funded Ebola Treatment Centre just like ours at Moyamba, opening the day before we do in Moyamba.

They have been working in Freetown for 13 years and been active in treating Ebola patients since the start of the epidemic, opening a standalone unit in September. This is a Heath Robinson model compared to the Royal Engineers beautiful design, but it works well.

I am reunited for a brief time with some of my colleagues from training in York who look as though they have been managing Ebola for years - seasoned professionals. I watch them in admiration as they captain this fleet of tented ships.

Emergency are unashamedly interventional. There is a spectrum of debate about Ebola Centres that ranges from viewing them as a public health intervention - essentially to isolate patients and to provide conservative management, reducing risk to staff, through to Emergency who think that there should not be double standards.

Survival in the West is 70% yet only 30% in Africa, and this inequality should be unacceptable. So they intervene as doctors like to do so much - every patient gets a catheter, and IV line, a central line, even ventilation.

I ask about survival, and am told it is 30-40%, and wonder if their approach is worth it. I am sympathetic with their noble philosophy. If I got Ebola, it would be a good place to come to. However the equality they strive towards only exists in this tiny pocket of Africa, and while it would be great to offer everyone kidney transplants and expensive new drugs, it is not sustainable in a low-resource setting.

The benefit this approach offers is probably marginal compared to providing basic health care: immunisations, maternal health, essential drugs and universal access to primary care.

The difference between Kerrytown and Laka is noteworthy. Kerrytown started from scratch in a bespoke, but untested Ebola Treatment Centre. They were plunged in at the deep end, without any opportunity to learn to swim. Their first month of operation has involved an enormous challenge of adapting their facility to the needs and demands of their patients.

Laka, in contrast, grew organically to meet the growing needs of patients in their community. They were well established and able to test and evolve in true quality improvement fashion. Hundreds of small changes over time to develop the model that works for them.

It’s a classic example of top down versus organic, bottom up approaches to change. However in this case the urgency of the epidemic and the lack of suitable Laka-like sites provided little option but to adopt an imposed response.

I manage for the first time to shake off my protective bubble and take a walk through the crowded back streets of Freetown. Tin music blares loudly from the tin huts that line the earthen roads. Women sway with impossible loads balanced effortlessly on their heads. Children dance around my legs. Chickens and goats scatter in my path. Heat, noise, smells, sights, laughter.

My senses are engulfed with this joyous humanity, and with a sudden, unexpected choking, I realise my loss, my disconnection from this essence of Africa. I have become so engrossed and single-minded in my mission I have forgotten where I am.

My relentless mindfulness about labs, recruitment, training, drug supply, types of protective equipment has drowned out the people’s lives that this disaster response is all about.

Enough of the planning already. Time to act. To Moyamba tomorrow for handover, and then to Bo for my first experience in the red zone.

MORE BLOG POSTS FROM PROFESSOR JOHN WRIGHT