Last night I received a call from a friend in Monrovia. He sounded weary and I immediately worried that he had fallen sick. He was fine, he told me, but he never calls me just to say hello. “The death rate in Monrovia is too high,” he said.
This friend was typically unflappable. He had survived all the different phases of fighting during the civil war—he’d never thrown in with any of the rebel groups, simply focused on making some money to raise his kids and send them to school, while supporting a large extended family. Politics didn’t interest him at all.
He told me planned to leave his home in Red Light, on the outskirts of the capital, to return to his ancestral village in Bong County as soon as possible. He felt that his family would be safer there. He and his wife were taking the necessary precautions, he said. But he worried that was not enough to keep them safe. “The children are difficult to control,” he explained.
That loss of control appears to stretch far beyond my friend’s community. The courageous reporting in Liberia right now is chronicling the unique nature of the Ebola crisis in Liberia. The virus has moved through Liberia much the same way Taylor’s revolution did in 1989, starting in the rainforest along the border in the winter then making its way toward the capital to arrive before the summer rains. It has been catalyzed by the dispossessed. Like the fighting two decades ago, Ebola is ravaging the capitol now. In many ways these parallel trajectories have been enabled by the U.S. government—which did little to rein the worst instincts of the Doe regime and continued to support the Sirleaf government despite internal misgivings about the quality governance. If the virus continues on the same course—and if history is any guide—Liberia will survive the outbreak, but this government may not.
Ebola is not only laying bare the failures of the Sirleaf government, but the divisions that define the society. Citizens there inhabit “two different Liberias,” as a leaked USAID report put it, where the haves and have-nots coexist in a fragile equilibrium. Inequality is fundamental to the Liberian identity. It is an artifact of the nation’s roots in American slavery. It was also the catalyst for the coup in 1980 and the 1989-2003 civil war that led to the country’s collapse. This same inequality makes Liberia the perfect host for the Ebola virus. I don’t know what prompted the looting of an Ebola clinic in West Point over the weekend but there’s nothing surprising about the anger in one of Monrovia’s poorest communities.
The equilibrium in Liberia has been propped up by the international community for more than a decade. While President Sirleaf has been applauded as a reformer and celebrated for fostering Liberia’s economic growth the truth is less triumphant. Her administration is just one plece in the patchwork of power structures that have kept Liberia from the brink of collapse—including UNMIL, the massive United Nations peacekeeping mission, and the legion of NGOs like Medecin Sans Frontieres and Samaritan’s Purse that have stepped in to provide basic healthcare services. As of 2011, the equivalent of 70% of Liberia’s gross national income came from donor nations—including the United States which as topped the list year over year, totaling over $4 billion from 2002 to that date. During that period, Liberia has reopened for business enjoying double-digit growth from the extractive industries (timber, palm oil) that Charles Taylor used to bankroll his government.
All the while, the nation has only ticked up the developmental scale in nearly imperceptible increments.
I put this question to President Sirleaf when I interviewed her last fall:
FP: Turning to Liberia, you’ve enjoyed explosive economic growth since your government has taken the reins over the economy, but development has lagged behind. Spending on education hasn’t grown in proportion to GDP. There’s only been a modest increase in public expenditures on the health system. How do you balance this economic growth with the job of providing services to the citizens of Liberia? EJS: Perhaps you’re not fully informed. First of all, when one mobilizes resources for investment, given the scarcity of our own domestic resources while we try to build the economy, there is a time lag between when you mobilize investments and when those investments create jobs and that improve the infrastructure. However, we have indeed begun to deliver basic services. We’ve been working on our roads. We’ve been working on our schools and our hospitals. We’ve been expanding the services that we render through our health institutions, our educational institutions. We’ve increased civil service pay because of that. The period we’re now entering is the period when the benefits from the $16 billion in foreign direct investment which we mobilized will begin to be felt. There’s no shortcut to the processes of development.
The numbers are significant, particularly in a country that is run by an economist. The Ministry of Health responded reasonably swiftly to the CDC’s first announcement of the outbreak on March 25, 2014. The government—and ECOWAS—almost immediately appealed for international support. Money came slowly: China provided $162,000 in March and April. The government of Liberia followed soon after with $250,000; then UNDP with four vehicles to assist in burial and contact tracing. The U.S. followed with 50 experts from the CDC. Eventually, three months after the CDC’s first announcement, President Sirleaf declared a national emergency. Then one month later—four months into the outbreak—her administration announces a $20 million "national action plan" back by $5 million from government funds.
If you look at Liberia’s “Budget Call Circular” for 2014-2015, a sort of guide for ministries planning their budgets published in March, the signs of trouble were apparent then:
* PSIP (Public Sector Investment Project)
Aside from the obvious question—why didn’t the remaining $5 million get disbursed?—you see that last year that the government only spent about $.20 per citizen on improving the public health care investments. Before Ebola, Liberia’s needs were many: roads and airport infrastructure, water and electrical capacity, education; the health care system was just one line item in the national budget. That system has buckled in the face of Ebola.
Liberia is hardly alone in the paucity of national resources devoted to health care. Looking at the Ebola-affected nations, you see some common trends.
Today, Liberian authorities are searching Monrovia for patients removed from the West Point clinic—each a potential carrier of the virus. Each a potential threat to the health of their communities.
"This is not a thing for politicians," President Sirleaf said after Liberia’s senate voted to close the border with Guinea in April in hopes of stemming Ebola. She is right. This outbreak doesn’t need politicians: it needs leaders.