Tolbert Nyenswah: A Liberian Perspective on Ebola

For a Liberian perspective on the Ebola outbreak, we reached out to Tolbert Nyenswah, Assistant Minister of Health. Earlier this month, we featured an article he wrote in Scientific American about Liberia’s Ebola outbreak. Nyenswah, a Johns Hopkins Bloomberg School of Public Health alum, fielded questions from GHN associate editor Dayna Kerecman Myers.
What has your role been in fighting the epidemic?
I’m currently managing the Incident Management (IM) System, hosted at the Ministry of Health and Social Welfare. The IM System is the coordinating body for the entire health response to the Ebola outbreak, I coordinate the work of various technical committees such as Case Management, EPI/Surveillance, Health Promotion, and contributions from partners such as CDC, USAID, MSF, and WHO. Coordinating, planning and implementing a response process has been a challenging job, and it has strengthened my resolve. 
What is the Western media missing or misinterpreting in its coverage of the outbreak?
Unfortunately, we’re seeing that much of the media reporting of this situation is deliberately exaggerated—and that is more harmful than helpful here. It’s causing airlines to cut off flights to Liberia, which not only impacts our economy but also delays shipments of needed supplies and technical expertise that typically rely on commercial flights. It is also stigmatizing Liberians. Liberians returning to the US, where they live and work, are being fired from their jobs, and face discrimination due to exaggerated fears about Ebola.
While the situation is much more dire than any other Ebola outbreak before and that cannot be underestimated, we would hope that the media wouldn’t exacerbate the situation. For example, the Western media recently referred to a transit holding center established by the government for Ebola suspects as an Ebola Treatment Center for patients who had tested positive for Ebola. In fact, these people were never confirmed cases, and the site was never a treatment center.
The other element the media often misses is the profiles of the incredible people at the frontline fighting this disease. This includes my colleagues in the Ministry of Health and Social Welfare, the remarkable health workers that are every day in the Ebola treatment units and holding centers, caring for patients, many of them in their last hours, and the community members who are doing everything they can to prevent the disease’s spread.
What support would you most like to see from public health colleagues outside of West Africa?
We have been able to mobilize support from key technical partners, but if there are others looking to get involved there are ways we still need support. At this stage, the more creative the better, as we’ve never faced something of this scale before. For example, we’ve learned from other emergencies about the use of cell phone data and geo-spatial mapping to help prevent the further spread of the disease, and to understand movement patterns to help aid in the government response. Ideally, we’d like to use more tools like that to better respond to the outbreak and plan where additional interventions are necessary. That would help us move from a reactionary response to a more strategic response to the outbreak. Another area to think about would be clinical trials of many vaccines and medication for Ebola.
How should Liberia’s health workers respond when Ebola victims ask for the serum given to the two Americans?
I personally interacted with the American doctor and health care worker at the time we negotiated with the community to expand the ELWA-3 Ebola treatment unit. The responses to the news they received the experimental serum, ZMapp, were mixed. Some feel it was ethically wrong to give it to them, while others were excited to think there might be some sort of solution. Because of this sentiment, our government officially requested the serum on compassionate grounds for 3 Liberians. The doctors already took the serum. Liberians feel strongly that more of the drugs should be approved, and full-scale phase III clinical trials should be launched. Ed. note: Sadly, we received news yesterday that one of these physicians died yesterday. See the BBC story: Ebola kills Liberia doctor despite ZMapp treatment.

How have you persuaded people to change their behaviors and deeply ingrained traditions like burial rituals?
The most important element to stop the spread of this disease is to stop the transmission at the community level. This can be done through distributing hygiene kits household to household, providing health education in every community, and social mobilization throughout the entire country—all are necessary steps already being undertaken that must continue. We all know Ebola is a frightening disease, and unfortunately we are still in the phase of explaining to people that Ebola is real, what it is capable of, and why it must be dealt with immediately. We’re getting these messages out by mobilizing community leaders, broadcasting health promotion messages on the radio, working with faith leaders, and mobilizing members of every community to go out and tell our people what is happening, and what they must do to stop this disease from spreading.

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1 comment

Sydell Goll
September 22, 2016

Thank you so much Nyenswah and all the health workers who risk their lives in the fight against this deadly disease. We pray for the souls of our brothers and sisters that left us. We all know what it means to see your motherland going through crisis and seeing your people dying. We thank God that calm is restored to our country again.

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