Monrovia

Monrovia

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In Liberia, disappointment at U.S. military's planned Ebola response

When President Barack Obama spoke about the U.S. military helping combat the Ebola epidemic on NBC News’s Meet the Press this past Sunday, Tim Flanigan, an American clinician working in Monrovia, says he was “ecstatic.” It was exactly what many of the people leading the Ebola effort in Liberia, the hardest hit country, had been hoping for. But that joy turned to dismay the next day, when Flanigan learned the details of the Pentagon’s plans.

Obama pledged “to get U.S. military assets just to set up, for example, isolation units and equipment there to provide security for public health workers surging from around the world.” On Monday, a Pentagon representative said the military planned to send only a $22 million, 25-bed field hospital to Monrovia, Liberia's capital. “It's not going to make any dent in Ebola treatment for the people of Liberia,” Flanigan warns. “It's such a small number of beds and they may well be directed toward non-Liberians."

Flanigan, who works at Brown University and from 1999 to 2012 headed the infectious disease unit there, arrived in Monrovia on 1 September and plans to stay for 2 months. A Catholic deacon, he is also working with health-oriented church groups and is blogging about his experience.

Flanigan says the Liberian and international officials and workers he has been speaking with had expected the U.S. military to set up field hospitals that have the capability to help up to 400 people. There’s a vast shortage of beds for Ebola patients in the nation, and standard care is in short supply even for people who are admitted to what are called Ebola Treatment Units. News that just a single, small facility would be coming was disheartening, he says, given expectations.

“The American military has the capabilities and the know-how and the training—and their infectious disease experts are second to none—to come in and establish an Ebola Treatment Unit that would be able to care for a large number of patients," he insists.

For the U.S. military, it is “a top priority” to get the “field-deployable hospital” to Monrovia and “we expect it to get there rapidly,” writes Navy Cmdr. Amy Derrick-Frost, a spokeswoman for the U.S. Department of Defense (DOD), in an e-mail to ScienceInsider. The military is also working with partner agencies—including the Centers for Disease Control and Prevention and the U.S. Agency for International Development—“to assess the situation in the affected areas to determine what additional needs and resources are needed or required,” Derrick-Frost writes.

A field-deployable hospital can be moved on pallets by plane and quickly set up, which DOD plans to do before handing it over to the Liberian government. “The intent of this piece of equipment is to provide a facility that health care workers in the affected region can use for themselves if they become ill or injured,” Derrick-Frost writes.

Flanigan says a stronger U.S. military response could help solve another upcoming problem that Liberia’s badly fractured health care system cannot address. There’s a push to treat Ebola patients with blood from people who survive the disease and possibly give infected people untested drugs, as well as a separate effort that may offer experimental Ebola vaccines to health care workers and other front-line responders. But hospitals and clinics do not currently have the capacity to gather the blood and tissue samples needed to study the impact of these interventions, Flanigan says. “We are not going to learn what we desperately need to know about treatment and prevention of this disease,” he says. “This isn’t in the best interest of the Liberian people, West Africa, or Americans.”

*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.

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