Liberia: Life after Ebola, One Year Later – Lidia Paladini, Germany/Italy

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Four Liberian students holding signs to celebrate the end of the Ebola outbreak in Liberia in May 2015. Source: UNICEF

Almost one year after Liberia was declared Ebola free, international media has completely stopped reporting on the West African situation. After the outbreak itself dominated most of Western media, it is now almost impossible to find a single report on how the country is coping with the long term consequences of the outbreak. It seems as if the West has turned its back on the former Ebola-ridden countries, leaving them to deal alone with the traces Ebola left behind.

A short overview: The Ebola outbreak in Liberia, of March 2014

Liberia was one of the most seriously affected countries in the most recent West African Ebola outbreak, with a total of 10,675 infections and over 4,808 deaths, as of November 25, 2015.

The first case of the outbreak was detected in March 2014, in the village of Méliandou in Guéckédou prefecture in Southern Guinea. Closely following this, the Liberian Ministries of Information, Culture, Tourism and Health announced two suspected cases in Liberia on the 24th of March. However, the government had not confirmed the crossing of the epidemic into the nation of Liberia.  

Over the next few months, the situation deteriorated at a tremendous pace, up to the point where the epidemic became “unprecedented in terms of scale, geographical spread and urban involvement”, according to a World Bank report. With the assistance of the international community, Liberia managed to fight the virus and become Ebola free on May 9, 2015, and again on September 3, 2015, after a resurgence of cases.

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An MSF health worker in protective clothing carries a child suspected of being infected with Ebola Source: MSF (Médecins sans frontiers)

In the short term, the Ebola outbreak had devastating consequences for every aspect of life in the Liberian nation. The already fragile social, political and economic structures of the country were severely damaged, and the epidemic impacted both the daily lives of the Liberian people and the overall functioning of Liberian inner and outer political processes.

In particular, the educational facilities and health system within the country were put to an acid test and suffered a harsh setback. As the public life had to cope with restrictions due to countless quarantine regulations, many shop owners had to close their businesses and major parts of the population were forced to live at the minimum subsistence level. Overall, nearly half of the working population of Liberia had been unemployed since the crisis began. Due to the epidemic, important economic factors such as export and trading also had to be kept at a minimum. Evidently, the outbreak of the Ebola virus impacted the Liberian state and people in more than only one way and set up a wide number of challenges which had and still have to be overcome.

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NATHAN KWAKAH, 38. I have had this store for almost five years now. The location is good, because this is a busy junction. When we had Ebola in Liberia, people stopped coming. Now the customers are slowly returning. Source: Mirva Helenius, Life Beyond Ebola

On a very personal level, the Ebola survivors and people whose family members, friends or relatives were affected by the virus experienced extreme restrictions in their social life and in their role in the society. In the short term, many experienced psychological problems, extensive trauma and social exclusion, which implicated further impairment of their socio-economic situation.

Jerald Prince Dennis III, Public Relations Officer of the Ebola Survivors Association of Liberia, is an Ebola survivor himself and knows about the personal consequences of being affected by the virus better than most other people. He is a Liberian living in Congo Paco’s Island in Monrovia, the capital city of Liberia. Along with being an Ebola survivor, a Bassa by tribe and a Christian, he’s also the father of two kids, a boy and a girl who he lives with. At the same time, he‘s also a former employee of the Nation referral hospital John F Kennedy Medical center in Monrovia, where he was infected with the Ebola virus. Presently, he serves as the Public Relations officer of the Ebola Survivors Association of Liberia and is a senior student at the University of Liberia, studying Public Administration and Management.

Talking about his own story of being an Ebola survivor, he says that being affected by the virus has changed his daily life. After he recovered from the virus, he noticed that the quality of his interactions with friends and family members declined due to stigma. “Whenever I sit with friends who are not survivors, I feel different than them, because instead of addressing me with my real name, they tend to call me Ebola survivor or ‘Ebola man’.” Even though he successfully fought the virus, many people are still treating him with distrust because they fear that a part of the virus still remains. The impact of the virus on his social life extends to a point where Jerald P. Dennis finds himself often relocating and changing his residence because of people’s reaction. He says, “Some people are also using our name to enrich themselves and don‘t consider the fact that Ebola has long term consequences for the survivors. People who should be protecting us are the ones highly involved in stigma and discrimination against Ebola survivors. Even our health ministry and government’s own health facilities take part in that. Back then, I sometimes used to read 15 page documents, but now I can barely read three pages without getting tired. This is one of the reasons why I feel bad about being an Ebola survivor.” Nevertheless, he says that being an Ebola survivor also had some positive impacts in his life by making him to meet a lot of great people in Liberia and all around the world.

The Ebola Survivors Association of Liberia is, Jerald P. Dennis says, an organization established to advocate for the well-being of survivors and orphans. Their main goals are to support the empowerment of survivors through capacity building activities, advocate for medical assistance, carry community awareness on stigma and discrimination and to unite survivors with their community.

This organization was founded and is lead by survivors, people who went through the horror of Ebola themselves and who can meet the needs of the survivors with a different level of understanding and compassion. The motto of the association is “He who feels it, knows it”.  Jerald P. Dennis emphasizes that “working with survivors is not an easy task, as there are many people who have lost hope.” The association’s task is to create a safe space where the seeds of the hope of these people will be able to grow again. Their daily tasks are to meet key stakeholders and provide feedback to their people through their head in the counties.

Social challenges Ebola left behind

Talking about the permanent impact the Ebola epidemic left on the society, Jerald P. Dennis firstly emphasizes that the virus left behind a significant number of orphans and semi orphans. Many families were torn apart by the epidemic, and a large number of children lost their parents and other family members to the virus. Even more than one year after the end of the epidemic, the majority of the Ebola survivors are still being confronted with a huge number of prejudices, extensive discrimination and labels. This circumstance leads to a significant complication of the reintegration of the survivors into the society and leads to further medical complications and social problems.

Offering further explanations about the social impact, he continues: “People’s interaction has changed since the Ebola epidemic broke out.” Signs of affection, such as shaking hands and hugging, became less common than before the outbreak as people try to keep a safe distance more often than not. Even one year after the end of the epidemic, this has not changed. From a big number of challenges the Ebola survivors are still confronted with, there are certain key problems that need to be addressed in order to restore the pre-Ebola situation: The lack of capacity-building activities, missing opportunities for orphans, the failing reintegration of survivors and the lack of scholarships for people who have been affected and limited in their actions by the Ebola virus.

These are the key challenges the Ebola survivors are coping with, and only when an approach to solutions to these challenges will be found, the Ebola survivors will have a chance to live their lives freely, without being defined by the label of being an Ebola survivor.

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LORPU KESSELLEY, 19. I lost both of my children to Ebola. Their deaths were extremely difficult for me. I was like paralyzed; I could not express my feelings, I had no words for my sorrow. The Red Cross volunteers have talked with me since my kids died, and they have helped me a lot. I still cry a lot and miss my children so much, but now I don’t keep my feelings to myself. I talk to other people and I talk to God. I’m still young. I might return to school. I want to finish high school. Source:

The Ebola outbreak – a harsh setback for the economy and the health sector

After going through a 14 year period of civil war (1989 – 1997 and 2001 – 2003) that destroyed Liberia’s basic infrastructure, the country was finally on the road to recovery again, with increasing development of the nation and the establishment of humanitarian aid.  However, the West African Ebola outbreak displayed a harsh setback for all the progress that had been achieved in the past decade. Beneath all the social consequences of the epidemic, the outbreak hit a country with an already weak economic situation and a fragile health system.

Even though a lot of time passed since the end of the outbreak, the health sector continues to face significant challenges as the Ebola epidemic took away many of the gains that the country made in the past decade. One of the major problems considering the Liberian health sector is the significant shortage of health workers. Liberia is one of the countries with the lowest physician densities in Sub-Saharan Africa, with less than 100 physicians estimated to be working in the public sector.

In the face of the most recent Ebola outbreak, this number continued to decrease as Liberia lost 10 percent of its doctors and 8 percent of its nurses and midwives to the deadly virus. Even one year after the outbreak, this is still one of the most critical flaws in Liberia’s health sector. Connected to the shortage of physicians is also a significant increase in maternal mortality of 111 percent compared to pre-Ebola rates.

Considering all that has been said, it’s clear that Liberia still is coping and will have to continue to do so with the long-term consequences of the most recent Ebola outbreak for the many years that lie ahead. However, the nation is on a good path to recovery and many steps into the right direction have already been taken. It’s now a matter of time and cooperation between the population and the state to see how the situation will develop. Good luck, Liberia!

 

Note: I want to thank the Liberian Red Cross and Jerald P. Dennis, both as an individual and representative of the Ebola survivors Association of Liberia for their support of my work  and eager will to help.

If you want to know more:

https://vimeo.com/138116638

 “We Survive”, a music video by Takun J, Angie Tonton, Peaches, Deng and JB. The song celebrates Ebola survivors and a resilient West Africa on the road to recovery and features some beautiful images of the communities which were affected by the outbreak.

http://www.lifebeyondebola.today/

Life Beyond Ebola is a photography project launched by the International Federation of Red Cross and Red Crescent Societies to create a platform to present the stories of people who have been directly or indirectly affected by Ebola.

https://www.facebook.com/LiberianRedCross/?fref=ts

The Facebook page of the Liberian Red Cross. They’re really communicative and if you have any questions, they are one of the organizations you might want to contact.

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