SEATTLE — It has been over two years since the outbreak of the Ebola epidemic in Liberia, but the situation still remains dire. The healthcare system is woefully inadequate, the economy is in shambles and the country is on the verge of famine.
The Ebola epidemic began in late 2013 and quickly spread to over 28,000 people, mostly in Liberia, Sierra Leone and Guinea, the three West African nations at its epicenter. Over the course of two years, the disease killed over 11,000 people.
Liberia was hit especially hard. Over a third of those infected by Ebola were Liberian, and the country was unable to properly deal with the catastrophe. The country’s four million inhabitants were served by only 50 licensed doctors (for comparison, there are about 50 doctors for every 100,000 people in the US). Liberia was also still recovering from a bloody civil war that raged from 1989 to 2003 and killed 150,000 people and displaced another 850,000.
So when the epidemic struck in December of 2013, the country was ill-prepared to fight it. Schools shut down to avoid spreading the disease (some of the schools were converted into makeshift hospitals and crisis centers). Farmers were not able to work in “kools, a traditional form of communal labor” because of strict quarantines. As a result, the farmers ate the food they had stored, “eating the seed rice they’d saved to plant the next year’s crops. After that, they ate nothing.”
Fortunately, the situation has improved in many key ways. The disease has just about disappeared from the country. Schools and markets have reopened. Aid organizations are rebuilding the country’s infrastructure.
But significant room for improvement remains. Liberia is still the eighth poorest country in the world. The Organization for Economic Cooperation and Development considers it a “fragile state,” and the Global Vulnerability and Crisis Assessment Index lists it as “highly vulnerable.”
To make matters worse, Ebola may flare up again and wreak just as much havoc as the last time. Ebola has flared up ten times in West Africa since Liberia was declared “Ebola free” in May 2015. Three of those flare-ups occurred in Liberia itself.
Furthermore, experts believe that Ebola can be transmitted sexually for many months after infection. As a result, the many thousands of survivors can still transmit the disease, sparking yet another outbreak.
Worst of all, if such an outbreak does occur, the country is not properly equipped to deal with it. Just as before the outbreak, 30 to 40 percent of Liberians still lack access to healthcare. Additionally, aid organizations have largely abandoned Liberia, moving on to new crises like Zika. Only a single Ebola treatment center remains operational today.
However, while the situation is certainly bleak in Liberia, there are a few bright spots. If these embers of hope can be sufficiently fanned, then perhaps Liberia can be lifted out of its dire condition.
Liberia was declared virus free (for the third time) on June 9, meaning that it has been over two months since the last Ebola patient tested negative for the second time. Some parts of Liberia’s infrastructure have also improved. Labs, for example, have increased in capacity due to foreign health investments. Likewise, the epidemic resulted in the training of many health workers who are now able to recognize and treat Ebola symptoms.
Liberia thus stands on the edge of a difficult precipice. On the one hand, the country’s economic and public health condition remains grim. On the other hand, a few small improvements to the country’s healthcare infrastructure may spur the greater changes necessary to make Liberia resistant to another outbreak and help alleviate some of its extreme poverty.
– Steffen Seitz