Triumph in adversity—just 9 months ago Liberia nearly collapsed, now it stands on the brink of victory over Ebola

West African country could be declared free from the terrifying virus this weekend. It will be emotional, and richly deserved.

ON Saturday, Liberia will be declared free from Ebola if no new infections are reported before then, the West African country having gone 42 days with no cases since it buried its last victim in March.

This represents twice the maximum 21-day incubation period for Ebola, counted from the last day when any person in the country had contact with a confirmed or probable case of the virus, in order to provide for a margin of safety.

“After almost 14 months spent under the cloud of Ebola, this will be joyful news for the country,” Karin Landgren, the UN secretary-general’s special envoy in Liberia told a rapt Security Council this week, in what may well be quite the understatement.

The country has had false dawns before and authorities are understandably cautious, but for Africa’s oldest black republic, it will be more than just an official announcement by the World Health Organisation (WHO).

It would represent a triumph of momentous worth against human adversity, the horrors of which threatened the very existence of the modern-day Liberian state.

It will also be a huge moment of redemption for president Ellen Johnson Sirleaf, a Harvard-educated Nobel laureate who at the height of the outbreak had her very leadership credentials questioned, as analysts spoke darkly of a “social explosion”. 

Few would doubt the toll this crisis has taken on her.

Tough times: president Ellen Johnson Sirleaf

Liberia is no stranger to difficulty—the ravages of war remain firmly etched in its memory. The second of two ruinous periods of regional conflict only ended in 2003, their protagonist Charles Taylor sentenced to 50 years in prison  by an international tribunal three years ago.

But the very high-mortality nature of the disease, and its terrifying presentation, coupled with a fear of the unknown, took Liberian society completely by surprise.

“This disease equals trauma,” Sirleaf advisor Emmanuel Dolo said in a riveting interview for the Council on Foreign relations in December. “And it’s a real culture shift. It’s the first time in their lives that Liberians are seeing high amounts of deaths without people shooting in the streets.”     

The civil wars meant Liberia’s institutions remain fragile, such that UN forces are still responsible for aspects of its security. It was thus completely unprepared for what was to come.

Some 4,716 dead

And by the time the disease had run its deadly course through the country of 4.3 million, some 4,716 Liberians had been killed by the disease, the largest share of the 11,005 who have died so far in West Africa.

On August 5, 2014 Sirleaf declared a national state of emergency, barely two weeks after she had ordered the country’s borders shuttered. 

Liberians found themselves denied even the most basic of social contact—from gathering in groups or moving at night, to participating in sports or hanging out at their local pub, or just going to school.

It was a time of extreme terror. The emotional accounts of those dark days tell of a desperation like none other. Death was everywhere, yet Liberians could not even bury their loved ones as disposal rules provided for cremation, a practice alien to a society where nearly 90% practice Christianity or its variants, and a government directive said “burn them all”.

Observers grimly narrated how bloated bodies floated gruesomely out of attempted safe burials as most of the coastal country’s water-table is only inches from the surface.

Liberia’s health system was weak at best, but the disease threatened to apply the coup de grace. Pre-epidemic, the country had one doctor for every 64,000 people. Not even those frontline workers were spared.

“While I was inside the Ebola treatment unit, I felt very bad. Fourteen of my health worker friends were infected and taken to the Ebola Treatment Unit. Ten of them died. I am one of only four who survived, so I thank God for that,” Liberian health worker Austin Jallah recalled. Some 189 of 275 infected health workers died.

The international stigma was deeper: Nigeria’s first case of Ebola was imported into the country by Liberian financial technocrat Patrick Sawyer, leading to several airlines, including African ones, grounding flights. 

Liberia would have every reason to bat back the African response—the famed spirit of Ubuntu was deeply lacking, this in a country that provided the setting for Africa’s first ever military intervention force in 1990.

The positive diagnosis of Thomas Duncan on US soil with Ebola in September sent the world’s media—and its spooked readers— into overdrive, further isolating a country that needed all of the help it could get.

International response

The depth of suffering in Liberia eventually led to a massive international response—including the unusual deployment of American troops, a country that it maintains long-standing ties with—up to 5% of Liberia’s population is to be found in the US. 

On September 18th, the UN Security Council declared the outbreak a threat to international peace and security.

In addition to the social cost, the economic consequences were big. Before the outbreak, Liberia had been at the start end of a longer-term transformation plan, having stabilised the initial post-conflict phase.

Before the coups, Liberia had strong growth with a 1980 per capita income that rivalled Egypt’s. The subsequent decline was one of the world’s fastest—90% by some measures. 

Liberia’s children can finally have their lives back. (AFP)

But it was turning that round—the country pre-outbreak was one of the 20 fastest growing economies, on the back of rich natural resource finds. After the civil war took out its entire grid, alongside most infrastructure, less than 2% were left connected to grid power. But last year, the World Bank begun $230 million work on putting back the lights on.

It was slowly creeping up the rankings of corruption perceptions—in 2007 Transparency International ranked it 150th, last year it was at 94, having reached 83rd in 2013. 

Sirleaf had also made progress on many social indicators—school enrollment rates were up albeit from a weak base, and maternal and mortality rates down. It was the first sub-Saharan African country to achieve Millennium Development Goal four— reducing the under-five child mortality rate by at least two thirds between 1990 and 2015.

Dramatic setback

Investors were funnelling money, including in resources, as they sought to take advantage of the gains from the reconstruction effort. Indeed it had the highest FDI to GDP ratios, with close to $20 billion sunk since 2006. 

Most fled in the wake of the epidemic.

The World Bank projects that, together with neighbouring Sierra Leone and Guinea, the three countries will lose 12% of their combined gross domestic product this year. Just this year alone, Liberia’s estimated GDP losses are at $240 million. In Sierra Leone, the GDP is estimated to have shrunk an unprecedented 23.5%.

The economic cost will be huge.

It is an amount Liberia can ill afford to lose—the cumulative effect is one that essentially catapults it several years back.  Early missteps proved decisive, international diplomats heard.  

“Now is the time to address factors which contributed to Ebola’s spread, in particular, weak social service delivery, lack of accountability and overly centralised government,” said special envoy Landgren.

That centralisation of power was a reason that allowed the virus to take strong root in the country, the administration severely blamed for the slow recognition that it had a major crisis on its hands.

Support from the international community was vital—the World Bank has so far provided $1.6 billion in the fight against the epidemic in addition to $2 billion in debt relief.

But the crucial breakthrough finally came from the effort of Liberians themselves, and started when the central government decentralised Ebola management that the tide really turned.

In November, a new approach was put together—where smaller localised teams were sent into Montserrado, the country’s largest county that ropes in the capital Monrovia. The new result-oriented approach emphasised community involvement, where locals, not outsiders, felt they fully owned the battle. In just two months, the outbreak was under control.

It all leads to May 9, when the country will declare a collective triumph over one of the deadliest diseases known to man. 

 And tapping into the country’s incredible resilient spirit, few would count against Liberia getting up again, like a bloodied boxer who just won’t give up after taking a pummelling.

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