December 10: Moving in and kitting out ready for patients

I take a group of 20 around, sharing their excitement. I ask if any of their families have had Ebola and three of them put their hands up. One woman tells me that her family were the first cases in the country, and with 10 dead, almost wiped out.

Jobs are few and far between in Sierra Leone these days, and we have been inundated with applications. The country has an extractive economy - mining - but all the major companies have been scared away. Last week a number of the Chinese mining companies still in operation finally pulled out, panicked by the ever increasing threat from Ebola.

The only work left is in the Ebola response itself. So there is a desperation for jobs, but also a real desire to join forces for this fight that is destroying lives and livelihoods.

In the hospital the wards are being cleaned and beds lined up. The pharmacy is stocked. There is much training to do and drills to rehearse, but our hastily assembled international task force is ambushed with a four-hour long protocol agreement meeting.

Item 1a : How to take blood, takes almost 2 hours. Really. So blood from Ebola patients is not something you want to splash around in your face, but we have regressed to the slowest, most cautious pace set by complete risk-avoidance.

It doesn't matter that people in the community are dying from Ebola every day, we have to be 100% sure that none of the staff have any chance of exposure. Attaining such absolute safety creates a paralysis by risk analysis and we are in danger of becoming a health and safety orgy.

At one stage I start to suspect that this is some sort of cunning plan to bore Ebola to death - “OK humans, I hadn't realised how bureaucratic this was going to be - I give up!”

There is internal wrangling about where the clinical ‘mission control’ office should be, with a suggestion that it is in a small tent far from the red zone. There is a perfect location with great access to triage and the red zone, but if we leave the decision to committee then I am worried we will need a UN convention to agree land ownership, so decide on an old-style British colonial style. Occupation.

While my colleagues drift off into gentle slumber I slip away unnoticed, assemble a few willing volunteers and start moving supplies into the room. By the time the protocol meeting has reached Item 2d: How to pass a sample to the laboratory, we have a respectable clinical briefing room.

The supplies tents that I raid are Aladdin's caves. DfID have sent six sea containers' worth of equipment, including enough to stock a small NHS hospital, a Boots pharmacy and a Staples store.

Two months ago some mandarins in London must have sat down and worked out a list of everything that might possibly be needed and then procured and shipped it. All we really need is some oral rehydration salts and some paracetamol, but the contingency planning is impressive.

I climb in large crates and unwrapping box after box, like a child on Christmas Day, ending up with that same feeling of emptiness that comes from material overindulgence.

I am worried about the politics of our loose international alliance which really needs a strong, quick-acting dictatorship rather than gentle, slow-witted consensus.

One of my Norwegian colleagues tells me that they have a saying in their language: many cooks, much mess. Snappier than our equivalent I feel. I am also a bit worried about the mental health of some of the team - levels of manic anxiety are in the red, and my attempts to reduce them (‘just take a chill pill’) don't seem to be helping.

At the evening Command meeting I am informed that the national policy, set with UK guidance, is that I will not be allowed to attend the meetings once I enter the red zone. I neglect to tell them that I have already been working in the red zone and protest vigorously: what is the scientific basis for this leper-like exclusion (I am religiously monitoring my temperature); how are they going to practically integrate with our Ebola hospital if they have no representative? What statement are they making by stigmatising health care workers? As a white male I savour my niche discrimination, and am offered an olive branch of a military report to Freetown to reconsider the policy.

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