Liberia is Ebola-free, but recovery will take time

May 9 brought a hugely important milestone for Liberia: It was the day the World Health Organization declared the West African nation to finally be free of Ebola virus disease.

Nearly 5,000 people had died from Ebola in a country with a population of 4 million. More than 10,000 confirmed or suspected cases were reported in Liberia in 14 months. Today, a few cases continue to be diagnosed in neighboring Guinea and Sierra Leone, but not in Liberia.

But the path forward is anything but easy for the country, which still struggles with the legacy of a 14-year civil war that ended in 2003.

Ebola survivors leave their handprints on a wall of the Bong County Ebola Treatment Unit. (Photo by Adam Parr, USAID)

Ebola survivors leave their handprints on a wall of the Bong County Ebola Treatment Unit. (Photo by Adam Parr, USAID)

Recovering from Ebola “is like recovering from the war,” said Kathleen Sobiech, program manager with the IU Office of International Development. Schools were closed for much of the past year. The fragile Liberian economy was devastated. Hospitals were overwhelmed. Thousands of children were orphaned.

Indiana University has longstanding ties with Liberia, through research and other activities. Starting in 2011, IU partnered in a U.S. government-funded project, called the Center for Excellence in Health and Life Sciences, to build the nation’s capacity for educating health-care professionals.

But Ebola intervened, forcing IU-affiliated personnel into the emergency work of tracing infection contacts, teaching the public how the virus was spread and developing strategies to contain the disease.

Ebola cases spiked sharply last summer, prompting fear that the epidemic would spread beyond control. The spread slowed as an initially skeptical public accepted the slogan “Ebola is real” and adapted to simple techniques for preventing the spread of infection.

Heroic efforts by health and medical professionals also played a role. Time magazine, naming West Africa’s Ebola fighters its 2014 Person of the Year, profiled a number of them, including IU School of Medicine alumnus Dr. Kent Brantly, who contracted Ebola in Liberia, and Harvard-trained epidemiologist Mosoka Fallah, a key consultant for the Center for Excellence in Health and Life Sciences.

Ebola chart

This Liberia Ministry of Health chart shows the sharp rise and fall in Ebola between August and December 2014.

The World Health Organization credited quick recognition of the importance of community engagement – along with decisive leadership by President Ellen Johnson Sirleaf, who received an honorary degree from IU in 2008 — with turning the tide.

“Health teams understood that community leadership brings with it well-defined social structures, with clear lines of credible authority,” the WHO said in a May 9 statement. “Teams worked hard to win support from village chiefs, religious leaders, women’s associations and youth groups.”

Also part of that effort was Tiawanlyn Gongloe, a Liberia native who spent her teenage years in Bloomington and earned bachelor’s and master’s degrees from the IU School of Public Health-Bloomington. She worked for the Liberian Ministry of Health and Social Welfare as part of a task force that conducted Ebola contact tracing and public health outreach about preventing infection.

Now, as the Center for Excellence in Health and Life Sciences project nears an end, Gongloe is teaching Ministry of Health employees to train field workers in the basics of public health. They are using an IU School of Public Health-Bloomington curriculum, Public Health & You, modified for Liberia.

“Strengthening public health,” Sobiech said, “is a basic that needs to happen.”

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