Paul M. Goi waited outside of the Redemption Hospital, a treatment center serving as a holding area for Ebola patients in Monrovia, Liberia, with his sick sister-in-law in the backseat of his station wagon. She had been vomiting, and he assumed that she had caught the Ebola virus. Across the street, inside an ambulance were other members of his family, including his daughter and granddaughter. They, too, were believed to be sick with Ebola.
"I'm very frustrated," Goi told VICE News. "I had been calling the ambulances since Sunday to come pick them up, and none came." Now that he had finally managed to get his sick relatives picked up and taken to the hospital, there was simply no room. All he wanted was answers, he said.
In an alleyway next to the hospital, a young woman in green scrubs lay on the ground a mere 10 yards from a side exit. A patient, she had escaped out the door because she was scared and wanted to see her family. She was too weak to venture much further. A crowd gathered but kept their distance. A nearby medical worker explained that some in the crowd were upset because they were unable to see family members inside, while others loudly cursed President Ellen Johnson Sirleaf, accusing the Liberian government of mismanaging the situation.
Ebola has now infected over 5,000 people in West Africa, mostly in Guinea, Sierra Leone, and Liberia, and over half those infected have died. Liberia is now the epicenter of the outbreak, the worst since the disease was discovered in 1976. Approximately half the infected cases and deaths have occurred in Liberia. The capital of Monrovia, with a population of approximately 1,000,000, has been hit hardest. The number of Ebola cases is expected to grow exponentially in the coming weeks.
In the past week, the Obama administration has pledged to send 3,000 troops to combat the epidemic, to build 17 treatment centers that have over 1700 beds. For now, though, the situation remains grim. The few treatment centers are filled to over capacity, and there is a complete lack of qualified medical professionals. Even before the epidemic, which has killed dozens of healthcare workers, it is estimated that there was only one doctor for every 100,000 residents in Liberia.
With the onset of Ebola, Liberia's healthcare system is completely overstretched. People are dying of treatable diseases because they can't get into hospitals, and pregnant women are giving birth in the street. Everything is collapsing.
An official familiar with the peace-building commission at the United Nations, which includes Sierra Leone, Guinea, and Liberia, said that one of the dangers of the current situation is that in fragile countries like Liberia, which is still recovering after 14 years of civil war, is that all problems in a country coming out of conflict are exacerbated: mistrust of state institutions, poverty, security issues, and distrust in government. "You're looking at food prices going up and schools closed, wages not being paid, businesses wrecked," said the official.
"Rightly so everyone is focused on the health crisis, but once the disease is halted, all these problems are going to need to be dealt with, and it's things these countries were making progress with and all that progress is turned back," he said.
On Wednesday, the World Bank warned that the already serious impact on the economies of the three countries - among the world's poorest and all ravaged by years of recent conflict - could be "catastrophic" if the epidemic was not swiftly dealt with.
Despite the dire situation, though, downtown Monrovia continues on with life. In most areas of the city there are few signs of the havoc the disease is wreaking. People are not walking around everywhere in hazmat suits. In most of the capital, the only signs pointing to the catastrophe are posters warning of Ebola hung up on billboards and walls, and chlorine buckets (chlorine kills the virus) placed outside many businesses. Awareness campaigns appear to have worked. No longer is there disbelief in Ebola, and residents have taken it upon themselves to educate their neighbors and help prevent the spread of the disease.
It is only near the treatment centers, or where bodies have been picked up, that one gets a scale of the tragedy.
Across town from the Redemption Hospital, the Medicine Sans Frontieres (MSF) clinic was forced to turn away patients. MSF has been responding to the Ebola outbreak since March of 2014, effectively spearheading relief efforts, and has repeatedly called on the international community to contribute more to the relief effort. Their clinic was filled to capacity, and the organization was reeling from the recent infection of a French staff member and trying to determine how this could have happened.
Across the street, a 27-year-old man stood near his older brother, who had been vomiting blood. Near tears, he said that he was confused about what to do now. Paul M Goi, who had spoke to VICE News outside the Redemption Hospital, showed up with his sick sister-in-law in the back of the car. JFK hospital had also been unable to admit her, and he had run out of options. Out front of the MSF gate, a sick man, clad head to toe in black rain gear, sat outside the gate, his hood up and bottles of water at his feet, awaiting entry.
An elderly woman said that a number of infected people who were unable to get into the clinic were vomiting and "toileting" and had walked back to their houses nearby. She offered to take VICE News to their house. After following her up a nearby road, a group of neighbors came out, angered by the lack of treatment and angered by the sick people for venturing back home. "They've gone back into the community, and they are going to get more people sick," they said.
All photos by Tim Freccia
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