As the Ebola outbreak continues and top donors like the United States work on containment, it’s important to remember that this is not simply a medical emergency. It’s a social and political crisis that will impact West Africa for years to come and requires a worldwide humanitarian response.
All humanitarian organizations — those that work directly in the medical field and those that support in other ways — have a critical role to play in fighting not only the deadly virus, but also its lasting impact on health care and development.
This epidemic has hit hardest countries that were already struggling for stability in the wake of conflict. The civil war that engulfed Sierra Leone from 1991 to 2002 killed tens of thousands of deaths and displaced more than 2 million people, about a third of the population. Today, nearly half of the country’s working-age population supports itself through subsistence agriculture. With its health system still weak, it has an unusually low rate of births taking place in health facilities and remains one of the most dangerous countries in the world in which to bear children.
Liberia, too, was brought to its knees by civil war. Settled by freed African-American and Afro-Caribbean slaves in the 1800s, the country saw conflict break out in 1989. Except for a short break from 1996 to 1999, the war raged for a decade before finally ending in 2003. Within those violent years, some 250,000 people were killed and many thousands more fled the fighting. Liberia today still relies heavily on foreign aid.
Concern Worldwide has been operating in Sierra Leone and Liberia since the early 1990s. We have earned the trust of community leaders, and right now trust is the most valuable coin in the treasury. That is why we are helping to play a critical, front-line role in both supporting health workers and educating the public so the disease can be contained.
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In Liberia, we have committed to build and support 19 new isolation units, while in Sierra Leone we are managing 14 burial teams. Flanking these newly started efforts, we have included Ebola-fighting training and techniques in ongoing programs with traditional birth attendants. Where previously we had helped them connect pregnant women to childbirth facilities, now we also update them in “no touch” home visits, train them to refer ill patients to care and equip them with hygiene kits and prevention messages that they — as trusted community members — are uniquely qualified to deliver.
As NGOs withdraw staff from Sierra Leone and Liberia and international airlines suspend commercial flights, it has become clear that it will be impossible for these countries to contain the outbreak on their own. Their infrastructures are too weak and health workers too scarce. In order to stop this epidemic, we need a comprehensive response now that is equal to the massive challenge we face.
At the same time, Concern and others must plan for the period beyond Ebola. Intense support will be needed to get economic and development goals back on track and help a strained health care system stabilize. The Ebola outbreak has created numerous challenges for the provision of primary health care in affected countries. Many people are not accessing health facilities due to fears that Ebola is being transmitted by those very facilities. The overall disruption of health systems means that many pregnant women and their children are not receiving care during and after pregnancy and are vulnerable to potentially fatal — but entirely treatable — illnesses such as sepsis and malaria.
We must plan now to devote resources to strengthen infrastructure in these countries that were only beginning to return to stability after decades of war.
Sierra Leone and Liberia need investments in their development, including better schools, roads, and hospitals. Once the emergency is over and Ebola is contained, humanitarian agencies must resist shifting our attention to the latest in an alphabet soup of crises across the globe. When Ebola is finally under control in West Africa, it will be time to dig in, not pull out.
It is in this light of the need for our commitment to these countries that I challenge the international community to support a “rebuild Liberia and Sierra Leone” campaign. This campaign would include funding a dollar for education and a dollar for health support for every dollar given to control the Ebola epidemic. This will not be a simple commitment to make, but I believe it is absolutely essential to ensuring the long-term stability of these two nations.
Our goal must be a healthy West Africa — not just one free from Ebola.
Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.