Brumskine: AS WE WELCOME THE AMERICANS; WHAT’S NEXT?

 by: 

 Charles Walker Brumskine

(September 23, 2014)

 In announcing the US Government’s plan to assist West African nations in the fight against the Ebola virus, President Barack Obama said that, “The Ebola epidemic in West Africa and the humanitarian crisis there is a top national security priority for the United States.  In order to contain and combat it, we are partnering with the United Nations and other international partners to help the Governments of Guinea, Liberia, Sierra Leone, Nigeria, and Senegal respond just as we fortify our defenses at home. Every outbreak of Ebola over the past 40 years has been contained, and we are confident that this one can—and will be—as well.”

 The United States’ strategy is reported as being predicated on four key goals:

  •  Controlling the epidemic at its source in West Africa;
  • Mitigating second-order impacts, including blunting the economic, social, and political tolls in the region;
  • Engaging and coordinating with a broader global audience; and,
  • Fortifying global health security infrastructure in the region and beyond.

We thank President Obama and the American people for their interest in, and support to the Liberian people during our national tragedy. We are also thankful for the assistance of United Nations, the World Health Organization (WHO), the European Union, the African Union and all of our fellow African nations, the governments and people of the People’s Republic of China, and Japan, Samaritan’s Purse, and Doctors Without Borders, as well as other donors who are generously donating to this fight for our national survival. 

As we welcome the intervention of the United States of America to help deal with the national health catastrophe, occasioned by the Ebola outbreak, let us not forget that the responsibility of containing the outbreak and eventually eradicating the Ebola virus from Liberia remains ours, as a Government, a nation, and a people.

The beefed up United States intervention should greatly assist in the fight against the Ebola virus, as the US military’s unique expertise in engineering, and command and control should be especially useful in dealing with many of the infrastructural and logistical challenges. We must, however, understand that the intervention is not intended to be, and will not be a panacea for dealing with the Ebola crisis; it most certainly will not rebuild our healthcare system. This is something that Liberia will have to do for itself. So, whether it is controlling the epidemic or mitigating the adverse economic, social, or political impacts on our nation we must remain cognizant of our national responsibilities.

 The experts have told us, in no uncertain terms, that Ebola is a public health problem, which, like any other public health issue, is more effectively dealt with through prevention rather than cure. So, as the Americans assist us in the short term, it remains our responsibility, as a nation, to deal with the real public health issue of prevention.

Not only were there many things we could have done over the past several months that might have contained the virus or at least minimized the scale of infection, but even as our US partner commences its beefed-up intervention, we are still struggling to mount an effective, coordinated plan that enjoys the confidence of the public. Hopefully the US intervention will help solve some of these problems, but it is important for us to keep in mind that Liberians will be required to do the real leg work that this crisis demands. We must bring to bear the local knowledge and experience that only we can deliver to inform the work of our US and other foreign partners. It is to facilitate the realization of this imperative that we make the observations and recommendations herein contained.

One of the major challenges faced in the current national effort in the fight against the Ebola virus has been the lack of timely information, presented with clarity and by credible messengers. The lack of trust in the government, low level of confidence in government’s efforts, and sometimes outright confusion about what the government’s plan is for combating the disease, have all contributed to the persistent denials of the existence of the Ebola virus in the country, its devastating effect notwithstanding.

 Because the current national effort at educating the public about the realness of the Ebola virus and how it is contracted continues to be met with skepticism and stubborn push-back, the education strategy needs reevaluation and modification. While the content of the message must continue to focus on the reality of the virus, how to avoid infection, and what to do if one or one’s relative is suspected of infection or dies from the virus, the government should reconsider the vehicle it uses to deliver that message. 

The difficulty about the anti-Ebola message is that people must adopt a behavioral mode that can be considered “un-Liberian”: not to do that which is a social and, for most, a moral obligation—to demonstrate love by caring for sick relatives and friends; not to shake hands, hug, pat backs, and the likes. The ant-Ebola message must, therefore, be conveyed with a sense of understanding and a degree of compassion, so that the hearer is willing to listen and comply instead of being offended and alienated. 

During my recent visit with the people of Bong and Nimba, for example, I suggested that the people interacted with me as if I had Ebola, in order for me to behave in like manner, without my hosts being offended, as well as demonstrating the easiest way to remain safe. People should be told that if you or someone you care about should contract the Ebola virus, do not be ashamed, report to the nearest medical center; getting Ebola does not mean you are a bad person, only that you may not have taken the necessary precautions. 

The cornerstone of a revised national strategy should be the employment of a new community-based vehicle for delivering the anti-Ebola message. The government needs to allow and empower individuals who have the confidence of their communities to be the vehicles through which the Ebola prevention message is delivered to the communities. The people are most likely to listen to and believe their own children and their local leaders. The effort must begin with the smallest socio-political unit outside of the family—the town/village. Each town or village has two types of leaders: chiefs appointed by the government, and chiefs/opinion leaders who exist outside of the government structure but who have earned the admiration, and therefore command the respect, of their people (the “Community Opinion Leaders”). It is the latter group of community leaders that the government needs to reach out to, convince about the reality of Ebola and how to prevent infection, and then empower them to get the anti-Ebola message to the people within their sphere of influence. Many among the former group have for too long been masquerading in Monrovia as traditional chiefs, without effective outreach to, and influence over their purported constituents. Any attempt to convey the anti-Ebola message through chiefs of the former group would prove futile at best. Their efforts would be summarily dismissed as those of yet another group of Monrovia or other urban politicians who have returned to their villages only to justify their government benefits. A similar fate would befall any “community mobilization” group whose members consist mainly of “outsiders” instead of local people of character, who not only understand the local customs, but also speak the local dialect(s). 

Community Opinion Leaders should be requested to create community cells consisting of young men and women of the village, who would serve as neighborhood watch teams. Properly trained and assisted by the Ministry of Health (MOH), they should be requested to track visitors to their community and all sick and dead persons. These local young people should also engage in contact tracing and prepare daily reports of their findings, based on an MOH template, to be picked up from the villages by the appropriate health workers based on a predetermined schedule. 

As a means of restoring or enhancing confidence in its efforts, we also recommend that the government designate a single spokesperson/office, who will update the public through regular press conferences on the efforts of the different actors involved in the fight against the Ebola virus. These regular press conferences and public updates must also be used to provide proper accounting of the many donations and budgetary appropriations that have been made and will continue to be made for the fight against the Ebola virus. Half of the battle against the Ebola virus would be won if a strong and trusting relationship can be established between the people and the “face” of our national efforts.

And while our national focus is on arresting the spread of the virus and ultimately eradicating it from the country, it is not too early for the government to begin considering how we, as a nation, might memorialize our fallen brothers and sisters, including our foreign friends who succumbed to this virus while serving us. A simple memorial at each burial site, or one national memorial, that lists the names of the victims of the virus, would serve our nation well. The memorial(s) would be an effective means of bringing closure to this tragic epoch for many families; also, as a nation, the memorial would symbolize our resolve to survive and the unity with which we confronted this deadly enemy.

The fight against the Ebola virus is a national effort, and the government must spare no effort to have all hands on deck. We can all learn from the collaboration of Liberians in the Diaspora under the banner “We Stand as One,” which has demonstrated that Liberians will work together when our national interest is at stake.

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