Burials of people who have died of Ebola are taking as long as five days in Liberia as a shortage of ambulances and fuel compound the fear and isolation that are stoking the worst outbreak of the virus on record.
A lack of vehicles and a fuel shortage are also hampering the ability of the World Health Organization and its allies to reach affected communities and investigate new cases, said Rick Brennan, director of the WHO’s department of emergency risk management and humanitarian response.
“Getting those activities running in the counties requires a lot of vehicles and fuel, and both of those are in short supply,” Brennan said by phone from Monrovia, the capital of Liberia, which has the highest death toll in the current outbreak at 694. “The roads here really beat up the vehicles, so they don’t have a long shelf-life.”
The cancellation of flights to West Africa by carriers including British Airways and Air France, contrary to advice from the WHO, also poses a challenge to bringing in people and supplies to the region and getting them where they need to go. The limits on transportation have also made local people feel isolated and demoralized, said Keiji Fukuda, the WHO’s assistant director-general for health security.
“If companies pull out, if airlines continue not to fly here and more close down, it is going to just worsen the economic impact and the social impact,” Fukuda said in a phone interview from Monrovia. “These countries don’t have that much resilience. What other countries may be able to withstand is going to send these countries potentially reeling.”
The worst-affected nations may see 1 percentage point to 1.5 percentage points shaved off economic growth because of the disease, African Development Bank President Donald Kaberuka said this week.
The human toll of the outbreak has risen to 1,552 dead of the 3,069 people infected so far in Liberia, Sierra Leone, Guinea and Nigeria, according to the Geneva-based WHO. More than 240 health-care workers have been infected so far and more than 120 have died because of a shortage of personal protective equipment or its improper use, the WHO has said.
“We need the sea ports and airports to be opened so we can receive supplies, medicines, relief items and personnel to help curb the spread of the disease,” said Musu J. Ruhle, charge d’affaires of the Embassy of Liberia in Ghana, at a meeting of West African health ministers in Accra, Ghana’s capital. “The whole country is isolated.”
Liberia has deployed more burial teams, Assistant Minister of Health for Preventive Services Tolbert Nyenswah said yesterday in Monrovia. Fourteen of 15 counties have received protective equipment after donations from China, the U.S. Agency for International Development, and the United Nations Children’s Fund, or Unicef. A fleet of 23 ambulances is now available, and India has donated water, rice and 100 beds and mattresses, Nyenswah said.
Health-care workers have been going through the equipment more quickly than expected through overuse or not reusing some items such as face shields, goggles, heavy-duty gloves and heavy aprons, said Nyka Alexander, a WHO spokeswoman. Goggles and boots can be disinfected and reused, though disposable gloves, surgical gowns and scrubs are destroyed after one use, Alexander said.
Direct Relief, a Santa Barbara, California-based charity, said a 4,000-pound shipment of supplies including gloves, gowns and antibiotics headed to Liberia via Brussels yesterday. The shipment, carried by Brussels Airlines and originally scheduled to arrive on Monday, has faced disruptions as Senegal closed its border to flights originating from the affected region.
Doctors Without Borders has a supply center in Brussels and has been chartering its own flights from there. Unicef this week delivered 100 tons of equipment to Liberia, including personal protective equipment, gloves and thermometers, the fund said in a statement.
The WHO is relying on Brussels Airlines and Morocco’s Royal Air Maroc, which are still serving the affected countries, as well as on the UN Humanitarian Air Service, which has a plane and three helicopters in the region.
“We are worried that more air carriers may suspend flights,” Brennan said. “Some of the shipping firms have shown a little bit of hesitation. These are issues we’ve got to watch very closely.”
The UN health agency and the International Air Transport Association have said that travel and trade restrictions aren’t warranted and that the risk of Ebola spreading through air travel is low. Airlines haven’t been listening.
Emirates is also among airlines that have suspended flights to affected countries.
DHL Express is still operating daily flights to the Guinean capital of Conakry; Freetown, Sierra Leone; and Monrovia, though it has stopped taking blood samples out of them, said Dan McGrath, a spokesman for the carrier in Bonn.
Meanwhile, the WHO has asked for volunteers from its 7,000 staff globally to assist in West Africa, Fukuda said.
“Everyone in the organization is asked to be ready to contribute,” he said. “There are a lot of people who are saying, ’We’re ready to go.’”