After the first cases of Ebola reached Liberia's capital, Monrovia, last June, local Rotary members feared that the city's limited health care system wouldn't be able to contain the highly infectious, often-deadly disease.
Those fears were realized when infections quickly multiplied, underscoring the speed with which Ebola can spread in an urban center. It was the first time the hemorrhagic fever had threatened a major city since it erupted in West Africa last March.
Now, after months of crisis-level response, and with the number of new cases declining, club members are looking to the long term, planning three projects that will have a sustained impact in the Ebola fight in their community.
"We were at the mercy of Ebola," recalls David Frankfort, a member of the Rotary Club of Monrovia and chair of its Ebola committee. "We didn't have enough trained health personnel or proper medical equipment to handle the onset of the epidemic here."
The Monrovia club quickly stepped up efforts to control the spread of the disease in the city. By October, members had donated 220 noncontact infrared thermometers, 10,000 examination gloves, 100 plastic buckets with spouts for handwashing, 120 pairs of rubber boots for health care workers, 80 mattresses, fuel coupons for Ebola response vehicles, and books for students who had to stay at home after the government ordered the closing of all its schools in June.
The 53-member club is also working directly with the Ministry of Health and Social Welfare to enhance local support for Ebola patients, health workers, and support staff.
"When this crisis hit, we weren't going to stand by and wait for help to arrive; we created our own emergency action plan," says Frankfort. "We felt a responsibility, as a Rotary club, to show our community that responding to disasters like this is what we are all about."
The Rotaract Club of Monrovia also pitched in, conducting a door-to-door outreach campaign aimed at raising awareness about Ebola prevention and home management. The effort was co-sponsored by the Liberian Nurses Association.
In addition, Frankfort says that dozens of clubs worldwide have assisted Rotary members in Monrovia, including the Rotary Club of Marlow, in Buckinghamshire, England, which raised more than $113,000 for the effort.
Cases drop, response stays strong
The Ebola epidemic, the worst on record, has claimed more than 3,600 lives in Liberia. In the three worst-hit countries -- Liberia, Sierra Leone, and Guinea, -- the death toll is more than 8,620, according to the World Health Organization (WHO). Ebola, which causes vomiting, diarrhea, and internal bleeding, is spread through direct contact with blood or other bodily fluids. It has no known cure.
However, the rate of new cases has declined in recent months, prompting the government to end the country's state of emergency in November. But William Martin, senior adviser to Liberia's Health Minister and a member of the Monrovia Rotary club, says more has to be done to end the epidemic.
"Our biggest concern is that this disease doesn't stop at the border. The boundaries of these three countries are poor. People migrate back and forth all the time," says Martin, who serves on the Presidential Advisory Council on Ebola. "Eliminating cases in Liberia isn't enough. We [the government] must continue to prepare for cases."
His club, which is celebrating its 50th anniversary this year, is also ready to continue the fight. "I'm extremely proud of what we've been able to accomplish so far. Every one of our members agreed that this outbreak is something we must take on as a challenge," he says. "But we can't stand down."
The Monrovia club plans to institute three major projects for long-term relief. Members will donate $80,000 to an orphanage caring for children who lost parents to the disease. They are buying an oxygen machine for the John F. Kennedy Medical Center, one of Liberia's largest and oldest medical facilities, which lacks proper equipment for Ebola patients. Martin says the machine will be crucial to the hospital's treatment of infected patients. The third initiative is to provide scholarships for people to study health and social work subjects.
Ebola's impact on Liberia was magnified by its deadly reach into the health care system. More than 300 medical workers contracted the disease, and 178 of them died from it. This was a significant blow in a country whose population of 4.4 million was served by only one doctor for every 100,000 people before the outbreak started, according to WHO. That compares with WHO's recommendation of at least one doctor for every 600 people.
As the club's efforts transition from emergency response to long-term relief, members will focus on filling gaps the government can't address, Frankfort says.
"There is going to be a strong focus on community outreach and awareness," he says. "It's crucial that people are educated on Ebola, because taking even a small step back can be disastrous for this country."