. Local health workers with members of Doctors Without Borders at a hospital in Conakry, Guinea on Thursday. More foreign doctors and nurses are volunteering, but a gap remains.

 

Doctors and nurses are finally volunteering to fight the Ebola virus in West Africa after a long period of paralyzing fear in which almost none stepped forward.

 

But, experts say, even though money is now pouring in from the World Bank, the Gates Foundation and elsewhere, and the United States Army is to start erecting field hospitals soon, there is likely to be a long gap before those hospitals can be fully staffed to care for the growing numbers of people with Ebola.

 

“As a result, thousands of people will die,” said Dr. Joanne Liu, president of Doctors Without Borders, which treats more patients than any other entity. “I can’t say the exact figure because we don’t know how many unreported cases there are. But thousands for sure.”

 

Because months went by this summer in which almost no volunteers could be found, and because it takes time to train them and get them to Africa, there remains a yawning gap between the number of medical professionals needed and those in place to do the work. Each 100-bed hospital needs a staff of 400, about 40 of whom are foreign doctors or nurses. Meanwhile, about 600 Ebola cases are being recorded every week, according to the World Health Organization, and that number doubles every three weeks.

 

“If we had 1,700 staffed beds right now, we could maybe turn the tide,” Dr. Liu said. “When we hear the pledges, we ask for timelines. Some say eight to 10 weeks. They’re going to wake up to a much bigger problem at Christmas.”

 

The first American troops with orders to build 17 100-bed hospitals are arriving in Liberia now. Other countries, particularly Britain and France, are under pressure to do the same in Sierra Leone and Guinea.

 

But the American military now plans to staff only one 25-bed hospital for infected health workers with members of the quasi-military Public Health Service. “Who will staff the rest?” asked Dr. Liu, whose organization is known by its French initials, M.S.F. “It needs to be hands-on. You have to chip in and expose yourself.”

 

Ebola field hospitals ideally contain three separate tents for confirmed, probable and suspected cases; separate toilet and washing facilities for each; and a double fence outside so relatives can talk without touching. They also contain separate dressing and undressing rooms for staff members wearing protective gear, and possibly laboratory and kitchen tents.

 

The few medical charities that do the risky work of treating patients have scoured their rosters of veterans and asked them to recommend colleagues.

 

A month ago, those agencies — including Doctors Without Borders and the International Medical Corps — had almost no volunteers. The corps had only seven responses to its first appeal. Four years ago, after the earthquake in Haiti, it got 2,000.

 

Now they — with the recent addition of Partners in Health, the medical charity run by Dr. Paul Farmer at Harvard Medical School — each have more than 100 professionals expressing interest. More than 1,600 others have signed up through the United States Agency for International Development.

 

“It really turned around in the last two weeks,” said Dr. Ariel Pablos-Méndez, the development agency’s assistant administrator for global health. More media coverage, appeals by President Obama, and radio and TV appearances by the U.S.A.I.D. administrator, Dr. Rajiv Shah, mentioning the website for volunteers all helped, he said.

 

Video | What’s Needed in the Fight Against Ebola With thousands of United States military personnel heading to West Africa, a look at what’s still needed for the effort and some differences with the mission that followed Haiti’s 2010 earthquake.

 

But the agency is still granting access to its list slowly, through a subcontractor, and the charities are winnowing their own lists, looking first for those who have worked in disaster areas or now work in hospital wards with the meticulous protection measures needed to prevent Ebola transmission.

 

There is no time to teach beginners the basics or worry about newcomers who might have panic attacks, the agencies said. “Once the first group comes back safe and sound, we hope that will encourage recruitment,” said Rabih Torbay, head of international operations for the International Medical Corps.

 

In the meantime, there are delays. People who are accepted must get permission to take six weeks off work and need visas and specialized training.

 

For the corps and for Doctors Without Borders, that training involves at least three days in Brussels. Then they get five to seven days in West Africa, working on patients under supervision.

 

The American military said it would train 500 health workers a week in Africa. But like other experts working there, Dr. Liu is skeptical, saying her agency, which has trained over 2,000 local people since March, was having trouble recruiting more.

 

A big problem, she said, is that many local hires cannot go home at night because their families are afraid. They will eventually need housing.

 

Doctors Without Borders now has 239 international volunteers, with enough veterans in the pipeline to fill its next round of six-week commitments. It operates six facilities with a total of 532 beds in the three countries, and plans to add only 35 more beds. The corps has 25 confirmed American volunteers and recently got access to the U.S.A.I.D. list. It has also recruited about 250 doctors and nurses from India, the Philippines, Jordan, Kenya and Ethiopia. It pays $4,500 a month.

 

“That’s pretty good money for people from some countries,” Mr. Torbay said.

 

Doctors Without Borders, in contrast, pays about $1,700 to first-time volunteers, said Kate Mort, head of field operations for its American branch.

 

Thus far, Partners in Health has heard from 107 volunteers since it put out its first appeal, on Sept. 11, said Jeff Marvin, a spokesman.

 

Dr. Hernando Garzon, a 50-year-old physician who just signed up to go to Sierra Leone with the corps, is the ideal volunteer.

 

He has previously taken time off from his job in a Kaiser Permanente hospital in California to work in Jordan, Indonesia, Kenya, Nigeria, Haiti and Pakistan during earthquakes, war and political violence. Two of his children, ages 19 and 23, joined him in Haiti and Kenya.

 

“The people in my life understand that I’ve been doing this for 20 years,” he said, “and it’s part of what I am.”

 

Before he volunteered, he analyzed why so many workers got infected, and decided they had made mistakes he would not. They did not realize their patients had Ebola, or they lacked protective gear, or were not trained to use it.

 

“Fear of the unknown is a big factor,” he said.

 

By DONALD G. McNEIL Jr.

NYTimes