The real story of how first US Ebola victim became infected in Liberia, and why it highlights Africa's health challenge

Thomas Eric Duncan caught deadly fever while trying to help landlord's fever. He could have been anyone in Liberia.

THE story of how the first Ebola victim diagnosed in the US caught the disease has exposed the multiple failings in his home country of Liberia, where poverty, an overloaded healthcare system and an unresponsive government have deepened the crisis, a situation that could as well have been in many other African countries.

Thomas Eric Duncan was hospitalised in Dallas, Texas, on September 28, becoming the first case to be registered outside Africa. 

He caught the deadly fever from Marthalyn Williams, the daughter of his landlord in Paynesville, a suburb of the Liberian capital Monrovia, shortly before he caught a flight to the United States.

Williams, who was pregnant, later died. She infected four people who have also succumbed to the virus as well as her parents, who are being treated in an Ebola centre, according to Liberian authorities.

Such stories have become disturbingly common in Liberia, the worst hit of the West African nations at the centre of the epidemic, which has already killed 3,439 people according to the latest figures from the World Health Organization (WHO).

Of these, 2,069 died in Liberia, where entire families have been wiped out as they try to help each other.

Williams’s mother took her to a clinic where “she began to convulse”, said the young woman’s aunt, Anna Diah. But because she was pregnant, the doctors said she had to go to a bigger hospital.

“They called a taxi and put her inside. Eric (Duncan) plus the father, the brother got in the car, plus Williams’ mother.”

The family drove all over town, but were unable to find a hospital with spare beds.

“All over, nobody could accept her. So they brought her back home,” said Diah.

Doctors Without Borders (MSF), which is spearheading efforts to contain the disease, say as many as two-thirds of infected Liberians will never reach a treatment centre.

A major shortage of ambulances combined with endemic poverty also mean families often have no choice but to travel together in taxis.

The virus can survive for hours after they leave the car.

Several patients at an MSF clinic in Paynesville told AFP that Ebola victims often arrived in taxis. Many had vomited, defecated or even died on the way.

The aid workers try to disinfect the cars but drivers are often too terrified to stick around.

“In Monrovia, taxis filled with entire families, including some members probably contaminated by Ebola, circle the town looking for a place,” WHO said, adding that infection of friends and family was “inevitable” in such situations.

Community level
The “Ebola Task Force” in Paynesville has tried to locate everyone that came into contact with Williams.

“We have found five people,” said one of the team, Peter Blidi. They have been placed under observation for 21 days, the maximum incubation period for the virus.

Blidi criticised the inertia of Liberian officials: “At the beginning, we signalled these cases to the government who were deaf to our appeals. They have been asleep in the face of this epidemic, so we are working at the community level.”

It is a feeling shared by Laurence Sailly, head of the MSF centre at Paynesville, who criticised the reaction time of ambulances and said the government had failed on even “basic logistics”.

“The system doesn’t work,” she said.

Patient distribution was a particular problem, she added. While most centres are overwhelmed, the MSF centre has dozens of spare beds.

If he survives, Duncan could face prosecution in Liberia, where the government has accused him of lying about his health when he left the country.

On Saturday, the Texan hospital where he is being treated since September 28 said he was “in critical condition”, without giving further details.

Liberia, too, is in critical condition—a situation not helped by news on Saturday that two clinics were being closed in Bomi province, northwest of the capital, after two staff died from Ebola.

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