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Ebola Doc

The Ebola crisis: the battle and the aftermath

By Alex Newman

When news of the Ebola crisis in West Africa finally broke on the world stage last summer, NGOs (nongovernmental organizations) had already been on the front lines for months battling the deadly disease.

While some news outlets, such as Al Jazeera and the BBC, picked up the story early on, it wasn’t until two health care workers – both with the Christian charity Samaritan’s Purse (SP) – contracted the virus and flew back to the U.S. for treatment in early August that the international community stepped in.

Although Ebola outbreaks occur every few years, this most recent is among the most severe. First diagnosis of the current outbreak occurred in March 2014 in Guinea by MSF (Médecins Sans Frontières – Doctors Without Borders), WHO (World Health Organization), and CDC (Centers for Disease Control and Prevention). It spread to Liberia and Sierra Leone from there and by summer was a full-blown epidemic in all three countries. By fall a thousand new cases were being reported each week.

Dr. Azaria Marthyman, a BC-based medical internist volunteering with Samaritan’s Purse Canada, first went to Liberia in July. He reports feeling “overwhelmed. It was an enormous, daunting task, a huge mountain that I felt we could not accomplish on our own. We did what we could.”

He – and other SP medical volunteers – used protocols implemented by Doctors Without Borders (MSF), the first NGO tackling the situation. It was a gruelling task, and “Human resources were pushed to the breaking point,” Marthyman says.

Thanks to being a presence already in Liberia for 13 years – since before the UN-imposed ceasefire in 2003 – Samaritan’s Purse was able to jump in immediately. They had 400–500 national Liberian staff workers in the country. And they had global volunteers – like Marthyman – who responded quickly.

Not every doctor can respond

This was Marthyman’s second time with SP. The first was in 2010 for the Haiti cholera outbreak. Not every doctor can respond, he says, because of work or family restraints. But he had the blessing of his wife, children and colleagues. Along with his specific skills in search and rescue, tropical medicine, orthopedics, emergency medicine, and trauma made him an ideal candidate for the Ebola crisis. His guiding scripture is Proverbs 3:27 – “Do not withhold good from those to whom it is due,” as long as it is in direct response to the leading of the Holy Spirit.

Marthyman has never doubted God’s involvement in this, or any other crisis. “I can’t answer why someone survives and someone else doesn’t, because that’s within God’s sovereignty. What I can do though is respond, and since God has touched me personally in this situation I know He’s involved, and therefore also in the lives of the people who survive and those who don’t.”

Brittany Taylor, SP’s international medical volunteer co-ordinator, feels the same way. She remembers how frightening the Ebola situation was, “with the number of cases growing and no help on the way.” It wasn’t until two of SP’s own, Nancy Writebol and Dr. Kent Brantly, contracted Ebola in the summer that the international community took notice and started sending help.

Although the SP team was devastated by the news of their colleagues, she says in retrospect they saw “that it was necessary to prompt the international community to get involved.”

Situations like Ebola are fertile Kingdom opportunities, Marthyman believes. “Christians are becoming relevant like never before. The world has such a spiritual void and each of us has something … that reflects back who God is.”

And because many Christian organizations are already at work in volatile or unstable locations, and have developed relationships and local networks, they’re in an ideal position for disaster relief. Thanks to its long presence in Liberia, Samaritan’s Purse, for example, had a network of pastors who could quickly mobilize as team leaders. The “ripple effect in education and public awareness was remarkable and so much more effective in areas where Samaritan’s Purse had been,” Marthyman says.

The doctor also said SP’s approach was the right one as the crisis worsened. Instead of “fighting fires,” they tackled it on several fronts – treating the sick, but also educating villages, providing kits and chlorine buckets for washing stations, and increasing local capacity by training nationals and creating community care centres.

One program was geared to training family members to nurse the sick at home, trying to contain the virus’ spread. “Each Ebola patient was infecting two to three others, and even reducing that to one would slow down the disease significantly,” Marthyman says.

A painful witness

Known for being calm under fire, Marthyman was nonetheless affected deeply by what he saw. “It was so painful to witness the dehumanization. It degrades people. A person in prime health can decline within days, lying in a fetal position, surrounded by excrement and vomit,” he says. “No family around to help and console because of the contagion. The natural response to that cry for help is to hold and console, but you can’t. I used my voice, but there’s a language barrier. I could hold their hand, but only through three layers of rubber gloves, which were bleached afterward to avoid germ transfer.”

The disease affects far more than its immediate victims. With schools closed for several months, education gains were interrupted. Over 16,000 children lost a primary caregiver and while most now live with extended family, UNICEF reports 3 per cent – or about 3,700 children – have been orphaned.

The health care system has been decimated and desperately needs money and resources to resurrect clinics. Of the 800 doctors and nurses who had served Liberia’s 3 million people, more than 350 died from the epidemic. Because all hospitals were turned into Ebola treatment centres, people with other conditions, such as malaria, typhoid or obstructed labour, were turned away and many died.

The economic impact as well can’t be underestimated, especially for a country that was already at a low point economically.

Recovery – and prevention of future outbreaks – can only happen, Marthyman says, if programs are put in place. “Under current conditions expect to see more of these outbreaks.”

What happens next

Samaritan’s Purse will remain in the country, and is currently discussing what recovery programs they will add to their regular programming.

One challenge in Africa is that the family cares for the body. “It’s their way to say goodbye. Kissing and touching the body is closure,” Marthyman says. “Most don’t understand germs or why you need to refrain from touching the body. And they’re mistrustful of any government information because of corruption.”

Taylor says SP’s main goal is to “provide training and personnel for sustainability programs, increase the capacity of the nationals so they can care for themselves. But it takes money.”

Governments are one source, but much more significant is the global Christian community. Marthyman knows firsthand how critical that is. “All that logistical support throughout the Ebola crisis – the masks, goggles, gloves, IV fluids, a helicopter – would not have been there without the support of Christians.”

Things seem to be changing, albeit glacially, thanks to the recent international assistance particularly in education. “The prevalence of Ebola has come down, especially in Liberia,” Marthyman says. “But we’re not at zero, and the worry is that as the international community pulls back and redirects its efforts to other situations, these countries will be on their own, and will give the situation less vigilance than necessary.”

Ebola vaccine trials currently underway will certainly help, but Marthyman says more critical is the ability to respond and act fast. “That’s one thing we learned from this – how to respond.”

Why does Ebola spread so quickly?

Ebola has flourished partly because of political unrest, especially in the three countries of the latest outbreak. Liberia’s two civil wars, 1989–1996 and 1999–2003, resulted in over 200,000 dead; Sierra Leone’s civil war from 1991–2002 left 50,000 dead. Both countries were in shambles with roads and communications networks destroyed, a health care system decimated and overcrowding in cities.

Although there were Ebola outbreaks in the 1960s, the virus was first identified in 1976 after an outbreak in Sudan and then Zaire, now the Democratic Republic of Congo, when microbiologists were able to isolate the virus. Ebola used to be containable because travel between villages was so limited. With greater movement between countries, and much higher urban densities, the recent outbreak resulted in “24,666 reported cases and over 10,000 deaths according to the most recent CDC data,” Marthyman says. “The worst outbreak to date.” –Alex Newman

Many EFC affiliates were battling the Ebola crisis.

· Since the Ebola crisis struck Sierra Leone, Intercede International’s partner ministry in that country has been starting to help many Ebola orphans by building a children’s home. This crisis has been a reminder to Intercede that it is children who are often the most impacted by the fallout from such situations.

· SIM’s (Serving in Mission) ELWA (Eternal Love Winning Africa) Hospital in Monrovia, Liberia has been at the centre of the Ebola crisis. The hospital has been inundated with cases. An SIM missionary serving in the hospital – Nancy Writebol – contracted and survived the disease as have a number of other workers. Currently SIM Canada has two Canadians serving at ELWA.

· World Relief Canada has worked to help stop Ebola from spreading. Where World Relief works in these regions, they have been distributing sanitation equipment and providing information sessions, and have seen no reported cases of Ebola during the entire life of the project. The main focus was in Zota District, Bong County, Liberia, where they worked with 16 communities and people from 30 churches, mosques, 6 health centres and 16 community centres.


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