In Monrovia, the blue steel gates guarding JFK Medical Center's Ebola ward separate two worlds, each hopeless. On one side, three Liberians lie huddled on the ground under a UNICEF shelter, waiting to get in. On the other side, a flatbed truck loaded with 10 bodies in white plastic bags waits to drive out.
The truck belongs to one of four burial teams who pluck the dead from treatment wards--or worse, from homes where terrified families huddle around loved ones, desperate for one last touch. For many Liberians, giving a body to the burial team for cremation is unthinkable. Yet those last touches--part of Liberian funeral practices--are the very things that spread Ebola.
I follow the burial team to a home said to hold five bodies, all Ebola victims. As rain falls and a crowd gathers, the team members from the truck put on white suits and masks and set out down a narrow alley to the home. In 10 minutes, they are back. There were only two dead in the home, and the family told them to leave. "It isn't Ebola," they said. No time to find out if they were right--there are many more bodies to collect.
I don't think the world is getting the message. The magnitude of the response needed for a deadly outbreak like this in a staggeringly poor country demands both dollars and people.
For four years I led the Centers for Disease Control's emergency-response activities, including the early response to the H1N1 flu pandemic in 2009. I speak from sad experience: The level of response to the Ebola outbreak is totally inadequate. At the CDC, we learned that a military-style response during a major health crisis saves lives. In a global setting, the CDC usually provides technical support to local ministries of health. This crisis calls for much more.
We need to establish large field hospitals staffed by Americans to treat the sick. We need to implement infection-control practices to save the lives of health-care providers. We need to staff burial teams to curb disease transmission at funerals. We need to implement systems to detect new flare-ups that can be quickly extinguished. A few thousand U.S. troops could provide the support that is so desperately needed. There could be casualties, but what military operation is ruled out solely because it is dangerous?
Some may ask why the United States should play this role. Well, no one country is doing enough. We have the expertise and the personnel to tackle this challenge. From a humanitarian and medical perspective, we have a moral obligation to provide care to those who need it, wherever they may live.
But go beyond humanitarianism: Epidemics destabilize governments, and many governments in West Africa have a very short history of stability. U.S. aid would improve global security.
In my 13 years at the CDC, I never witnessed an outbreak as disturbing as this one. We have the tools to save thousands of lives, but our response has been inadequate. We underestimated this epidemic, and the people of West Africa are paying for it. We know how to control Ebola. It's time to step up and get the job done.
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Richard E. Besser is chief health editor at ABC News.
Editorial on 09/13/2014