Chasing Ebola: Worcester's ties to Liberia and the Fight Against Ebola

Chasing EbolaWORCESTER’S TIES TO LIBERIA AND THE FIGHT AGAINST EBOLA

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WORCESTER MAGAZINE IN LIBERIA: CHASING EBOLA FEBRUARY 5, 2015 2

On the cover: Sunday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: Martha Gbarner lost her husband, the brother of Worcester resident and Liberian Jesse Gibson, to Ebola. His death left her with several children, including a young son, to support and put through school, even though she does not work.

Above: Monday, Jan. 19, 2015 Paynesville, Monrovia, Liberia: A man washes his hands with a bleach and water solution, a mandate from the Liberian government, and then will have his temperature taken before he is allowed to enter the ELWA Hospital.

FEBRUARY 5, 2015 WORCESTER MAGAZINE IN LIBERIA: CHASING EBOLA 3

CHASING EBOLA

WORCESTER’S TIES TO LIBERIA AND THE FIGHT AGAINST EBOLA

BY WALTER BIRD JR. — PHOTOS BY STEVEN KING

When the wheels of an airplane meet the tarmac in Af-rica, passengers sometimes will break out in applause to celebrate their safe arrival. When Flight 1247 from Brussels touched down at Roberts International Air-

port shortly after eight in the evening Liberia time Friday, Jan. 16, there was only the sound of one woman’s moan of pain.

For much of the last leg of the flight from Brussels to the capital city of Monrovia in Liberia, following a stop for fuel in Dakar, the woman had uttered not a peep. As the plane descended, however, she cried out loud, “I’m burying

my baby!” as flight attendants hurried over to her middle-row seat on the plane, where she sat clutching a large doll. Her son, she told them, had died of Ebola. The woman’s cries reached a howl when she finally descended the stairs of the plane and touched her feet to the ground, her legs buckling. Falling to the ground, she was steadied by a man standing with her. The rest of the passengers filed by her, boarding a shuttle to customs. Still standing outside at the foot of the plane, the woman’s mournful sobs were silenced as the sliding doors closed shut.

The shuttle rolled a brief ways to the small building that receives visitors at the airport, its passengers spilling out and directed to large containers of water resting on tables outside the building. Buckets underneath caught the splash as people furiously scrubbed their hands with the chlorinated water. At the

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Monday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: A view of the West Point community from the top of the Ducor Hotel, which is built atop of a sand bar is considered Monrovia’s worst ghetto.


door, a worker held a thermometer to each person’s head, waving them on if there was no sign of fever. The lone luggage carousel hummed as people jostled for position to grab theirs. It was a chaotic scene, with security frantically trying to check each piece of luggage. Outside, taxis lined up to snag hurried customers. Personal drivers held signs to catch the attention of their passengers. Night had descended over Monrovia, a blanket of heat cloaked over the 970,000-plus people that live there — most of them in abject poverty.

When daylight broke the next day, the cries of a heartbroken mother had long faded, but much like the buckets of chlorinated water at the airport, there were signs all over Monrovia that, while the disease that has claimed the lives of more than 3,680 Liberians

may be loosening its death grip on the country, it has not freed it entirely. Some here are saying the World Health Organization could declare the crisis over as soon as March.

“Someone tell me, ‘Ebola is gone,’” Rev. Dr. Samuel Reeves Jr. of Monrovia’s Providence Baptist Church said in the Liberian English practiced here. “I say, ‘No, it is not gone. It is going.’”

Until it is vanquished, Ebola remains very much a threat in West Africa. Even when it is not directly responsible for someone’s death, the devastating disease that has claimed close to 9,000 victims in Liberia, Sierra Leone and Guinea, and completely changed the way of life in these West African nations, is not free of guilt.

Twelve-year-old Musu Fofana of Brewerville City in Liberia’s Montserrado County was allegedly raped Sunday night

Jan. 18, and reportedly died the next day when two hospitals in Monrovia — Redemption, a government-run facility, and Faith Clinic — refused to admit her. According to reports, personnel at Redemption saw the girl was bleeding and told relatives they were afraid of Ebola.

While the sounds are not as frequent, ambulances still speed by, lights flashing and alarms blaring, often in a rush to take a patient to one of the city’s Ebola Treatment Units (ETUs). They fight for priority over the massive push of cars and motorcycles along the paved roads in Monrovia. Traffic is, more often than not, snarled along the main roads, the congestion only worsened by so many emergency vehicles donated from other countries in the fight against Ebola. The cars, trucks and bikes also must contend with the crush of pedestrians and child hawkers, some

no older than eight, moving swiftly, vehicle to vehicle, selling candy, gum and shouting “watta, watta, watta” to their rolling clientele. The water comes in small, knotted bags from buckets that were, much earlier in the day filled from local well pumps. They prove tempting during the humid days as West Africa lurches into its hot season.

American and other military personnel are also a visible presence here, a result of an outpouring of help from the international community. Since arriving, they have built mobile laboratories that have dramatically sped up the time it takes to test for Ebola, and have delivered much-needed food, medicine and other supplies to a country largely populated by families living in poverty.

There are other, more literal signs that Ebola remains a threat not to be taken lightly. One cannot drive more than several hundred

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Below: Sunday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: ELWA Hospital staff attend an early prayer service at the chapel before they begin their shift.


The 4.4 million Liberians who have survived Ebola still bare the national face of despair regarding the future of their health care in the devastating aftermath of the disease. They are weakened and bracing for the next epidemic that will underscore the profound medical chasm that distances hope for a sustainable system of healthcare. At Seven Hills Global Outreach (SHGO), we partner with our Seven Hills staff and their developing home nations, to address a wide range of needs including healthcare, economic development, education, disability inclusion, and basic public health services such as clean water and sanitation. With our proven experience and success in seven developing countries, SHGO is standing united with its Liberian staff to initiate “32 FOR 32,” calling on 32 hospitals in the U.S. to partner with the 32 hospitals in Liberia to bring first-class health care to this deserving and dignified under-resourced country. Be the medical “instrument of change”—one of the 32 out of more than 5500 hospitals in the United States that chooses to stand united with SHGO and advance health care for a nation and the world. At Seven Hills, we have the vision to see the potential and the experience to make it happen. To learn more, contact Ashley Emerson Gilbert at 508.755.2340 x1308 or [email protected].

81 Hope Avenue, Worcester, MA 01603 • 508.755.2340 • www.sevenhillsglobaloutreach.org

An Affiliate of Seven Hills Foundation

LiberiaThe Future of Health Care in

32 32FOR

HOSPITALS UNITE LIBERIA

Dr. David A. Jordan

President/CEO Seven Hills Foundation


yards, it seems, without spying a billboard or sign along the side of the road, or attached to a building, warning of the dangers of Ebola. A sign reading “Ebola is Real” hints of when the disease first infiltrated Liberia, and many of its citizens ignored the calls to protect themselves. Despite being told to do the exact opposite, these loving and expressive people continued to shake hands, to hug and to kiss. It is, after all, their custom. That physical contact and exchange of sweat and other bodily fluids, however, is also how Ebola does what it has done with such unrelenting fury since the first outbreak in West Africa was identified in 2013.

‘NOTHING CALLED EBOLA’

The arrival of Ebola in Liberia last year was initially met with disbelief, which some claim played a huge role in the path of destruction carved out

through the ocean-side city. A public that had grown distrustful of its government simply did not believe it was being told the truth. When reality did take hold, many people were too afraid to go near loved ones to help them.

“On March 19, 2014 the government told

the Liberian people they have experienced this new illness in the country, called Ebola,” recalled Alfred Gezaye, a Liberian writer for the Insight Newspaper. “The first pronouncement was so discouraging. We were told do not touch anybody who contracted Ebola, do not go close to the person, do not go close to your family member. So a lot of people died.”

People, he said, blamed the government for many things before Ebola hit. As a result, he said, many did not heed the initial warnings, and did not protect themselves.

“People thought the government was lying, that there was nothing called Ebola,” Gezaye said.

As the disease spread, and fear mounted, so, too, did casualties from treatable illnesses not at all related to Ebola.

“One person lost his daughter from asthma,” said Gezaye. “He went to the hospital, his daughter died right on his lap from asthma. No one would take care of the child. All of the major hospitals in Monrovia were closed. Doctors and nurses, they too were contracting the disease, so there was fear, they had fear.”

Because of that fear, he continued, many people were afraid to enter a hospital.

“People were saying if you go to the hospital, people will spray you with chlorine, and some people will inject you and give

you pills,” Gezaye said. “So a lot of things were into play. A lot of people were afraid, so people were dying from curable diseases.”

His own father, he said, died of cholera in August, although he died when Ebola was tearing through Liberia. Both diseases present similar symptoms, and the question of whether his father, in fact, died from Ebola remains. Gezaye said his aunt died from Ebola.

There was also the problem of patients arriving at hospitals for medical procedures and not informing the staff that they were, in fact, infected with Ebola. Esther Kolleh, a certified midwife at the Eternal Love Winning Africa (ELWA) Hospital in the Paynesville section of Monrovia, said she encountered cases where patients outright lied about their condition.

“The one thing about Ebola, they don’t talk the truth, the patients,” Kolleh said. She pointed inside her office as she continued. “I remember one day we had two Ebola patients, one sitting right in here. I tried to interview her, but she would not talk to me. Later on, when her labor was advancing, she started crying. People said she had not been anywhere, had not been near anybody. We took her to do a C-section, the baby died, she herself died. They did a test and she was positive. The relative left and never returned. They knew it was Ebola, this is why they

brought her here, and they lied to us.”Compounding the situation in the early

days of the disease, with fear spreading rapidly, many Liberians felt shut off from the rest of the world. Some countries banned incoming flights from Liberia. There was some pressure in the U.S. to do the same, but it was resisted, with critics warning it would only worsen the crisis. Much of the panic was born of misinformation and misunderstanding. As more was learned about how the disease is spread — it is not airborne, and can only be transmitted from a symptomatic person (early symptoms include, but are not limited to, fever, headache, diarrhea and vomiting) — nerves have calmed somewhat.

To be sure, the disease is not nearly as widespread now as it was in August, September and October, when so many people were infected there were simply not enough beds for them. Bodies were dumped in the streets, not touched by anyone, lest they risk contracting Ebola themselves. Patients showing up to doctors and hospitals for other illnesses were often turned away. Some diseases, such as cholera, which presents symptoms similar to Ebola, may have been misdiagnosed. Pregnant women sometimes gave birth on sidewalks in full view of frantic mobs desperate for medical treatment. Now, the confirmed cases of Ebola have slowed to


Wednesday, Jan. 21, 2015 Paynesville, Monrovia, Liberia: The ELWA Ebola Treatment Unit where Dr. Richard Sacra spent the first days after being diagnosed with Ebola before he was flown back to the U.S. for treatment.


a trickle; according to the United Nations late last month, Liberia was dealing with just five remaining cases.

In addition, the first 300 doses of an experimental Ebola vaccine made their way to Liberia late last month, although some say the drug is coming too late — after the country has weathered the worst of the disease.

A global response of humanitarian relief, supplies and other support helped stem the tide. The military established mobile labs that allowed for an Ebola diagnosis to be made in a matter of minutes, as opposed to the eight days it took when the disease first broke. Blood samples previously had to go outside the country, sometimes to Paris. Dozens of NGOs (non-governmental organizations) have set up around the country, and in Guinea and Sierra Leone, where the disease remains. Charitable organizations from around the globe have responded in West Africa’s hour of need. In Liberia, which is just eight or so years removed from a civil war that tore it apart, the need is exceptionally great.

More than 6,000 miles away, a city that at first blush could not be more different than its Liberian counterpart in Monrovia, has answered the cries for help in a big way.

PAIN FELT IN WORCESTER

With such a diverse population and a proclivity for helping others in need, it should not be surprising that Worcester

is among the global communities that have upped their game in response to the Ebola outbreak in Liberia. UMass Medical Center and Seven Hills Foundation are among the city’s institutions that have footprints here. By extension, one of the city’s major col-leges, Clark University, is playing a role. The president and CEO of Seven Hills, Dr. David Jordan, is an adjunct professor there, and the director of the Foundation’s Global Outreach affiliate is a graduate.

There also happens to be a large Liberian population in and around Worcester (an estimated 5,000-plus in Worcester County), one that has felt the sting of Ebola quite personally. Some, like Rev. Jesse Gibson, have lost relatives to the disease. His brother died Oct. 18 last year, and left behind a wife and several children, contracting it like so many others have — trying to help. In Liberia, Gibson’s nephew, Pastor Remon Gibson Jr., and his mother, Martha, are struggling to maintain hope and faith — two things held dearly by Liberians — in the face of overwhelming grief.

“Our father was involved in helping people,” Gibson Jr. said outside of the

rundown shack that serves as home for his family. It is accessed by walking along dirt trails off the main road. Coconut trees provide some shade but no respite from the flies and mosquitoes. “That was his passion. He helped people who had malaria. Unfortunately, he had the wrong patient and came into contact with the virus.”

Making the matter worse, Gibson Jr. had warned his father not to go near patients who might have Ebola. He said his father was afraid to tell him at first after being diagnosed with Ebola. Now, with his father gone, Gibson Jr. worries his mother will not be able to afford an education for her youngest children. At 29, he is a junior in college, and plans to finish.

“It was a big blow to me when I lost my father, because I know when he was alive his most important goal was to see us get an education,” Gibson Jr. said. “It’s not easy to lose him. [His mother] is not actually working. He was the working man. The head is gone, everybody is going to suffer.”

Those challenges have been compounded by the significant changes in Liberian customs, such as the display of affection. Gibson Jr. does not even chance a physical show of love with his own family, for fear they

may have left home and come into contact with an infected person.

“Oh, really, it was hard,” Gibson Jr. said of not being able to hug or shake hands. “Sometimes your friends, you’ve got to warn them, they give you their hand, ‘Oh, my man, don’t forget.’ With God above, we got used to it and we adapted to it.”

Gibson Jr. may be thousands of miles away from his uncle, but the Liberian community in Worcester has worked hard to make sure neither he, nor any of the thousands of other people staring down this killer disease, is forgotten.

The Liberian Association of Worcester County (LAWC) brought together many of the Liberian immigrants who have settled here to rally around their homeland. They were aided by a city that went so far as to host a night specifically in celebration of West African culture. From raising awareness of the health crisis in Liberia to raising money to fight the disease, Liberians here are doing what they can to help those back home.

“All of us here have deep connections in Liberia,” said Moses Makor, the liaison chair for LAWC’s Ebola Crisis Response team, which was established in direct response to the Ebola crisis. “Even though we are

thousands of miles away, whatever help we can give, it’s really letting them know we’re working along with them.”

Makor, a nurse at Saint Vincent Hospital, recently volunteered to go to Liberia in March, through an effort with UMass Medical School.

“As much as we’ve done everything here, it would be more helpful if we are there working for them as members of the medical profession,” Makor said.

Worcester, he added, “really afforded us the platform to assist the folks back home.” Makor singled out Mayor Joe Petty and City Manager Ed Augustus Jr. for opening the door to the Liberian community.

Gibson Jr. and Makor are but two links between Worcester, a city just shy of 200,000 people, and the city of Monrovia, more than four times its size. From the Liberian community in Worcester to its educational and medical institutions, there is a little bit of Liberia around every corner here, just as there is seemingly a bit of Worcester sprinkled throughout Liberia in the ongoing effort to eradicate Ebola.

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Wednesday, Jan. 21, 2015 Paynesville, Monrovia, Liberia: Dr. Richard Sacra makes his morning rounds at the ELWA maternity ward.


I would love to live here and be working here full-time. I would love to be back here again.

The real passion I have in my heart is for training doctors, and I would love to be full-time here

training doctors, but obviously family comes first. We want to make sure our kids are doing fine and

they’re well-established. That’s first priority, number one.

— Dr. Rick Sacra of Holden, an Ebola survivor who returned to Liberia,

where he contracted the disease, to work with his mission, SIM at ELWA Hospital


SACRA BACK IN LIBERIA

Dr. Rick Sacra is, perhaps, the most visible and well-known example of the city’s efforts in Liberia. His connection is both professional and

fiercely personal, having lived in the country several years and volunteered as a missionary for longer. The Holden physician, an appoint-ed assistant professor of family medicine and community health at UMass Medical School, contracted Ebola last August while working at the ELWA compound where Kolleh is a midwife. A born-again Christian, Sacra was there with colleagues as part of a mission with SIM Ministries. He and his family resided in Liberia for about 15 years, before moving back to the U.S. Sacra has frequently gone back, however, to assist at ELWA. He was there at the height of the Ebola crisis in Liberia back before full safety measures were put in place. Wearing what he normally would wear while working with pregnant women at ELWA, he likely contracted the disease when remov-ing a glove or garment, splattering blood or other bodily fluid onto his skin or face. Sacra survived the disease, first landing in the Ebola Treatment Unit (ETU) known as ELWA-2 on the compound before being treated in the U.S. at the Nebraska Medical Center.

Just five months after going home to his family, however, Sacra returned to the scene of the crime, so to speak, unable to resist what he sees as his calling to care for others. He flew back Jan. 15, accompanied by a writer and photographer from Worcester Magazine. Leaving behind his wife, Debbie, and three sons, he planned to spend four weeks total in Liberia before coming home again. After that, he intends to return three more times this year.

Sacra came to ELWA under very different circumstances than when he last left. First of all, according to his doctors, he is now immune to Ebola, although he has said he does not plan to put it to the test. Indeed, performing his rounds at the hospital — a facility in dire need of renovating, but still up to the task of treating the sick — Sacra followed protocol to the letter. Wearing gloves, if he touched a patient, he went outside to one of the chlorinated water buckets, washed the gloves first, removed them, then washed his hands. Before moving on to the next patient, he donned a new pair of gloves.

What has also changed since Sacra’s last time there is Ebola is no longer claiming lives with such a voracious appetite. While still proving problematic in Sierra Leone, the disease in Liberia, as of late January, was absent in all but two of the country’s 15 counties — Montserrado and Grand Cape Mount. In one county, Lofa, more than 90 days

had passed without a new case of Ebola. In order for the entire country to be declared free of Ebola, there must be zero cases reported over 42 days — two incubation periods (Ebola incubates over 21 days, although symptoms may appear much earlier than that). There have been 35 new cases, between one and two a day, in Liberia since Jan. 1 according to Tolbert Nyenswah, head of Liberia’s Ebola response team through the Incident Management System. He describes the battle against Ebola almost like a hunting expedition.

“We’re chasing the virus,” Nyenswah said. “We’re hunting the virus, we’re chasing it, we’re going to the ground level in every community, every household [the two counties that still have the virus]. We are making significant progress as a country, but we’re warning every single day against complacency.”

The landscape, at least from a medical perspective, is far different for Sacra than in August. He is back to tending to patients — ironically enough, his first day back on the job at ELWA on Jan. 19 saw him in the maternity ward.

It was not all business, however, because when he was taken home last year, Sacra left behind a community that had not only embraced him, it had taken him in as one of its own. He had made many friends both in the SIM community and the country that has become his second home. His return brought out many of them. From colleagues such as Dr. John Fankhauser, medical director at ELWA, to fellow congregants at the International Church of Monrovia (ICM) that Sacra attends on the compound — the greetings, smiles and welcomes have been many. One of the hardest things, though, has been ignoring the urge to hug or shake hands with his friends. Physical contact of any sort has been strongly discouraged in the wake of Ebola, since it is transferred through the exchange of bodily fluids such as sweat. In a country whose people traditionally are emotionally expressive and generally warm in their reception of others, that has been a tough task.

“Several people drove by, stopped by, old friends,” Sacra said of his first couple days back in Monrovia. “It is really nice to be able to see them. It is a little funny, because you want to give them a hug, and we don’t do that right now in Liberia.”

Instead, it is elbow and fist bumps, accompanied by warm smiles and apologies from the locals for not being able to be more affectionate. Still, Sacra was greeted like a rock star on the ELWA compound during his days back. From colleagues such as Fankhauser and longtime ELWA nurse Marthalyne Freeman, to the man who actually drew the blood sample from Sacra that tested positive for Ebola, they all smiled broadly upon first sight of their old friend. At a Sunday morning service at ICM, the priest singled him out, along with his

Wednesday, Jan. 21, 2015 Paynesville, Monrovia, Liberia: Dr. Richard Sacra talks with Marthalyne Freeman, a nurse who treated him in the ELWA Ebola Treatment Unit before he was transported to the U.S. for care.


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guests, the journalists from America. He was front and center again at an early chapel service on his first day back at work at the ELWA Hospital. After, many colleagues stole a moment or two of his time. The catching up was good for them, but also for Sacra, who while separated by some 6,000-plus miles from the wife he met in his sophomore year at Brown University, is surrounded by his Liberian “family.” He also learned new details about when he first fell ill.

“I had it in my head that I started feeling ill in the evening on Friday, Aug. 29,” he said. “I had it in my notebook that I checked my tem-perature and it was 100.8. That was how I had it in my mind ... but I actually found out first [Friday, Jan. 16] on the plane, when I met up with [a colleague] who I had had dinner with that evening. He said, ‘You know, Rick, you told me you weren’t feeling well at dinner, and

you said to me, I hope it’s not Ebola.’” Then, the day after arriving back in Liberia,

Sacra spoke with Fankhauser.“He said, ‘Oh yeah, the [hospital] staff said

you weren’t feeling too good at the hospital that day,’” Sacra said. “I had forgotten that. It’s interesting, I think the memory is more plas-tic than we think it is, and we all need to rely on each other to fill in the gaps sometimes.”

Sacra very quickly assimilated himself back to his work at ELWA, even if his presence has brought some added media attention — cable news giant CNN runs his blog regularly. With that extra attention, of course, comes greater exposure for Sacra’s Christian faith and for the SIM mission, not to mention the work being done in Liberia. And while the media spotlight may fade, Sacra’s devotion here will not. The periodic returns to ELWA could again lead to a permanent life here.

“I would love to live here and be working

here full-time,” he said. “I would love to be back here again. The real passion I have in my heart is for training doctors, and I would love to be full-time here training doctors, but ob-viously family comes first. We want to make sure our kids are doing fine and they’re well-established. That’s first priority, number one.”

THE SEVEN HILLS CONNECTION

From Sacra to UMass Medical Cen-ter and UMass Medical School to the Seven Hills Foundation, even to Worcester Polytechnic Institute, the

ties in Liberia are strong. Some were forged long before Ebola, which has been present in Africa since 1976, first struck Liberia; others

have arisen because of the disease. The con-nections should last well into the future.

One of them involves the Seven Hills Foundation, which was approached by members of Worcester’s Liberian community to visit Liberia and examine ways his organization might be able to help the country. It led to the recent launch of two initiatives aimed specifically at strengthening the medical and educational systems in Liberia and Sierra Leone, which with more than 3,100 confirmed deaths as of earlier this month, has also been hard-hit by Ebola.

Through its affiliate, Seven Hills Global Outreach (SHGO), led by director Ashley Emerson Gilbert, a graduate of Clark University, the Foundation is working to partner hospitals and schools in the U.S. with their counterparts in the neediest parts of West Africa. The SHGO effort has initially identified two schools and two medical clinics seeking partners in Sierra


Sunday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: A family in Monrovia, Liberia sits under the overhang of its home, shaded from the hot sun.



Leone and Liberia. Soon, three additional hospitals and three more schools in Liberia will be added to the initiative.

“Rather than trying to address one small piece of one area,” said Dr. David Jordan, presi-dent and CEO of Seven Hills, “we wanted to begin looking at a more systemic approach.”

That has involved examining the various difficulties facing Liberia, most of which have their roots in economic development. From education to healthcare, the infrastructure there is weak, at best. Years of war rendered the country’s economic base tenuous; Ebola has nearly crippled it. Even as hospitals started to reopen and treat Ebola-stricken patients, and schools were getting ready to open Feb. 2 after closing last July, there is near unanimous agreement that, were the international community that responded to the crisis to leave now, the entire system would be in danger of collapse. There is particular concern with the healthcare system.

“Part of our problem is planning,” said Reeves. “We just don’t do a good job with planning. I’m hoping the government will see reason to start planning now for the future. A lot of what we do here, we react. You see it all the time here. Nobody sits down and says, ‘What if? What if this happens?’ If it never pans out, amen. But if it pans out, at least we’re ready.”

Jordan and Seven Hills are aiming for that. All the good work being done by so many selfless volunteers and medical professionals right now, Jordan said, could go for naught if the right foundations are not laid for Liberia to move forward as a country once Ebola is but a terrible memory. To that end, Seven Hills has launched an ambitious initiative.

“We started to move to create a network to develop hospital partnerships and school partnerships,” Jordan said. “We are trying to link 32 health clinics in Liberia with either a hospital, business or large entity in the U.S. that are willing to become partners with a hospital in Liberia for a minimum of three years.”

Those institutions would agree to provide equipment support and supplies, human capital and financial assistance.

Jordan cited St. Timothy Government Hospital in Robertsport, a seaside town northwest of Monrovia. That facility, he said, has less than the bare essentials.

“They had five bottles of medicine in their ‘pharmacy,’” he said. “There are flies all over the surgery room, and there is no anesthesia.”

If, Jordan said by way of example, Worcester’s St. Vincent’s Hospital partnered up with a hospital like St. Timothy in Liberia, “it would turn around people’s health dramatically.”

A similar effort could prove just as beneficial for the country’s schools. According to Jordan, $2,000 a year for education in Liberia could support a school for 200 students.

Those kinds of approaches, he said, are necessary in addition to the footwork being done to fight Ebola.

“We need a different perspective on how to approach things,” he said. “The current concern is Ebola, but once Ebola goes away, guess what else goes away? So does all the financial aid, all the resources, and something else comes in, and in my opinion it will be worse than Ebola.

“The missionaries and health workers, what they’re doing is great to patients, and absolutely laudable and necessary. But it is like a grain of sand on a big issue. The work

by great men like Dr. Sacra is going to be unraveled in an instant.”

Liberian Sen. Peter Coleman has been a point of contact for Jordan and Seven Hills. A surgeon, he chairs the Senate on Health, Social Welfare, Gender, Women and Children issues. From 1998-2006, he served as minister of health. Coleman also oversees the Foundation for the Empowerment of Rural Dwellers.

“I represent a county that is, most likely, the most under-developed county of Liberia,” Coleman said of Grand Kru County, with a population around 58,000. “A lot of things Seven Hills and

my foundation are collaborating on are basic things. In these parts, basic social services are almost nonexistent. People have a problem with access to safe drinking water, sanitation, health care and schools. My foundation, along with Seven Hills, is looking at how to fix the benches at schools.”

As Jordan noted, the two initially will address secondary-level hospitals in Liberia and try to pair them with major U.S. hospitals. The primary intent would be to train medical professionals, because in Liberia, medical training has not been a

Thursday, Jan. 22, 2015 Paynesville, Monrovia, Liberia: A boy waits in the morning sun for his turn to fill plastic containers at the neighborhood water pump.


Thursday, Jan. 22, 2015 Paynesville, Monrovia, Liberia: Workers at the Ministry of Defense Ebola Treatment Unit 1 pause at the entrance.

We’re chasing the virus. We’re hunting the virus, we’re chasing it, we’re going to the

ground level in every community, every household [the two

counties that still have the virus]. We are making significant

progress as a country, but we’re warning every single day

against complacency.

- Tolbert Nyenswah, head of Liberia’s Ebola response team on the country’s efforts to eradicate the disease



priority. According to Sacra, there has been no medical residency training in Liberia for 20 years.

“They do internship training,” he said, “then they’re out.”

On-the-job training has led many doctors and nurses in Liberia to become well-equipped to serve, but “it still doesn’t replace residency training,” Sacra said.

The lack of trained personnel, Coleman acknowledged, is one of the country’s biggest problems.

“The enormous international response to the Ebola outbreak is helping to train our health workers,” he said. “Infection prevention and control was not too well-established in our health system.”

As a result, he said, many health professionals died as Ebola ripped through the country.

“Basic diseases,” Coleman said. “Our greatest burden of disease is infectious disease here. We still have tuberculosis, HIV/AIDS, malaria. The issue here is to get basic medication. Many times, our government we build the health facilities, but it’s not the building that makes that place a clinic, but how you impact the health level of the people.”

UMASS IN WEST AFRICA

Dr. Trish McQuilkin surveyed the mounds of boxes inside a make-shift warehouse in the shadows of the mammoth Monrovia Sports

Complex, where nary a game of soccer has been played in months (the action is expected to return in February). Dozens upon dozens of pallets hold even more boxes of PPE (personal protective equipment) and other medical supplies to be distributed to doctors and nurses at hospitals as well as to ETUs.

Just days before, McQuilkin had been at UMass Medical School for Sacra’s official announcement that he was returning to Liberia. She arrived a few days after he did, and is spending most of her time behind the scenes coordinating the teaching and training of doctors at 25 hospitals throughout Liberia. It is part of what used to be called The Consortium, but is now known as the Academic Consortium Combating Ebola in Liberia, or ACCEL for short.

A presence in Liberia is nothing new for UMass, working on the implementation of residency training programs, but Ebola stopped all that work in its tracks. A new way to help was born out of contact between the hospital and colleagues in Liberia.

“We were hearing they weren’t getting PPEs and needed them desperately,”

McQuilkin said of the change in focus once Ebola hit the country. “We started just sending over whatever we could gather and get off of Amazon.”

Another colleague, Dr. Michelle Miescierenko of Boston Children’s Hospital, started a Kickstarter campaign online. Through their combined efforts, and with no small amount of help from the Liberian community in Worcester, which raised several thousand dollars on its own, the hospitals were able to send over three shipments of supplies.

Even then, however, more needed to be done.

“There was still a lot of need,” Miescierenko said. “We started applying to various grant funders for training, PPEs, ongoing mentorship. [McQuilkin] and I wrote a proposal and sent it to anybody who would receive email.”

With both women laughing, Miescierenko said, “We got ‘almost funded’ several times.”

Fate struck through a connection between UMass Medical School Chancellor Dr. Michael Collins and the Paul G. Allen Family Foundation, which committed at least $100 million toward fighting Ebola. McQuilkin and Miescierenko successfully applied for a three-part, $7.5-million grant as part of a collaborative that includes, in addition to UMass and Children’s Hospital, MIT, the University of Florida, University of Maryland and others.

The three-pronged approach consists of infection prevention control (IPC), recruiting doctors and nurses to work at ETUs in Liberia and building up lab testing at two key hospitals there: Redemption and Tapita. The training is largely done by Liberia doctors, nurses and midwives; the country brought forth its 12 best, according to McQuilkin, and the Consortium supports them as they go out in the field to train other medical professionals.

Makor’s scheduled return to Liberia is part of the grant for recruiting doctors and nurses to work in Liberia.

For McQuilkin, who has visited Liberia several times, this time was much different. Whereas in the past, the plane rides over would include many Liberian passengers, when McQuilkin and Miescierenko went over in November, those passengers were almost exclusively humanitarian relief workers. It reminded Miescierenko of when the pair first started visiting Liberia in 2008, just two years after the end of the war. Many Liberians had fled the country, and were not yet returning.

“I love coming here,” McQuilkin said, “but this time it was different, because after Ebola hit, all these NGOs were coming, but we had to kind of sit by the sidelines and watch these things happening. Things were getting really bad, so we were really

THE CHILDREN OF EBOLA:DEALING WITH YOUNG SURVIVORS

A place with thousands of orphaned children, West Africa hardly needed any more. Ebola did not care, rendering thousands more kids without a mother and father as it swept through Guinea, Sierra Leone and Liberia. In that country alone, more than

2,000 children have been orphaned since the disease first struck. Even those who have been lucky enough not to have been left without parents have still felt Ebola’s devastating effects.

While they face an uncertain future, these youngsters are not alone. The road ahead is rocky, but organizations such as YoungLife will be there to help. So, too, will Monrovia’s Providence Baptist Church.

At YoungLife in West Africa, regional director James Davis II and area director Paul Kangar deal with youths every day who have in some way been impacted by Ebola. For them, the organization has offered Ebola Survivor Camp, the first of which was held in December. A second was planned for February.

“Ebola in Liberia affects every aspect of society,” Kangar said. “Most victims we have happen to be the young people. Even those that survive, many of them are young people. We have to work with these young people, so we see a very big challenge.”

YoungLife in West Africa has more than 50 participants from around Central Monrovia who have survived the disease. With schools closed since last July, many of the youngsters who have lost parents or lived through Ebola find it difficult to remain engaged in healthy activities and maintain a positive outlook.

“They have to become self-supportive,” said Kangar. “They live by themselves. We tell young people, ‘Look, you lost your parents, but you still have somebody who is more than your parents, and that is Jesus. Put your trust in Jesus and forget about what happened.”

That is not easily done, Davis acknowledged. “It has not been an easy thing,” he said of Ebola. “It has been a serious challenge. It had a

huge impact on our ministry.”With schools closed, and many of YoungLife’s members of high school age, the

organization has had to work harder to stay in contact with them. Ebola Survivor Camp has been a blessing in that regard. More than 100 took part in the initial camp, according to Davis. More than 200 are expected at February’s camp.

“We slept with them in the same cabin, we played with them, we ate with them,” he said. “We gave them the vision to go back into their community and serve. We wanted them to not be carried away by what people considered them.”

That is often the most difficult thing for Ebola orphans: facing scorn and ridicule from, even being outcast, by their own communities.

“I saw tears running down the faces of so many young people,” Davis said. “They had nobody to sit and talk to them. After all the horrible things that happened to them, nobody was even able to hear their stories — and they were horrible stories. Some young people with both parents who died, a brother, a sister, only you survive.

“Community dwellers fear them. Nobody is willing to sit with them. Nobody wants to share anything with them. Today, we still visit their homes, call their house, go to visit and sit.”

Rev. Dr. Samuel Reeves Jr. of Monrovia’s Providence Baptist Church said Ebola orphans pose one of the biggest challenges for Liberia. His church is working on building what he said would be the first Ebola children’s orphanage on the border of Liberia and Sierra Leone, where there is already a ministry, school and health care.

Such a facility could make a dramatic difference in a country that currently has a moratorium on adoption because of past problems of children being taken out of the country illegally, Reeves said.

“We can do some, and I’m sure there are other institutions who can,” he said of taking in some of the children left behind by Ebola. “We want to start with 10 units, start with small homes and kind of let them grow up in a real home instead of a big orphanage. It would be kind of a big dormitory. We want to give them some real dignity.”

— Walter Bird Jr.




Friday, Jan. 23, 2015 Paynesville, Monrovia, Liberia: UMass Medical School professor Dr. Trish McQuilkin stands in the ACCEL warehouse where she helped to secure a $7-million grant that was used to buy personal protective equipment.

I love coming here, but this time it was different, because after Ebola hit, all these NGOs were coming, but we had to kind of

sit by the sidelines and watch these things happening. Things were getting really bad, so we were really happy to get this

grant so we could jump back in and start helping.

- Dr. Trish McQuilkin, UMass Medical School, on being in Liberia as part of the Academic Consortium Combating Ebola in Liberia (ACCEL)


happy to get this grant so we could jump back in and start helping.

“It’s good to be back, but it’s so different here now. There’s all these people around that just aren’t usually here.”

It was not unlike the exodus of so many doctors and nurses when Ebola first struck. Hospitals were forced to shut down, and even now some, like Redemption, continue to struggle. The John F. Kennedy Medical Center, where general physician Kanagasabai Udhayashankr works, closed for a few weeks at the height of the crisis, re-training staff before reopening. There was, he conceded, a great amount of fear among the medical community.

“Most of the doctors and nurses have returned [to area hospitals],” Udhayashankr said. “There was a bit of a moment when everybody was frightened, and there was a

lack of knowledge. But once people realized there were measures that could be taken, a lot of healthcare workers returned.”

“It was frightening seeing family and friends getting infected and not being able to help,” he added, saying he, too, lost colleagues to Ebola, including a couple professors, an intern and a medical student. “Even when hospitals were closed, however, a lot of healthcare workers just changed their focus, so instead of working in hospitals they worked in the ETUs.”

ENGINEERS OF PROTECTION

Worcester is at the forefront academically when it comes to helping Liberia through the Ebola crisis, and one of the big-

gest players is Worcester Polytechnic Institute (WPI). Researchers there recently received awards from the National Science Foundation (NSF) to develop new technologies to help protect workers caring for patients with Ebola and other infectious diseases.

The Rapid Response Research awards totaled $275,000. The first award, $200,000, will fund a new type of “smart” mobile treatment tent, called a medical Cyber-Physical System (CPS). It will feature so-called “smart” technologies to improve the delivery of care and decrease the risk of contamination for patients and clinicians. The project will see the WPI team outfit an actual mobile treatment tent that could include tele-operated robots to deliver food, water and medicine; pressure-sensitive mats to detect the location of patients and workers; Bluetooth low-energy localization beacons and microwave and infrared motion

sensors for surveillance, and to detect breaches of patient isolation protocols; wireless communication networks panning infrared cameras to remotely monitor patient temperatures; barcodes and other tracking methods for equipment and food; and a telemedicine interface to allow medical staff and family members to interact with patients without coming into contact with them.

“We want to create a realistic environment that can quickly provide us with the data we need to adapt the kinds of technology we are developing at WPI in the fight against infectious disease,” said Taskin Padir, assistant professor of electrical and computer engineering and principal investigator for the project. “We need to take what we know and employ it in different ways to enhance our understanding of the environment to reduce clinicians’ exposure to pathogens and minimize the spread of disease.”

Friday, Jan. 23, 2015 Lower Margibi County, Monrovia, Liberia: Outside the crematorium, where it’s said several thousand Ebola positive bodies were burned by a wood-fired furnace. Butter was applied to the bodies to make them burn hotter.



Reducing the need for physicians and workers to wear PPEs, the medical CPS will lower costs while improving patient care, according to Dr. Jeff Bailey, assistant professor of medicine at UMass Medical School.

“Patient treatment for Ebola is severely limited by the constraints of PPE,” said Bailey. “PPE is unwieldy and, importantly, limits the time a health care worker can work with the patients before overheating. Cyber systems and robotics have a great potential to be able to offload repetitive tasks and provide comprehensive monitoring so that doctors and nurses can focus on human interactions with patients and more complex work that can improve patient care and hopefully save more lives.”

The second grant, $75,000, was awarded to Padir and Dmitry Berenson, assistant professor of computer science. It will support the creation of a human-robot system to

assist in the removal of PPE, a multi-step process that brings with it a significant risk of infecting the workers wearing them.

Utilizing the Baxter robot, which was originally built to help researchers and students consider industrial applications of robotics, especially in manufacturing, Berenson and Padir want to minimize the amount of contact between workers’ hands and the PPE through strategies that allow a robot to assist in removing the equipment.

“If you watch videos of how healthcare workers take off the protective gear, there’s a lot of risk of contamination if you make even the slightest mistake,” Berenson said. “So what we want to do with Baxter is help the workers take off the gear. It’s not going to totally undress someone. That’s actually very difficult. But it can aid in the human getting out of the gear by themselves without having to touch their own heads or bodies and

possibly contaminate themselves.”

DANGER ZONES

Preventing further contamination is of utmost concern at hospitals and ETUs in Liberia. At one ETU, the so-called MOD-1 (Ministry of Defense

Unit 1) staffed by World Health Organization (WHO) workers, the “donning” and “doffing” of equipment — putting it on and removing it — is a painstakingly meticulous process.

The unit is actually two separate units — MOD-1, where confirmed Ebola patients are treated, and MOD-2, which is used for training and does not hold any patients. At MOD-1, those who will tend to afflicted patients in the “red zone” prepare themselves in the “green zone,” which is free from contamination. Workers there apply their

PPE, which under WHO standards consist of a semi-permeable suit, two pairs of gloves, mask, goggles and boots. That area is just outside the red zone. Closer to the main entrance of the facility, which is along Congatown Road, are the kitchen area, changing rooms and a conference area, where coordination and clinical meetings are held.

Patients are brought in by ambulance, and unloaded outside the unit. They are taken to a triage tent, where they are admitted. A one-and-a-half-meter space is maintained at all times between the patient and admitting personnel.

When workers are done treating an Ebola patient, they head to a decontamination tent. The first step involves removing the most contaminated part — the apron. The worker is then sprayed before removing the suit. After washing their hands, workers remove their goggles, wash their hands again, then

Wednesday, Jan. 21, 2015 Paynesville, Monrovia, Liberia: Marthalyne Freeman a nurse who helps run the ELWA Ebola Treatment Unit (ETU) keeps a photograph of an 18-year-old boy who at one time, near death, was bleeding from his eyes, nose, mouth and ears. He complained of ants eating the blood from inside his eyes, which they were. The boy lived, making a full recovery, his photograph an inspiration to the ETU staff.


Sunday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: A Liberian woman with tears in her eyes welcomes back Dr. Richard Sacra at the International Church of Monrovia on the ELWA compound.


remove the mask and gloves before once more washing their hands.

Some equipment, such as the boots, are soaked in decontaminant and reused.

Since the unit started operating Nov. 5, no worker in MOD-1 has contracted Ebola, according to Emerson Rogers, a physician’s assistant and the unit’s acting director. He praised the efforts of health workers in the face of such a deadly disease for helping to prevent an even larger-scale disaster.

“When the virus came everyone was afraid,” Rogers said. “What are we going to do? Where to start from? How can we contain the virus? It started to claim a lot of lives. It took the bravery of health workers and the international community to come in and help. If not for the bravery of the health workers, it would have been difficult to contain.”

While ETUs are rife with danger for infection, so too are the cemeteries where bodies are buried. The risk of infection of others is at its greatest when a victim is deceased. Early on in the crisis, the bodies of Ebola victims were incinerated. According to Matt Ward of Global Communities, however, bodies were buried right from the start up-country in Liberia. Now, in Monrovia, they are buried.

Ward oversees the temporary burial site at Lower Margibi Cemetery, where there are roughly 250 bodies currently buried. About 25 percent of them came from ETUs, he said, and not all of them died from Ebola.

When a body arrives at the cemetery, it is brought to a temporary morgue, where burial teams are waiting. Those teams, Ward said, could wait as many as several hours for a body to arrive. Other days, they could be in PPE for two hours straight. Team members wear full PPE, with not one part of the body exposed; on busy days, the heat can become almost overwhelming. Each team member is assigned a specific role: two people carry the head of the victim, two carry the torso and two carry the feet.

“Everyone,” says Ward, “knows their position and what to do.”

The body is lowered into a grave. There are not mass burials, only single graves. Global Communities performs no cremations at the cemetery, but does burn protective clothing and potentially contaminated items such as mattresses that might arrive from an infected house.

While not every corpse that arrives at the cemetery is the result of Ebola, Ward said each body is treated as though it had the disease. Despite the extra precautions, a

measure of humanity is preserved.“Everyone here’s a person,” Ward said.

“They’ve got family.”

A FRACTURED COMMUNITY

While the physical toll from Ebola in Liberia has been dev-astating, it has inflicted dam-age in other ways. As Rogers

put it, “The virus has struck at the fabric of this nation — educationally, economically, socially. It’s traumatizing.”

Reeves, who was in the U.S. last year when Ebola was claiming so many lives in his home country, agreed. Ebola, he said, has become much more than a health crisis.

“[Ebola] has created an economic crisis, a psychological crisis and a spiritual crisis,” said Reeves, who has worked both with Gibson and Gibson’s brother in the past. In order to wipe out Ebola, he said, Liberians must maintain vigilance and follow the advice of avoiding physical contact. But that exacts an emotional toll.

“These are things that go against the culture,” Reeves said. “We love touching

people, and we speak by touching. I think one of the reasons the numbers [of Ebola cases] went up is because of some of those things. Even at church, at fellowship time we typically do a lot of everybody shaking everybody’s hands, hugging. There is none of that now.”

The disease, he said, has affected the local economy; it has definitely hit church coffers hard.

“At one time here I know it affected almost every other church in town,” said Reeves. “We run weekly a little over 2,000 in our attendance, with four or five services a week. Our attendance has dwindled to less than 400 and there isn’t any offering.”

Liberians have been sorely tested spiritually, as well, he said.

“I wasn’t here when things were really, really rough,” he acknowledged, “but I hear the sirens were going by every hour of the day, trucks loaded with dead bodies. You get back here and someone tells you the story, you can see how that’s affected their spirits and well-being.”

There is also, Reeves added, a psychological aspect. At some point, he said, the Liberian people will deal with the emotional scars left by the crisis.

Friday, Jan. 23, 2015 Lower Margibi County, Monrovia, Liberia: A young grave digger takes a break from wielding his pick-axe at Lower Margibi cemetery just outside Roberts International Airport.




Friday, Jan. 23, 2015 Lower Margibi County, Monrovia, Liberia: Graves are dug at Lower Margibi cemetery by Roberts International Airport, in anticipation of more Ebola positive bodies.



“We’re in the midst of death and people are still dying,” he said. “In a couple months, a year down the road, I think that’s when we have to start dealing with the psychological issues. We’ve got to start laying the groundwork now. People are still dying. When some of that subsides, I think people are going to have to deal with that.”

WHAT COMES NEXT

As the threat of Ebola abates and Liberia grows ever nearer to a decla-ration that the crisis is, indeed, over, questions remain: What is the next

threat facing Liberia? Is the country ready to face it on its own? How prepared, exactly, is the nation — and West Africa as a whole — for the next big crisis, whatever form it may take? The answers from many in Liberia have a common thread: the overall need for better healthcare and sound medical infrastructure.

“At this state, the healthcare system is ill-prepared,” Nyenswah said. “We need to carry on a robust assessment and build a resilient healthcare system. We are looking at what went wrong before Ebola, what happened during Ebola and how we build a healthcare system that is resilient in the future. At this state, this is what we’re working on as a country. We know Ebola has exposed our healthcare system to be very, very weak.”

Preparing for the future, according to Coleman, is what the Liberian government

is trying to do. To that end, an agreement has been signed with the Centers for Disease Control (CDC) for that organization to remain in Liberia for the next seven to 10 years to run the country’s main laboratory. Complacency, he promised, will not be allowed to take hold.

“For us, we’re going to continue to work,” Coleman said. “Even after the WHO tells us we’re Ebola free, we have to continue a disease surveillance program.”

The program is linked to the CDC and, according to Coleman, boosts the ability to detect not just Ebola, but other diseases that are endemic to the region.

Medicine and other supplies continue to be needed, he said, and while Liberia has received a great amount of assistance from the U.S., China, the European Union and

others, “It’s just inadequate,” Coleman said. “We need more.”

Rebuilding the healthcare system, said Fankhauser, is crucial, as is having the right kinds of medical help available.

“The kind of physician help that can take calls at night in their hospitals and do C-sections and other procedures when you need them” is among the biggest needs, Fankhauser said. Health community outreach, he added, will also be necessary.

Even the basics remain an essential need, Kolleh said.

“We need more PPE,” she said. “We need it, we need plenty. We need more doctors.”

ELWA, specifically, needs repairs she added, citing an outer wall she said has started to deteriorate. There is a newer facility under construction elsewhere on the compound, but it is uncertain when it will be finished.

There is fear that, as Jordan suggested, once Ebola is gone, so too will all the outside forces that have helped guide the West African countries ravaged by the disease. In the case of UMass, that will not happen, according to McQuilkin.

“We’re really here for the long-term,” she said. “We want to give medical education, getting people back to work in residency programs.”

Liberians such as Nyenswah hope the global community feels the same way. Walking away because Ebola is no longer deemed a threat, he said, would be a mistake — one his country can ill afford.

“We need international resources into this,” Nyenswah said. “I’m appealing to the world, do not forget about Liberia, Guinea and Sierra Leone when Ebola is over, because the history is clear: it will come back.”

Worcester Magazine cordially invites the Worcester community to a special, free public presentation on “Chasing Ebola.” Editor Walter Bird Jr. and a special panel of invited guests, including Ebola survivor Dr. Rick Sacra, will talk about Worcester Magazine’s recent visit to Liberia, the fight against Ebola there and how Worcester has been a huge part of those efforts. Join us Thursday, Feb. 19, at Clark University, Jefferson Hall, Room 320 (home of Cinema 320), from 6-7:30 p.m. for this special evening. Light refreshments will be served and a question and answer session with the public will follow the presentation. The evening is sponsored by Seven Hills Global Outreach. For more information, contact Walter Bird Jr. at 508-749-3166, ext. 322 or by email at wbird@ worcestermagazine.com. We look forward to seeing you there.

Sunday, Jan. 18, 2015 Paynesville, Monrovia, Liberia: A young girl hides behind a wooden post outside her home.



Final Thoughts

Spending a week in Liberia gives a glimpse of what life is like in the midst of a disease that has turned its societal and cultural norms upside down.

It is important to note that we spent just seven days, and Steven and I had a driver when we were there. We drank bottled water. We were able to fly back home. Once back, sure there was snow, but when things returned to normal in New England, trash pickup resumed, folks went back to work, kids went back to school.

In Liberia, many homes dump their trash outside and burn it, filing the air with a stench not easily wiped from the senses. Kids as young as 7 or 8 — maybe younger, sometimes older — weave in and out of traffic selling water, gum, candy, anything to make money to take home to their family. If you give a kid a buck in Liberia, he is likely to turn around and buy his sister a biscuit to snack on. Half-finished construction projects stick out in the landscape, yet another sign of how life came to a halt in the face of Ebola.

This story looks at how a disease no one in Liberia every expected has affected so much change. It looks at how Liberians have changed their very way of life, and what should and must be done to strengthen the nation for the next threat that undoubtedly will arise. To be able to tell that story, in photographs and words, is an honor — but it is just one story of millions that could be told. All should be remembered. As one of the people we spoke with, the rest of the world must not forget Liberia, Guinea and Sierra Leone once Ebola is officially declared a defeated enemy. Others will surface. More challenges remain. If this effort by Worcester Magazine somehow keeps that thought in the public conscious, that would be the greatest reward.

— Walter Bird Jr.

Credits: Putting together a story that takes you halfway around the world is not done without a lot of help. In that vein, we offer the most sincere thanks to the following individuals and organizations for assisting Worcester Magazine in compiling this special story: Dr. David Jordan, Seven Hills Foundation and Seven Hills Global Outreach; UMass Medical School; Penny Dumas, AAA Travel; Jayah Hassan; Alfred Gezaye; Rev. Jesse Gibson; Joe Santa Maria; Mike Murray; Dr. Richard and Debbie Sacra and family; and Clark University


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Documents

Chasing Ebola: Worcester's ties to Liberia and the Fight Against Ebola