Despite a shortage of resources and a lack of experience with epidemics such as Ebola, Dr Jerry Brown of the ELWA II Hospital managed to set up the country’s first isolation ward – and save many people’s lives in the process.
In 2014/2015 West Africa experienced the most severe outbreak of Ebola fever ever seen. Along with Guinea and Sierra Leone, Liberia was one of the countries hardest hit. A total of 10,000 people fell sick. Some 4,000 of them died.
The first cases of this infectious disease were registered in Liberia in March 2014 in regions close to the border with Guinea, the zone of the initial outbreak. From there the virus – which is transmitted by direct bodily contact, or contact with body fluids or contaminated objects – spread rapidly throughout the country. By August of that year, a total of 12 out of 15 regions were affected. The capital Monrovia was particularly badly hit. Controlling this outbreak of the Ebola fever created huge challenges for the country’s health system. Due to the civil war that had raged for almost 15 years (1989-2003), large parts of the entire infrastructure (education, health, transport, energy) remained extremely underdeveloped. The rapid rise in the number of suspected cases posed numerous problems, not only for medical and non-medical personnel, but also for the national government and its agencies. As well as a shortage of medical materials, needed equipment and laboratories, there was also a lack of reliable information and experience in dealing with the disease. Also lacking were standard guidelines on appropriate measures to treat and contain the disease, as well as trained personnel.
Thanks to his huge commitment and his ability to launch epidemic control measures even under (medically) difficult conditions Dr Jerry Brown, Medical Director of the ELWA II Mission Hospital in Paynesville, Monrovia, succeeded in setting up the first isolation ward in Liberia. He also cured patients there.
Treat people with Ebola and save human life.
Targeted training and further education of doctors and nurses.
Enlighten the population: introduce hygienic measures, alleviate someone's fear of contagion.
In April 2014 the first Ebola patient was admitted to the ELWA II Hospital. In the weeks and months that followed, the number of people suspected of being infected with Ebola shot up. They included a Liberian nurse, and an American missionary doctor from the non-governmental organisation Samaritan’s Purse. He was flown home for treatment, whereupon the NGO initially withdrew from Liberia. On his own initiative and using the simplest means, Dr. Brown set up the capital’s first Ebola Treatment Unit (ETU) in the mission compound. This unit was used to contain the risk of infection and treat people known or suspected to be infected. At the same time he reorganised the hospital. For example, access to the hospital was limited to a single entrance. People made makeshift protective clothing from surgical gowns, as well as plastic bags and aprons, and made face masks out of rubber boots. One of the greatest challenges was convincing the local population, and especially hospital personnel, that given the right protective measures Ebola patients can be cared for without risk. Many nurses and healthcare workers had refused to continue working for fear of infection. Taxi drivers were refusing to transport hospital personnel.
A radio interview with Dr Brown finally helped improve the situation. The Government of Liberia, church organisations and business people became aware of the work of the ELWA II Mission Hospital, and promised to provide the necessary financial support as a result. This made it possible to train doctors, nurses and ancillary staff such as cooks and cleaners in how to deal with patients, and particularly how to deal with issues of hygiene and decontamination with the means available. A large donation made by the charity action medeor from Tönisvorst in Germany made it possible to build a separate isolation ward. Having set it up initially in a small chapel, Dr Brown later moved it to the kitchen and washroom area.
Between July and December 2014 a total of 700 patients were treated on the mission hospital’s isolation ward. Together with his team, Dr Brown successfully cared for and treated 220 people. In 200 cases, suspected infection with Ebola was not confirmed. Thanks to the protective measures introduced, not a single infection occurred either in the hospital or on the isolation ward. In recognition of his work to fight the Ebola fever, Time Magazine declared Dr Jerry Brown one of the Persons of the Year 2014.
This example from Liberia demonstrates that personal dedication and talent for improvisation can at least partially compensate organisational and infrastructural deficits when fighting biological emergencies such as the Ebola fever. To ensure responsible and sustainable action in developing countries and emerging economies, however, comprehensive support will be needed. Primarily this will involve establishing and developing health infrastructures, and a stronger commitment to education. Here, development aid is needed in order to guarantee rapid responses to epidemics in the medium and long term.
In this context it will be necessary to focus on the local level and build capacity there. In Liberia, for instance, priority is attached to establishing centralised healthcare services with a high standard of technical equipment such as laboratories. A further priority is improving the resources of hospitals. Through systematic training measures for doctors and nursing staff, in conjunction with public awareness raising, it will be possible to overcome obstacles in the fight against such diseases. Once these measures are in place, it will then be possible to control even serious infectious diseases such as Ebola.
Website: Eternal Love Winning Africa (ELWA)