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Column: The Ebola outbreak is much more than a medical emergency

Food scarcities, rocketing transport costs, closures to schools and clinics – an on-the-ground account of the situation in Liberia.

Alistair Short

WITH THE DEATH toll currently over 2,000, the Ebola outbreak in west Africa is the most devastating incidence of the disease in history.

However, notwithstanding the pressing need to bring this outbreak under control, there is more at play here than a medical emergency.

We in Liberia are witnessing a plethora of knock-on effects of the Ebola crisis on the people with whom we work and we are seeing similar impacts in Sierra Leone, where the government has just announced a four-day general lockdown starting on 18 September.

Food prices are rising and there is a general increase in food scarcity. This is resulting primarily from restrictions on movement imposed by the government’s state of emergency and a drop in trade between neighbouring communities.

Patients with non-Ebola conditions and medical needs – such as HIV and malaria patients, expectant mothers – are staying away from clinics because of a fear of contracting Ebola. Some clinics are closed as medical staff are afraid to turn up for work.

Liberia Ebola Gloves and rubber boots set to dry after being washed at a clinic in Liberia this week. Source: Abbas Dulleh/AP/Press Association Images

Schools, too, have closed. Transport costs are rocketing.

Looming largest around the immediate Ebola crisis itself, though, is the issue of food availability and affordability and we are seeing here first-hand the reason why the UN, the World Health Organisation and others have been issuing warnings in this regard.

In both the Lofa and Grand Bassa regions of Liberia where Concern works, farmers and members of local communities are reporting higher food price levels as a direct result of the state of emergency.

The price of essential food staples, such as rice, salt and onions, is increasing sharply, making them less affordable to local families. Before the Ebola emergency, 50kg of rice in Lofa cost the equivalent of €25. Now, the same amount costs €28.80.

When you consider that 76% of Liberia’s population live on less than $1 a day and 52% live on less than $0.50 a day, it is easy to understand how significant and debilitating this price hike is.

Red palm oil used for cooking has increased in price by 60% and salt has jumped in price by 100%.

These rising prices are unsustainable and making life increasingly difficult.

Liberia Ebola Buying foods at a market as West Point reopens after tens of thousands of people were barricaded there amid the Ebola outbreak in Monrovia, Liberia. Source: Abbas Dulleh/AP/Press Association Images

Based on the assessments our team has carried out on the ground in Lofa and Grand Bassa, we are expecting an increase beyond what we normally see each year in the number of months during which families go hungry from October onwards.

With less food comes rationing; not just eating a smaller quantity of food, but also eating a less diverse diet. This will have dire consequences in Liberia, a country with a chronic malnutrition rate above 30%.

With fewer people travelling due to the emergency, sellers can no longer command the prices they are accustomed to. For people who rely on selling crops for their livelihood, this is disastrous.

In Lofa, some communities have long been dependent on the sale of bush meat for their livelihood, but now there are no buyers for fear of contracting the dreaded virus. As a result, there are now large stocks of bush meat with no buyers.

A lack of buyers travelling from the capital Monrovia is affecting farmers all over the country. I spoke with one farmer in Bayaquellah who hires local labourers every year to help him weed his farm.

However, this year he cannot afford to do so as the people who buy his produce have not visited his village; they have stayed in Monrovia. His produce remains unsold and he has far less income as a result.

Almost incredibly, in order to continue the running of his farm, he has had to use his farm as collateral to access local credit.

Alistair Short of Concern (left) in Liberia The author Alistair, left, in Liberia. Source: Concern Worldwide

It is not just food prices that are rising – the cost of medicine is increasingly sharply as well. The price of paracetamol, for instance, has doubled in the last month.

Transport prices, too, across the country have skyrocketed to compensate for the loss of revenue arising from carrying fewer passengers. This not only makes trade more difficult, but many locals I know in Monrovia are suffering as they cannot visit their families in other parts of the country.

This human aspect of the situation cannot be ignored; for many people who have migrated to Monrovia for work, their families remain in their home towns and villages and are now out of reach.

Isolation is increasing.

In responding to the Ebola outbreak, we must remember that it is far bigger and broader than a medical emergency.

The Concern Worldwide team here is continuing to implement our long-term development work as best we can, while contributing to the Ebola emergency response with community information and training, education talks and the distribution of fact sheets to try to assuage fears and combat myths around Ebola.

We are also supporting the Ministry of Health here with training and logistics support in its efforts to control the spread of the disease and the tracing of new cases.

Source: Abbas Dulleh/AP/Press Association Images

We do so with the grateful assistance of the government via Irish Aid and the Irish public through their donations. Once again, Ireland has not been found wanting in the international arena when others need its assistance.

However, the countries most severely affected by the Ebola crisis, especially Liberia and Sierra Leone, urgently need the effective support of the international communities as outlined in the World Health Organisation (WHO) roadmap. Governments, NGOs, UN bodies and other international actors on the ground need to contribute the staff, money and other resources needed to deal with the Ebola outbreak itself and the wider consequences already mentioned.

A critical component of this is the need to get international transport and freight operations back into the region so that we and other agencies can actually provide the assistance required. The WHO has stated that there is no need for travel restrictions – effective screening operations can be established at airports, and other gateways. Closing off travel and transport links with the west African countries affected by Ebola is actually counter-productive and is hindering an effective response.

Immediate and effective engagement by all parties, not isolation, is the answer.

Alistair Short is Country Director with Concern Worldwide in Liberia.

Killer virus Ebola threatening Liberia’s very existence>

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