In its long-running civil war that lasted from 1989 to 2003, Liberia lost more than 250,000 citizens as the international community, wary of getting involved in African conflicts, stood on the sidelines. Liberians frustrated by the lack of international response stacked bodies of the dead at the U.S. Embassy in the capital, Monrovia.
The West African nation is once again being ravaged by a terrible crisis that is threatening the very fabric of its society. The Ebola epidemic has gone from bad to worse in recent months. Treatment centers set up to isolate and care for Ebola patients are overflowing, leaving the sick and dying to lie on the ground outside the centers in the hope that a bed opens up for them. Over the last few weeks, I have seen young children close to death turned away from crowded centers and heard stories of ill relatives left at home waiting for days to be picked up by ambulances.
In a move that has been widely welcomed in Liberia, President Barack Obama announced on Tuesday that the United States will set up a military command in Monrovia to help deal with the crisis. The U.S. will construct large treatment facilities and train local health workers, the White House said in a statement. If built and staffed quickly, these facilities have the potential to save thousands of lives. But bureaucratic delays or a lack of medical personnel to staff those facilities could make the outbreak uncontrollable.
Dying of preventable illness
Nongovernmental organizations such as Doctors Without Borders (DWB) and their Liberian colleagues have performed admirably, but exhausted staffers warn that the disease is spreading much faster than they can care for those already stricken by the virus. Liberians have shown a heroic response to the epidemic. Health care providers work under dangerous conditions in overcrowded treatment facilities; ordinary citizens disseminate prevention materials to each other and drive ambulances. Despite these efforts, unless the international community acts immediately, many more will die.
The World Health Organization (WHO) says “many thousands of new cases are expected in Liberia over the coming three weeks.” The WHO emphasized that current efforts are falling short of what is needed to win the battle against Ebola. The alarming assessment echoes earlier comments by DWB.
“Rather than building new Ebola care centers in Liberia, we are forced to build crematoria,” said MSF president Dr. Joanne Liu in a speech to the United Nations on Sept. 2, adding that her staff is “completely overwhelmed.”
The lack of treatment facilities for those who have contracted Ebola has terrible consequences. Those Liberians suspected of being infected must travel across Monrovia, often stopping at one of the three main destinations for treatment multiple times. When they arrive at a treatment center, they are often told that there is no space for them and directed to yet another overcrowded facility. The risk of infecting others increases as the patients grow sicker while in transit or back at home. The few ambulances that are running pickup and drop-off services are forced to leave patients waiting in front of treatment centers. Another common practice is for families to pay taxi drivers to carry contagious loved ones to the facilities. This is no way to fight the worst Ebola outbreak in history.
The case cannot be made any more strongly: The United States and other global powers must initiate their planned response without delay and ensure that help arrives immediately.
To make matters worse, people are dying of preventable illnesses as underequipped health workers refuse to examine anyone displaying even the slightest potential symptoms of Ebola. Malaria is the leading cause of morbidity and mortality in Liberia, causing thousands of deaths every year. The collapse of the country’s health services holds dire consequences for people with malaria and other illnesses who could be saved with the most basic care. Outside the Ebola unit at John F. Kennedy Hospital on Sept. 12, a family wailed over the body of their dead mother, whom they say died of untreated diabetes. Nervous hospital staff had referred them to the Ebola unit next door, where the family was told she did not appear to have the virus and that they should bring her back to the main unit. Her condition worsened and she passed away as the family moved her back and forth.
The case cannot be made any more strongly: The United States and other global powers must initiate their planned response without delay and ensure that help arrives immediately. The United States in particular bears responsibility to lend its hand to Liberia. Founded by freed American slaves, Liberians see themselves as our distant cousins. For too much of its history, Liberia has been neglected and ignored by its closest Western relative, who has time and again failed to act to save Liberian lives.
So far, however, efforts have been underwhelming and slow. On Sept. 8, the Pentagon announced plans to set up a $22 million, 25-bed field hospital to support health workers who are trying to contain the spread of the deadly virus. It is critical that the U.S. forces arrive soon and are able to construct, equip and staff new treatment facilities in the coming days and weeks.
This time around, Liberians hope that the U.S. response will be different, and that the Obama administration’s plan will be carried out with the urgency needed to bring a quick end to the outbreak. Trained personnel must be sent to staff the facilities that the U.S. military will build, and home care packages must reach families of the sick immediately. Ambulance and health care workers must receive adequate equipment and compensation to continue to perform their duties. There is also a need to educate Liberians that Ebola is survivable, so that fear and stigma do not further complicate the response. The most critical element of all is time: Every life saved matters.