Ebola: The Unforgettable Story…And The Task Ahead – By: Y. Solomon W. Watkins, ysolomonwwatkins@gmail.com +231 777 463 908

What began as a single case of the Ebola virus disease (EVD) in the West African nation of Guinea, quickly spread to neighboring Sierra Leone and Liberia. A small number of cases, mostly travel-associated, occurred in Nigeria, Senegal, Spain, Mali, and the United States. The outbreaks in Nigeria, Senegal, and Spain have been declared over.      

In West Africa, a lack of healthcare services, governments weakened by decades of civil wars, and grossly inadequate infection prevention procedures and Personal Protective Equipments (PPE’s) have hampered efforts to contain/curb the spread of the disease. Citizens distrust of the government, misconceptions about how Ebola spreads, and in some cases, myths and misconceptions about the virus existence have prevented efforts to restrain the malady. Critical for health workers and community dwellers has been to isolate those who have come in contact with the virus.

Every day and night, in hot, moist, and really difficult environments, healthcare and social workers performed critical tasks that saved lives and prevent further spread of the virus. For healthcare workers, using PPE’s is one source of discomfort and stress, let alone, being at a health post saving lives is petrifying and sometimes relatives, friends and contacts fear closer contacts whenever they (healthcare workers) are not in such risky environments. Stigmatization and discrimination of communities, families of dead Ebola victims, as well as Ebola survivors are pervasively high; thereby, posing serious challenge to government and partners in containing and decontaminating the outbreak of the virus.   

While attention was being given these, shortage of more health facilities and workers, beds, supplies and land to carryout save burial became international concern.  Patients were left to die in the streets because there was nowhere to put them and nobody to help them. Protest by some communities forbidding burial of Ebola victims in or near their environment, as well as, from families and relatives who felt their deceased members died of something else, other than Ebola, most times brewed conflicts. In Liberia, protest for the government to pay the few brave health workers their risk benefits for working during the height of the Ebola crisis amidst an economy crisis became a concern.

As Ebola intensified, Liberia had to forgo most traditional practices (handshaking, hugging, kissing, washing the bodies of the dead ones, burial rites, etc). For example, it was painful for Liberians to see their loved ones being cremated as the usual burial rites – embalming, wake keeping, touching the body and putting the body in the grave – became associated with spreading Ebola rapidly.

To-date, some 152 healthcare workers have been infected and 79 have died. When the outbreak began, Liberia had only 1 doctor treating nearly 100,000 people in a total population of 4.4 million people, according to the World Health Organization (WHO) factsheet of August, 2014. Every infection or death of a doctor or nurse significantly depleted the response capacity in Liberia.

As of September, 2014, Liberia registered the highest deaths ever in world history, with regards to the EVD.  WHO, later reported on 8th September, 2014, that of all Ebola-affected countries, Liberia stood the most cumulative in figures of reported cases and recorded deaths, tolling  to nearly 2,000 reported cases and more than 1,000 recorded deaths. The case-fatality rate of Liberia stood at 58% (also among the highest-according to the WHO 2014 report). Just about the same time Liberia had lost several of its nurses and few doctors who were willing to stand in the gap of lifesaving duties.

Trepidation loomed over the entire country, Africa and the World when WHO declared World Emergency to curb EVD. But hope came when U. S. President Barack Obama said at the UN General Assembly on 25th September, 2014: “Ebola is a horrific disease. It’s wiping out entire families. It has turned simple acts of love and comfort and kindness — like holding a sick friend’s hand, or embracing a dying child — into potentially fatal acts. If ever there were a public health emergency deserving an urgent, strong and coordinated international response, this is it.”

Recognizing the heavy burden of the virus, countries worldwide scaled up personnel, equipment, financial and technical support to decimate Ebola in West Africa and stop its spread to other parts of the world.

Although it was difficult to break its chain, today the story around its deadly manipulation has positively changed with people in the world, including health practitioners residing in Africa and Africa’s Oldest Republic, Liberia, now welcoming news that the country will soon be freed from the hands of the all-powerful, inhuman and deadly EVD, if Liberia maintains its status of reporting zero new cases of Ebola scourge.

Liberia has made significant strides in response to EVD. On Thursday March 8, 2015, the nation released what was thought as her last diagnosed Ebola patient- Beatrice Yardolo – from a Chinese run-Ebola Treatment Unit (ETU). For Beatrice, three of her five children died from the virus before she became ill and was taken to the treatment center on February 18. The released of Beatrice, a 58-year old and class room teacher, in the words of many Liberians and health experts, marked a major milestone of the Africa-West Africa and partners’ response to the deadly Ebola virus.

However, while all hopes were very high, following more than 10 days of no new cases reported, an outbreak of the virus in the Caldwell Community came to the fore and speculations are still being held over how Ruth Tugbeh, a 44-year old woman contracted the illness. Ruth is said to have contracted EVD from her boy friend that had earlier contacted the virus but survived the EVD. Unfortunately, efforts to restore her life did not materialize as of Friday, March 27, 2015.  

Since the last reported death, Liberia has gone more than 15 days without a new case.

The WHO has announced that while the number of new patients in Liberia is declining, numbers are still fluctuating in both Guinea and Sierra Leone. A total of 30 confirmed cases of Ebola virus disease (EVD) were reported in the week to 5 April. This is the lowest weekly total since the third week of May 2014. Case incidence in Guinea decreased to 21, compared with 57 confirmed cases the previous week. Liberia reported no confirmed cases. Sierra Leone reported a fifth consecutive weekly decrease from 25 confirmed cases in the week to 29 March, 9 cases in the week to 5 April, WHO told the world.

Many thanks to international efforts, including the UN and its organizations, the EU, AU, MSF, the Centre of Disease Control, other international organizations and NGOs, foreign countries (for example Britain, USA, China, Canada, Australia, Cuba and many others unnamed) who have been of great help to Africa; and people who are praying for the Continent and helping those residing in Liberia, Sierra Leone and Guinea.

However, it is inarguable that the EVD has been a malady teacher to the continent of Africa. It gave Africans a staid test and now it’s out of bed for lessons learned. It taught not only Africans a lesson, but everyone, including global policy makers and multilateral donors.

Research has shown that Africa is the world’s resources richest continent full of crude oil, coal, diamonds, uranium and timbers. These are just few among the many natural resources that Africa has; yet, it is widely known that the continent languishes in depletion of its resources.

Unprecedented wasteful spending of resources continues to undermine growth and development. Basic social services like education, health, roads, electricity, and water, which should be prioritized, are usually not in most African nations. Thus the ordinary masses become underprivileged and languish in pains and sufferings for the most part of their lives. No wonder Ebola practically met Africa, especially the West Africa’s health delivery system, ill prepared. Hence the question: Are Africa natural resources a curse or blessing?

In Liberia, Ebola met the continent’s oldest independent state without needed human resources and lack of better facilities, ambulances, medical equipment and supplies (as simple as GLOVES) to care for infected and affected populations, resulting in the deaths of thousands of people, including the ordinary, doctors and nurses, religious leaders and you name it; despite millions of US dollars being generated as revenues from the national resources sector or infused into the economy from multilateral donors.

The EVD crisis in the three Mano River Union (MRU) countries of Liberia, Sierra Leone and Guinea has left public officials and health practitioners with no alternative but to begin rethinking their strategies, and utilizing their resources for the general good of every citizen.

Regionally, one lesson that the EVD outbreak has taught us in the sub-region is that the three governments should begin to plan ahead to meet future health disasters by investing in training of more health workers, building and equipping of regional epidemiology centers, investing resources in scientific research, and promoting botanical gardens as a source for the provision, growth and manufacturing of medicines for local consumption. The reason for such collaborative efforts by the MRU countries is that if they ‘do not scratch their stomachs first; no one will scratch their backs’; that is they must make substantive efforts first before outsiders will come to help them. For these countries saw how the WHO, in its own admission, said it was late in responding to the calamity in West Africa. For had it not been for MSF-France after its persistence that a calamity that could cause havoc in the world was occurring in West Africa, even the world body, UN, would have remained silent.  

Another lesson learned is that, in an emergency response, there is need to work together with communities, taking into consideration their norms. The social mobilization to communities suffered in the beginning because community mobilizers or social animators did not consider the peoples norms when planning to carry out the mobilization.

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