Liberia Tom Friedman: “The Situation Is Dire”

Dr. Frieden at ELWA Isolation Center/ Photo: Wade C. L. Williams

Dr. Frieden at ELWA Isolation Center/ Photo: Wade C. L. Williams

“The situation with Ebola in Liberia today, is dire. There is need for urgent action. The world has never seen an outbreak of Ebola like this. Unfortunately, not only are the numbers large, but we know that there are many more cases, than have been diagnosed and reported. I wish, I didn’t have to say this, but it is going to get worse, before it gets better.” – Dr. Tom Frieden, Director, Centers for Disease Control


Dr. Frieden said the amount of Ebola death is increasing, adding that the more Ebola cases have been diagnosed and suspected than have been reported. He said the outbreak is severe for Liberia and West Africa, adding that it is a potential threat to Africa and other parts of the world. Dr. Frieden called for a joint global fight against the virus adding: “The world must come together because every day this virus continues to spread in Liberia and there is a risk of an export of the virus to another country.”

Frieden said, the CDC is committed to fight against Ebola in the region and has seventy experts spread in countries affected by Ebola in West Africa. Dr. Frieden said there has to be tougher action to combat the Ebola crisis, adding that progress has to be measured on an hourly basis. “This virus is a tough virus to fight and it is unprecedented and it will need an unprecedented response, our progress has to be measured in hours not in week, the CDC is here to work with you and we will be here until it is over,” he said.

The Director of the Centers for Disease Control and Prevention recommends to the government of Liberia that all of its activities be organized at all levels, the increase in Ebola treatment unit adding that they should ensure that all burials are safe. Dr. Frieden said he is impressed by the response so far, despite the challenges faced by the governments to combat the virus. “I have been impressed by the response I have seen. We met dozens of volunteers answering dozens of calls every day, 24hr daily, we met dozen of healthcare workers and dozens of community volunteers in rural areas willing to help with the response,” said Dr. Frieden.

The CDC boss said there are misconceptions surrounding the spread of Ebola adding that it spread through two strings. “We know how to stop it, there is misconception but we know how it spreads by just two strings, if you block those strings, you can stop the outbreak,”Frieden said. Continued Frieden: “One if somebody is sick, don’t touch them or their body fluid; someone who is not sick cannot spread Ebola and when they are sick, they become increasingly infectious, if someone is sick, help support, but don’t touch, if someone has died don’t touch.”

Dr. Frieden said his visit is to see firsthand the impact of the Ebola outbreak, to assess response activities and hear from government, international partners and health care workers. Jeremy Konyndyk Director of USAID’s Office of U.S Foreign Disaster Assistance said that U.S government has provided additional $5 million to help combat the Ebola outbreak in West Africa.

The announcement brings USAID commitment for the Ebola response to nearly $ 19.6 million since the outbreak was first reported in March. Konyndyk said, the additional funding would be used to provide health equipment and emergency supplies, train and support health care workers and public outreach campaigns.

“We know that Liberia can and will survive this outbreak, we will do everything possible from the U.S government side to support Liberia fight this Virus,” he said. “We are particularly focusing on rescuing the healthcare workers, the healthcare workers are on the frontline in containing this outbreak. We will be providing additional funds in the coming weeks and months to scale up efforts.” The announcement comes just days after USAID airlifted more than 16 tons of medical supplies and emergency equipment to Liberia.

Dr. Frieden and the team visited the isolation center set up by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) on Wednesday. MSF said it is rapidly scaling up its operations in Liberia, as the global response to the Ebola outbreak in West Africa continues to be chaotic and entirely inadequate. The center, which is MSF’s newest Ebola management center—known as ELWA3—in Monrovia is already overwhelmed and housing 120 patients.

Liberia: MSF’s New Ebola Management Centers Already Overwhelmed

MSF New Ebola Centers Overwhelmed/Photo: Wade C. L. Williams

MSF New Ebola Centers Overwhelmed/Photo: Wade C. L. Williams

The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is rapidly scaling up its operations in Liberia, as the global response to the Ebola outbreak in West Africa continues to be chaotic and entirely inadequate. In its first week, MSF’s newest Ebola management center—known as ELWA3—in the capital, Monrovia, is already at capacity with 120 patients, and a further expansion is underway. Meanwhile, in the north of the country, patients continue to flow into the newly rehabilitated Ebola management center in Foya.

“It is simply unacceptable that, five months after the declaration of this Ebola outbreak, serious discussions are only starting now about international leadership and coordination,” said Brice de le Vingne, MSF director of operations. “Self-protection is occupying the entire focus of states that have the expertise and resources to make a dramatic difference in the affected countries. They can do more, so why don’t they?”

The outbreak is spreading rapidly in Monrovia, overwhelming the few medical facilities accepting Ebola patients. Much of the city’s medical system has shut down over fears of the virus among staff members and patients, leaving many people with no health care at all and generating an emergency within the emergency.

“In the aftermath of an earthquake, it would be unthinkable that there are so few places where women can safely deliver their babies, or where people can be treated for life-threatening conditions,” said Lindis Hurum, MSF emergency coordinator in Monrovia. “This is not only an Ebola outbreak — it is a humanitarian emergency, and it needs a full-scale humanitarian response.”

The number of people seeking care at the newly constructed 120-bed center in Monrovia, which opened on August 17, is growing faster than the team can handle, both in terms of the number of beds and the capacity of the staff. Patients are coming from nearly every district of the city. The staff is struggling to screen new arrivals, care for admitted patients, safely remove the bodies, and transport them to the crematorium.

“The numbers of patients we are seeing is unlike anything we’ve seen in previous outbreaks,” said Hurum. “Our guidelines were written for an Ebola center with 20 beds, and now we are expanding beyond 120 beds. The situation means we have to constantly adapt and we are recruiting and training, health and hygiene staff day and night. The priorities now are maintaining a safe facility; separating suspected, probable, and confirmed cases; and providing compassionate care.”

Like other Ebola centers, ELWA3 serves an important role in slowing the outbreak by isolating Ebola patients and preventing further infections. However, the unprecedented influx of patients is forcing MSF to reduce the level of care. It is not currently possible, for example, to administer intravenous treatments. MSF is preparing for further construction and to erect three larger tents with space for 40 beds each.

In the very remote area of Foya, near the border with Guinea, the lack of assistance is compounding the emergency. MSF teams are working around the clock to contain the epidemic and the Ebola management center currently has 67 patients.

“We have arrived into an extremely chaotic situation, and there are hardly any aid organizations to be seen,” said Hugues Robert, emergency manager for MSF. “In some places around Foya, the Ministry of Health is experiencing shortages of protective equipment essential for the medical management of the disease. They also have limited capacity to safely bury bodies, and to provide ambulance services to refer patients. They need support. Aside from the provision of urgent medical care, we will also make it our priority to educate the community about the disease and how to prevent transmission.”

In Nigeria, MSF has also recently started providing technical support to the health authorities in their fight against the Ebola outbreak in the city of Lagos. MSF provides technical expertise in areas such as isolation, contact tracing, training, and public education. MSF’s assistance is designed to last over a month and is exclusively advisory. At this point, Nigeria does not need MSF’s hands-on support. The six-person MSF team is supporting the isolation ward set up at the Infectious Disease Hospital (IDH), the referral center for Ebola patients in Lagos.

MSF began its Ebola intervention in West Africa in March 2014 and is now present in Guinea, Liberia, Nigeria, and Sierra Leone. The organization runs five Ebola case management centers with a total capacity of 415 beds. Since March, MSF has admitted a total of 1,885 patients. Of those, 907 people tested positive for Ebola, and 170 have recovered. MSF has deployed 184 international staff to the region and employs 1,800 nationally hired personnel.



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