Can Fragile African Health Systems Withstand the Ripple Effects of Ebola?

Four years ago, I traveled over a deeply washed away and rutted dirt track to visit villages in the northern Liberian jungle, in what is now the epicenter of the Ebola outbreak. I focused on a network of small health clinics, which were dealing with the scourges of war and the impact of gender-based violence. Once the emergency of war eased, foreign assistance for these clinics was cut – and now what remains of these clinics are at the heart of an Ebola outbreak.
Recently, President Obama announced that the administration will be tackling the largest and longest Ebola outbreak in history by deploying troops, increasing the supply of medical resources across West Africa, and increasing collaborative efforts with the United Nations and other international organizations. The United Nations estimates a need for $1 billion in efforts to contain the outbreak and reduce the probability of a humanitarian catastrophe.
InterAction members are responding to the unprecedented Ebola outbreak, providing clinical care, logistical support and community outreach. For instance, International Medical Corps recently opened and is running a new Ebola Treatment Unit in Bong County, Liberia – a unit constructed by Save the Children. This facility increases the total number of Ebola treatment facilities in the country to six. International Medical Corps works with local partners and employs over 200 specially trained staff, 90 percent of whom are Liberians.
The healthcare systems in the countries most affected by the virus – Liberia, Sierra Leone and Guinea – have collapsed. Even before the Ebola outbreak, these countries had very low doctor-to-patient ratios; Liberia had one doctor for every 100,000 people prior to the outbreak. The strain that the Ebola outbreak has placed on an already weak healthcare system means that the system cannot respond effectively; there is not enough proper medical equipment, trained medical professionals or space to isolate those infected. Hospitals and treatment centers are forced to turn away patients, who return home and risk infecting their family and friends.
This health crisis has morphed into a humanitarian crisis with sweeping effects on daily lives and economies. The ripple effect of the Ebola outbreak on West Africa’s healthcare means many people with prevalent ailments – such as typhoid, dysentery, malaria and malnutrition – may not receive treatment. Additionally, as farmers cannot tend to their fields and shipping embargoes hinder food imports, the Ebola epidemic has sent food prices soaring. The UN estimates that 1.3 million people in Liberia, Sierra Leone and Guinea will need food assistance in the coming months. Along with shipping embargoes, mining activities and cross-border trade have diminished. Liberia has cut its growth projections.
During my trip to the villages in northern Liberia prior to the outbreak, the fragile healthcare network seemed vulnerable and susceptible to shocks. Four years later, the horrifying impact of a weak healthcare infrastructure is evident to us all. Whether it is Ebola or another medical issue, countries will repeatedly experience outbreaks if solutions focus on symptoms and not the underlying need for strong local systems. The Ebola outbreak is the result of a frail healthcare system. It is imperative that international aid communities join forces with local governments, organizations and leaders in order to contain the virus while being cognizant of the need to also build stronger, more resilient, healthcare systems.
Editor’s Note: This blog was originally written for InterAction and appeared on Sept. 23, 2014. It is reprinted here with permission.

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