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TIME Person of the Year 2. Ebola Fighters. By David von Drehle, with Aryn Baker / Liberia. On the outskirts of Monrovia, the capital of Liberia, on grassy land among palm trees and tropical hardwoods, stands a cluster of one- story bungalows painted cheerful yellow with blue trim. This is the campus of Eternal Love Winning Africa, a nondenominational Christian mission, comprising a school, a radio station and a hospital. It was here that Dr. Jerry Brown, the hospital’s medical director, first heard in March that the fearsome Ebola virus had gained a toehold in his country.
Patients with the rare and deadly disease were turning up at a clinic in Lofa County—part of the West African borderlands where Liberia meets Guinea and Sierra Leone. It was then that we really started panicking,” says Brown. Even in ordinary circumstances, the doctor’s workday was a constant buzz of people seeking answers: Can you help with this diagnosis?
Would you have a look at this X- ray? What do you make of this rash? Inevitably, Brown would raise his eyebrows and crease his forehead as if surprised that anyone would think he might know the answer. Just as inevitably, he would have one. Ebola was different.
On this subject, Brown had more questions than answers. He knew the virus was contagious and highly lethal—fatal in up to 9. But why was it in Liberia? Previous Ebola outbreaks had been primarily in remote Central Africa. Could the disease be contained in the rural north? The membrane between countryside and city in Liberia was highly porous; people flowed into Monrovia in pursuit of jobs or trade and flowed back to their villages, families and friends. Sooner or later,” Brown remembers thinking, “it might reach us.” And what then?
A poor nation still shaky after years of civil war, Liberia—population 4 million- plus—had just a handful of ambulances in operation. How could Liberia possibly deal with Ebola?(Read the Ebola Doctors’ Stories)Because he couldn’t answer these imponderables, Brown focused on what he could do.
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At a staff meeting, he assigned Dr. Debbie Eisenhut, an American with Serving in Mission (SIM), to research the disease. By combing the Internet, Eisenhut found what little there was to know about Ebola virus—symptoms, modes of transmission, treatment options. In its early stages, Ebola looked like any number of human infections common in that part of the world, including malaria: fever, achiness, a general sense of malaise. By the time it produced more shocking symptoms—uncontrollable vomiting, torrential diarrhea, organ failure and sometimes bleeding—the patient’s chance of survival was small. The best news Eisenhut found was that Ebola virus does not pass through the air; transmission requires direct contact with the body fluids of symptomatic patients.
As for treatments, her findings were meager: fluids to stave off dehydration and Tylenol for pain. And to prevent its spread, chlorine bleach solution to disinfect skin, clothes, bedding and floors. There was no known cure.
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Eisenhut’s findings made it clear that Ebola patients must be separated from the rest of the hospital population and treated by staff wearing protective gear. And this posed further questions for Brown. The Eternal Love Winning Africa (ELWA) hospital didn’t have an isolation ward, nor was there time or money enough to build one. No hospital in Liberia had one. Looking around the compound for a solution, Brown’s eye settled on the modest chapel, bare but for a few battered wooden pews and a lectern that served as a pulpit.“Well, of course, turning the chapel into an Ebola unit was not welcomed by the staff of the institution.
The bulk of them said, ‘Why should we turn the house of God into a place where we put people with such a deadly disease?’ And some said, ‘Where will you provide for us to worship in the morning?’” Brown recalls. His story, like all the accounts quoted here, was shared in an interview with TIME.)Read More: The Ebola Nurses’ Stories. Dr. John Fankhauser, another volunteer, a family physician from Ventura, Calif., had a ready answer to those objections. Jesus himself treated patients in the house of God, Fankhauser noted. Still, the idea remained unpopular, so Brown tried a more personal brand of persuasion. One by one, or in small groups, he asked the upset hospital workers, “What if you get sick with Ebola, or a member of your family? If the ELWA facility is not prepared to treat patients, where will you go?” Eventually, as Brown recalls, “a couple of them saw reason.”Brown arranged for staff training and stockpiled bleach.
Eisenhut took charge of the chapel conversion, assisted by Dr. Kent Brantly, a physician from Texas who had moved to Liberia with his family as part of the Christian relief group Samaritan’s Purse. The doctors found room for six beds, which seemed like plenty, because they assumed that Liberia’s Ministry of Health would eventually create a proper Ebola treatment facility. The chapel would be needed only as a safe place to hold infected patients while they awaited test results and transfers.
Vast and tragic questions lie behind that mistaken assumption. The Ministry of Health did virtually nothing. Why did it fail to take timely action?
And why was the failure replayed in Guinea and Sierra Leone? Why weren’t these governments encouraged and supported by international watchdogs like the World Health Organization (WHO)?
Why were so many officials from Washington to Geneva to Beijing unable to see what Brown could see, unable to prepare as he prepared? Watch Man On The Train HDQ. Why didn’t the news from the borderlands produce immediate official action in March, when the worst Ebola epidemic in history—by far—might have been contained and snuffed out? Why, in short, was the battle against Ebola left for month after crucial month to a ragged army of volunteers and near volunteers: doctors who wouldn’t quit even as their colleagues fell ill and died; nurses comforting patients while standing in slurries of mud, vomit and feces; ambulance drivers facing down hostile crowds to transport passengers teeming with the virus; investigators tracing chains of infection through slums hot with disease; workers stoically zipping contagious corpses into body bags in the sun; patients meeting death in lonely isolation to protect others from infection? According to official counts, more than 1. Ebola virus in this epidemic and more than 6,3.
Guinea in December 2. Many on the front lines believe the actual numbers are much higher—and in any event, they continue to rise steeply. The virus has traveled to Europe and North America, where the resulting fear exceeded any actual threat to public health. In West Africa, however, the impact has been catastrophic. The number of Liberians with jobs fell by nearly half as businesses and markets closed in fear of Ebola.
Sierra Leone’s meager health care network simply collapsed: Ebola patients were told by the government to stay home rather than look for a hospital bed. In Guinea, the epidemic stoked distrust of government and aid workers. Medical missionaries were driven from villages by violence and threats. Read More: The Ebola Caregivers’ Stories. Ebola should not have been a surprise. The steady expansion of human habitat brings people into contact with remote reservoirs of poorly understood diseases, and mobile populations allow pathogens to infect large numbers in a short time. The story of Ebola is the story of SARS, of MERS—and most of all, it is the story of HIV and its nearly 8.