On 14th January, the World Health Organisation announced that Liberia had reached zero Ebola cases, bringing an end to the devastating epidemic in West Africa.
But the good news was short-lived- one day later, Sierra Leone declared a new Ebola death. A week later they declared another case.
Seema Manohar, Health Director in Liberia, worked on our Ebola emergency response in Liberia in 2014 and has led the response since January 2015.
She describes why focusing on reaching zero cases in Liberia can be misleading, when Ebola appears to be becoming endemic to the West Africa region.
Considering the situation a year ago, reaching zero Ebola cases in West Africa this January was an incredible achievement.
The governments and people of all three countries, supported by donors from around the world and aid workers, really had a lot to be proud of.
But this milestone is not the end. In fact, Ebola has probably become endemic to this part of the world.
NOT THE END
Liberia had already been declared Ebola-free twice before the regional announcement – so there’s a strong chance that further cases will once again be discovered, especially if the neighbouring countries remain at risk.
The problem with declaring a region free of the disease is that it leads to false expectations both among the people who live in these countries and the people around the world.
There are many in-country conversations around how to dispel the myth of being Ebola-free and finding responsible ways to tell Liberians that Ebola will always be an infectious disease that the country will have to deal with.
EXPLAINING THE REALITY
With the Ministry of Health, we help to communicate this through speaking with communities, radio messages and training health workers.
We also help communities prepare for emergencies and develop response plans, so that local communities and public health officials feel empowered to address any new cases of Ebola as well as other infectious diseases.
A strong level of surveillance needs to continue to effectively detect, isolate, test and treat any Ebola cases. Luckily, the countries now have the experience and capacity to tackle cases quickly so that the disease doesn’t spread and become another outbreak.
CHILDREN’S LIVES DESTROYED
The situation in Liberia is still dire for many children whose families were affected by the outbreak.
Around 5,000 children lost one or both parents in Liberia.
Children were kept out of school for nearly seven months.
Support systems to help children understand what was going on with their families and their communities just didn’t exist.
The country as a whole is in many ways still developing coping mechanisms to deal with the tragedy that the disease has brought into children’s lives.
HOW WE’RE HELPING
We’re continuing to strengthen community-level child protection systems, by supporting Child Clubs and Child Welfare Committees to raise awareness of children’s rights, addressing stigmatisation of Ebola affected children, and supporting the Ministry of Gender, Children and Social Protection (MGCSP) in the monitoring of care homes.
These care homes were relied upon when orphaned or abandoned children had nowhere to go during the Ebola outbreak. We work with the MGCSP to ensure that these homes meet accreditation standards. When they fail to do so, we work together to shut down these institutions and reintegrate the children with extended families or communities.
Along with UNICEF, we’ve also closely supported the MGCSP in institutionalising an information management system for child protection (established during the Ebola outbreak) within community and government structures – so that documentation on children’s welfare and protection needs will be consistently available.
WHAT WE NEED FOR THE FUTURE
Moving forward, we need to have flawless systems in place to support technical and field teams to do the work and to prepare for crises like the Ebola outbreak.
We need to be quick, assertive and bold in responding to public health emergencies and trust the experiences and knowledge of people in the country offices to enhance an emergency response.
It’s essential that the international community continue to commit resources to the recovery process.
Liberia’s fragile health system was exposed during the Ebola outbreak and we have the chance now to invest in building a resilient health system.
At Save the Children we must also address the more pervasive issues of maternal, neonatal and child mortality and morbidity in Liberia – they were at shocking levels before Ebola and have worsened over the last year.
Our commitment to the communities we serve will be tested now, and we need to use all of our resources and experiences to achieve long-lasting social change and well-being in Liberia.