Ebola: Liberian leader sees decline, but aid too slow

International aid to battle the Ebola epidemic in Liberia is arriving too slowly, President Ellen Johnson Sirleaf said on Wednesday, though she said there were early signs that the outbreak in her West African country might be “in decline”.

On a tour of the villages of remote northern Liberia, Johnson Sirleaf told Reuters that she wanted to give her people hope that the virus could be beaten, though the World Health Organisation (WHO) warned on Wednesday there was no evidence yet the epidemic was being brought under control.

The hemorrhagic fever, which has no proven cure, has killed nearly 3 900 people in four West African countries, from a total of more than 8 000 people infected. More than half the dead were in Liberia, where the healthcare system was still reeling from a devastating 1989-2003 civil war.

Johnson Sirleaf dismissed warnings from the WHO that as many as 20 000 people could be infected with Ebola by next month, saying that an education campaign was curbing traditional practices in Liberia that had helped to spread the highly contagious virus, such as washing the dead by hand.

“We make a judgment by the number of people who are called to be carried to Ebola treatment centres, by the empty beds in the treatment centres, by the number of dead who have been buried, and all of those seem to be a bit in decline,” she said in an interview.

Johnson Sirleaf offered no firm figures and acknowledged that some victims may not be coming forward, but said: “We still believe it looks good. We are cautiously optimistic.”

Not seeking treatment
Medical charity Medecins Sans Frontieres (MSF) said admissions at its Ebola treatment centre in Monrovia had remained steady at around 120-130, despite capacity rising to 250 beds. However, it voiced concerns that infected people may be staying at home rather than seeking treatment and families may be burying their own dead.

In its latest update, the WHO said the death toll in Liberia had reached 2 210 and warned that a fall in the reported number of cases nationally was likely due to misreporting, with overwhelmed medical staff failing to record accurate data.

Johnson Sirleaf said Ebola had exposed a lack of investment by donors in Liberia’s hospitals and clinics, which had only around 50 trained doctors for the country’s four-million people. About 95 medical staff have so far died of Ebola and more than 180 were being monitored for signs of the disease.

“We have to rebuild the whole healthcare system,” the 75-year-old president said. “Ebola has brought us to a shock awareness so it is a huge awakening call that I hope ourselves and our partners can try to respond to.”

Military mission
Liberia, founded by freed American slaves, has strong cultural ties with the United States (US) and President Barack Obama has announced a 3 000-strong military mission to build treatment centres and train staff, which is gradually deploying.

Aid organisations from USAID to Save the Children are also providing funds for clinics, medical equipment and supplies.

Yet, in Liberia’s dilapidated ocean-front capital Monrovia, named after 19th century US President James Monroe, there remains a shortage of ambulances and medical workers.

Johnson Sirleaf, a winner of the Nobel Peace Prize for her work on women’s rights, said international efforts were “appreciated” but promised aid was slow to arrive.

“The commitment is strong. We just need to see a little bit faster action, that’s all,” said Johnson Sirleaf, Africa’s first elected female president, wearing her trademark blue turban. “We would like to speed it up.”

During a tour of the northern Nimba county, Johnson Sirleaf met doctors, nurses and local leaders, distributing food and money to hard-hit communities. In some villages, people lined the street clapping, singing and waving branches as her convoy passed.

Yet many local people also voiced frustration at the pace of the government response. “We are tired of Ebola,” shouted one girl at the passing convoy as she hung from the side of a bus.

‘Didn’t know what to do’
The worst Ebola outbreak on record has been marked by several false dawns, particularly in April and May when international health officials were hopeful the epidemic had been contained in the forests of southern Guinea.

The virus, which is spread by contact with bodily fluids, had never before struck in West Africa and caught local communities and health officials unprepared. Johnson Sirleaf acknowledged that her government was slow to react.

“Our own response was slow because we just didn’t know what to do. We did not know how to deal with it and we did not have the capacity to deal with it,” she said. “So many people died simply because we’re dealing with an unknown disease.”

With many doctors and nurses abandoning their posts due to fear of Ebola, Johnson Sirleaf said her government was preparing a package of “hazard pay” incentives to get them back to work.

International fears about the spread of the virus soared after Liberian Thomas Duncan took the infection to the US this month. Duncan, who died in a hospital in Dallas on Wednesday, was the second Liberian to carry Ebola overseas after Patrick Sawyer took it to Nigeria in July, killing eight people.

Johnson Sirleaf said she had ordered officials at Monrovia airport to step up health checks and to keep a list of people under surveillance for Ebola to prevent them travelling.

The president said Duncan’s actions had derailed talks with Kenya and Côte d’Ivoire to resume flights to Liberia. The suspension of most international flights to the nation has harmed its economy and hampered aid efforts.

Heavy blow
Johnson Sirleaf acknowledged Ebola had dealt a heavy blow to her efforts to get Liberia back on its feet after the civil war in which 250 000 people died, often at the hands of drug-crazed child soldiers.

With many major investors in mining and agriculture fleeing because of Ebola, she said economic growth would almost halt.

“We were expecting a rate of growth well over 7%, as we have done in the last few years. It was reduced to 5.2%, now it’s one,” she said, adding that talks had begun on a recovery stimulus package with the International Monetary Fund and the World Bank.

Johnson Sirleaf, whose second term ends in 2017, said she was confident she would have laid to rest the Ebola outbreak by then and returned the country to growth.

“Will I achieve all of my development goals? Probably not,” she said. “We’re going to restore all that was lost by Ebola and maybe have a bit more gain before we come to the end.” – Reuters

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Daniel Flynn
Daniel Flynn works from Sao Paulo, Brazil. Latin America Editor for Thomson Reuters. Former bureau chief in Brazil and West Africa and correspondent in France, Spain, Italy, Greece and Venezuela. Daniel Flynn has over 1419 followers on Twitter.

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