Bounce Back From Failures – Republic of Liberia

The Republic of Liberia, commonly known as Liberia, is a country on the West African coast. In the year 2014 Liberia was severely affected by the Ebola Virus Disease (EVD) which caused fever, severe bleeding, organ failure and eventually death in some cases. It spread through human contact. What made the situation worse were the severely compromised health systems, significant deficits in capacity, and rampant fear about the virus. Let us learn from Liberia’s journey of overcoming this challenge.

Take Ownership of the Failure

Liberia’s first two cases of Ebola were confirmed in the Lofa County on March 30, 2014. On April 7, the country reported 21 suspected cases and 10 deaths. The situation then seemed to have stabilised with no new cases being reported. The authorities thereby did not exercise enough caution. However, this proved to be an illusion as the situation worsened later. They soon realised that the demands of the Ebola outbreak had outstripped the government’s capacity to respond. Very shortly, 14 of the country’s 15 counties had reported confirmed cases. 152 health care workers had been infected and 79 of them had died, representing a significant loss of talented doctors and nurses at a time of immense need.

The authorities had failed to curb this spread in the nascent stages despite having the opportunity to do so. However, when they realised their error, they accepted it and immediately employed desperate measures to bring the situation under control. On August 6, President Ellen Sirleaf declared a three-month state of emergency and announced a string of new regulations, including curfews and restrictions on the movement of patients and their contacts, enforced by the country’s military. These steps were taken despite the country’s impoverished, war-torn economy. Her swift decisions, frequent public communications and presence at sites of outbreak highlighted how the authorities had taken ownership of this failure and were determined to resolve it.

Communicate Effectively

Liberia has a religious population. People flocked for refuge to their places of worship and came out infected. Thus, it was crucial to resolve a confrontation between faith and science. Health officials were quick to recognise the importance of engaging with community leadership. Teams worked hard to win support from village chiefs, religious leaders, women’s associations, and youth groups. To drive the message to the general population and especially the youth, the authorities engaged pop stars to compose jingles and songs. ‘Ebola is Real’ and other songs became some of the most-played ones on the radio.

Community task forces were formed to create house-to-house awareness, report suspected cases, call health teams for support and conduct contact tracing. See-through walls around the treatment centre replaced opaque ones, allowing families and friends to watch what was happening inside. This helped in building trust on authorities and dispelling rumours.

Ask for Help

When faced with failure, it is easy to isolate oneself or go into a denial mode due to the fear of being criticised. Liberia accepted its failure to tackle the situation and asked for help without inhibitions. Liberia’s minister of Commerce and Industry, Axel Addy, addressed a conference in London and shared, “We are in a race against time. Our entire health sector has been crippled by this new invasion.” When asked about when he wanted international help, Axel replied saying ‘like yesterday’, indicating the urgency of the situation. The world got together to help and this support helped Liberia tackle the disease in a much better way.

Thanks to clear strategies, result driven execution and help from various countries and organisations, on May 9, 2015, WHO declared Liberia free of Ebola virus transmission, during this particular outbreak. The efforts from the authorities reduced the number of cases in the country from 300-400 cases per week during its peak of transmission in August and September 2014 to zero for nearly six weeks before this announcement.

Let us learn from the experience and spirit of Liberia and successfully tide through the current Coronavirus pandemic.