A year after West Africa’s Ebola Virus Disease (EVD) outbreak, the global health community has begun to evaluate national and international responses. Experts are starting to ask difficult questions about the epidemic—predominantly, “what could we have done differently?” As public health leaders, we’ve asked ourselves this many times, particularly within the context of Liberia, where our Ebola-related work is centered.
There is no question that Liberia’s health sector was under-prepared. No one anticipated how quickly the epidemic would spread nor its extensive damage to urban areas. At the beginning, many believed Ebola could be easily contained. Even when the outbreak was finally declared a crisis, many Liberian communities did not believe it was real. Distrust of the health system was so great that they ignored the Ebola prevention instructions that the Ministry of Health provided. Even if they had followed instructions, the supplies that communities needed to prevent and manage Ebola cases were not available.
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