It was exactly 10 years ago when I went on my first mission with MSF (Medecins Sans Frontieres/Doctors Without Borders) to Liberia, specifically Monrovia. It was a year after the end of the second Liberian civil war, which the locals had termed World War III. Fighting was still going on in the midst of the United Nations’ disarmament and demobilization program.
At the time, MSF was one of a handful of actors providing primary and secondary health care, filling the gap left by a dysfunctional public health system, which had huge deficits of facilities, resources, equipment and manpower to provide the necessary care to their people.
It was a country decimated by civil war, trying to get its feet back on the ground.
Whatever gains were made in this past decade are now on the brink of collapse as a result of this unprecedented Ebola epidemic. Another conflict has come to Liberia, a life-and-death struggle against a virus.
Since the beginning of the outbreak in March, MSF has been ringing the alarm bells but response from the international community has been slow.
Seven months later, the situation is catastrophic, with thousands dying. Ebola cases continue to surge, isolation centers are overwhelmed, my colleagues on the ground are exhausted. Today in Monrovia, we have to resort to turning away patients who urgently need care because there are no beds or space available.
The public health infrastructure is collapsing, with health workers on the front line becoming infected and dying in shocking numbers. Others have fled in fear, leaving people without care for even the most common illnesses such as malaria or common respiratory tract infections. Pregnant women have nowhere to go to have a safe delivery. Entire health systems have crumbled.
Fear is paralyzing everything and food supplies are dwindling as trade and the economy grind to a standstill.
In the neighboring country of Sierra Leone, the situation is far from under control. We see no downward trend in the admissions of patients in our centers. Cases are starting to rise in the capital, Freetown, and without a massive and immediate response, the risks for another densely populated city are considerable.
While the health system of Guinea in general has not been as badly affected as that in Liberia, the situation remains tenuous. The government has an ambitious plan to fight the epidemic but would need significant support on logistical and human resources to stop the virus.
Every day of inaction means more deaths and the slow collapse of societies.
In a speech given by Dr. Joanne Liu, MSF international president, at the UN Special Briefing in New York on Sept. 2, we appealed to states with biological-disaster response capacities to aid in the Ebola response. We called for the scaling up of isolation centers; deploying mobile laboratories to improve diagnostic capabilities; establishing dedicated air bridges to move personnel and equipment to and within West Africa; and building a regional network of field hospitals to treat suspected or infected medical personnel.
What is the Asean (Association of Southeast Asian Nations) contribution?
While we welcome the recent announcement by US President Barack Obama to deploy 3,000 troops and other assets to Liberia, gaps remain for the region. What can Asean do in turn?
With the experience of SARS in Asia and the long decade of pandemic preparedness planning in Asean using a multisectoral approach, the organization and its member-states can play a role in leadership, in demonstrating regional solidarity and in sharing experience in coordinating multiple sectors. The knowledge gained by Asean in the last 10 years will be an important asset and support to the affected West African countries today.
The window of opportunity to contain this outbreak is closing. We need more countries to stand up. This robust response must be coordinated, organized and executed under a clear chain of command
This is a transnational crisis, with health, social, economic and security implications for every continent. And Southeast Asia can make a difference to the outcome.
Dr. Maria Guevara is MSF’s regional humanitarian representative in Asia. She is based in Hong Kong.