More than 300 beds in a matter of weeks.

That's the plan for construction of the "world's largest Ebola treatment unit" in Liberia, says Rajiv Shah, head of USAID, the U.S. Agency for International Development. It's one of 18 facilities going up in Liberia alone.

The czar of the federal agency for foreign aid took a break from his tour of West Africa, where he is monitoring the progress of American interventions, to speak with Morning Edition's Rachel Martin.

"The extraordinary engineering and design is something to watch," Shah said.

Special piping for chlorinated water has been installed, so health care workers can quickly spray down others wearing personal protective equipment after they've treated a patient. Incinerators are being built to dispose of medical waste safely.

A 25-bed "world-class" hospital explicitly for international healthcare workers should also be complete in Monrovia, Liberia, by the end of October, said Shah.

Construction of Ebola facilities is also underway in Sierra Leone and Guinea, he added.

Shah concedes that the number of active Ebola cases will continue to rise before it drops significantly, but he sees hopeful signs: Liberians have already changed their behavior in ways to keep the disease from spreading.

"People are not shaking hands. They're bumping elbows," said Shah. "Everywhere you go, you wash your hands with chlorinated water before walking into any building."

This is Shah's first trip to the region since the outbreak. Asked for his impressions, he spoke of the families who've lost a love one. "It is extraordinarily challenging to lose a member of your family to Ebola. It's even more challenging to know that as that person is passing away, they are a contamination risk, and therefore, the natural human instinct to hug your child is no longer safe. You can just feel the palpable sense of tragedy and that reality," said Shah.

And he had great praise for the healthcare workers. "There are hundreds ... coming in from around the world," he said. "[They] are the heroes of this response. Our goal is to just support these heroes as much as possible and scale this effort as quickly as possible so we tackle Ebola at its source."

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Transcript

RACHEL MARTIN, HOST:

The Ebola outbreak has claimed more than 4,000 lives, most of them in West Africa. Rajiv Shah is the head of the U.S. Agency for International Development. He is in the region to assess what next steps the international community can take to minimize the spread of the disease. We reached him on the line in Guinea. Thanks so much for being with us.

RAJIV SHAH: Thank you.

MARTIN: As we mentioned, you're in Guinea now but you've also been traveling in Sierra Leone and Liberia. Have you seen the scale of the outbreak? Have you seen the victims? Have you talked with any of the families?

SHAH: Well, I have. I've talked to survivors who have expressed how difficult it has been but now that they are survivors, they're encouraging others and letting them know that you can actually survive this disease. I've talked to medical workers who make the point that as we stand up more Ebola treatment facilities, they're seeing more and more patients survive. And that clear sense of hope is what we're trying to encourage in order to really scale the response.

MARTIN: Let's talk about the response. The U.S. has promised to build to 18 Ebola treatment centers in Liberia alone. Can you tell us about the progress on those?

SHAH: Yes. They'll come on line over the next several weeks. I had a chance to visit one of them that is almost complete and will be the world's largest Ebola treatment unit with more than 300 beds. Really, the extraordinary engineering and design is something to watch. I mean, they have to put in special piping for chlorinated water so they can spray down people who have personal protective equipment on. The have to have incinerators and safe places to dispose of medical waste. They need to have intake areas so that patients can safely come in. It's quite complicated but they're going up throughout Liberia. They're going up in Freetown, in Sierra Leone and they're going up in Guinea.

MARTIN: Time is crucial here. These facilities you expect to be on line in the next couple of weeks, but as you know this is an outbreak where every single day matters. Do you just have to concede that in this response effort, many more people are going to die in those two weeks?

SHAH: I expect the number of active Ebola cases will continue to rise before it comes down significantly. That said, there are important things that we can all do right now. As you go through Freetown or Monrovia, everywhere you go, you wash your hands with chlorinated water before walking into any buildings. People are not shaking hands. They're bumping elbows. We know that the 53 burial teams we have supported in Liberia have helped to clear bodies of the deceased. Those types of efforts are all critical to rapid reduction of transmission.

MARTIN: Finally if you could just crystallize for us what it is that you have seen. This is your first trip to the region since the outbreak. What kind of impressions are you leaving with?

SHAH: Well, the most stunning impressions are the stories from families who have lost loved ones. It is extraordinarily challenging to lose a member of your family to Ebola. It's even more challenging to know that as that person is passing away, they are a contamination risk and therefore the natural human instinct to hug your child is no longer safe. You can just feel the palpable sense of tragedy in that reality. At the same time, I come away with an absolute amazement at how large communities are standing up to fight back and I think our goal is to just support these heroes as much as possible, as quickly as possible so we tackle Ebola at its source.

MARTIN: Rajiv Shah is the head of the U.S. Agency for International Development. He spoke to us on the line from Guinea. Thanks so much.

SHAH: Thank you. Transcript provided by NPR, Copyright NPR.

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