In Boston, some natives of Liberia are working to improve sanitation conditions and train health workers on the ground in their homeland, as the country and two of its neighbors battle a deadly Ebola outbreak.
Dr. Raj Panjabi was born in Liberia and is co-founder and CEO of Last Mile Health. He’s also a physician in the Division of Global Health Equity at Brigham and Women’s Hospital. Saran Kaba Jones is founder and CEO of FACE Africa, which has its headquarters in Boston and focuses on installing clean water wells in remote areas of Liberia.
WBUR’s Deborah Becker asked Panjabi and Jones what it’s like watching the Ebola epidemic unfold in their native country, and what their nonprofit groups are trying to do about it.
Saran Kaba Jones: It’s quite devastating. Liberians have been through so much, as you know. We’re still rebuilding from decades of a civil war and dealing with already weak infrastructure and extreme poverty rates. And so having an outbreak, an Ebola outbreak, just compounds the situation and makes it quite scary for all of us.
Deborah Becker: And your family is there?
Saran Kaba Jones: Yes, I still have family there. In fact my father is there at the moment. One of my cousins described it to me as a post-war zone because everything is very quiet, everyone is walking on eggshells and at the same time taking measures to try to curb the spread of this disease.
Dr. Panjabi, how is it for you to watch what’s been happening in Liberia?
Raj Panjabi: It’s heartbreaking. Having been born there, I had a chance to go back as a physician a decade ago. And I’ve had the privilege of caring for patients with a a number of illnesses. And I can tell you we’ve not seen anything quite like this epidemic.
The good news is that in the last few weeks, the government of Liberia and a number of partners are ramping up a response by getting more people in for treatment, but also doing the important work of reducing the fear and misunderstanding, which sometimes kills as much as the disease does.
What are some of the fears that are really getting in the way that those of us in Boston may find surprising?
Raj Panjabi: The reports that are coming out in the public and the media are really around the fear, the viciousness of the disease itself. And that is causing people to have an incredible amount of hesitation in presenting those who are ill in their communities to the health worker system because they’re almost afraid that it’s like a death sentence, that at the most vulnerable time of, say, your father or mother or brother’s life, when they’re sick with this illness, they’ll be removed from the village and cared for by people who look like they’re in space suits. However, if you get care early, the survival rate could be almost half.
Saran, you were shaking your head during this. It sounds like there’s not really trust of the health workers, and that obviously can be a huge issue.
Saran Kaba Jones: There are all these rumors that are going around, for example, that the Ebola is just another ploy that the government is employing to attract more donor money so that they can misuse it and abuse it. And that’s why it’s extremely important to make sure that we’re putting out the right information.
And that’s what your group is really focusing on right now?
Saran Kaba Jones: That’s exactly what we’re focusing on right now.
Dr. Panjabi, you’re in Washington for the U.S.-Africa Leaders Summit. Do you think that we will get positive action from this summit that’s taking place in Washington right now?
Raj Panjabi: Yes, I do think so. A number of companies that are here have business interests in that region of west Africa. They’re concerned. And you’re already seeing that mobilize.
The World Health Organization has put out a $100 million plan that they’re trying to mobilize resources for the three countries in that region. If we can put those pieces together, we can have the resources to fund an action plan to stop this in the coming weeks.
Is that what you would say that your organization is also going to be helping with?
Raj Panjabi: We have had an active network of village-based frontline health workers that have been providing primary care for mothers, for children, for years. We have equipped those workers with the protective gear they need should they encounter a case of Ebola in their community. We have trained them to educate and make their own communities aware of how to prevent getting the disease.
Liberia was hit with one of the worst health worker shortages after the war. We had just 51 medical doctors to serve a country of four million. It would be the equivalent of Boston having about 10 doctors. If there had been a functioning primary care system in the place this started, in southern Guinea, we wouldn’t have stopped Ebola, because Ebola gets transmitted from the animal reservoir to people. But we might have stopped the spread of it.
I’m wondering if I could also ask both of you to describe folks you know who are members of the Liberian community here in the Boston area and how you think this is affecting them or their families in terms of travel or anything like that.
Raj Panjabi: I think the biggest impact is losing a loved one, and there are people we know who have lost loved ones. It’s devastating.
The other thing I worry about is the stigma that could come from this crisis. I mean, the more we try to close off Liberia, Guinea, Sierra Leone from travel or put restrictions on, I think the harder it’s going to be for us to wash away that memory from the public’s image of those three countries.
Saran Kaba Jones: Yeah, I mean Liberia is such a small, tight-knit community, everybody knows somebody who knows someone. So even if you haven’t lost a loved one directly, you’re six degrees of separation from someone who died as a result of Ebola.
It’s extremely scary, but it’s been really encouraging and heartwarming to see the level of support that has come as a result of this. Liberia has been through so much. Sierra Leone, as well. And I think we can fight this and we will rise from this, as well.