Ebola again in Liberia: Hope dampened but not destroyed

No complacency: The mood after 20 days without infections in Liberia may be dampened but hope is not destroyed by the newly confirmed case of Ebola in Monrovia. It is a stark reminder to keep up vigilance, attention and investments.

Almost half way through to the magic number of 42 – the number of days without new infections considered the minimum to declare a place “Ebola free” - a new case was confirmed yesterday in Liberia. The people of Liberia and the many international helpers in the country had started preparing to celebrate defeating the disease while in neighbouring Sierra Leone and Guinea the acute fight continues. Certainly this new case is disappointing. But hopefully something good will come out of this.

Travelling in the past days in Monrovia I noticed the lack of public message displays on Ebola prevention in the streets. And most organisations I visited are in transition mode out of acute response into rehabilitation already.  This was in stark contrast to what I saw a few days earlier in Sierra Leone, where public warnings and acute control measures are ever present.

Ebola public messages, Sierra Leone. Photo: Carsten Völz/Oxfam

After the many hard months with fear, disruption of normal life, loss of more than 10,000 lives who were the loved ones of families and friends and loss of income it is understandable that people urgently want to “move on” and return to normality.

And we definitely have to start working seriously on recovery. The countries have been shattered. Economies need to be restarted, jobs and incomes are urgently needed and stronger health services need to be built.

However, I think even without this unfortunate new case in Liberia it clearly is too early to already move on and phase out of emergency mode.

We all knew that risks of undetected cases and of infected people moving across regions and borders are substantial. As long as one country in the region has active cases, the entire region remains at risk. And given the long-term under-investments into health structures and systems in West Africa, the international support to manage the acute crisis is critical.

We cannot stop responding to this crisis until Ebola has been eradicated from West Africa. There is no room for complacency! And we know that in addition to international support community ownership, understanding and engagement are critical or treatment, safe burials and contact tracing, cannot be effective.

Oxafm Ebola WASH facilities at a school in Monrovia, Liberia. Photo: Carsten Völz/Oxfam

Currently this crisis still has the attention of the international community. The more than €4billion committed by international donors to fight Ebola, equal 15 times the combined annual health budgets of Liberia, Sierra Leone and Guinea. We need to ensure that this external attention and support translates into both continued active fighting the epidemic until we reach zero cases everywhere and long-term committed resources to building up the health structures bottom-up and to strengthen disaster response systems in the region as part of a larger resilience approach.

We still have a good chance to reach 42-days celebration points in all three countries in the coming months. And we have a duty to ensure that as a mid-term outcome the region is better prepared and resilient to risks and shocks, including to renewed disease outbreaks.

This entry posted by Carsten Völz, Humanitarian Director, Oxfam International, on 25 March 2015.

Oxfam is responding to the Ebola outbreak and will contribute to the recovery. We plan to spend $43 million in Sierra Leone, Liberia, Mali, Gambia, Guinea Bissau and Senegal to help over 3.2 million people. In Liberia and Sierra Leone, we have reached over 1.1 million people through working with communities and supporting medical facilities with water, sanitation and cleaning equipment.

We know that to successfully tackle Ebola communities need to be fully involved in the fight. That’s why we are piloting bottom-up approaches where local people promote health messages to their own communities – we’ve seen how effective this is to improve understanding and change risky behavior. Without this, other aspects such as treatment, safe burials and contact tracing cannot work.

All photos: Carsten Völz/Oxfam, 21 March 2015

Top: Oxfam water pump at a community health clinic, Monrovia, Liberia.

Middle: Ebola public messaging, Sierra Leone.

Bottom: Oxfam water and sanitation (WASH) facilities at a school in Monrovia, Liberia.

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