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August 19, 2014 6:59 pm
The continuing spread of the Ebola virus in Liberia and Sierra Leone is threatening to undermine efforts by other west African states to contain the worst-ever outbreak of the fatal disease, which has now officially claimed at least 1,229 victims.
Yet the international response to appeals by the stricken countries for more help remains “non-existent”, according to Médecins Sans Frontières, the main aid agency battling to contain the epidemic in Guinea, Liberia and Sierra Leone.
MSF, which has a long history of involvement with Ebola outbreaks elsewhere on the continent, said it was struggling to set up enough isolation wards to cope with the number of infected patients in the near total absence of other international assistance and in the face of a total breakdown in Liberia’s public health service.
The crisis is also having a calamitous knock-on effect for the wider economy in Liberia, which like Sierra Leone is still in the early stages of a recovery from civil war in the 1990s.
In Liberia’s Lofa county, the epicentre of the outbreak, there are 125 patients infected with the disease occupying an MSF isolation ward designed to hold no more than 60. In the capital, MSF is intending to scale up a 125-bed facility – already the largest it has ever created for an Ebola outbreak – to hold as many as 700 patients.
“We have never faced a crisis of this scale and type, with this virulence and mortality,” said Brice de le Vingne, who is co-ordinating MSF’s response across the region.
“We are completely amazed by the lack of willingness and professionalism and co-ordination to tackle this epidemic. We have been screaming for months. Now the situation is even worse – we are today on the verge of seeing an entire country collapsing.”
The fear among health workers is that if the disease is not brought under control in Liberia – and to a lesser extent Sierra Leone – it will continue to infect other west African countries and reinfect those such as Guinea that have been more successful in containing the virus.
Lofa county recorded 124 new cases last week and 60 deaths. The World Health Organisation and Liberian officials have warned that, because healthcare workers have little access to more remote jungle areas, the actual toll may be far higher.
Guinea, the first country in the region to be affected by the deadly virus, said it would reopen an Ebola clinic in its remote southeast as sick people living in Liberia and Sierra Leone spill over the borders in search of better treatment.
Ebola kills more than half of those who catch it and causes fever, vomiting, haemorrhaging and organ failure. But transmission of the disease is slow by comparison with other killers such as cholera and in previous outbreaks in countries such as the Democratic Republic of Congo and Uganda, its spread has remained relatively contained.
In Liberia, the government was slow to respond to the initial outbreak, only stepping up public information campaigns on preventive measures once it had gained a grip on the capital.
At the weekend in Monrovia, Liberia’s capital, slum dwellers attacked and looted a clinic in their neighbourhood, apparently fearing it was bringing the disease to them. The incident led to the disappearance of 17 infected patients and the dispersal of potentially contagious bedding and other materials across a densely populated part of the capital.
The situation in Liberia is catastrophic and I am not using that word lightly
- Brice de le Vingne, MSF
Nigeria, which has had a total of 13 confirmed Ebola cases since the Liberian-American health consultant Patrick Sawyer travelled into the country with the disease last month, has been far more successful at containing it. Five of the 13 victims have made a full recovery and dozens more primary and secondary contacts at risk of infection have been released from quarantine.
Guinea, where the disease is thought to have originated in a remote jungle area bordering Liberia and Sierra Leone at the end of last year, has also recorded a marked decline in the number of fresh cases.
According to MSF, the main UN and other international agencies with the capacity to assist have been reluctant to deploy qualified teams on the ground in Sierra Leone and Liberia – both weak states whose healthcare workers have been among the main casualties.
“The situation in Liberia is catastrophic and I am not using that word lightly,” Mr de le Vingne said. “In Monrovia, a city of 1.3m people, there are no hospitals open whatsoever so you have an emergency inside the emergency – people have nowhere to get medical care. If you have a car crash there is nowhere to go.”
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