SEATTLE, Washington —Liberia, a low-income West African country, has 1,311 confirmed COVID-19 cases and 82 deaths, which is exceptionally lower than some higher-income countries like the United States. Liberia has a fragile healthcare system with little access to clean water, low infectious waste capabilities, a lack of medical supplies and a limited number of healthcare workers. Despite this, COVID-19 in Liberia is being handled relatively well due to tremendous community-based efforts learned from Liberia’s experience with Ebola.
Ebola in Liberia
3 Essential Takeaways from Ebola
- Strong Leadership — President Ellen Sirleaf took decisive action during the Ebola outbreak stating “the disease is a threat to the nation’s economic and social fabric.” She made the Ebola response a priority in various government branches, delivered frequent public announcements about the infection status and even visited places dealing with the outbreak to show solidarity.
- Community Response — In an interview with Gavi, the Vaccine Alliance, President Sirleaf explains the necessity of the community response. To effectively fight the disease, it became apparent that communities needed to be active in contact tracing and communicating information on Ebola. Additionally, the coordinator of Active Case Finders and Awareness Team, Archie Gbessay, explained in 2014 that Ebola would be eradicated by now if foreign interventions were all it took.
- Respect for Local Cultural Beliefs and Perceptions — Julienne Anoko, an anthropologist working with the Ebola response team, states the importance of listening to communities and developing solutions specifically for them rather than coming in with preconceived ideas. Body bags used to be black; however, for Liberians, the color of mourning is white. This prompted a change from black to white body bags. Additionally, it was known that communities often feared the treatment centers because it seemed like their loved ones would never return. To ease this fear, the treatment centers were redesigned with fences rather than walls allowing families to see what goes on within them.
How These Ebola Lessons Helped Liberia’s Response to COVID-19
- Strong Leadership — Following President Sirleaf’s example, current Liberian President George Weah took decisive action against COVID-19. After the first confirmed case on March 16, all travel was suspended if countries had more than 200 cases. Additionally, on April 8, President Weah declared a national state of emergency as well as a 14-day stay-at-home order. Citizens continue to be encouraged to stay at home unless they need to gather necessities and when they do step out, they are required to wear masks in public.
- Community Response — Archie Gbessay, coordinator of Active Case Finders and Awareness Team, and his team, who worked tirelessly to defeat Ebola, came back to fight against COVID-19 in Liberia. Using many of the same tactics developed during Ebola, his team is recruiting and training contact tracers, setting up hand-washing stations as well as convincing businesses not to serve those not wearing masks.
- Respect for Local Cultural Beliefs and Perspectives — Just as with Ebola, fears around COVID-19 have spread. Some believe COVID-19 is a government hoax or a means to control the population. This has resulted in some running away after testing positive fearing death in treatment centers. To help ease these fears and build trust, Gbessay and his team go door-to-door (6 feet apart) to follow contact traces as well as inform the community about the reality of the COVID-19 situation.