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PLOS BLOGS Speaking of Medicine and Health

Ebola: Liberians Destined for Extinction

Liberian medical student Gondah Lekpeh gives us his perspective from the front lines of the Ebola outbreak.

On July 22 of this year, the Liberian Minister of Health informed us and the world that the Ebola hemorrhagic fever outbreak in our country is out of control. This disease is caused by the deadly Ebola virus, and the fate of infected individuals is death in 90% of cases.

The announcement followed more than a month of efforts by the Ministry of Health to contain and eradicate the virus. The Ministry is doing what it can, but with the weak health care system because of the lack of human and other resources, the Ebola outbreak has caused the system to break down. The disease continues to directly and indirectly take away lives. Indeed, our relatives, colleagues and friends are perishing daily and our survival as a people is unpredictable. Either through natural selection some will survive, or we will all be extinct. As I was writing this, a childhood schoolmate of mine, a nurse, just died this morning after contracting the disease at St. Catholic Hospital while treating a patient about two weeks ago.

Here in Liberia, the virus is spreading like wildfire, devouring the life of everyone along its path. Limited health resources, ignorance, stigmatization, denial, and cultural burial rites are fueling the spread of the disease. Ebola cases are reported in ten of the fifteen counties in our country. I do not have the space and time to elaborate on how ignorance, denial, stigmatization as well as cultural practices are spreading the virus. But regarding limited health resources, here is the tip of the iceberg. As part of control measures, everyone was advised to call the Ebola response unit for safe transfer of suspected cases and disposal of corpses from communities in and around Monrovia. There are two ambulances to transfer suspect cases to isolation center and two burial teams for Monrovia. These teams are overwhelmed and it takes about two to three days to respond to calls from communities. The relatives of suspected cases end up transporting the patient in a commercial vehicle, thereby contaminating themselves. The remains of suspected cases who died at homes spend days before the burial team can arrive. Moreover, there is only one treatment center in Monrovia. The isolation center is full to capacity and suspected cases are reportedly turned away. When will the spread and death of Ebola stop in the wake of limited resources? I do not know. But I know for sure that contact tracing is not possible and we are overstretched and exhausted.

Besides Ebola directly killing here, others are dying of treatable conditions due to closure of health facilities. Most health facilities in and around Monrovia have been closed for the past three weeks. This followed the failure of most health workers to show up on duty after the death of their colleagues. They fled due lack of equipment as simple as gloves to protect themselves. At the beginning of this week, some of these health facilities reopened. But activities currently at these hospitals are limited to training of staff on precaution measures. I do not know the fates of those with treatable conditions other than Ebola. Where the obstetric emergency cases are being managed? Where are the hundreds of children who usually present weekly at John F. Kennedy Medical Center under-five ER with diarrhea and severe dehydration and severe malaria complicated by anemia, hypoglycemia and seizure, seeking care? I do not know. But I know there are numerous corpses in homes in and around Monrovia which have overwhelmed the burial teams.

The Ebola virus is like a merciless rebel determined to annihilate his weak and feeble enemies (Liberians). Help! Help! We are drowning in the sea of Ebola.

About the author: Gondah Lekpeh is a fourth year medical student at A.M. Dogliotti College of Medicine in Monrovia, Liberia.


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