Why the escape of numerous Ebola patients in Liberia’s worst slum is so terrifying


A man carries a girl from an Ebola isolation center as a mob overruns the facility in the West Point slum on Aug. 16, 2014 in Monrovia, Liberia. (Photo by John Moore/Getty Images)

The chants in the Liberian capital of Monrovia, according to reports, began near dusk. People gathered near the entrance of an Ebola isolation unit, where dozens of patients, many of whom were suspected if not confirmed to be infected, were getting treatment. Pictures showed some in the crowd had masked their faces with T-shirts or shawls. Others, including a woman in a red dress named Batu Flowers, tried to convince the mob that Ebola was real, they weren’t being lied to, that news of the outbreak wasn’t a hoax. But the crowd wouldn’t be dissuaded.

It pushed against the gates of the Liberian primary school, which had been converted into a treatment center in the middle of West Point, which some call the most squalid community in Liberia if not West Africa. Thanks to poor sanitation and open sewers, the community of tens of thousands crowded onto a peninsula jutting into the Atlantic Ocean has long been prone to debilitating sicknesses from typhoid to malaria to lethal diarrhea. Now it has one more to contend with — a virus spread through feces, blood and vomit.

“No Ebola in West Point!” the crowd chanted, according to Getty Images photographer John Moore. “No Ebola in West Point!”

Three patients had already escaped, reports Buzzfeed’s Jina Moore. “We begged them” to stay, one nurse worker told the reporter. We “told them people are coming tomorrow to help you. But there was no way we could fight them.”

They also couldn’t fight the mob. Its members were angry their community had been used to isolate Ebola patients. They were upset they couldn’t see the patients inside. They were suspicious of the whole operation.

Soon, between 17 and 29 Ebola patients had run away — or were physically removed by their families — and the looting began. They took off with items — goggles, masks, blood-stained mattresses and blood-stained sheets — that were likely infected with Ebola, a lethal disease that the World Health Organization says has killed 1,145 people in West Africa, 413 of whom were Liberian. Following the patients’ escape and Saturday’s looting, officials and health workers fear even more will be infected as patients return to their family’s homes and looters sleep on fetid mattresses.

“They said, ‘The president says you have Ebola, but you don’t have Ebola; you have malaria. Get up and go out!’” Jemimah Kargbo, who works at the clinic next door, told Buzzfeed. “Everybody left with their own thing. What are they carrying to their homes? They are carrying their deaths…. We can’t let them turn around and come back and infect us. I have four sons. I am a single mother. I’m not going to let that happen to my children. I’m not going to let anybody infect me, to die of the disease and leave my children.”

MONROVIA, LIBERIA - AUGUST 16: People watch as a crowd protests before entering the grounds of an Ebola isolation center in the West Point slum on August 16, 2014 in Monrovia, Liberia. A mob of several hundred people, chanting, "No Ebola in West Point," opened the gates and took out the patients, many saying that the Ebola epidemic is a hoax. Just moments before they drove off a burial team with police escort, who had tried to take away the bodies of four deceased residents from the neighborhood. The isolation center, a closed primary school originally built by USAID, was being used by the Liberian Health Ministry to temporarily isolate people suspected of carrying the virus. Some 10 patients had "escaped" the building the night before, according to a nurse, as the center had no medicine to treat them. The Ebola epidemic has killed more than 1,000 people in four West African countries, with Liberia now having the most deaths. (Photo by John Moore/Getty Images)
People watch as a crowd protests before entering the grounds of the Ebola isolation center. (Photo by John Moore/Getty Images)

It’s difficult to imagine such an incident occurring in a more vulnerable place. The slum of West Point, which health officials have considered quarantining, is populated by some of the poorest people in West Africa, most of whom have few resources or training to adequately treat or quarantine sick residents. Dominated by rusted shanties of corrugated iron, crime and drug abuse, analysts contend the overcrowded and densely populated peninsula could become another hot zone in the worst Ebola outbreak in history.

“It’s an informal community, a ‘slum,’ with no running water or toilets,” wrote Moore. “People can live seven or more to a single dwelling, and the density is dangerous: A positive Ebola patient disappearing into the maze of metal shacks can be a public health horror story.”

Residents agreed. “As I speak, the police station is deserted,” one resident named Moses Teah claimed in an interview with FrontPageAfrica. “There is no security now in West Point. I said to myself, ‘What a place.’ West Point people really shocked me yesterday.”

West Point’s population surged during Liberia’s civil war between 1989 and 2003, which killed a quarter-million people and displaced 1.3 million. Thousands fled fighting in the countryside and pushed into West Point, populating the community with refugees and child soldiers who grew into adulthood in the slum. It became one of the least hospitable places in the country.

“West point is the worst slum in Liberia,” commented Vice Media journalist Shane Smith in a documentary he did on Liberia. “Which makes it one of the worst slums in Africa, which makes it one of the worst slums in the world.”

Indeed, despite its location on what should be profitable oceanfront property, the residents have always been poor, according to a 1991 paper published in Environment and Urbanization. “West Point is densely populated, characterized by a constant through-flow of residents, who come from other parts of Liberia and neighboring West African cities.” The makeshift dwellings became permanent — and even now, almost all of them are without indoor plumbing or running water.


People walk through rain puddles near the Ebola isolation center. (Photo by John Moore/Getty Images)

According to the United Nations Office for the Coordination of Humanitarian Affairs, which reported on the slum in 2009, there were only four public toilets servicing 70,000 residents. Using the toilet cost 3 cents, and bathroom operators estimated they got about 500 patrons per day. “The facilities can be smelled 50 meters away, with the floor of each squalid cubicle 15 cm deep in soiled newspaper that residents use to wipe their posteriors,” the service reported. “Staff use gloved hands to scoop the used paper into a wheelbarrow, which they lug to the nearby river or beach to dump its contents into the water.”

Other residents prefer not to deal with all that, and instead use the beaches as public bathrooms. “Before I can take my first step into the sand [I see] the small black and brown piles underfoot,” a Providence Journal missive says. “A few yards ahead, a scattering of about a half a dozen or so small children squat, eyes towards the sea.”

Now, if Ebola ravages the slum as some fear, it is this act of public defecation that may tragically fuel its rise.

Terrence McCoy is a foreign affairs writer at the Washington Post. He served in the U.S. Peace Corps in Cambodia and studied international politics at Columbia University. Follow him on Twitter here.
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