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Just before arriving in the Ebola-torn nation of Guinea, 33-year-old Craig Spencer posted a picture of himself on Facebook smiling in a yellow hazmat suit, face mask, and gloves—his new uniform.

In the caption next to his image, after announcing his mission with Doctors Without Borders/Médecins Sans Frontières (MSF), he typed a plea: “Please support organizations that are sending support or personnel to West Africa, and help combat one of the worst public health and humanitarian disasters in recent history.”

His brave mission, followed by a devastating diagnosis, complicates an already nightmarish scenario for health-care workers fighting against Ebola: It may be deterring doctors from helping—right when they’re needed most. The news of Spencer’s positive test for the virus, announced Thursday night in New York City, might achieve the exact opposite of his stated goal.

Spencer, whose LinkedIn account lists him as an international emergency-medicine fellow at New York-Presbyterian Hospital/Columbia University Medical Center, completed his assignment in Guinea on Oct. 12 and landed at JFK International Airport on Oct. 14. Once back in his Harlem apartment, he closely monitored his condition, taking his temperature twice a day. Feeling healthy, he reportedly went on a 3-mile jog, as well as took the L train to Williamsburg to go bowling at a venue known as Gutter. According to health officials in New York, he did not present a fever until Thursday morning, meaning he was not symptomatic on public transit. Four people have been identified as potential contacts, including Spencer’s fiancée, but all are in stable condition.

At a press conference Thursday evening, New York Mayor Bill de Blasio addressed the situation calmly. “We want to state at the outset there is no reason for New Yorkers to be alarmed. Ebola is an extremely hard disease to contract,” he said. “Being on the same subway car or living near a person with Ebola does not in itself put someone at risk.” New York City Health Commissioner Mary Travis Bassett reinforced de Blasio’s statements saying that Spencer followed the self-monitoring guidelines set out by MSF for those returning from West Africa, which includes checking one’s temperature twice a day.

In West Africa itself, in the four weeks since Spencer arrived in Guinea, things have gotten worse. Much worse. With close to 10,000 confirmed cases and more than 4,800 deaths in West Africa, humanitarian organizations’ calls for more medical workers have turned to shouts.

Around the time that Spencer decided to go to West Africa, it seemed that the world was finally getting involved. In mid-September, the United States, joined by several other countries, pledged more than $175 million to the fight and 3,000 troops. Days after that announcement, the United Nations Security Council unanimously passed an “unprecedented resolution” calling for $1 billion (and an additional $570 million on behalf of WHO) from world leaders in order to send the people and supplies necessary to contain the epidemic.

Ten days later, when the dust had settled, MSF President Joanne Liu called their bluff. “Generous pledges of aid and unprecedented UN resolutions are very welcome. But they will mean little, unless they are translated into immediate action,” Liu said. “The reality on the ground today is this: The promised surge has not yet delivered.” As of Oct. 17, over a month after the plans were set, the UN has only collected 38 percent of its goal.

MSF, the first humanitarian organization to recognize the epidemic, has been waiting for help to come since March. According to a spokesperson, the organization employs 270 international and around 3,018 locally hired staff in the three affected countries: Liberia, Guinea, and Sierra Leone. Among those nations is a population of 22 million. Some heroic volunteers, like Spencer, have joined the fight—but not enough. “The sick are desperate, their families and caregivers are angry, and aid workers are exhausted,” Liu continued at the meeting. “Maintaining quality of care is an extreme challenge.”

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