The President was paying a courtesy visit to what Liberia and the world had hoped would be the country’s last Ebola survivor. It turned out to be a pre-mature expectation. For, rather unfortunately on March 20th, 2015 another person tested positive to the virus, thus reversing the gains that had been made in the twenty-six days when no new infections were reported.
Before the meeting with Beatrice Yardolo, a primary school teacher and the announcement of the latest case, Johnson-Sirleaf was riding on a wave of success.
Buoyed by the unprecedented success of the battle to roll back the Ebola disease, a burden which she courageously carried on her shoulders, the president’s popularity was also rolling forward from the backward slide of the past few years.
Mounting domestic outcry over poor living standards and limited jobs had seen her legacy on the ropes for large spells and though largely stable, her government had also seen some cracks especially under intermittent pressure from political actors, the civil society and the media.
The Capitol Insider delves into the crisis, the defining moments, the political infighting and exemplary leadership shown under immense pressure. It relives the most horrifying periods; the highs and the lows as well as the unsung heroes whose courage and patriotism brought the nation back from the edge of the abyss.
The Crisis Unfolds
Liberia recorded its first known cases of the Ebola Virus Disease outbreak between March 24 and 26, 2014 after a woman, who had reportedly travelled to and returned from a business trip to neighboring Guinea, fell sick. In quick succession two deaths and five other probable cases were reported to the authorities by the Foya Health Center in Lofa County in the north. The situation was largely said to be under control, with no apparent need to panic. But weeks later, similar cases were reported in two other counties - Margibi and Montserrado.
President Johnson Sirleaf was away to Rome on official trip and meeting with the Pope at the Vatican when the news of the fatalities broke but assurances from the health authorities meant the President had no need to be alarmed. It would turn out that this assurance was not based on any clear strategy of curtailing a situation that might spiral out of control. And this precisely was what happened.
A publicly announced success in containing the first outbreak, would only last a few weeks with the emergence of new cases in multiple localities around June. For example, a sick person who had come in from neighboring Sierra Leone reported at the poorly equipped Redemption Hospital in the populated New Kru Town suburb of Monrovia. At this stage, the disease was set for the rampage.
Still, the crisis didn’t catch national and global attention until a combination of high profile events shook the nation and jolted the world.
Sawyer’s Flight of No Return
In July, the crisis was now virtually out of hand, with pockets of cases sprouting in well over several counties. Health officials were scrambling to contain the outbreak, with the American charity Samaritan Purse and the Doctors Without Borders leading much of the response efforts. As the administration dragged its feet to take control of the crisis, public anxiety, fear and anger reverberated all across the country. Then, on the morning of July 25, 2014, news quickly spread that a senior official of government, Patrick Sawyer, had died in Nigeria on suspicion of having contracted the Ebola Virus.
Patrick Sawyer had left the country on July 20, 2014 for Nigeria via Lome for an ECOWAS meeting. But he had previously catered for his ailing sister who also reportedly died from Ebola prior to the trip. Patrick collapsed upon arrival at the Murtala Muhammed International Airport Lagos and was immediately taken to hospital by ECOWAS personnel.
Back in Liberia and a day later, news of the death of renowned health practitioner, Dr. Samuel Brisbane, sent shock waves across the country. Brisbane turned out to be first medical doctor to fall prey to the disease.
Both Sawyer’s death abroad and the huge international media coverage it generated and Dr. Brisbane’s shocking demise triggered a chain of rapid events that would define the remaining months of the crisis. At the Ministry of Finance where Sawyer worked, officials including the Minister of Finance Amara Konneh placed themselves under voluntary quarantine, shutting the building down and ordering full disinfection.
Task Force Established
President Sirleaf then announced the constitution of a Task Force to deal with the crisis as investors, foreign workers and some Liberians began to flee the country. On July 26, she constituted the National Task Force on Ebola and convened its first deliberations a day after but the room was short on ideas, leaders and strategy. This was so because the crisis was on a scale that had never before be seen nor managed.
“The system was not prepared for it; the whole world was not prepared for it”, recalls Dorbor Jallah, head of the National Task Force on Ebola. “I can remember a conversation with authorities at the Centres for Disease Control (CDC) and World Health Organisation (WHO), the people mentioned openly that they just didn’t know how to deal with an outbreak of such magnitude especially being an infectious disease. This was something that had never happened before especially in a poor country like ours that lack resources and is underdeveloped.”
Indeed, experts grounded in Disaster Management work were themselves overwhelmed by the scale of the chaos, misery and deaths across the region.
As the response effort got underway and President Sirleaf began to show leadership, the initial response was tailored towards curtailing the virus. But the virus was outpacing the response, ravaging the country, and infecting health workers at an alarming rate and instilling fear in the entire health system.
Part of the initial response was to remove decomposing corpses in and around Monrovia streets and the countryside, amid a storm of intense and somewhat incessant international media coverage of the unfolding carnage, which really didn’t help to ease public anxiety.
“We were collecting about fifteen (15) to thirty-five (35) bodies a day and on the look of things, it was impossible to bury every one of these corpse. Had we done so, we could have been overwhelmed, so this was the reason we thought to cremate the dead. It was a horrifying experience but we had to answer to the call of our nation”, says Samuel Nimely, the Commissioner for Police Intelligence.
“Pressure was mounting and the President was losing sleep. She would keep on the phone for hours late in the night, researching and thinking but visibly confused and worried. The death toll was so overwhelming and the chaotic nature of her government’s response efforts in August didn’t help matter”, a source close to the Executive Mansion said.
As one insider pointed out, “I think we didn’t know what we were doing in August. While people were eager to help, we were learning by doing. At some stage, it was a battle for who controls the resources. All agencies felt they were relevant and could help but the bottom line was who controls what goes where. This affected the quality of our engagement and stole much needed time and focus to getting things right.”
Invariably, a state of emergency was declared and a curfew imposed to deal with the crisis, while the world dragged its feet despite the severity of the potential human disaster.
“We were basically making decisions in silos and making appeals for body bags, food, ambulances and sanitary materials, thinking this could arrest the crisis, but it didn’t. We were simply stretched and lost on ideas”, a source working with the Task Force told The Capitol Insider.
“I can remember a meeting was called by the President of all the principals on the Task Force at the GSA Compound on UN Drive and I was opportune to be in that meeting. It was in August. The President presided in the room and looked the most vulnerable I have ever seen her. She was distressed, down beat and looking for solutions in the room - solutions the men and women around that table could not offer. It was at this point I knew we were in a hell of a serious mess.”
Calls for International Handover
The National Task Force on Ebola was attracting a lot of support from private donors and other actors but the death toll was not abating. Public outcry was getting louder and the system was being pressed to respond beyond its capacity. Opposition to the government and key actors in society were adding to the pressure with calls for the President to cede control of the crisis to an International Consortium.
“It was a desperate call and a clear attempt to undermine the legitimacy of the President and her government. Not that we were against working with our partners, as of course a number of international organizations were already providing leadership on a lot of issues, so the suggestion for us to adopt a hands-off approach was totally out of place”, said a senior official who chose to remain anonymous.
Even with the lack of strategic direction in the early stages, it was difficult to imagine the President ceding leadership of the crisis to anyone.
“She could see the failings first hand but she saw this as an opportunity to reconnect with her people and deliver when most needed. In all the chaos I could see sheer determination and courage to go over the finish line. Her courage galvanized not only the team but the nation as a whole,” the Executive Mansion source noted.
Voice From Outside: Visit of Tom Frieden
For all the energy oozing out of the government’s tank, the coordination of the crisis remained poor. By mid-August, the cracks in the response were very visible. The botched quarantine attempts on the West Point slum suburb and other places around the country provided ample proof that things were going awfully wrong. But on August 25, 2014 something significant happened.
The United States dispatched one of its highest ranking officials to the region in the person of Tom Frieden, head of the Centers for Disease Control. On arrival in the country, Frieden said the crisis was huge, “..and needs a global response. They need a lot of help from the world.”
He emphasized that the toll was “far larger than has been recorded, not because they are trying to hide anything but because they are really overwhelmed by these numbers.” Beyond this, he said, the cases “are increasing at an extremely quick rate, and this is very alarming.”
“I think Tom’s visit brought the government back to basics. There was a new sense of urgency in the strategic direction of the fight. Different organs of the implementation system that were working in isolation had seen the need to harmonize efforts”, a member of the Task Force told The Capitol Insider.
“For example, while the NTEF was meeting at the General Services Agency to conduct routine briefing meetings, the health team was meeting at the Health Ministry and the burial team at the Liberia National Red Cross. There was a visible disconnect in the way the response was being coordinated and a quiet turf war over who should lead the effort. Folks from within the Ministry of Health argued it was a national health emergency and they should have been the ones leading the effort, whereas others felt the crisis had crossed the health boundary and had far reaching implications requiring a much broader national direction.”
Clearly this infighting all but affected the quality of the response effort and dragged the crisis further up the cliff. During his visit, Freiden advised President Sirleaf to scrap the Task Force and establish an operational framework (Incidents Management System) to be coordinated by the Ebola Operation Center or EOC. With this central dashboard, all actors would converge and make decisions around the same table.
“I remember when this proposal was made by Frieden, not many colleagues on the NTEF were happy but the President had no choice. She was focused on results and opened to new ideas. She wanted everyone to think outside the box. She led and we had no alternative but to follow.”
Common Purpose, One Goal
Freiden’s visit didn’t deliver any magic bullet nor had any immediate impact as such. As a matter of fact the crisis started to hit peak levels in September, with more and more deaths reported. Nonetheless, Freiden’s proposal would pave the way for better coordination and effective management of the crisis.
A significant strategic move also was to start the process all over again. After three weeks of intense discussions and deliberations, a new strategic response document providing better direction to the fight against Ebola was developed by all the stakeholders. Through the strategy, the government was able to carve out a common purpose and single goal around which all the major actors, donors and stakeholders were rallied by the end of September.
International appeal efforts were now being fast-tracked, better organized and optimized with more commitments coming from various donors across the world. Gains were also being made domestically.
Restoration of Trust
So viciously destroyed before and during the early stages of the crisis, trust was the single most critical factor that had Ebola spiraling out of control. To defeat the virus, the government and particularly the President had to win the hearts and minds of a frustrated, skeptical and disenchanted public.
There were two unrelated events that won back public trust in the system. The first was the fact that people continued to lose close friends and family members, compelling them to have a rethink about traditional practices, behaviors and attitudes. Second, was President Sirleaf’s hand on approach in driving public awareness and sensitization across the country. Her decision to remain in the country during the crisis was a huge boost to public confidence and her approval ratings.
“The more people believed, the more they took their health in their own hands. The emphasis on social mobilization in the government’s revised strategy paid a massive dividend”, explains Lewis Konoe, a community resident in Barnesville.
“The more and more people accepted the reality of the disease, the more the communities became aggressive in dealing with the crisis”, adds Mary Broh of the General Services Agency.
Letter to Obama
By the time President Sirleaf was writing the now famous letter to US President Barack Obama, Washington had already committed to assist Liberia but the letter would dramatically alter the scale and timeliness of the assistance.
Sirleaf knew time was being lost and the US government’s intended help was still miles away and with no more breathing space left, she needed to be aggressive in drawing urgently needed attention to the country’s plight.
The letter, a classic act of astute political choreography, was crafted to send an emotional shock to the conscience of not only the US but the World community.
“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,” wrote Sirleaf in the letter, dated September 9, 2014.
“Only governments like yours have the resources and assets to deploy at the pace required to arrest the spread,” she wrote, adding, “Without more direct help from your government, we will lose this battle against Ebola.”
All the major international news media reported the letter and US President Barack Obama didn’t just respond, he led the international appeal for assistance. The Obama letter arrived when the crisis was hitting its heights and the response efforts was being better organized and coordinated.
“This was Johnson Sirleaf at her vintage best, plowing and probing, using her vast experience and knowledge in international diplomacy to woo the world’s powerful and richer nations to her country’s plight. She accomplished all these by remaining in charge of the crisis, learning from one mistake to another and leading from in front on a daily basis,” a source familiar with the management of the crisis told The Capitol Insider.
The US responded and did so in very big fashion. It deployed the full weight of its military and civilian resources and allotted huge sums of money to finance the response. President Obama himself moved quickly to set-up an Ebola team in his office and provided constant advisory to the American public.
Defying the Odds
With strong leadership and focused determination, Sirleaf stirred her country through a terrible and bitter period. While she wobbled in the early stages, she was able to learn as the process unfolded and learnt valuable lessons to defeat the unseen enemy.
Liberia’s story of triumph in adversity could potentially save a legacy that was already under threat. How she picked herself from this moment of despair and rallied her citizens to a common sense of purpose, should define the remaining months of her Presidency.
What would probably be difficult to deny is that Johnson Sirleaf delivered when most needed and her type of leadership will be remembered for generations.
Culled from The Capitol Insider Magazine