Monrovia
– Many Liberians remember Jerry Brown, the doctor leading the country’s
coronavirus response team, for his fearlessness during the Ebola crisis in the
West African state.

When the virus was poorly
understood, and an infection tantamount to a death sentence, Brown risked his
own life providing primary care for suffering patients.

“I must admit, the Ebola
crisis was difficult,” said the doctor, who was named one of Time
magazine’s people of the year in 2014 for his Ebola work.

The disease killed over 4 800
people between 2014 and 2016 in Liberia, the hardest-hit country in the West
African outbreak.

Just four years later, the
country of some 4.8 million people is now staring down the barrel of a coronavirus
outbreak.

From his base in a military
hospital 20km from the capital Monrovia, Brown said Liberia had to draw on its
Ebola experience.

“No individual effort can
contain this virus,” he said, explaining that several sections of society
had to pull in the same direction to defeat Ebola.

“I am sure we can do the
same thing with corona,” Brown added.

Liberian doctors interviewed by
AFP echoed the sentiment, saying they were optimistic that they had a head
start on fighting the virus.

There are still fears the country
is woefully under-equipped for a large outbreak, however.

Already decimated by back-to-back
civil wars from 1989 to 2003, Liberia’s economy is also still reeling from the
impact of Ebola.

About half of the country also lives
on less than $1.90 a day, according to the World Bank, and the healthcare
system is underfunded and fragile.

The authorities are acutely aware
of the risk. After an initial slow start, the number of recorded cases has
increased quickly. There are now 101 official coronavirus cases in Liberia,
with eight fatalities.

President George Weah declared a
state of emergency and locked down Monrovia this month after warning of the
gravest threat to the country since Ebola.

The former AC Milan striker
pointed to tragedies unfolding in countries such as Italy and Spain.

“The horrific scenarios that
are beginning to emerge should serve as sufficient warning for every one of us
to spring into action,” he said.

Ebola advantage

Liberia’s
fight against Ebola boosted its initial response to coronavirus, according to
the country’s chief medical officer, Francis Karteh.

Authorities quickly reopened five
Ebola-era intensive care units spread across the country after detecting the
first case in March, he said, adding that epidemic protocols were already in
place.

“We already had our contact
tracing teams set, the community teams were still intact, and we only needed to
reactivate them,” Karteh said.

Heounohu Hessou, a student doctor
during the Ebola crisis who is now on the front line, also said complicated
logistics had already been worked out.

“As far as clinical care [goes],
we have the existing knowledge,” he said.

But doctors are not blindly
optimistic. Brown, for example, noted that change to Liberia’s creaky health
system had been “insignificant” after Ebola.

“I foresee some of the same
challenges that we had during the Ebola,” he said.

The health system was quickly
overwhelmed during the last crisis, and violence erupted around the country as
people clashed with security and health officials.

It is also unclear if Liberia has
sufficient protective equipment or ventilators, which can help critical Covid-19
cases breathe.

The chief medical officer said
the country has only one ventilator, however, media reports have cited five or
six.

‘Still defiant’

One
of the hardest impediments to stamping out the virus will be convincing people
to obey health restrictions, doctors say.

The government has locked down
Monrovia, and banned large gatherings nationwide, as well as flights to and
from virus-stricken countries.

But police have had to disperse
huge crowds of worshippers over the past few weeks, underscoring the difficulty
of enforcing the measures.

On Monrovia’s first day of
lockdown, 11 April, confusion also reigned as people thronged the streets in
some districts despite stay-at-home orders.

As in other poor countries in the
region, overcrowding in cities makes it hard to uphold social-distancing rules.

Health Minister William Jallah
urged citizens to respect the restrictions last month.

“Despite the bitter
experience from the Ebola, some people are still defiant when it comes to
implementing advice,” he said.

Coronavirus cases remain
relatively low for now, but they are rising. In neighbouring Guinea – which was
also hit by Ebola, and suffers many of the same problems – infections have
skyrocketed.

Some doctors fear the death toll
in Liberia may be understated.

“Many of the patients with
severe conditions have been dying in the communities, they die before getting
here,” said Brown, adding that some are unaware the virus exists.

“If people don’t change
their behaviour, you can cure as many persons as possible in the hospital,
people will still be coming,” he said.

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