Why is it that it is often only bad news stories which grab out attention? People sometimes fail to highlight good news. A good news story here in Liberia, Sierra Leone, and Guinea is that the Ebola Virus Disease (EVD) epidemic is over and that it was local community mobilization that made the big difference in the medical battle.
More than 11000 people of all ages and backgrounds lost their lives to EVD which infected more than 28,000 throughout the three countries that were especially affected. The epidemic “brought the national health systems to their knees, rolled back hard-won social and economic gains in a region recovering from civil wars, sparked world-wide panic and cost at least several billion dollars in short-term control efforts and economic losses” (international panel of 19 experts’ indictment of WHO’s slow response).
The worst case scenario projected in late 2014 for EVD was upwards of a million cases by 2015. However, beginning in November 2014 the number of new infections began a dramatic drop. This was a happy surprise to the international Ebola experts. What made the difference?
Many factors played a role in defeating Ebola in Liberia. The remarkable engagement of the United States was one. Great improvements in laboratory testing and diagnostic speed were others. The construction of Ebola treatment units (ETUs), which allowed infected persons to be isolated and treated, and the virtual elimination of unsafe burials and the imposition of mandatory cremations were also important. But of all these it was the social mobilization of the Liberian citizenry was the single most important key to the victory.
In October 2014 I joined twelve students and faculty from the Kofi Annan Institute of Conflict Transformation (where I teach) and the medical school of the University of Liberia in a project supported by the Canadian Jesuits International to go door to door in a rural community in Grand Cape Mount County, where EVD had taken many lives.
We talked about how to contain the epidemic and prevent its spread through hand washing in a correct mixture of a chlorine and water solution and careful observation of people who might have the signs and symptoms of EVD, who needed to be brought to an ETU for laboratory testing and then treatment if they tested positive for EVD.
I found our Ebola awareness program tiring, because it meant climbing up hills and descending into valleys all day long, but worth-while. The people we visited either already knew what we had to tell them and had already implemented the prevention strategies we suggested or were eager to learn about these things.
Posters we distributed and which were found everywhere in the country said “Let’s kick Ebola out of Liberia.” In hundreds of villages and towns local leaders and their people suddenly took this message to heart and instituted voluntary 21 day quarantines for all visitors and created “neighborhood watch” teams to identify and isolate anyone who was ill.
While most of us were delighted by the good news story that occurred in early 2015 perhaps one group who may have had mixed feelings were the 3000 American soldier who had just built 14 well equipped ETUs throughout Liberia, many of which did not have even a single patient to care for.