The president of Liberia, Ellen Johnson Sirleaf, has implored President Barack Obama for help in managing her country’s rapidly expanding Ebola crisis and has warned that without U.S. assistance the disease could send Liberia into the civil chaos that enveloped the country for two decades.
In a letter Tuesday to Obama, Johnson Sirleaf wrote that “I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us.”
She urgently requested 1,500 additional beds in new hospitals across the country and urged that the U.S. military set up and run a 100-bed Ebola hospital in the besieged capital, Monrovia.
Infectious disease experts have criticized as inadequate the Obama administration’s response to the Ebola crisis, particularly in Liberia, a country founded by freed U.S. slaves. Global agencies like the World Health Organization and the United Nations have also come under criticism for responding too slowly to the Ebola outbreak.
The epidemic has taken an estimated 2,288 lives out of 4,269 cases in West Africa. So far more than 1,000 people have died of the virus in Liberia.
Johnson Sirleaf’s request was made several days after Obama, in an interview on NBC’s Meet the Press, called the disease a national security priority and said the United States must lead the international effort in containing the spread of Ebola in Africa.
Shortly afterward, his administration announced that it would use the U.S. military to set up a 25-bed health facility in Liberia to treat health care workers, a gesture that many infectious disease specialists working in West Africa derided as paltry, particularly in comparison with the Pentagon’s large-scale response to the earthquake in Haiti in 2010.
“When President Obama announced that the U.S. government was going to greatly increase its help, I was ecstatic,” said Dr. Timothy Flanigan, an infectious disease specialist with Brown University, in an interview from Monrovia, where he has been working for the past month. “The 25-bed hospital that’s being provided is hardly a drop in the bucket for the people of Liberia.”
Obama administration officials said Friday that the president on Tuesday would go to the Centers for Disease Control and Prevention in Atlanta, when he would announce a more aggressive U.S. response to the disease.
The military’s 25-bed hospital, a senior administration official said, “is the floor in terms of DOD’s response, not the ceiling,” referring to the Department of Defense. “You’ll see more of that on Tuesday.”
On Monday, the WHO issued a dire Ebola warning for Liberia, saying that the number of new Ebola cases was increasing exponentially and that all new treatment facilities were overwhelmed, “pointing to a large but previously invisible caseload.”
The organization’s data indicated a 68 percent spike in Ebola cases in Liberia over the past three weeks. The description of the crisis in Liberia, which along with Sierra Leone and Guinea is at the center of the worst Ebola outbreak ever recorded, suggested an even more chaotic situation in Liberia than had been thought.
Global consulting firm Oxford Analytica said this week that of the three West African countries at the epicenter of the Ebola outbreak, Liberia is in the worst shape because of the high concentration of infected people in Monrovia.
In an echo of the colonialism that characterized West Africa in the 19th century, Britain has focused its assistance on its former colony Sierra Leone, as British troops head there to build and staff a 63-bed facility near the capital, Freetown. France has sent medical experts to its former colony Guinea.
That leaves Liberia, with its historic ties to America’s antebellum era, in U.S. hands. In an interview Thursday, Johnson Sirleaf, the Liberian president, said a perception by other countries that the United States would take care of Liberia had hurt the country so far in the Ebola fight. She said a health expert with the French group Doctors Without Borders told her recently: “We’re French. You’ve got America behind you; Why should we have to do this for you?”
But the government of Johnson Sirleaf, a Nobel Peace laureate, had also come under criticism for its response to the Ebola crisis, in particular a quarantine that she placed on a densely populated Monrovia neighborhood that caused deadly riots. That quarantine was lifted after 10 days.
In her letter to Obama, Johnson Sirleaf asked that the Pentagon set up and operate “at least one” Ebola treatment center in Monrovia, an echo of several infectious disease specialists who say that only the U.S. military has the capacity and experience.
Many health experts say that the military brings much-needed organization and discipline to the work at Ebola treatment centers, including ensuring that health workers adhere to strict safety protocols. Because the disease, transmitted by bodily fluids, is contagious when patients are sick, or after they have died, health care workers must wear gloves, masks and full-body protective gear before touching patients and must go through several steps of chlorination after treating patients.
“It has been three months since I felt the warmth of bare skin that was not mine,” said David Knight, a U.S. doctor working in Liberia, in an email. “Two months since I have been less than two feet of another human without PPE,” or personal protective equipment.
Health workers in Liberia, Knight said, “move with an invisible force field of three feet between us and the nearest human.”
Rear Adm. John Kirby, the Pentagon spokesman, said Friday that “since the outbreak began in March, the whole government has been engaged in fighting this.”
He added that the Defense Department is “actively working to look at capabilities that we might be able to provide that would be of use.”