2014 was the beginning of the largest ever Ebola outbreak. What did this look like on the ground?
Early in 2014, there were reports of people dying of an unknown disease in Guinea. Nobody thought it could be Ebola, because that was considered a disease of Central Africa, not West Africa. But at MSF, we thought that the symptoms of the patients were suspiciously similar to Ebola. And in fact, there had been one case of Ebola in West-Africa: in Ivory Coast, in 1994, a person had been infected with a very rare strain of Ebola, Taï Forest. This was not very well known: it was only one case, and the patient had survived the infection. But when we read the reports from Guinea, we thought this was probably an outbreak of Taï Forest Ebola. We sent our Ebola teams on the ground. At that time, MSF was one of the very few organisations with experience in Ebola outbreaks.
Once on the ground, two things became clear. Firstly, this was not the rare Taï Forest strain, but the infamous Zaïre strain, which we knew was very deadly. Secondly, this outbreak had been slumbering for months (since end of 2013) and it was already present in many more places than MSF – or anybody else – was used to deal with. It had started in the Southeast of Guinea, an area that was poor and mostly ignored by the national government. But it is very close to the border with Sierra Leone and Liberia, and people from all three countries regularly move across those borders. The bordering regions in Sierra Leone (Kailahun) and Liberia (Lofa) were similarly forgotten by their governments. This way, the virus could spread and cross the borders, for months, before authorities started acting upon it.
The outbreak happened in a place in the world where no one expected Ebola, in an area that didn’t interest the authorities, and no one was ready to deal with it. It also looked like no one wanted to deal with it. It took governments, UN agencies and aid organisations a very, very long time to take the outbreak seriously. MSF felt very alone in those early months. We frantically rang the alarm bell, multiple times, but nobody seemed to listen. Everybody was in denial.