y Tami Hultman
Washington, DC — Imagine 
this choice. Your child has Ebola symptoms. You have no protective 
gloves to help keep you alive to care for her. But she needs comfort, so
 you wash her and wipe away her vomit – and you both die.
Liberia, one of the three most-affected countries, doesn't have 
enough gloves even for medical staff. Overwhelmed international 
caregivers – like the uniquely engaged Médecins Sans Frontières/Doctors 
Without Borders (MSF) – are expressing disbelief at the 'too little, too
 late' international response.
"We are completely amazed by the lack of willingness and 
professionalism and coordination to tackle this epidemic," the group's 
operations director, Brice de le Vingne, told the 
Financial Times,
 saying Liberia, where MSF is scaling up treatment centers, is a country
 on the verge of collapse. "We have been screaming for months," he said.
The group says there is nowhere near the assistance needed, despite 
recent efforts. Only after a traveler from Liberia took the virus to 
oil-rich Nigeria, Africa's most populous nation and host to large 
international investments and businesses, did the global response reach 
even the current modest levels.
The 
World Health Organization this month is launching a U.S. $100 million disaster plan, after exhausting previous contributions of $7 million. The U.S.
 Centers for Disease Control
 (CDC) has sent 19 people to work in Liberia, and Public Affairs 
Director Barbara Reynolds says at least 60 CDC people are in Liberia, 
Guinea and Sierra Leone, plus Nigeria.
Nobody who has been working on the Ebola crisis in Guinea, Sierra Leone or Liberia thinks that's close to what's needed.
Contrast that with the world response to the 2010 Haitian earthquake.
 Over $3.5 billion was donated by governments, organizations and 
individuals. Within 24 hours, the small nation of Israel had equipped a 
plane with emergency medical supplies,
 and 40 doctors and 20 nurses and 20 medics were able to set up a field 
hospital on arrival – including a patient identification system and 
electronic medical records. More than 300 CDC staff went to Haiti to 
assist in the recovery, including battling the ensuing cholera epidemic.
 In much of North America, Latin America and Europe, commercial 
businesses put out collection boxes for relief donations. Individuals 
responded massively.
Nothing like that is in place for west Africa.
"The virus has devastated the entire health infrastructure of the country," says Riva Levinson, whose Washington,DC-based 
KRL International
 works with the government of Liberia to get its message out. That means
 Liberians are dying in large numbers every day from easily treated but 
common diseases in one of the world's poorest countries routine 
gastrointestinal infections, pneumonia, complications of pregnancy, and 
malaria – which is at its highest levels in the current rainy season – 
due to the absence of care. [See AllAfrica's 
Bokai Fofana's blog about the heightened worry about finding treatment when his young son developed malaria.
Clinics and hospitals have closed, not only from losses of staff but 
from for lack of infection control supplies and disinfectant to make 
buildings and wards safe for caregivers or other patients following 
treatment of Ebola sufferers. That lack of capacity forced Dr. James 
Sirleaf, medical director of the medical assistance group 
Heartt Foundation,
 to pull its volunteers out of John F. Kennedy Hospital (JFK) in 
Monrovia, the country's main teaching and referral facility. "It was an 
agonizing decision," he said.
Heartt has formed ties with at least 19 major U.S. medical schools 
and universities and has a program that takes volunteers to JFK on short
 rotations to teach medical students and other health professionals 
while providing patient care. Last month the epidemic claimed JFK's top 
medical consultant, Dr. Samuel Brisbane.
Dozens of health workers have died, in a country that – before Ebola 
struck – only had around 50 doctors for a population of over four 
million. AllAfrica's Patience Dalieh's cousin, a nurse, died last week, 
after treating patients in a cross-roads market town of Kakata, in 
central Liberia; eleven other nurses in the facility died. (Patience 
didn't let fear stop her from trying to prevent Ebola's spread in 
Monrovia, Liberia's capital. See 
her blog.)
On Friday, in a rare bit of good news for Liberia, Dr. Phillip 
Ireland, who was treated at the same Ebola treatment center as Brisbane,
 walked out of the center, arms raised as he greeted family and 
supporters.
Heartt's Sirleaf first met Ireland when the then-medical student 
approached him for help in augmenting his emergency medicine skills. 
"When I heard he had contracted Ebola, I cried," says Sirleaf. "His 
recovery is wonderful news!"
But there is little good news for the country that already was 
struggling to recover from a quarter century of conflict that killed 
250,000 people and dislocated three-quarters of the population, while 
destroying almost all the infrastructure – clinics, schools, roads, 
bridges and public buildings. The administration of President Ellen 
Johnson Sirleaf has been battling to rebuild, and there were clear signs
 of recovery against the odds. [See 
Briefing: Moving From Stabilization to Transformation]
 .Now, much of that hard-won progress has been erased – and is 
threatened with reversal. Schools have closed, Peace Corps teachers have
 left, companies working on critical development projects have withdrawn
 staff. The government announced that essential work on dams and roads 
has stopped.
Without strong intervention, widespread famine looms. In-country 
trade in agricultural products has ground to a standstill, and essential
 grain and rice shipments, as well as imports of fuel for electric 
generators has slowed, as ships bypass the Port of Monrovia. All but two
 airlines – as of this writing, Brussels Air and Royal Air Maroc were 
still flying – have halted service to Monrovia.
What's desperately needed, says Levinson, is a global response on the
 model of the assistance for Haiti. "If we don't recognize that we need 
to fight Ebola and contain it in a big way and provide the countries 
with support, we're not going to be capable of arresting it. And right 
now the support is not even scratching the surface."
"In Haiti, everyone wanted to go there and volunteer," she says. "The
 challenge now is the level of fear. The focus has been on preventing 
the disease 'coming to us', and it has completely missed the devastation
 it has caused."
Blaming the Victims
Much of the early warnings about Ebola came from policy experts who 
pinned responsibility for the slow response on the governments of the 
three countries – and media reflected that view.
Former National Public Radio reporter Laurie Garret - author of The 
Coming Plague, which warns about emerging diseases such as Ebola – is 
now senior fellow for global health at the Council on Foreign Relations.
 In an 
opinion piece for CNN, she gives a nod to the history of regional conflict, but puts the blame squarely on poor governance:
"Fear, suspicion, poverty, pain and superstition are the norm, the 
noise that everybody lives with, every minute of their lives. Ebola is 
simply a new scream heard above that terrible background din. The 
challenge today in these barely functioning states is to find ways to 
lower the overall noise, focus on stopping the Ebola virus, and bring 
governance and peace to three countries that have rarely experienced 
either.
Garret's position was widely echoed in other media and by other 
pundits during the critical period for containing the virus and 
minimizing the loss of life and the long-term economic catastrophe. The 
failure of the international organizations that had the scientific 
expertise to warn African governments and advise them on effective 
mitigation received little scrutiny.
A New York Times 
editorial on 15 August
 citing a "painfully slow" international response was an important 
corrective to the 'blame the victim' narrative, saying the World Health 
Organization had "snoozed on the sidelines for months" and commending 
the heroic efforts of MSF and Samaritan's Purse.
Two intrepid media professionals, photojournalist 
John Moore of Getty and reporter 
Jina Moore of Buzzfeed
 have been posting heart-wrenching images and stories – a key component 
to mobilizing public pressure for political action. National Public 
Radio has a team in Liberia this week.
Levinson and other advocates for the affected countries would like to
 see former American Presidents Clinton and Bush, who established the 
Clinton Bush Haiti Fund
 take similar action on behalf of Ebola victims and to stimulate more 
helpful media coverage of the needs in Liberia, Sierra Leone and Guinea.
 She says it can't be soon enough.
"All of the governments are democratically elected, all post-conflict
 success stories, all inherited non-existent infrastructures that had to
 be re-built from close to zero. With so much to lose, what is the world
 waiting for?"
The AllAfrica Foundation is launching this week a Give a Glove 
campaign – to call attention to the need for international action and to
 support the Ebola BlockAID campaign of the Heartt Foundation. Watch for
 information.http://allafrica.com/stories/201408201797.html?viewall=1