The Humanitarian Effectiveness Project

Download the essay ‘The un-ness of an emergency: A reflection on the Ebola response in Liberia’, by Fernando Espada

The humanitarian context in Liberia

Between 30 March 2014, when the first Ebola case was confirmed in Liberia, and 14 January 2016, when the country was declared free of the virus for the third time, 4,809 people died. Countless other people also suffered directly or indirectly from the deadliest Ebola outbreak on record, which also affected Guinea and Sierra Leone, where 2,536 and 3,956 deaths were reported respectively. The real figures will never be known, but might be much higher due to the number of infected people who were never diagnosed and those who died from other illnesses without access to treatment.

The World Health Organisation declared the Ebola epidemic in West Africa a public emergency of international concern in August 2014, and an ad-hoc international coordination and leadership structure, the United Nations Mission for Ebola Emergency Response – the first ever UN emergency health mission – was created (it closed down in July 2015). The US led the international response in Liberia, deploying thousands of soldiers there, and committed almost $2.4 billion to the response in West Africa as a whole – out of $3.62 billion of total humanitarian funding. The exceptional spread of Ebola in West Africa – much larger than all previous epidemics, both in terms of geographical scope, morbidity and mortality – was attributed to a combination of factors. Among the most cited were high population mobility among densely populated cities, dysfunctional national healthcare services, initial reluctance among locals to accept that the outbreak was real, and cultural practices – such as traditional burials – that involved direct contact with those infected.

During the first months of the outbreak, the number of international actors in Liberia was very small; organisations such as Médecins Sans Frontières (MSF) made repeated calls for the drastic scale-up of resources. After the summer of 2014, the deployment of US military personnel and international organisations changed the response landscape; funding commitments increased exponentially. The priority was two-fold: to stop transmission of the virus in Liberia, Sierra Leone and Guinea through outbreak control measures, and to prevent the spread of Ebola to neighbouring countries and outside West Africa.

After two relapses since the first Ebola-free declaration, Liberia now faces the challenge of recovering from the damage caused by the epidemic, while keeping a close eye on a virus that may have become endemic to the region.

Last updated May 2016.

Photo credit: Louis Leeson/Save the Children.

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