Melissa Galarza
May 26, 2015
A Journal of the Ebola Year

Early Events of Ebola in Liberia:
It was March 24th, 2014 when I first heard of the term Ebola. I, among the rest of my neighbors, were confused as to what exactly was happening. The Liberian Ministries of Information, Culture, Tourism and Health announced that two individuals from Lofa and Nimba County grew sick with symptoms of the virus. However, there was no confirmation. Some people said it was a government scam to attract Western aid; others said it was a deadly virus. Whichever it was, the only thing that mattered was that it was present in Liberia, near my home, Gbarpolu.

My name is Juliet and at just 19 years old, I experienced the most devastating epidemic my country has ever faced. I’m a very curious person, so this became a journey to finding myself and helping others. However, my mother, father and younger sister of 9 years old were struck with terror when they gained knowledge of Ebola. They all relied on me to keep them safe since I was the only one who’s made it so far in school. We were a middle class family living in Gbarpolu and although we weren’t poor, we couldn’t afford to flee the country as a family. Actually, we could’ve but my father refused to use the money I had saved up for college to flee. So typical of him. Despite staying in Liberia during an intense epidemic, we dealt with it as knowledgeably as possible. This was only because we had the help of the internet – we are one out of 10 homes in the County who had access to modern technology.

Here in Liberia, we're very limited in communication. There's barely any advanced phones, internet, radio nor television. Most of the citizens from Liberia get their information from each other. Rumors are their number one source. However, since I had a laptop, I was able to keep myself accurately informed of what was going on. After three days of Ebola being the number one topic in villages, finally, on March 31st, 2014, the government confirmed the first cases of Ebola. Rumor had it that the patient from Lofa was the first death of Ebola in Liberia. Doctors Without Borders (DWB) also warned on March 31st that the spread of the epidemic is unprecedented and they are concerned because past outbreaks took place in remote locations. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) If it worried them, it worried me. I, unlike many others, was convinced that it was not a scam. I remained genuine because the information I found online based on Ebola was real – actual facts. There’s no way the government could have done such thing purposely.

Many people of Liberia were convinced that it was a scam because of decades of corruption by the government. The country was doing badly in the health department, which made it easy to believe that they created Ebola in order to attract funds from international donors. (Jerving, Sara. "Why Liberians Thought Ebola Was a Government Scam to Attract Western Aid." 2014. Web.)

Ebola went quiet for about a week, which maintained citizens of Liberia calm. However, the gossip regarding the virus was never-ending. On April 8th, World Health Organizations assistant director-general for health security informed citizens that “This is one of the most challenging Ebola outbreaks we have ever faced.” WHO also stated that they had 50 staff in West Africa with plans to send others. (Christensen, Jen. "How the World Reacted as Ebola Spread." CNN. 2014. Web.) This gave me some clarity as to how serious the situation was. Although it hadn't reached us as violently and heavy as it had in Guinea, I began informing my neighbors to be careful. Later on that day, WHO mentioned that there were 23 suspected cases and 7 deaths in Liberia. Days later, On April 15th, DWB released that the epidemic is fatal up to 90 percent of cases. (Christensen, Jen. "How the World Reacted as Ebola Spread." CNN. 2014. Web.) They informed people that it was the Zaire strain, “the most aggressive and deadly.” This was the beginning to where people began growing alarmed and scared.

My cousin, among many of those who were terrified, decided to flee to New York. Before leaving, she tried her best to convince me to pack my bags and go with her. However, there was no way I was leaving my family behind in a different country where there was a deadly epidemic happening.

As all of this was happening, I began to grow more interested in the virus rather than scared. I would stay home most of the time looking after my family and making sure they were kept clean of any contact. I thought to myself, why not apply my interest and help to others? And so I did. My best friend and I teamed up and drove across villages (From Gbarpolu County to Lofa County to Montserrado County) to spread news about just how serious the virus was. We painted information and pictures on the walls and streets and spoke to villagers. We also decided to create a daily blog where we spoke about the epidemic as it was happening in Liberia for the whole world to see.

June 2014:
As we traveled from Lofa County to Montserrado County, we realized that Ebola was beginning to spread at a faster rate. This made me question whether or not to return home, but I knew that people needed to be informed. In just four days, June 19 to June 22nd, a total of 10 new cases and 8 deaths were reported. This brought the cumulative number of cases to 51 and deaths to 34. Ebola had only reached four villages (Lofa, Montserrado, Margibi, and Nimba) – my best friend and I tried our best to prevent it from spreading to another village. Nevertheless, this was difficult because the number of contacts (people who interacted with someone who had Ebola) countrywide was 232. It follows: Lofa, 112 and Montserrado, 120. I did my research as soon as I got home.

After we helped spread some information in those villages, we decided to travel back to our homes in Gbarpolu for our health's sake. After all, DWB was on top of everything, unlike the Liberian government. They are taking a very aggressive approach to dealing with Ebola. They forget that we are humans and terrified of this deadly virus. For example, On June 30th, President Ellen Johnson Sirleaf proclaimed that the government would prosecute anyone who held suspected Ebola cases in their homes. (Watson, Jim. "Ellen Johnson Sirleaf." - The New York Times. 2014.) After this statement, you'd expect our President to increase traffic of suspected Ebola cases to formal health institutions such as hospitals and Ebola treatment units where Liberians could be properly isolated. However, that was not the case. In fact, health institutions were crowded with people who were free of Ebola and those who were sick with Ebola. The threat of prosecution was beyond unnecessary and only scared us away.

July 2014:
In July, it became noticeable that many health care officials such as doctors and nurses were contracting the virus and dying. For example, On July 2nd, a head surgeon from Redemption Hospital died from Ebola, causing the hospital to shut down and have its patients distributed to other facilities. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) Whether the hospital remained open or closed – it was extremely risky and had no way of improving the spread of the virus. If Redemption hospital remained open, patients who were admitted without Ebola would soon become infected.
July 21: four nurses at Phebe Hospital in Bong County contracted Ebola.
July 27: one of Liberia's top doctors, Samuel Brisbane, died from Ebola.
("Ebola Virus Epidemic in West Africa Timeline." Wikipedia. Wikimedia Foundation, 2015. Web.)

I thank God that my best friend and I decided to return home because on July 28th, most border crossings had been closed, with medical checkpoints and quarantines. I had advised my mother to stop sending my little sister to school in the beginning of July, which thankfully she listened because on July 30th, all education systems were shut down. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.)

One morning in July, my friend Watson was able to call me and inform me about how terribly things were going in Monrovia. She awoke to 150 people gathered in front of her home where seven people had died. They all doubted that Ebola was the cause of the deaths, which led them to get together and prevent representatives of the Ministry of Health from taking away another ill neighbor. Watson told me, “I was hearing people tell me that what was happening wasn’t Ebola, that whatever it was had been created in labs as an effort to kill Liberians,” she said. “That it was a way the government could get money from the World Health Organization so that it could then put the money in its pockets.” But she knew that was no longer true. She believed that Ebola exists in the country. However, she doesn't think the government is handling the response effectively. (Jerving, Sara. "Why Liberians Thought Ebola Was a Government Scam to Attract Western Aid." 2014. Web.)

August 2014:
Liberia officially has 468 cases and 255 deaths. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) Things are really bad now, especially with the way President Sirleaf Johnson responded. She banned public gatherings and sent the army out to enforce quarantines in order to maintain Ebola. Without knowledge of how cases were increasing in Monrovia, my best friend found herself trapped in a quarantine days later after Liberians in Monrovia found out Ebola had reached them.

Before any riots and quarantines, my best friend followed the story of a boy named Michel. She wanted to prove that health care was limited and spread the word in order for other organizations to step in and make things better. On August 9th, a 19 year old Michel had ridden to his father's town and reported stomach pain. Soon, he was suffering from fever, diarrhea and stopped eating. His father, Fallah, isolated Michel and prevented touching him because he knew it was most likely Ebola.

After resisting the government's public health warnings, Liberians in Monrovia began taking the disease seriously. However, the Liberian government failed to get ambulances, facilities and hot-lines to aid people who may be infected. Most of the hospitals in Monrovia were closed due to an extensive amount of deaths among health care workers who contracted the virus and others who were afraid to work.

Because of overcrowding in hospitals, the aid group Doctors Without Borders began building a treatment center with 120 beds in Monrovia. But the construction was delayed due to resistance from residents who live nearby. Either they were in denial that Ebola had infected their home, or they were angry at the government because they still believed it was a scam.

On Saturday, two days after Michel arrived at the West Point center, it was ransacked. The government had failed to mention that an Ebola facility would open in the angry protesters neighborhood – which led them to free patients and loot the building. My best friend recorded the whole thing, it was hard to watch because they just made the situation worse. Health care officials are trying to give us help to defeat this deadly virus, and here we are destroying our resources. Denial was an issue.

By Sunday, West Point center was gone. Patients reportedly escaped, spreading the virus elsewhere and the treatment options for people who wanted help was limited. Michel's father, Fallah, claimed that he tried reaching an ambulance for 5 days – nobody ever came.

Four days later, Fallah took Michel to Redemption Hospital in a shared taxi. Michel was sent to the emergency room, where there were only five patients who were suspected to have Ebola. “No one was catering to them, the doctor in emergency stood far from him.” said Fallah. This proved that Ebola patients weren't getting the correct formal treatment – causing them to die.

On Thursday, Michel was transferred to another nearby hospital because the main treatment center in Monrovia was packed. It was built to accommodate 45 patients, yet held almost twice that number. Patients were said to sleep on thin, uncomfortable mattresses on the floor. One person who remained anonymous claimed that the facility was so crowded that patients who may not have Ebola when they arrived could have definitely became infected as they awaited a diagnosis.

By Saturday, Michel was dead – and this was all because of limited health care services. I believe clean needles, bed sheets, proper medication and more ambulances would have made a difference. Hundreds of people could have been saved with the right treatment. For example, my best friend spoke to a woman who said, “The people bring me to the hospital because they say all my family dying, they say I come here and they take test for me.” In addition, she mentioned that on Monday her mother died. On Tuesday, her husband and his mother died. Ebola was evolving in Monrovia rapidly, it was unstoppable.

Quarantines were also a major factor in spreading the virus. As I mentioned before, angry protesters descended upon the West Point center. They turned violent, threatening caretakers, removing the infected patients and looting its supplies – including blood-stained bedspreads and mattresses. The next day, the Liberian government quarantined West Point and issued a curfew statewide. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) Liberians felt as if they were being punished rather than being helped. The military was being aggressive. For example, they fired on protesting crowds – causing a riot. Riots helped spread the virus due to saliva, sweat and blood being rubbed off on one another. This was preventable because the military fired with complete disregard for human life. A week later, the government realized that quarantine was making matters worse and lifted the blockade. (MacDougall, Clair. "Chaos and Fear Overtake Liberia’s Ebola Response | Al Jazeera America." 2014. Web.)

September 2014:
World Health Organization reported that Liberia has had 3,458 cases, 1,830 deaths and 914 lab confirmed cases. It only took one month for Liberia to become heavily infested with Ebola. We were doing the worst out of Guinea and Sierra Leone at the time. It was scary walking in the streets and finding corpses lying around for weeks. The streets look abandoned, everywhere I turned seemed dirty – as if it were infected. My family and I had managed to remain healthy. It took some serious quarantining in the house. The only person who stepped out of the house was my father, and that was only to get food. He wore gloves and a shirt wrapped around his head which covered his nose and mouth – I made sure he went out prepared.

Since Liberia was at its worst, the government decided to finally open another clinic which provided 150 beds and 6 ambulances. There was finally improvement. However, it was still extremely limited compared to the amount of cases there were each day.

Of course, two days later, 112 beds were already filled with 46 patients testing positive for Ebola, while the rest were only admitted for observation. It took 100 construction workers and 3 weeks to get the clinic open, and in just 24 hours the capacity was exceeded.

My best friend, being as heroic and nonchalant as she is, decided to help in one of the clinics by transporting sick people back and forth from their counties to the clinics. Till this day, her stories still give me the chills. People would be so sick to the point where they had no strength to get up and walk. She would see people crawling towards the ambulance asking for help, but she could only take one patient at a time. It eventually took an emotional toll on her. She had such a big heart and it hurt her to only leave with one sick person out of ten. As for precautions she took, she wore gloves, long sleeved shirts, pants, sneakers, and a mask – this prevented her from getting direct contact with any patients who had Ebola.

By late September, there were already three clinics in Monrovia. However, it was common to have patients waiting and even dying outside due to limited space.

October 2014:
In West Point, I stumbled across several signs which listed the symptoms of Ebola, what do to when infected, where to call, etc. There was one in particular which I found very helpful, it listed the “10 Commandments of Ebola.”
1. Thou shalt not HIDE ANY SICK person even family member or friend;
2. Thou shalt not SHAKE HAND or TOUCH someone with high fever;
3. Thou shalt not TOUCH DEAD BODY even if it’s your family member who died;
4. Thou shalt not PUT MAT DOWN for dead people;
5. Thou shalt not EAT or DRINK from the same pan, plate or cup;
6. Thou shalt not ALLOW ANYBODY even family friend to spend time;
7. Thou shalt not HAVE SEX with strangers, stick with who you know very well;
8. Thou shalt not PEE OUTSIDE, use a plastic bottle and wash your hands;
9. Thou shalt not TOILET outside, use a plastic bag
10. Thou shalt call this TELEPHONE NUMBER 4455 for Responsive Center when sick
(Nikiforuk, Andrew. "The 10 Commandments of Ebola." The Tyee. 1 Sept. 2014. Web.)

In addition, President Sirleaf Johnson continued to ask for more aid for the fight against Ebola. (Watson, Jim. "Ellen Johnson Sirleaf." - The New York Times. 2014. Web.) Many countries such as the United States sent millions of dollars. 100 U.S troops also arrived, bring the total to 565 to aid in the fight against the virus. On October 16th, President Obama authorized the use of National Guard and reservists to Liberia. In addition, one clinic with 60 beds opened and another with 48 beds opened, which filled up almost immediately.

In the month of October, the Liberian government banned journalists from Ebola clinics. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) I wasn't sure if it was because they wanted to lessen the bad press or if the government did it just because they cared for the health of those journalists. Either way, it was a bad move. People needed to know every single detail us Liberians were enduring.

The nation's capital, Monrovia, is worsening by the day. There are about 1 million people in the city, which gives Ebola the opportunity to evolve rapidly. In the week ending October 19th, there were 305 new cases. Although my village was far from Monrovia, I was scared for my best friend who was helping aid those in need. Health care officials such as nurses and doctors had a greater chance of becoming infected. I hadn't heard from her in about a month now, she had a very hectic schedule.

Hiding of Ebola infected and dead became very common in Liberia during October. In Liberia, we hold the ones we love very close to our heart – the thought of burning their corpse is tragic. We believe our loved ones deserve proper burials. However, cremation was the only option they had for those who passed away. Because of this, clinics which were once rapidly filling up suddenly decreased. I know this because my best friend informed me. There were Ebola treatment unites found that out of 742 spaces, 351 were occupied by patients. Here in Liberia, we must have traditional funerals for our loved ones, it’s difficult to burn them into ashes – it’s almost a form of disrespect. However, considering the circumstances, it must be done since it's the safest way to reduce the spread of Ebola. ("In Photos: Fighting Ebola in the Slums of Monrovia." VICE News RSS. 21 Sept. 2014. Web.)

November 2014:
As of November 5th, the number of cases had climbed to 6,525 and deaths to 2,697. WHO reported, “There appears to be some evidence of a decline at the national level in Liberia, although new case numbers remain high in parts of the country.” In addition, a report by CDC released that there has been a reduction in new infections in Lofa, where the virus first began. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.) This was the first good news I had gotten in about four months, I was desperate for things to get back to normal. The streets were still empty with dogs feeding on dead bodies which lay on the streets. However, safe burial practices such as cremation were created which lessened the number of corpses in the streets – reducing infection.

On November 13th, President Sirleaf Johnson finally lifted the state of emergency. (Watson, Jim. "Ellen Johnson Sirleaf." - The New York Times. 2014. Web.) This gave us all hope. We were finally on the road to recovery – sort of. However, the decline in Liberia cases is contradicted in the latest reports from WHO which states that 439 new cases have occurred in a matter of five days.

Since I hadn't been out of my home much, I discovered in late November that a black market for the blood of Ebola survivors had been created. People who bought the blood hoped to gain immunity or recovery – which was highly ineffective. These transfusions posed a risk for the transmission of HIV/AIDS and other blood-borne diseases which are widespread in Africa.

December 2014:
The number of Ebola cases and deaths were slowly declining. Many of my neighbors were still quarantining themselves. Schools were still closed. I stayed home most of the month and invested my time in homeschooling my younger sister.

2015:
The Liberian government announced that new cases in Liberia were now restricted to only two counties. Monrovia was finally free of new cases. One of the treatment centers which opened in August had been partially dismantled – it was down to two patients.

As of January 13th, Liberia was finally down to only FIVE confirmed cases! ("Ebola Virus Epidemic in West Africa Timeline." Wikipedia. Wikimedia Foundation, 2015. Web.) This was exciting news. I was in complete shock. Just three months ago my country was doing horribly and we're finally getting back on our feet – slowly but surely. Schools also reopened. However, my family decided to keep my little sister home for another month, just to be safe. In February, the U.S. Military ended its relief mission and Liberia finally opened its land borders. ("Ebola Virus Epidemic in West Africa Timeline." Wikipedia. Wikimedia Foundation, 2015. Web.)

In March, WHO announced that Liberia had released its last Ebola patient after going a week without any new cases of Ebola. However, later that month, two weeks after no new cases, there was a confirmed case. The patient had developed symptoms on March 15th and passed away on March 27th. The countdown to 42 days without any further confirmed cases began. As of May 9th, we were finally declared Ebola free. We still remained in high alert. (Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.)

It was a long journey, and to finally be able to say that we are Ebola-free is a blessing, as well as surviving it with my family in perfect health. It allowed me to view my life in a different way. After sitting in my home for a couple of month’s straight, I had a lot of time to think. What if my people hadn't reacted the way they did? What if the government would've invested their money in health facilities before Ebola attacked? What if we didn't have the help of other countries? Regardless of the traumatic events and many lives lost, this epidemic opened new doors for Liberia. Our medical skills increased as well as clinics and unity. It also opened new doors for myself. I realized how interested I grew in journalism. My blog had thousands of views in just one month. Since then, I've decided to pursue a career in journalism.

Works Cited

Christensen, Jen. “How the World Reacted as Ebola Spread." CNN. 2014. Web.

"Ebola Virus Epidemic in West Africa Timeline." Wikipedia. Wikimedia Foundation, 2015. Web.

"In Photos: Fighting Ebola in the Slums of Monrovia" VICE News RSS. 21 Sept. 2014. Web.

Jerving, Sara. "Why Liberians Thought Ebola Was a Government Scam to Attract Western Aid." 2014. Web.

MacDougall, Clair. "Chaos and Fear Overtake Liberia’s Ebola Response" Chaos and Fear Overtake Liberia’s Ebola Response | Al Jazeera America. 2014. Web.

Nikiforuk, Andrew. "The 10 Commandments of Ebola" The Tyee. 1 Sept. 2014. Web.

Watson, Jim. "Ellen Johnson Sirleaf." - The New York Times. 2014. Web.