Charity scrambles as Liberia health care system collapses under Ebola

Medical charity Doctors Without Borders has begun distributing antimalarial drugs in Liberia’s capital city of Monrovia, as the country’s already overstretched medical system grapples with a longtime health care crisis made vastly worse by the Ebola outbreak in West Africa. 

Ebola has killed more than 5,000 people since June — most of them in Liberia, whose fragile public health care system has collapsed. Medical professionals have been scrambling to care for people needing surgery and other treatment for other health complications like car crash injuries, pregnancy complications and malaria.

Malaria is mosquito-borne and is endemic to the country, but adequate care has become nearly impossible to come by since the latest West African Ebola epidemic emerged earlier this year.

The first symptoms of malaria are similar to those of Ebola and include fever, headache and overwhelming fatigue. If patients have Malaria, early medication can help reduce their symptoms and make them less likely to go to Ebola test centers — where they incur a higher risk of becoming infected with the deadly hemorrhagic fever virus — said in a statement from Doctors Without Borders, also known as MSF, its abbreviation in French.

“The objective is also to eliminate the risk that patients with fever, suspected of having Ebola, will end up in Ebola treatment centers in contact with infected persons,” said Chibuzo Okonta, MSF’s deputy director of emergency programs.

Stringent safety measures are in place to limit the probability of people spreading or catching the virus while picking up the malaria drugs. Treatment packages are distributed early in the morning, when the streets are still mostly empty and contact is reduced. On Wednesday, 100,000 people — 20,000 families — received a first dose of malaria treatment and mosquito nets in the New Kru neighborhood, a northwestern coastal suburb of Monrovia. MSF said it would distribute the medication at 55 locations in the next two months.

The distribution of antimalarial medication and mosquito nets is taking place in the poorest neighborhoods of Monrovia, benefiting approximately 300,000 people. Access to care in these densely populated areas was “already very limited before the Ebola epidemic,” and “barely exists any longer,” MSF said.

The initiative comes in the week that marks the halfway point in the United Nations’ Ebola response plan, which aims to bring the outbreak under control by the end of November. Massive underinvestment in public health and extreme income inequality have exacerbated the crisis, according to an Oxfam report published on Wednesday.

"Before the outbreak, only 51 doctors were available in Liberia for a population of 4.2 million. Water, sanitation and hygiene facilities were inadequate, unreliable and overstretched," said Paul O'Brien, vice-president at Oxfam America.

The limited presence of experienced field professionals has prompted MSF and others to set up workshops for nongovernmental organizations and humanitarian workers looking to be trained in Ebola protocols. But the number of heath care professionals deployed in the field in the worst-hit countries of Sierra Leone, Liberia and Guinea remains too low to adequately stop the epidemic from infecting more people, according to Oxfam. Prohibitive quarantine protocols in the United States could further deter medical personnel from traveling to West Africa, MSF has warned.