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The United States is planning to build as many as 17 Ebola treatment centers in Liberia, with about 1,700 treatment beds, while the United Nations is planning an expanded mission in the region, based in Accra, Ghana, according to Anthony Banbury, the United Nation’s Ebola operation crisis manager. It is intended to be more nimble than the United Nations’ notoriously bureaucratic operations, bringing in as many as 500 trucks and jeeps from other missions in Africa, possibly paying teams in one country to speed up safe burials, buying fuel for monitoring teams in another country, or offering helicopters to transport health workers where they are needed.

Whether Sierra Leone’s lockdown will constitute an effective response is open to question. Despite the mobilization, the volunteers hardly appeared to be thick on the ground. In some neighborhoods, residents said they were yet to see any of the green-vested young men and women who had volunteered.

While many have emphasized the enormous assistance hauled into the region by the United States and international organizations, there is strong evidence, especially here in Monrovia, that the biggest change came from the precautions taken by residents themselves.“Fundamentally, this is about the extent to whi

Reeling from the explosion of infections in August, volunteer Ebola watchdog groups sprang up in many neighborhoods, typically overseen by local elders and led by educated youths, drawing from a long history of community organizing to survive war, poverty and government neglect.

“Heroes emerged in every community,” said Dr. Mosoka Fallah, a Harvard-trained Liberian epidemiologist who often acted as a liaison between neighborhoods and the government. “The volunteer task forces may be the biggest reason behind the drop in October.”

United Nations officials said Tuesday, estimating the cost of this effort at $1 billion.

Most of the patients in the United States also received experimental drugs or plasma transfusions, but doctors say rehydration played a major role in saving them.

Ebola wards need an unusually high level of staffing, Dr. Sprecher said. Not only does each patient require a lot of care, but the protective gear causes health workers to overheat so quickly and severely, especially in wards that lack air-conditioning in bare-bones facilities, that they cannot work for more than an hour without coming out to cool down. Extra workers are needed so that they can spell each other.

The Security Council in September passed a resolution that declared Ebola a threat to international peace and security. On Tuesday, it heard sobering alarms about Ebola’s widening impact on the region.

Hervé Ladsous, the under secretary general for peacekeeping, told the Council that 39 peacekeepers in Liberia were currently “under quarantine or are being closely watched for possible exposure.”

While the United States, Canada and Britain have taken emergency steps to screen international passengers to limit the risk of importing Ebola, most of Europe is still struggling with that issue.

But one piece is missing: staff. The facility opened recently with a skeleton crew. Now, in an especially hard-hit area where people are dying every day because they cannot get into an Ebola clinic, 60 of the 80 beds at the Kerry Town Ebola clinic are not being used.

It is like this with a lot here: good intentions, bad planning. Aid officials in Sierra Leone say poor coordination among aid groups, government mismanagement and some glaring inefficiencies are costing countless lives.

Even after patients recover, many treatment centers delay releasing them for more than a week until there are enough other survivors, sometimes dozens, to hold one huge goodbye ceremony for everyone — again, keeping desperately needed beds occupied. “I just wanted to get home and see my wife,” said Suliman Wafta, a recent Ebola survivor treated nearby. “But I had to wait eight extra days.

The U.S. government is sending flimsy plastic aprons and gauze masks to the Africans with assurances that the donning and removal processes are where the majority of the risk to caregivers is realized. This is simply not true. As is evident by the precautions currently being taken in the U.S. and other developed countries, multiple layers of protection are employed by health workers, and cadavers are treated as highly infectious.

President Obama has sent nearly 5,000 members of the U.S. military to West Africa to assist in trying to stop the spread of the disease for a very good reason — the problem is quickly spinning out of control, and has the potential to become a serious national security concern.

Since 2010, the Department of Defense has partnered with Tekmira Pharmaceuticals to develop a vaccine for Ebola. Tekmira was given ‘fast track’ authority to develop a vaccine earlier this year.

One of the worst parts of the crisis is that the countries affected are being abandoned. Several airlines have cancelled flights, non-governmental agencies are calling their personnel home, and neighboring countries have closed their borders. Consequently, even those doctors and nurses recruited by foreign charities have difficulty accessing the countries.

The Ebola epidemic has overwhelmed its health professionals. With four million people, Liberia has only 200 doctors and 1,500 nurses, most of whom are in and around the capital of Monrovia.

As with most emergencies in developing countries, it is their health professionals that provide most of the care to their citizens. They are in a better position than the brave volunteers from foreign charities to manage a crisis, since they know the country’s customs, language, and are there for the long haul. However, one of the major problems faced by poor countries is the inadequate number of trained health workers.

But it is only now, four or six months later, that the great machine of the so-called "international community", the United Nations, is lumbering into action.

Imagine trying to set up and run a medium sized multinational company. But then imagine trying to set it up in countries with very bad roads and electricity supply, dodgy telecommunications and mostly badly-educated populations

To establish your "multinational company" you have to do some mundane tasks. You have to bring in people from all over the world. Then you have to feed and house them. You have to get them cars and desks and telephones. You have to make sure each bit of the machine knows what the other bits are doing. And that's before your aid workers can move to the front line and actually do their job.

A senior European diplomat in Geneva involved in health issues, who was not authorized to speak publicly, lamented the limited international response. “The scale of the epidemic is what the international community is still not getting,” the diplomat said. “It’s becoming obvious that what you need is to scale up by a factor of 20. There’s not enough international coordination and imagination going into this.”

uba sent 165 doctors and nurses last week, China has expanded a medical team deployed there, and British personnel are scouting sites for at least five new centers and 700 additional beds that will bring the total closer to the World Health Organization’s target of about 1,300 beds.

United States delivers on a pledge to provide up to 17 100-bed units, said Dr. Ian Norton, who is coordinating foreign medical teams for the W.H.O. In Guinea, the W.H.O. says there are four treatment centers working with 160 beds available, with 100 more beds needed.

But the latest round of fighting appears to have given Israel the upper hand in a conflict that has already outlasted all expectations and is increasingly becoming a war of attrition.

Israel’s advantage has never looked more lopsided. In contrast to the earlier phase of the war, Israel this week deployed its extensive intelligence capabilities and overwhelming firepower in targeted bombings with limited civilian casualties less likely to raise the world’s ire.

“There’s a longstanding conventional wisdom that Israel doesn’t do well in wars of attrition,” said Michael B. Oren, an Israeli historian and a former ambassador to the United States. “That overlooks a broader historical view that Israel’s entire existence has been a war of attrition, and we’ve won that war.”