Rethinking the Ebola response: How Liberians helped themselves

The unprecedented crisis caused by the spread of Ebola across West Africa has been well documented, but the crucial aspect of how Liberian citizens contributed to the relief effort has gone largely overlooked. It is widely believed that Ebola was curtailed in Liberia only after the United States sent in a response unit of over 3,000 Marines. In reality, while the global response lagged, Liberian citizens took the reins and drove the recovery in their own communities. By the time the first U.S. troops landed in Monrovia in October, the ground work of coordinating health messaging, dispelling rumors, and keeping the peace in a tense environment had already been laid by citizens.

Liberians’ community response to Ebola has mostly been mentioned in passing, tacked on to praise of the international response and efforts of the Liberian government. Beyond shortchanging the efforts of citizens putting their lives on the line, the development community is missing crucial insight into how the crisis was quelled. The fight against Ebola tested a relatively young, but rapidly professionalizing, civil society. Dissatisfied with the government’s response, citizens and local groups took charge, bringing legitimacy to messages from the World Health Organization and the government of Liberia, while addressing community issues and gathering information to feed back to health workers in Monrovia.

Weak systems and distrust threaten lives

Liberia’s crippled health infrastructure stood little chance of stemming the tide of the Ebola outbreak and poor communications channels caused misinformation to permeate, leading to the continuation of unsafe burials, sick people opting for treatment from traditional healers over Ebola Treatment Units, and infected citizens not seeking isolation. As the death rate skyrocketed, Médecins Sans Frontières’ call for an urgent global response largely fell on the deaf ears of Western governments, and the situation on the ground continued to deteriorate.

A history of misrule, widespread corruption, made worse by years of civil war eroded Liberians’ trust in government, so when the government quarantined entire communities, tensions rose. The tipping point came when government soldiers forcefully quarantined the community of West Point, one of Monrovia’s poorest enclaves, without prior notice — residents clashed with government security forces resulting in the death of one teenage boy. The quarantine was eventually lifted as a result of protests. But as the Liberian government remained unable to respond to the scale of the crisis, it became evident to citizens that they would have to take matters into their own hands.

Nongovernmental and citizen organizations — groups that best understood the realities of the havoc Ebola was wreaking in communities — were perfectly positioned to respond. As the weeks wore on, it became increasingly clear that they would have to act, with or without outside help.

Trusted voices help save lives

In isolated communities, village leaders and local groups sought to bring infected people to ETUs, provide food and care to families of Ebola victims, and quell unsafe burial practices. Getting the latest and most accurate information to citizens on how best to protect themselves from contracting the disease was paramount to staunching further spread. As trusted arbiters of information, civil society organizations, along with community radio stations, served as a lifeline to communities during the crisis and acted as a crucial resource to combat misinformation. In the midst of the crisis, CSOs acted as community mediators and trusted voices.  

“We didn’t have to wait for the government, we could do it ourselves,” said S. Aaron Weah-Weah III of NAYMOTE, a Liberian NGO that focuses on youth engagement and building a democratic culture in the country. Through community leadership forums (an initiative spearheaded by IREX and funded by USAID) CSOs such as NAYMOTE worked within the traditional and formal structures of communities to plan, implement, and provide ownership of Ebola response activities. IREX had been working with civil society on the ground in Liberia for years, knew the local context and leaders well, and was able to rapidly coordinate the initiative. Held in 60 communities in 13 of Liberia’s 15 counties, these forums provided opportunities for citizens to voice their fears and concerns while building solutions in the face of a crisis that was largely being managed, without their input, by the Liberian government and international NGOs.

Promoting diversity, the forums served as a platform to elevate marginalized voices and addressed a range of issues. For example, when armed robbery spiked in a community in Montserrado once curfew was imposed, a forum brought together citizens to map the roads and alleys in the community, pool small resources to provide money for a night watch, and set up a call center for security and Ebola-related concerns.

When community members in Bomi feared stigmatization for seeking treatment at an ETU, a CSO worked to equip volunteers with WHO facts to sensitize residents to the realities faced by Ebola survivors and victims’ families. When officials in a Gbarpolu community grew lax in enforcing preventative measures such as hand-washing, a forum galvanized residents to establish a taskforce to monitor hand-washing at homes, buildings and public forums.

Empowered by groups and individuals that understood the complex situations in communities and who garnered respect from residents, citizens stood up and took charge. Creative solutions and rapid response of trusted actors validated official health messages and delivered immediate, highly visible solutions — results that could not have been possible by parachuting in a short-term response team.

WHO puts the peak of Ebola transmission somewhere between August and September 2014. By the time U.S. marines arrived in Monrovia in October, the rate of new Ebola cases was already decreasing, thanks in large part to the efforts of myriad NGOs, community groups and citizens. The actions of Liberian citizen groups demonstrate the critical role of civil society in a crisis.

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