Medecins sans Frontieres are working in Liberia, and have given an interview today to the BBC saying that Liberia’s official figures were "under-representing the reality", and that the health system was "falling apart".
The MSF co-ordinator for Liberia, Lindis Hurum, told the BBC: "Our capacity is stretched beyond anything that we ever done before in regards to ebola response." She said five of the biggest hospitals in the capital Monrovia had closed for more than a week. "Some of them have now started to re-open but there are other hospitals in other counties that are just abandoned by the staff. We are definitely seeing the whole health care system that is falling apart."
The BBC story picture shows a sidewalk notice board showing Ebola related news, including a scoreboard with “Ebola 7 Govt 1” which shows that at least one chalkboard blogger is maintaining the dry humour of an independent mind. Less reassuring is the news that a Govt Minister has had to explain that the local nut-based cola, Bitter Kola, is not a cure for the disease.
Liberia was colonized by African Americans in 1820. The Wikipedia entry estimated life expectancy to be 57.4 years in 2012, a fertility rate of 5.9 births per woman, maternal mortality at 990 per 100,000 births in 2010. Communicable diseases are widespread, including tuberculosis, diarrheal diseases and malaria. Liberia imports 90% of its rice, a staple food, and is extremely vulnerable to food shortages. In 2007, 20.4% of children under the age of 5 were malnourished. In 2008, only 17% of the population had access to adequate sanitation facilities.
To put it mildly, Liberia is not a poster child of governance. This leads to a dilemma: if a country cannot protect its citizens from a disease which requires soap, disinfectant and body bags, do we send in extra support for international health agencies to do the job that Liberians cannot do, and then do the same across West Africa, or do we send them instructions and exhortations and hope for the best?