JOE RAEDLE/GETTY IMAGES Ebola VictimWent From Liberian …

VOL. CLXIV . . . No. 56,646 © 2014 The New York Times NEW YORK, MONDAY, OCTOBER 6, 2014

Late EditionToday, sunshine mixing with someclouds, breezy, high 68. Tonight, in-creasing clouds, low 60. Tomorrow,a shower in the afternoon, high 73.Weather map appears on Page C8.

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By KEVIN SACK

DALLAS — The murderouscivil war that terrorized Liberiafrom 1989 to 2003 left at least 5percent of the population dead,and sent wave after wave of refu-gees to neighboring countries. Toescape the ethnic and politicalturmoil, more than 700,000 fledfrom a nation that had barely twomillion residents when the con-flict began.

Among them were ThomasEric Duncan, the man whobrought the Ebola virus to theUnited States last week, and Lou-ise Troh, the woman he had cometo Dallas to visit. After meeting inthe early 1990s in a refugee en-campment near the Ivory Coastborder town of Danané, the twoLiberians started a relationshipand bore a son, several familymembers said.

It is not clear what drove thecouple apart — Mr. Duncan, 42,who is fighting for his life at aDallas hospital, has not spokenpublicly, and Ms. Troh, 54, whowill be quarantined for anothertwo weeks, declined to discusstheir history.

But starting in 1998, when Ms.Troh left for the United States —first settling in Boston, and thenin Dallas with another Liberianman — they began a 16-year sep-aration.

Not only did Mr. Duncan notsee Ms. Troh, he missed the en-tire childhood of their son, Kar-siah, who adapted well enough tohis new home to become thestarting quarterback for the Con-

JOE RAEDLE/GETTY IMAGES

Parishioners, many of them Liberian, prayed for victims of Ebola during a church service in Euless, Tex., on Sunday.

Ebola Victim Went From Liberian War to a Fight for LifeJoyful Reunion Turns

Into Health Crisis

Continued on Page A13

By ADAM NOSSITER

FREETOWN, Sierra Leone —It has been sitting idly on thedocks for nearly two months: ashipping container packed withprotective gowns, gloves, stretch-ers, mattresses and other med-ical supplies needed to help fightSierra Leone’s exploding Ebolaepidemic.

There are 100 bags and boxesof hospital linens, 100 cases ofprotective suits, 80 cases of facemasks and other items — in all,more than $140,000 worth of med-ical equipment locked inside adented container at the port sinceAug. 9.

Hundreds of people have diedof Ebola in Sierra Leone sincethen, and health workers haveendured grave shortages of life-saving supplies, putting them ateven greater risk in a countryreeling from the virus.

“We are still just hoping (!!!)— which sounds like BEGGING— that this container should becleared,” one government officialwrote in a frantic email to his su-periors, weeks after the containerarrived.

In many ways, the delay re-flects what some in the growingranks of international officialspouring into this nation to fightEbola describe as a chaotic, dis-organized government responseto the epidemic.

“It’s a mess,” said one foreign

official working alongside the Si-erra Leone government agencyset up to deal with the crisis. Theofficial, who spoke on condition ofanonymity to maintain vital rela-tions with the government, saidthat nobody appeared to be incharge at the agency, known asthe “emergency operations cen-ter,” and that different factionsmade decisions independently.

“It’s the only body responsi-ble,” the official said. “What is itdoing?”

In the case of the shipping con-tainer, the desperately neededsupplies seem to have been

caught, at least in part, in a trapthat is common the world over:politics, money and power.

The supplies were donated byindividuals and institutions in theUnited States, according to Cher-noh Alpha Bah, who organizedthe shipment. But Mr. Bah wearsanother hat, as well. He is an op-position politician from PresidentErnest Bai Koroma’s hometown,Makeni — a place that clearlyshowed the government’s inabili-ty to contain Ebola.

A recent surge of cases therequickly overwhelmed healthworkers, with protective gear solacking that some nurses haveworked around the deadly virusin their street clothes.

More than 80 health care work-ers in Sierra Leone have died inthe outbreak, and even in thecapital, Freetown, some burial

SAMUEL ARANDA FOR THE NEW YORK TIMES

Chernoh Alpha Bah in Freetown, Sierra Leone, on Friday. Med-ical supplies that Mr. Bah shipped to Sierra Leone to help fightEbola have sat in a shipping container for almost two months.

Help Nearby, But DelayedOn the Docks

PRAYERS AND AID Liberianchurches on Staten Island sendmoney and supplies. PAGE A12

NEW YORK PREPARES Dispatch-ers for 911 now ask about recenttravels to West Africa. PAGE A12

By JONATHAN MAHLER

Who owns How?No, that’s not a line from a Dr.

Seuss book or an Abbott and Cos-tello routine.

It’s the question at the centerof a bitter legal battle pitting abest-selling author and manage-ment guru against America’slargest Greek yogurt manufac-turer.

The author, Dov Seidman, is inthe business of helping compa-nies create more ethical cultures.He has distilled that business to asingle three-letter word: how.President Bill Clinton wrote theforeword to his book, “How: WhyHow We Do Anything Means Ev-erything.” (“This is a HOW book,

not a how-to book,” it begins.) Enter the yogurt maker, Cho-

bani. Founded in 2005 by a Turk-ish immigrant who was turnedoff by the runny texture of Ameri-can yogurt, Chobani recently gotinto the “How” business, too. Thecompany is in the midst of an am-bitious brand campaign intendedto highlight the quality of its yo-

gurt and the way it is made, in-cluding a straining process thatmakes it extra dense. It is builtaround the phrase “How Mat-ters.”

To Mr. Seidman, who also uses“How Matters” in some of hismaterials, the campaign repre-sents a frontal assault on thebrand that his company, LRN,

has spent 10 years building. Cho-bani has stolen his “How,” hesays, and he wants it back. He issuing the company and its ad-vertising agency, Droga5, askinga court to order Chobani to haltthe campaign because it repre-sents an infringement on histrademark for the word how.

Chobani and Droga5 have re-sponded aggressively, not onlydenying that they had ever heardof Mr. Seidman — let alone stolenhis intellectual property — butalso asking the court to cancelLRN’s trademark for “How,” say-ing that it’s too broad. To top itoff, Chobani has filed its owntrademark application for thephrase “How Matters.”

There have been trademark

If the Word ‘How’ Is Trademarked, Does This Headline Need a ™?

The author Dov Seidman’s book title and the yogurt makerChobani’s slogan have led to a fight over a three-letter word.



By DAMIEN CAVE and FRANCES ROBLES

EL PARAÍSO, Guatemala —The smugglers advertised on theradio as spring bloomed intosummer: “Do you want to livebetter? Come with me.”

Cecilia, a restless wisp of a girl,heard the pitch and ached to go.Her stepfather had been mur-dered, forcing her, her motherand four younger siblings intoher aunt’s tiny home, with justthree beds for 10 people. It was allthey had — and all a smugglerneeded. He offered them a loan of$7,000 for Cecilia’s journey, withthe property as a guarantee. “Igave him the original deed,” saidJacinta, her aunt, noting that thesmuggler gave them a year to re-pay the loan, with interest. “I didit out of love.”

The trip lasted nearly a month,devolving from a journey of wantand fear into an outright abduc-tion by smugglers in the UnitedStates. Freedom came only afteran extra $1,000 payment, made ata gas station in Fort Myers, Fla.,as her kidnappers flashed a gun.

Now in Miami, Cecilia, 16, isone of more than 50,000 unaccom-panied minors who have come tothe United States illegally fromCentral America in less than ayear. Though the number of newarrivals has been declining, the

Obama administration says it isdetermined to “confront thesmugglers of these unaccompa-nied children,” and the “cartelswho tax or exploit them in theirpassage.”

But breaking up these net-works will be difficult. Behind thesurge of young migrants showingup for a shot at the Americandream is a system of cruel andunregulated capitalism with aproven ability to adapt. The hu-man export industry in the re-gion is now worth billions of dol-lars, experts say, and it has be-come more ruthless and sophis-ticated than ever, employing agrowing array of opportunistswho trap, rape and rob from thepoint of departure to the end ofthe road.

Thousands of migrants are be-lieved to be kidnapped andabused every year while goingthrough Mexico. Others, like Ce-cilia, are held for ransom in theUnited States, and officialsacross the region lament that theugly business of human smug-gling keeps getting uglier. Espe-cially here in Guatemala, smug-glers, or “coyotes,” have grownincreasingly adept at marketingthemselves to poor families,drumming up hopes with falsedepictions of American immigra-tion policy, then squeezing theirprey with death threats, demand-ing payment through bank loansor property titles.

The result, visible throughoutmountain villages like this one, isa relentless cycle with depar-tures that ebb and flow but neverseem to end. In this self-perpetu-ating system, the seeds of futuremigration have already beensown in the debts of the past andpresent. Cecilia’s inability to sendmoney home right away led herpregnant mother to try to makethe journey herself a few weekslater in a desperate bid to savethe house, only to fail. Now she

A Smuggled Girl’s OdysseyOf False Promises and Fear

Part of Pattern, Migration Turns Into an Abduction

ANDREA BRUCE FOR THE NEW YORK TIMES

Cecilia’s mother in the homein El Paraíso, Guatemala, that10 family members share. Continued on Page A8

By JONATHAN WEISMAN

ORANGE, Va. — In June, afterhe had written a scorching opin-ion article seeking to constrainthe president’s unilateral powerto make war, Senator Tim Kaineof Virginia, one of Barack Oba-ma’s earliest supporters, button-holed the commander in chief atthe White House for what hecalled “a spirited discussion.”

The militants of the IslamicState were pouring across the

Syrian borderinto Iraq, andseizing citieswhere so muchAmerican bloodand treasure hadbeen spilled. ButMr. Kaine saidhe told the presi-dent in no uncer-tain terms that ifhe intended to goto war, he would

have to ask Congress’s permis-sion. President Obama politelybut firmly disagreed.

They have been battling eversince.

Mr. Kaine is an unlikely leaderin the fight between Congressand the White House over a dec-laration of war. Genial and junior,the former Virginia governor wason Mr. Obama’s short list for thevice presidency in 2008. He be-came Mr. Obama’s handpickedDemocratic Party chairman, thenhis handpicked senatorial candi-date after Senator Jim Webb, a

An Obama AllyParts With HimOn War Powers


SenatorTim Kaine

By PAUL MOZUR and VINDU GOEL

HONG KONG — For Americantechnology companies fromMicrosoft to Facebook to Google,China is a difficult, even impossi-ble, place to operate.

But one company, the socialnetwork LinkedIn, has found away to do business — by beingwilling to compromise on the freeexpression that is the backboneof life on the Western Internet.

LinkedIn’s experience pro-vides a blueprint, and perhaps acautionary lesson, for Silicon Val-ley as it tries to crack the vastChinese market. Other Americantech companies are watchingwith great interest, wonderingwhether LinkedIn will find anequilibrium between free speechand Chinese law that it can livewith.

“Over the next five years,things will continue to progressin a positive fashion over there,so it’s important to be there to-day,” said Kerry Rice, an Internetanalyst at Needham, a brokeragefirm. “If LinkedIn figures outhow to navigate the operating en-vironment in China, clearly othercompanies will try to imitatethat.”

LinkedIn’s global English-lan-guage site has attracted four mil-lion Chinese members withoutgaining much attention from theChinese government. But thecompany wanted to reach moreof China’s estimated 140 million

To Reach China,LinkedIn PlaysBy Local Rules

Continued on Page B5

State officials have begun catalogingbloodstained uniforms and other storedobjects, including a makeshift knife,above, from the 1971 uprising at Atticaprison. PAGE A19

NEW YORK A17-21

Reviewing Artifacts of a Revolt Mike Moustakas and Kansas City sweptthe Los Angeles Angels in an AmericanLeague division series and will face Bal-timore, which swept its series againstthe Detroit Tigers. PAGE D3

SPORTSMONDAY

Royals and Orioles Advance

A tightly contested election in Brazilwas narrowed to a race between Presi-dent Dilma Rousseff and Aécio Neves,the scion of a political family. PAGE A4

INTERNATIONAL A4-11

Brazilian Leader Faces Runoff

Some drivers who take workers to andfrom the company’s headquarters wantto join the Teamsters union. PAGE B1

Facebook Bus Drivers Organize

“The Curious Incident of the Dog in theNight-Time” shows an autistic genius’sworld. Ben Brantley reviews. PAGE C1

ARTS C1-7

An Autistic Boy’s Story Dazzles

Norman Lear, 92, whose 1970s sitcom“All in the Family” shattered TV’s rules,has written a memoir. PAGE C1

Those Were (and Are) His Days

Paul Krugman PAGE A23

EDITORIAL, OP-ED A22-23

Afghanistan’s new government is allow-ing the return of a New York Times cor-respondent who was expelled. PAGE A4

Afghans Lift Ban on Reporter

Michael Vick replaced Geno Smith atquarterback in a rout by San Diego. TheGiants rallied past Atlanta. PAGE D1

SPORTSMONDAY D1-8

Jets Bench Smith in a Loss Proposition 47, if approved, would alterpenalties for low-level theft and drug-possession crimes. PAGE A14

NATIONAL A14-16

In California, a Vote on Prisons

Hewlett-Packard is expected to splitinto two entities, one for personal com-puters and printers and one for corpo-rate equipment and services. PAGE B1

BUSINESS DAY B1-6

Hewlett-Packard Plans Split

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FREETOWN, Sierra Leone

IT has been sitting idly on the docks for nearly two months: a shipping container packed with protective gowns, gloves, stretchers, mat-

tresses and other medical supplies needed to help fight Sierra Leone’s exploding Ebola epidemic.

There are 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks and other items — in all, more than $140,000 worth of medical equipment locked in-side a dented container at the port since Aug. 9.

Hundreds of people have died of Ebola in Si-

erra Leone since then, and health workers have endured grave shortages of lifesaving supplies, putting them at even greater risk in a country reeling from the virus.

“We are still just hoping (!!!) — which sounds like BEGGING — that this container should be cleared,” one government official wrote in a frantic email to his superiors, weeks after the container arrived.

In many ways, the delay reflects what some in the growing ranks of international officials pouring into this nation to fight Ebola describe

By ADAM NOSSITER



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SenatorTim Kaine










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SenatorTim Kaine










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as a chaotic, disorganized govern-ment response to the epidemic.

“It’s a mess,” said one foreign of-ficial working alongside the Sierra Le-one government agency set up to deal with the crisis. The official, who spoke on condition of anonymity to maintain vital relations with the government, said that nobody appeared to be in charge at the agency, known as the “emergency operations center,” and that different factions made decisions independently.

“It’s the only body responsible,” the official said. “What is it doing?”

In the case of the shipping con-tainer, the desperately needed sup-plies seem to have been caught, at least in part, in a trap that is common the world over: politics, money and power.

The supplies were donated by individuals and institutions in the United States, according to Chernoh Alpha Bah, who organized the ship-ment. But Mr. Bah wears another hat, as well. He is an opposition politician from President Ernest Bai Koroma’s hometown, Makeni — a place that clearly showed the government’s in-ability to contain Ebola.

A recent surge of cases there quickly over-whelmed health workers, with protective gear so lacking that some nurses have worked around the deadly virus in their street clothes.

More than 80 health care workers in Sierra Leone have died in the outbreak, and even in the capital, Freetown, some burial crews wear pro-tective gowns with gaping holes in them, a clear indication of the urgent need for more supplies.

The government official who pleaded for the shipment to come in said that the political tensions may have contributed to the delay, to prevent the opposition from trumpeting the donations.

Mr. Bah said he thought the equipment would be welcomed by the struggling authori-ties, and he said he expected the shipping fee of $6,500 would be a small detail for Sierra Leone. According to the official, the government has already received well over $40 million in cash from international donors to fight Ebola.

The shipping company, as a good-will ges-ture in a moment of crisis, had agreed to send the goods without being paid first, Mr. Bah said. But no more. Three other containers of similar value

await shipment from the United States, he said, halted by the government’s long refusal to pay.

“We will appreciate if the payment is made quickly so that the medical supplies will be sent directly to the affected or targeted areas,” Mr. Bah wrote to the government on Aug. 16.

Instead, top government officials argued over the fee, said that the proper procedures had not been followed, and finally brushed aside the official urging that the supplies be let in, say-ing they wanted to hear nothing more about it.

“They are blaming us for shipping in with-out authorization,” Mr. Bah said. “It appears all they are interested in is cash donations. And all we have are supplies.”

At one point, a senior official close to the president, Sylvia Olayinka Blyden, acknowl-edged in an email that the items listed in Mr. Bah’s container were “very impressive.” But she said “future shipments” should follow pro-cedure. That was on Sept. 1, and she has since left her post. The goods are still inside the con-tainer on the dock here.

“He should have contacted the ministry and discussed it with the ministry,” Yayah A. Con-teh, an official at the health ministry, said of Mr. Bah, adding that the medical supplies would be cleared “very soon.”

In times of crisis, when needs are great and officials are overburdened, trickles of uncoordi-nated donations can be a distraction, some aid workers say, requiring a lot of attention without solving the biggest problems.



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But some Sierra Leoneans say that the gov-ernment’s resistance has discouraged other po-tential donors in the diaspora.

Ibrahim Kamara, a Sierra Leonean in Canada who has put together what he says is a $55,000 container of medical supplies, said that he was now encountering the same prob-lems with the government — an unwillingness to pay the $5,000 shipping fee.

“There is no positive response, no feedback, no anything,” Mr. Kamara said. “It’s been over a month now.”

The emergency operations center was es-tablished to manage the urgent but confusing patchwork of agencies and international aid groups trying to battle the virus. The health ministry itself has been rocked by corruption and mismanagement scandals in recent years, further weakening efforts in a country that, even before the Ebola epidemic, suffered from some of the world’s worst health statistics after a brutal 10-year civil war.

Twenty-nine of the country’s top health of-ficials were indicted last year in connection with the misappropriation of a half-million dollars in vaccination funds. The leaders were all acquit-ted. A free health care program set up by for-

eign donors has been damaged by corruption problems, with nurses illegally selling drugs and doctors charging for services. In 2010, a for-mer health minister was convicted on corrup-tion charges. This year, the health minister was pushed aside during the Ebola crisis amid ques-tions over her competence.

At a recent meeting at the emergency op-erations center, local politicians discussed at length how they might be able to use the gov-ernment’s recent three-day national lockdown — in which volunteers went door-to-door to educate people about Ebola — for their own political benefit.

Meanwhile, reported cases of Ebola are doubling every 30 to 40 days, according to the United States Centers for Disease Control and Prevention. More than 620 deaths have been recorded, with the real number almost cer-tainly much higher.

The government official who pleaded for the supplies to be let in argued that the epidemic, “like the war we experienced between 1991 and 2002,” had exposed the extent of government corruption.

The more urgent the pleas, the official said, the more it “elicited only disdain from some people in authority.” n

A12 N THE NEW YORK TIMES, MONDAY, OCTOBER 6, 2014

CONFRONTING AN OUTBREAK

crews wear protective gownswith gaping holes in them, a clearindication of the urgent need formore supplies.

The government official whopleaded for the shipment to comein said that the political tensionsmay have contributed to the de-lay, to prevent the oppositionfrom trumpeting the donations.

Mr. Bah said he thought theequipment would be welcomedby the struggling authorities, andhe said he expected the shippingfee of $6,500 would be a small de-tail for Sierra Leone. Accordingto the official, the governmenthas already received well over$40 million in cash from interna-tional donors to fight Ebola.

The shipping company, as agood-will gesture in a moment ofcrisis, had agreed to send thegoods without being paid first,Mr. Bah said. But no more. Threeother containers of similar valueawait shipment from the UnitedStates, he said, halted by the gov-ernment’s long refusal to pay.

“We will appreciate if the pay-ment is made quickly so that themedical supplies will be sent di-rectly to the affected or targetedareas,” Mr. Bah wrote to the gov-ernment on Aug. 16.

Instead, top government offi-cials argued over the fee, saidthat the proper procedures hadnot been followed, and finally

brushed aside the official urgingthat the supplies be let in, sayingthey wanted to hear nothingmore about it.

“They are blaming us for ship-ping in without authorization,”Mr. Bah said. “It appears all theyare interested in is cash dona-tions. And all we have are sup-plies.”

At one point, a senior officialclose to the president, SylviaOlayinka Blyden, acknowledgedin an email that the items listed inMr. Bah’s container were “veryimpressive.” But she said “futureshipments” should follow pro-cedure. That was on Sept. 1, andshe has since left her post. Thegoods are still inside the contain-er on the dock here.

“He should have contacted theministry and discussed it withthe ministry,” Yayah A. Conteh,an official at the health ministry,said of Mr. Bah, adding that themedical supplies would becleared “very soon.”

In times of crisis, when needsare great and officials are over-burdened, trickles of uncoordi-nated donations can be a dis-traction, some aid workers say,requiring a lot of attention with-out solving the biggest problems.

But some Sierra Leoneans saythat the government’s resistancehas discouraged other potentialdonors in the diaspora.

Ibrahim Kamara, a Sierra Le-onean in Canada who has put to-

gether what he says is a $55,000container of medical supplies,said that he was now encoun-tering the same problems withthe government — an unwilling-ness to pay the $5,000 shippingfee.

“There is no positive response,no feedback, no anything,” Mr.

Kamara said. “It’s been over amonth now.”

The emergency operationscenter was established to man-age the urgent but confusingpatchwork of agencies and in-ternational aid groups trying tobattle the virus. The health min-istry itself has been rocked by

corruption and mismanagementscandals in recent years, furtherweakening efforts in a countrythat, even before the Ebola epi-demic, suffered from some of theworld’s worst health statistics af-ter a brutal 10-year civil war.

Twenty-nine of the country’stop health officials were indicted

last year in connection with themisappropriation of a half-milliondollars in vaccination funds. Theleaders were all acquitted. A freehealth care program set up byforeign donors has been dam-aged by corruption problems,with nurses illegally sellingdrugs and doctors charging forservices. In 2010, a former healthminister was convicted on cor-ruption charges. This year, thehealth minister was pushed asideduring the Ebola crisis amidquestions over her competence.

At a recent meeting at theemergency operations center, lo-cal politicians discussed at lengthhow they might be able to use thegovernment’s recent three-daynational lockdown — in whichvolunteers went door-to-door toeducate people about Ebola — fortheir own political benefit.

Meanwhile, reported cases ofEbola are doubling every 30 to 40days, according to the UnitedStates Centers for Disease Con-trol and Prevention. More than620 deaths have been recorded,with the real number almost cer-tainly much higher.

The government official whopleaded for the supplies to be letin argued that the epidemic, “likethe war we experienced between1991 and 2002,” had exposed theextent of government corruption.

The more urgent the pleas, theofficial said, the more it “elicitedonly disdain from some people inauthority.”

Help for Ebola Victims Is Nearby, but Is Delayed on the Docks in Sierra Leone


Chernoh Alpha Bah in Freetown. Many health care workers in Sierra Leone have died of Ebola.

From Page A1

By MARC SANTORA

One week after the first diagno-sis of Ebola in a patient in theUnited States, every person whocalls 911 in New York City and re-lates symptoms such as fever orvomiting is now being asked anew question:

Have you been to West Africain the last three weeks? If so, didyou come into contact with some-one sick with the virus?

If the caller has traveled to oneof the countries where the diseasecontinues to spread, a series ofprotocols is supposed to kick in,starting with the emergency med-ical workers’ donning protectivegear to limit their risk of infection.

Taking of a travel history by 911dispatchers is one of a series ofmeasures the city has been usingin recent months to prepare forthe arrival of the virus, effortsthat have been stepped up sincelast week, when a man travelingfrom Liberia was told he had thedisease in Dallas.

New York officials are alsoreaching out to the city’s West Af-ricans, encouraging anyone whomay be sick and who has been ex-posed to Ebola in recent weeks tobe checked out at a hospital.

Dr. Thomas R. Frieden, the di-rector of the Centers for DiseaseControl and Prevention, told re-porters on Sunday that fear of thevirus was not a bad thing.

“For health care workers, wewant them to be scared,” Dr. Frie-den said. That fear, he said, en-sures a healthy respect for the vi-rus that can be channeled into be-ing “incredibly meticulous” aboutinfection control.

New York City officials saidthey did not want to repeat mis-takes made in Dallas, where thepatient was at first sent homefrom a hospital even though hetold health care workers that hehad recently been in Liberia.

“Identifying potential Ebolacases is not easy or straightfor-ward,” said Dr. Irwin Redlener,the director of the National Cen-ter for Disaster Preparedness atColumbia University and a spe-cial adviser to Mayor Bill de Bla-sio.

He said that while the city haddone extraordinary work in pre-paring, it was possible the viruswould still find its way here.

“But it won’t be because thiscity isn’t doing everything pos-sible to keep any situation undercontrol,” he said.

One vital message that needs tobe communicated, he said, is let-ting New York’s West Africansknow they can seek medical careregardless of their immigrationstatus or ability to pay.

Since the city’s emergencyrooms are one of the first lines ofdefense against the spread of thedisease, hospitals have steppedup their own preparations.

In addition to increased train-ing and education and emergencydrills, test patients simulatingsomeone who might have Ebolaare being dispatched to assess thereaction of the staffs.

Dr. Ross Wilson, the chief med-ical officer at the New York CityHealth and Hospitals Corpora-tion, said that after each test,there is a full debriefing to evalu-

ate performance.“We are very reassured that

most of our training is workingvery well,” Dr. Wilson said. Onearea that needed more work, hesaid, was ensuring that healthcare workers who do not fre-quently put on and remove pro-tective gear know how to do it inthe best and safest way.

As hospitals are preparing forthe possibility of Ebola cases, thefederal government is weighingwhether to increase its screeningefforts at international airports.

The Obama administration isconsidering sending morescreeners to United States air-ports to check passengers arriv-ing from West Africa for Ebola, asenior administration official saidon Sunday.

Even as American officialspublicly express confidenceabout their ability to contain thedisease, they are privatelyweighing a set of more aggres-sive steps to prevent Ebola’sspread in the United States.

The news comes on the eve of ameeting President Obama isscheduled to hold at the WhiteHouse with his national securityteam and other senior officials toreceive an update about the Ebo-la outbreak in West Africa andthe United States’ response.

As recently as Friday, seniorofficials publicly ruled out ex-panding the screening of passen-gers arriving from West Africa orimposing a travel ban, which theysaid would be ineffective or evenharm international efforts tocombat the spread of the virus bylimiting the mobility of medicalworkers and others who could as-sist in the response.

Since August, as the diseasespread in West Africa, the city’shospitals and health care work-ers have been on high alert.

Over the last six weeks, on av-erage, every day one person hasgone to a city emergency roomand been placed in isolation be-cause of concern the patientmight have Ebola. Last weekalone, four people were placed inisolation in city hospitals.

Dr. Mary T. Bassett, the city’shealth commissioner, said thatthe health department had con-sulted with doctors in more than80 cases and, of those, 11 raisedserious concerns.

No one has been found to havethe disease and, in all but one ofthe suspected cases, doctorswere able to rule out Ebola with-out blood tests.

Since September, the city hasbeen able to perform its owntests for Ebola. By not having tosend samples to Atlanta, theheadquarters of the Centers forDisease Control and Prevention,the city can get results withinfour to six hours, Dr. Bassett said.

“We have been dealing withthis for a couple of months,” shesaid. “We are confident that weare ready.”

Emergency medical workersface some of the greatest chal-lenges. Frank Dwyer, a spokes-man for the New York Fire De-partment, said that the depart-ment decided last week to haveits 911 dispatchers ask about trav-el, he said, because it helps makesure that emergency medicalworkers know when they arewalking into a high-risk situation.

New York City Steps UpPreparations for Ebola

Julie Hirschfeld Davis contributedreporting.

By ALAN FEUER

After the offering was takenand the service was coming toan end, the Rev. Roselyn Holder-Dimerson of the Temple of FaithChurch on Staten Island askedher congregation to do togetherwhat they were no doubt al-ready doing on their own.

“Let us pray now,” she said,“for Liberia and for all the otherAfrican countries affected bythis Ebola disease.”

All across Little Liberia, acommunity of African expatri-ates in the Clifton section of Stat-en Island, praying people turnedtheir minds on Sunday to theirhomeland, which has beenstruggling for months with anincreasingly perilous Ebola epi-demic. In large churches and intiny storefront houses of wor-ship, local Liberians this week-end sent their best wishes — andin many cases their money —home to their families, hopingthat their prayers and donationscould make up for a lack of cot-ton balls, rubber gloves and oth-er medical supplies.

There are more than 50 Liberi-an families that worship at theTemple of Faith and each ofthem, said Walters Weah, thechurch’s administrator, knowssomeone overseas who has diedfrom Ebola. Stories havereached Staten Island aboutstricken relatives lying for days— or sometimes weeks — athome without any attentionfrom physicians or the govern-ment.

“We hear about sick peoplewho call for help, and no one

comes to pick them up untilthey’re dead,” Mr. Weah said. Hischurch has begun an effort tobuy an ambulance and ship it, atits own expense, to Liberia. Butwhile the money has been forth-coming, there have been prob-lems getting the aid to where itneeds to be.

“Many of us have given uphope,” Mr. Weah reluctantly ad-mitted. “The government hasdone very little to address the sit-uation. Everyone here is worried,everyone is praying. The truth isthat we don’t know what to do.”

One thing the community hasmanaged to do is set up a handfulof drop-off sites in the neigh-

borhood for donation. It had alsoplanned a concert and fund-rais-ing event for Sunday night at theChrist Assembly LutheranChurch on Hudson Street. Theorganizers, the Liberian Commu-nity Association and the StatenIsland Ministerial Alliance,hoped to raise as much as$50,000 for Ebola relief, Mr.Weah said.

There are five major Liberianchurches on Staten Island, whichis home to a substantial Liberianexpatriate community. Some,like Temple of Faith, maintain in-formal, more familial relationswith their homeland. Others, likethe First Central Baptist Church

on Wright Street, have sent offi-cial missions to Liberia in recentyears, to build schools and affili-ated churches.

“Through our sister church,we have already sent bleach, al-cohol, medical swabs and almost$2,000 overseas,” the Rev. Deme-trius S. Carolina Sr., the pastorat First Central Baptist, said.“It’s obviously a delicate socialand economic situation overthere and we, here on Staten Is-land, are united in trying tocome together and lend supportin as humanely way as we pos-sibly can.”

On Thursday night, officialsfrom the city’s health depart-ment met with leaders of the Af-rican community in the Bronx,and they plan to hold similarevents in the other boroughs.

Dr. Mary T. Bassett, the city’shealth commissioner, said theirimmediate focus was to makesure that anyone who had re-cently traveled from West Africaand had fallen ill went to the hos-pital. All will be treated, regard-less of their immigration statusor their ability to pay.

“These are the people whomost directly affected,” Dr. Bas-sett said. “We want them to havethe information they need.”

For the city’s West Africans, ithas not been easy watching theepidemic from afar. Recently,one member of First CentralBaptist got word that his wife,his daughter and his cousin hadall died of Ebola in Liberia. Oth-er church members have suf-fered similar losses in the lastfew months.

“Is what is going on in Liberiaaffecting us here on Staten Is-land?” Mr. Carolina asked. “Theanswer is, yes. Absolutely, yes.”

PHOTOGRAPHS BY ROBERT STOLARIK FOR THE NEW YORK TIMES

The Temple of Faith Church on Staten Island, led by the Rev. Roselyn Holder-Dimerson, center, is closely watching the epidemic.

Offering Help and Hope as Ebola Epidemic UnfoldsExpatriates at Staten Island ChurchesSend Money, Supplies and Prayers

The Rev. Demetrius S. Carolina Sr., pastor at First CentralBaptist Church in Staten Island, on Sunday. His churchhas sent almost $2,000 to Liberia to combat the outbreak.

Marc Santora contributed report-ing.

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