TIME central african republic

One of Joseph Kony’s Top Commanders Just Surrendered to U.S./African Union

The leader of Uganda's Lord's Resistance Army rebels Joseph Kony (seated C), surrounded by his officers, addresses his first news conference in 20 years of rebellion in Nabanga, Sudan, on Aug. 1, 2006.
Adam Pletts—Reuters The leader of Uganda's Lord's Resistance Army rebels Joseph Kony (seated C), surrounded by his officers, addresses his first news conference in 20 years of rebellion in Nabanga, Sudan, on Aug. 1, 2006.

Dominic Ongwen could have information about the movements of Joseph Kony

At 10 he was forced to become a child soldier and he rose to become a commander of child soldiers. Now Dominic Ongwen, a senior commander in Joseph Kony’s Lords Resistance Army [LRA], a cult-like rebel group that started in Uganda, has surrendered to members of a joint military task force run by the United States and the African Union.

According to U. S. State department spokeswoman Jen Psaki, U.S. officials have yet to confirm that Ongwen, who declared his defection from the group in the Central African Republic on Tuesday, is who he says he is, but Ugandan army spokesman Lt. Col. Paddy Ankunda trumpeted a rare success in the region-wide hunt for the group best known for amputating the limbs of detractors and turning young children into soldiers and sex slaves. “This is great news,” says Kasper Agger, the Uganda-based field researcher for the Enough Project, a Washington D.C.- based human rights advocacy organization that has been tracking the Lords Resistance Army across Uganda, South Sudan, Congo and the Central African Republic. But whether or not Ongwen’s defection will lead to the eventual capture of Kony “is the million dollar question,” says Agger. “We can hope that he has vital information to share, but nailing down Kony at a specific time and place is still very difficult.”

According to Psaki, the defection of Ongwen, 35, would “represent a historic blow to the LRA’s command structure.” Ongwen, who was abducted by the LRA on his way to school according to Agger of the Enough Project, quickly made his way up the ranks to become a brigade commander, collecting multiple charges of grievous human rights abuses along the way. In 2005 the International Criminal Court in The Hague indicted Ongwen for seven counts of crimes against humanity including murder, pillaging and enslavement.

Ongwen’s defection, says Agger, may be a sign of weakening leadership within the organization, but it is also possible that the commander may have had a falling out with Kony and was in fact fleeing for his life. “We do know that he had been increasingly marginalized over the past few years,” says Agger, but Kony also has a tendency to pull commanders back into the fold as younger, less experienced soldiers die off. “So he could still have some useful information.” Ongwen’s defection may be a “victory along the road” says Agger, but it is no reason to rest in the hunt for Kony. “If anything, it’s an encouragement to keep up the pressure, to make sure that we see this through to the end, and that the Lords Resistance Army is truly finished.”

TIME Nigeria

Everything to Know About Boko Haram’s Advance in Nigeria

Image taken from a video by Nigeria's Boko Haram terrorist network, Oct. 31, 2014.
AP Image taken from a video by Nigeria's Boko Haram terrorist network, Oct. 31, 2014.

The fall of the Baga military base in north eastern Nigeria caps a slew of successes for the Islamist group

The Nigerian militant group Boko Haram has roared back into the headlines in recent days, with a series of bold attacks on remote villages in the country’s northeast, culminating with an assault on a multinational military base near a town called Baga on the shores of Lake Chad over the weekend.

Refugees fled on boats, while the last bastion of government control in the northern part of Borno State erupted into flames. As the uptick in attacks seems poised to disrupt the upcoming Presidential elections slated for Feb. 14, here’s everything you need to know about Boko Haram’s advance, and why its ambitions extend way beyond kidnapping schoolgirls:

Why are we seeing so many attacks in Nigeria’s northeast?

Borno State has long been a hotbed for Boko Haram supporters. Since the Islamist group started gaining strength in 2011, the militants and the military have traded control of many of the area’s small towns and military bases in a chess-like series of feints and retreats that have left the region perpetually on edge. “The militants build their capabilities by raiding police bases and armories for vehicles and weapons, then the military beats them back,” says Roddy Barclay, senior Africa analyst at Control Risks, a political risk consultancy.

But the military’s heavy-handed tactics, from arbitrary arrests and detention to extrajudicial executions, have alienated the local population. When a military operation is over, the militants move back in to remind local communities that they are the real source of authority. Even though Boko Haram also traffics in fear and intimidation, says Barclay, they have the local advantage. “[The most recent attack in] Baga is part of the cycle of violence that draws on local grievances to accelerate recruitment to the militant cause,” he says. The more the military responds, the more fresh recruits flock to Boko Haram.

Where will Boko Haram go next?

Boko Haram’s leaders have set their sites on the state capital Maiduguri, which they lost to government forces in 2011. Such a defeat would be a devastating blow for the Nigerian government, which suffered a major setback last year when militants launched a daring raid on the main military barracks. It is not clear that Boko Haram has the capacity, manpower and weapons to retake the town – at least for now. But they do have the capability to launch devastating suicide attacks, a method that they have used to great effect several times over the past 6 months.

Could the threat spread beyond Nigeria’s borders?

Boko Haram shares many characteristics of transnational terror groups; it adheres to the strict Salafist ideology of governance by Islamic law, and controls an estimated 30-35,000 square kilometers, roughly the same amount of terrain as Syria and Iraq’s Islamic State. It has also launched small scale operations in Cameroon and Chad in what some analysts have described as an attempt to establish Islamic rule across a region once contained within the borders of the historic Kanem-Borno Empire.

For the moment, though, it seems largely focused on its immediate region, in the country’s impoverished north-east. But even if the group’s activities have minimal impact outside that region, the symbolic weight is immense, says Peter Pham, Africa Director for the Washington D.C.-based Atlantic Center policy institute. “Nigeria is the regional power, and if its government is proven impotent in the face of the insurgency, that could have a spillover effect on other countries in the region,” which are equally threatened by Islamist uprisings.

And its domestic threat shouldn’t be understated, says Pham. “You have Africa’s most populous nation and its largest economy. And now it’s coping with a hollowing out of the state – the government can’t control its territory, resources are being diverted to combat the insurgency, and there is the reputational harm as well. Lagos may be a world away, but if terror attacks are the main news item coming out of the country, it won’t help the investment climate. “

What role will Boko Haram play in the upcoming Presidential elections?

Boko Haram has already denounced the elections as “un-Islamic.” Barclay, of Control Risks, predicts a surge in violent attacks in the weeks leading up to February’s vote. The result will be two-fold: along with the spread of terror, elections will not be be held in some areas due to the security risks, undermining the legitimacy of the candidate that secures the presidency — likely to be the incumbent Goodluck Jonathan. “Even if the election meets the legal requirements, it would still be a hollow victory,” says Pham. Jonathan’s campaign doesn’t need the three northern states most impacted by the insurgency to win, but if residents don’t turn out to vote for fears of an attack, it would shrink his mandate, says Pham. “That would not only weaken his hand in terms of dealing with the Boko Haram crisis, but also with the looming threat of declining oil prices” — Nigeria’s largest export.

And what happened to the kidnapped girls of Chibok?

Despite an ongoing government search, with U.S. assistance, none of the girls kidnapped last spring have been recovered. Most likely they have been forcibly married off to militants, or used as camp hands. Some local media outlets speculate that they could be part of a recent surge in female suicide bombers. But Boko Haram didn’t stop with the girls; for a militant group plagued by military losses, kidnapping is part of the growth strategy. Hundreds of men, women and boys have been kidnapped over the past year; the Baga offense started with the forced conscription of some 40 young men after a sermon at the local mosque, according to CNN. Hundreds more are likely to be abducted before the Chibok girls are ever found.

TIME Africa

Africa Fashion Week Showcases the Continent’s Best Talent

The growing trend of Fashion Weeks across the African continent challenges the notion that global fashion starts in the northern hemisphere

The lights dim on the catwalk as a capacity crowd quiets in anticipation. A pounding drum rhythm builds suspense as, backstage, stylists swarm the waiting models, applying last-minute dabs of foundation, glittering lip-gloss and bursts of hair spray. Next to the catwalk, professional photographers jostle for space with fashion bloggers preparing to snap candids with raised iPhones.

The scene could come from any of Europe or America’s frenzied fashion shows, but for two key differences: the models are mostly black and the designers all African. Welcome to Fashion Week Africa in Johannesburg, an annual event that offers a sharp rebuttal to the idea that international fashion begins and ends in the northern hemisphere. “When it comes to fashion design, Africa is the next frontier,” says Precious Moloi-Motsepe, a women’s health doctor and wife of South African billionaire Patrice Motsepe who founded African Fashion International, which organizes the event, in 2007.

Now in its sixth year, Fashion Week Africa—which recently picked up Mercedes Benz’s sponsorship in a sign of its growing prominence (the company also sponsors fashion weeks in Australia, Russia and Mexico)—is a showcase for Africa’s top designers. Headlining designer David Tlale of South Africa makes regular appearances at New York’s fashion week, while Mozambican Taibo Bacar and South African Hendrik Vermeulen wowed audiences in Milan and Rome earlier this year.

The message from Johannesburg is clear: Africa is no longer just a source for ethnic inspiration and fashion shoots, but a fount of original talent that may just give the established global brands a fresh dose of creativity, Tlale tells TIME. “The industry needs fresh blood. Armani is tired. Galliano is trying to resuscitate himself. McQueen is gone. Gucci is failing to reinvigorate and Prada needs a new creative team. It’s time for the big fashion investors to start looking to Africa. Not appropriating our themes, but taking on our design talent.”

The first obstacle may be overcoming expectations. When Tlale, arguably Africa’s best-known designer, first showed in Paris in 2007, reviewers needled him about his line’s lack of leopard print. It still happens today. “There is so much more happening in Africa than animal prints,” he groans. “The time for showcasing the big five is over.” He is talking about the big five safari animals, but he could just as easily be referencing Africa’s big five fashion clichés: Mandela shirts, animal skins, vibrant Ghanaian fabrics, Ndebele beadwork and the red plaid and beaded collars of the Maasai.

Take the clothes on the catwalk in Johannesburg on Oct. 29 to Nov. 2: from diaphanous trench coats to daring hotpants, they have nary a whiff of the African stereotype. Tribal motifs made an appearance, but they were translated into muted knitwear that could almost pass as Nordic.

As much as international fashion design could use a jolt of African creativity, Africa, which has become dependent on imported fashion, needs the economic stimulus of domestic production. In South Africa, the clothing manufacturing sector used to be the country’s biggest employer, even more than mining, according to Anita Stanbury, of the South African Fashion Council. But in the early 2000s changes in the law allowed Chinese imports to take over, and the industry all but collapsed. South Africa’s fashion weeks, of which there are six year round, are one way to encourage interest, and investment, in local production. South African fashion retailers only buy 25% of their product locally, says Stanbury. If they bought 40%, the number of clothing manufacturing jobs in South Africa would nearly double, from 80,000 to 150,000. “That is a huge reason why we should support the domestic fashion scene,” says Stanbury. “It gives us the opportunity to pull people out of poverty, and make them consumers in the market.”

The domestic economic benefit is one of the main reasons Moloi-Motsepe started with fashion, but pride plays a part as well. She believes it’s time for African fashion to take its place in the spotlight. “We see ourselves as global fashion players,” says Moloi-Motsepe. Just as she pairs Prada with creations by local designers, she is waiting for the day she spots a Londoner mixing Stella McCartney with Tlale. Global fashion, she says, would be better for the cross-pollination.

TIME ebola

Faster Ebola Tests Could Help Stem the Outbreak in West Africa

Liberia Races To Expand Ebola Treatment Facilities, As U.S. Troops Arrive
John Moore—Getty Images A health worker in Paynesville, Liberia, carries a girl awaiting her test results

Better Ebola testing in West Africa would save lives and could help bring an end to the outbreak

The dying at the tin-roofed clinic in the rural Kono district of Sierra Leone comes at a ruthless pace. In the first two weeks of October, 20 out of the 22 patients seeking treatment for Ebola died. That fatality rate, high even by the lethal standards of Ebola, could easily be brought down, says Dan Kelly, an infectious-disease doctor who is currently in Kono with the Wellbody Alliance, a medical nonprofit organisation he set up eight years ago. “The ability to test for Ebola, to test quickly, has become ever more important,” says Kelly, who believes the high death toll in the Kono clinic was due in part to the fact that there is no place to test for Ebola in the entire district. Instead, blood samples from suspected Ebola patients have to be sent to the capital over rutted mud roads that are often washed out by rain. “Even if we have the best treatments available, without a timely diagnosis people are still going to die,” says Kelly.

Work out quickly who does and does not have Ebola and you’ll get a long way toward stopping an outbreak that has killed at least 4,877 and infected thousands more. Right now that simple proposition can feel like a fantasy. In Guinea, Sierra Leone and Liberia, the three countries with the most cases, the need for rapid test results far outpaces the capacity to carry them out.

That means patients often aren’t getting treatment until it’s too late, when the disease has ravaged their bodies beyond repair, and when they may have already infected friends and family. “If patients are promptly diagnosed and receive aggressive supportive care, the great majority, as many as 90%, should survive,” wrote the global health expert Paul Farmer in a recent issue of the London Review of Books.

Even in a top U.S. laboratory it can take up to eight hours to search a blood sample for Ebola through an expensive and complex array of technical hardware and computer software called a polymerase chain reaction (PCR) test. The U.S. Centers for Disease Control and Prevention and the U.S. military have helped by setting up four additional labs in West Africa over the past six months—Liberia now has a total of five, Sierra Leone four and Guinea three—but capacity is still limited to about 100 tests per lab per day, not nearly enough to cope with an epidemic that could grow to 10,000 new cases a week by December, according to the World Health Organization. Laurie Garrett, an expert on Ebola at the Council on Foreign Relations and author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance, says that number could be brought down through better testing. “The only thing that makes a dent when you model what is going on with the epidemic now and what it looks like in two months, is being able to separate the infected from the non-infected.”

Health care workers on the ground say that more PCR labs are urgently needed. “Crushing this epidemic means getting 70% of the population with Ebola into isolation and care,” Kelly says. That could be achieved, he believes, by putting a PCR lab in every district.

The challenges don’t stop there. Testing can create risks even as it offers solutions. Medical personnel must draw blood from patients for a PCR test, a potentially lethal process for caregivers. “Taking samples is extremely dangerous,” says Dr. Estrella Lasry, a tropical medicine adviser in Liberia for Doctors Without Borders (MSF). At any time you risk a needlestick injury that can expose you to the virus.”

And then there’s the risk that patients without Ebola are being exposed to patients with the disease. Lasry estimates that 30% to 50% of people coming into the MSF clinics end up testing negative for Ebola and instead have other illnesses like malaria that have similar early symptoms. All those being tested for Ebola must wait in holding centers for their results, to ensure they don’t have an opportunity to infect others back at home if they test positive. That means patients with other illnesses must wait among patients with Ebola, increasing the chances of transmission.

Kelly hopes researchers can develop a test that could give readings at a clinic immediately and wouldn’t require trained technicians to interpret the results. “It would be a game changer if you could immediately identify patients needing quarantine from those who do not,” he says. Several versions of so-called point-of-care rapid diagnostic tests are already in development, but while some are at the testing stage, it is not clear when they could actually be used on the ground.

One U.S. company, Corgenix, received a $2.9 million grant in June from the National Institutes of Health to perfect its prototype, a pregnancy-test-style slip of paper that reveals a dark red line within 15 minutes when exposed to a drop of Ebola-infected blood. Instead of needles and syringes, test takers need only a pinprick to get the sample, much like an insulin test for diabetes patients. These tests, which would cost anywhere from $2 to $10 (PCR tests average about $100 each) could also be used in airports to confirm whether someone with symptoms has Ebola.

If the Corgenix test had been available, says one of its lead researchers, Robert F. Garry, a professor of microbiology and immunology at Tulane University School of Medicine in New Orleans, it might have helped diagnose Amber Vinson, an American nurse infected with Ebola, before she boarded a flight from Cleveland to Dallas on Oct. 13. “This is a test that could be used anywhere you would want to test for Ebola,” says Garry. “Anyone could use it, and anyone could read it.”

With the epidemic worsening in West Africa, medical staff in Ebola-hit countries can’t afford to wait for companies like Corgenix to bring their product to market. Kelly has been hearing about better, faster tests almost since he started working on Ebola in June. He fears that pinning hopes on future technologies undermines efforts to ramp up testing facilities. “Everyone says they have a new test, but at this point I’m like, ‘Show me the money,’” says Kelly. “ We already have a working technology that is deployable. Get me a PCR in every district capital, and then we can start talking about faster tests.”

Garry says he has people in every U.S. time zone working “as fast as humanly possible” to get the Corgenix test out. “We want to make an impact on this outbreak,” he says. “With enough tests, we can shut it down it down.” Without them, Ebola may be here to stay.

TIME South Africa

Heated Reaction in South Africa to Pistorius Sentence

Oscar Pistorius after he is sentenced at the Pretoria High Court on October 21, 2014, in Pretoria, South Africa.
Herman Verwey—Getty Images Oscar Pistorius after he is sentenced at the Pretoria High Court on October 21, 2014, in Pretoria, South Africa.

The six-time Paralympic medal-winning athlete is sentenced to five years in the shooting death of girlfriend Reeva Steenkamp, eliciting charges of injustice in his native South Africa

When the judge sentenced Oscar Pistorius to five years in jail for killing his girlfriend, his reaction was muted. The response elsewhere in South Africa was not. “Five years for murder?” screeched one angry caller to a local radio talkshow. Twitter lit up with angry condemnations of the judge, some commentators going so far as to suggest that all murderers would be so lucky to have her presiding over their case.

After all the drama of a trial that evoked Hollywood theatrics and a blockbuster viewership over the course of its seven-month-run, Judge Thokozile Masipa finally delivered her sentence Tuesday morning in the courtroom in Pretoria, condemning Pistorius to five years in prison for killing his girlfriend, 29-year-old law graduate and model Reeva Steenkamp in what he described as a tragic mistake. Pistorius wiped his eyes upon hearing his sentence and reached for the hands of family members gathered behind him.

Pistorius, 27, killed Steenkamp on Valentine’s Day last year, shooting her four times through a closed bathroom door in his home. He testified that he had mistaken her for a nighttime intruder. Immediately following his sentencing he was escorted out of the packed court, down a flight of stairs and into the court’s detention center to await transport to the prison.

On Sept. 12 Masipa convicted Pistorius of culpable homicide, a crime similar to manslaughter, but acquitted him of murder at the conclusion of a trial that had become an international spectacle. Pistorius, a double amputee dubbed the “Bladerunner” for his athletic prowess on blade-shaped prosthetic limbs, alternately wept, vomited and collapsed at various points of the trial as the prosecutor presented graphic evidence taken from the scene of the crime and asked Pistorius to recount, in agonizing detail, the events of the night his girlfriend was shot. The prosecution accused Pistorius of murdering Steenkamp in a fit of rage.

In sentencing Pistorius to five years imprisonment, Masipa split the difference between the prosecution’s argument for 10 years and the defense’s case that any jail term would be an unjust punishment for a double-amputee in a violent prison system where Pistorius could be subjected to abuse because of his disability. His lawyers had argued for a three-year probation period of house arrest and community service.

The Steenkamp family appeared to be satisfied, with family lawyer Dup De Bruyn saying that it was “the right sentence,” and that “justice was served,” according to Reuters, suggesting that an appeal is unlikely. Public reaction has been much more heated. Radio talk shows were inundated with angry callers lambasting the judge. “Lady justice just had her legs amputated,” shouted one irate caller. Another cursed Masipa on air, prompting a flurry of Twitter comments over the inappropriateness of denigrating a judge, no matter the reason.

It is likely that Pistorius will be paroled after serving at least one sixth of his sentence — 10 months — according to legal analysts, prompting sarcasm from one math-impaired Twitter commentator: “Three women are killed by their partners every day in [South Africa]. I guess an 8-month sentence will help fight this,” tweeted@ justicemalala.

Meanwhile, the International Paralympic Committee, which has awarded Pistorius six medals throughout his career, says that he will be banned from competing for five years, even if he is paroled early. Given the high profile nature of both Pistorius and Steenkamp, it was a given that no matter the sentence, people would be angry. Twitter commentator @ZuBeFly summed it up best: “Only way I’d feel 100% satisfied is if any type of sentence the judge passed would bring Reeva back. No winners here either way.”

Read next: Oscar Pistorius Gets 5 Years for the Culpable Homicide of Reeva Steenkamp

TIME ebola

Why Protective Gear Is Sometimes Not Enough in the Fight Against Ebola

Health workers receive assistance with putting on their protective gear before entering the high-risk zone at the Bong County Ebola Treatment Unit near Gbarnga in rural Bong County, Liberia, Oct. 5, 2014.
Daniel Berehulak—The New York Times/Redux Health workers receive assistance with putting on their protective gear before entering the high-risk zone at the Bong County Ebola Treatment Unit near Gbarnga in rural Bong County, Liberia, Oct. 5, 2014.

Human error can endanger even the most experienced health care workers in the fight against Ebola

When it comes to Ebola, the full-body Personal Protective Equipment [PPE] suit is probably the best way to prevent infection. But a PPE can also be one of the easiest ways to get Ebola. A PPE is usually made up of a full-body, impermeable suit with a hood, rubber boots covered by Tyvek booties, multiple pairs of surgical gloves, a surgical mask over the nose and mouth, a plastic bib, goggles, a plastic apron and a lot of duct tape. There is a reason why they are nicknamed moon suits: worn properly, they shouldn’t show an inch of skin. Putting them on right requires two people and about 10 minutes. Taking them off, in even the best of circumstances, is a clumsy, arduous process with multiple opportunities to make a lethal mistake.

It is not yet clear how, exactly, two health care workers at a Dallas hospital tending Thomas Eric Duncan, the first man to be diagnosed with Ebola in the United States, caught the disease, but health authorities are looking closely at the protective measures used at the hospital, and whether or not they were sufficient. Meanwhile, in Spain, where a nurse, Teresa Romero Ramos, is being treated for Ebola that she caught from a patient recently returned from Sierra Leone, officials are questioning whether or not she wore her PPE properly. On a Spanish television program quoted by the New York Times, Madrid’s regional health minister, Javier Rodríguez, questioned the need for extensive training on using the PPEs. “You don’t need a master’s degree to explain to someone how you should put on or take off” a protective suit, he said.

Maybe not, but no matter how experienced and qualified you are in putting on and taking off a PPE there is always room for error. I recently spent two weeks in Monrovia, Liberia, reporting on Ebola, and climbing into, and out of, PPEs on a regular basis, and I am still not sure I ever got it right. I was trained by the best, too: the Red Cross Dead Body Management teams, the guys responsible for picking up deceased Ebola victims and transporting them to the crematorium for safe disposal. An Ebola patient is at his most infective in the hours and days after death, when the virus swarms the skin and bodily fluids.

When the Dead Body Management team workers finish zipping a corpse into a double-sealed body bag they undergo an extensive decontamination process that best resembles a military drill in its precision and attention to detail. Each worker is paired with a sanitizer, a man wearing a backpack sprayer filled with a chlorine and water solution. The process is initiated with a good dousing of chlorine solution and a vigorous washing of the gloved hands. The worker removes his goggles, which are sprayed thoroughly and then discarded. His hands are sprayed again. Then the hood goes down, and the zipper is sprayed, as are the hands for another time. He unzips, and his hands are sprayed yet again. Then he has to shrug out of the suit without allowing any of the external surfaces to come into contact with his hands or the clothing underneath. And so it goes, layer after layer until the worker is left standing in boots, medical scrubs, and the last pair of gloves. Again he is liberally sprayed down with the chlorine solution, at which point he has to jigger off his gloves in a way that ensures that the surface does not come into contact with the skin.

Each organization, be it the Red Cross or Médecins Sans Frontières [MSF], has a similar ritual, even if small details vary. Still, mistakes are made. Even MSF, which has spearheaded the Ebola response in west Africa since day one, and probably knows more than any other organization about how to prevent infection, has seen two international health workers sickened with the disease. A United Nations medical worker infected in Liberia and transported to Germany for care died on Oct. 13. A doctor working for an Italian medical charity contracted Ebola last month, and is still receiving treatment in Germany.

The gear works, but the possibility of human error is still high, especially when working in a high-stress environment, when fatigue and fear stalk every move. PPEs can also provide a dangerously false sense of security. When they are not put on right, or if they are taken off incorrectly, they may as well not be there at all.

If you are lucky the droplet of sweat dropping into your eye as you remove your goggles without bending over first didn’t pass over some Ebola-contaminated material on your hood. I met one health care worker who thinks he caught Ebola when a young patient vomited on him, and the vomit passed through a chink in his Tyvek armor, where his suit didn’t entirely zip up over his mask. Both he and the patient survived. Which is why having the right kind of protection is only the beginning. There needs to be training, and it has to be drilled in daily. There needs to be a buddy system, in which one health care worker is always watching the other, to ensure that the protective gear is on correctly, and that it is taken off correctly. But there will always be mistakes. Ebola will get through. The important thing is to be ready when it does.

TIME ebola

Ebola Health Care Workers Face Hard Choices

A Doctors Without Borders health worker in protective clothing carries a child suspected of having Ebola in the MSF treatment center on Oct. 5, 2014 in Paynesville, Liberia.
John Moore—Getty Images A Doctors Without Borders health worker in protective clothing carries a child suspected of having Ebola in the MSF treatment center on Oct. 5, 2014, in Paynesville, Liberia

The risks to doctors and nurses are never far from their minds

For Laura Duggan, going to Sierra Leone to care for patients with Ebola wasn’t so much a choice as a moral responsibility. “This is one of the biggest public-health emergencies of our time,” Duggan, a 34-year-old Irish nurse, told TIME as she prepares to leave London. “I’m trained to do this and there’s a great need. I couldn’t sit here and not go.”

Duggan had done her research, and knew the challenges: fatigue, long hot days spent working in sweltering biohazard suits, and the emotional toll of watching more than half her patients die no matter how heroic her efforts. But as for catching the disease itself, she wasn’t worried. Ebola is only spread through contact with infected bodily fluids. Duggan was confident that as long as she followed basic self-protection protocols, she would stay safe. But then, on Oct. 6, a nursing assistant in Madrid contracted Ebola from a priest who had recently returned from Sierra Leone. A week later, an American nurse treating a Liberian man in Dallas who died of Ebola also tested positive for the virus. Duggan’s partner, a Spaniard, pointed out that the Spanish nurse had been following the same rules, and still got sick. “He was getting a little nervous and saying, ‘Well, if she followed procedure and you’re saying you’ll follow procedure, then what happened? Why has she become infected?’” Duggan recalled. “That was my first little wobble and I kind of just went, Oh God.”

Despite pledges of support and widespread international concern, the Ebola epidemic in the West African nations of Liberia, Sierra Leone and Guinea is rapidly outpacing all efforts to contain it. As of Oct. 10, the number of cases had topped 8,399, with 4,033 deaths. With local populations of doctors and health care professionals cut down by disease and fear, and with those that remain overwhelmed, it is essential that their ranks be filled with international volunteers who can treat the ill and help prevent Ebola’s spread. But finding qualified doctors and nurses willing to face the risks, as well as repercussions back home, is “a challenge,” says Eric Talbert, the USA executive director for Emergency, an international medical organization that is setting up a 100-bed Ebola treatment center in Sierra Leone. “There is a significant fear factor. They are putting their lives on the line for people they have not met. It’s a courageous ask.”

(PHOTOS: See How A Photographer Is Covering Ebola’s Deadly Spread)

Never has the need been so great, and it looked like it might be exacerbated Monday when health care workers in Liberia signaled they would strike to protest conditions and pay — although many workers ended up defying the call to strike).

Calling the Ebola outbreak in West Africa a “tragedy not seen in modern times,” at the annual meeting of the International Monetary Fund and the World Bank on Oct. 9, Sierra Leone’s President Ernest Bai Koroma said, via video link, that his country would need 750 doctors and 3,000 nurses to treat the anticipated caseload.

As the numbers climb in West Africa, so too does the chance that more cases will be exported abroad, raising the likelihood that doctors and nurses around the world will find themselves faced with Ebola. “There is no doubt that we will see more cases of health workers getting sick” in West Africa, and those volunteers will have to go home for treatment, says Heather Etienne, a registered nurse from Texas who is on her way to Sierra Leone to work in an Emergency Ebola treatment center. So far, 416 health workers have been infected with Ebola in West Africa, and 233 have died, a sobering outcome. “You have to be comfortable with some amount of risk before doing something like this. You don’t have to be at peace with the idea of your death, but you shouldn’t be too uncomfortable with the concept either,” Etienne says.

(PHOTOS: Inside the Ebola Crisis: The Images That Moved Them Most)

Having the wrong people could be just as bad as — if not worse than — not having enough, Talbert says. Ideally, volunteers would be willing to commit to a length of time that would make their training and airfare expenses worthwhile. They should have experience in the region, says Talbert, “so they know what they are getting into,” and experience working with highly infectious diseases, “because making mistakes can be lethal.” And because the risk of burnout is so high, there needs to be enough workers to fill a continuously rotating roster. Health care workers in Ebola treatment centers work under extreme duress, sweltering under layers of protective plastic to take care of patients who have a high chance of dying. “It takes a physical and emotional toll. Nobody can do that for too long,” Talbert says.

Umar Ahmad, a 29-year-old junior doctor at the Royal London Hospital in Whitechapel, who recently completed a three-month program at the London School of Hygiene and Tropical Medicine, is ready to take up the challenge, but he is finding it hard to take a few months away from a full time job. “There are plenty of doctors that would volunteer, but the issue is, what it actually means is that you take a financial hit, a career hit,” Ahmad says. “For lots of people, they’ve got responsibilities and they can’t justify it.”

For Etienne, the nurse from Texas, getting time off wasn’t an issue. Even though many of her colleagues told her she was “insane” for going to Sierra Leone, her superiors were supportive. Her main concern is about what happens when she comes back. As a nurse, she well understands the fear and stigma brought on by Ebola. Upon her return she intends to observe an informal self-quarantine, staying away from her hospital for 21 days, the incubation period for Ebola. “Given how jittery everyone is these days, they don’t really need me at the patient desk, only to have someone say, ‘Oh, you just got back from Sierra Leone. Get me out of here!’” she says.

Clare Parsons, a 28-year-old doctor who is leaving for a one-month stint with the King’s Sierra Leone Partnership, an initiative of King’s Centre for Global Health in London, shares those concerns. Even if she displays none of the symptoms of Ebola, she is planning to lay low at home for a few weeks, just in case. “Obviously I don’t want to go gallivanting around London and be known as the person that spread [Ebola] all over the London Underground,” she says.

Duggan, the Irish nurse, finally decided to go through with her mission despite her concerns, and left on Oct. 13 to work with Doctors Without Borders for six weeks. She is still afraid, she said, but she keeps reminding herself to go back to the facts and follow the procedures. In the end, she said, nursing, wherever it is, “is my job, and something that I’ve been trained to do.” Experience in other international aid missions has taught her that international health workers can sometimes be a breed apart. “You have a very high concentration of people who are willing to make a sacrifice and put themselves at risk for the need of others,” she said.

If Ebola is to be defeated, she, and several thousand more like her, will have to join their ranks.

Read next: CDC Chief Urges U.S. Hospitals to ‘Think Ebola’

TIME Nobel Peace Prize

Malala Yousafzai and Kailash Satyarthi Win Nobel Peace Prize

The prize was awarded to them for their efforts in the education of women and against the exploitation of children respectively

Exactly two years and a day after Taliban gunmen shot her in the head for daring to speak up for the rights of a girl to get an education, Malala Yousafzai of Pakistan was awarded the Nobel Peace prize Friday. She shares the award with veteran children’s rights campaigner Kailash Satyarthi, 60, from neighboring India.

Both Yousafzai and Satyarthi were lauded “for their struggle against the suppression of children and young people and for the right of all children to education,” according to the Nobel Committee’s statement. Though it may not have been intentional, the joint award evokes certain symmetry: Yousufzai, who has since moved to England to continue her education in a safer environment, is at the beginning of a life she has repeatedly said will be spent furthering her cause. Satyarthi is looking back on a career studded with achievements and dedicated to protecting children from exploitation. His work on developing international conventions for children’s rights is what enabled Yousufzai to launch her own campaign, first in her native Pakistan, and then around the world.

That the two come from rival countries and oft-clashing faiths only strengthens the message that the need for children’s education trumps both nation and creed. “The Nobel Committee regards it as an important point for a Hindu and a Muslim, an Indian and a Pakistani, to join in a common struggle for education and against extremism,” said the Peace Prize statement.

For Yousufzai, who continues to receive threats from the Pakistani Taliban who attempted to silence her demands to be educated two years ago, receiving the Nobel Peace Prize offers no better, and no louder, rebuttal.

Your browser is out of date. Please update your browser at http://update.microsoft.com