09/03/2015 20:22 GMT | Updated 09/05/2015 06:59 BST

Ebola: A Turning Point?

With Liberia's last confirmed ebola patient discharged from treatment and the country counting down towards being ebola-free, we should celebrate this major milestone in the fight against the epidemic. But the good news does not mean the epidemic is over. Significant numbers of ebola cases remain in two neighbouring countries, and even in Liberia, everyone must remain vigilant to prevent a recurrence. But at the same time, we need to be looking forward.

I was in Brussels this week at an international conference where the leaders of Liberia, Sierra Leone and Guinea appealed for continued support to rid their countries of Ebola and start rebuilding shattered economies. As humanitarian organisations, we often talk of building back stronger. Nowhere do we need to deliver on this more than in these desperately poor countries in West Africa.

The Liberian President, Ellen Johnson Sirleaf, echoed Oxfam's February appeal for a 'Marshall Plan', akin to efforts to rebuild Europe after the Second World War. Cities may not have been reduced to rubble but ebola has devastated lives across the already poor countries of the region. It has undermined the livelihoods, education and economic growth desperately needed to lift people out of poverty, hitting the poorest and most vulnerable hardest.

When I visited Liberia and Sierra Leone last month, many people told me of their struggle to feed their families as trade and much agriculture were restricted and people's food supply and incomes plummeted. Half of Liberian heads of household are out of work and nearly 180,000 people have lost their jobs in Sierra Leone.

The outbreak has also shown up gaping holes in essential services like health care, water and sanitation - and in some cases created even worse conditions. Hundreds of health workers have died of the epidemic, patients have lost confidence in the system, and many, including mothers and newborn children, have been left uncared for while most services have been suspended.

The priorities are now to end this outbreak, ensure such a deadly epidemic is never repeated, and help the three countries on the long road to recovery.

Amazing work has been done to combat the epidemic with around 10 times fewer new cases per week across the region now than in September and the generosity of the public has played a crucial part in this success. But getting to zero could be the hardest part yet. The risk of infection is still very real. But there's a danger of complacency as countries lift curfews and reopen schools. It's understandable that people want to get back to normal after enduring the horror of ebola for so long. However, it's vital that protective habits such as hand washing and safe burials continue and that we track down, isolate and treat the remaining cases.

Medical experts are clear that the virus will rear its head again. Guinea Bissau is particularly at risk and unable to cope with an outbreak. To prevent ebola flare-ups running out of control requires better preparation and more investment in health care and hygiene for at-risk countries. Liberia, for example, only had 150 doctors at the start of the outbreak and many of the health facilities I visited had no safe water or sanitation. A new report warns that 28 vulnerable African countries have even worse health systems than Liberia.

As the numbers of ebola patients drop, the world's attention must not drift away. There's an urgent need to reboot stalled economies with immediate cash injections and investment in jobs. Communities in Liberia and Sierra Leone have been clear about what they need - jobs, better access to health care, support to get their children back in school. Ebola has raised awareness of the importance of hygiene and they are asking for clean water and decent sanitation.


This week we've already seen a positive step forward. Institutional funders pledged to make children in Liberian schools safer and healthier post-ebola with clean water and proper toilets. A staggering 55% of the country's 4,600 schools have no water supply and 43% lack working toilets. This welcome move will help guard against infectious disease as well as boost educational performance and increase school attendance, especially among girls.

A great opportunity coming out of last year's horror is the work of local people in educating, policing and protecting their own communities. In the last six months many organisations, including Oxfam, have trained and supported thousands of community health volunteers. Alongside medical workers, they have been the real front line. Gradually, national governments and funders have stopped seeing local people as 'targets' and started to wake up to what every development studies student learns in their first year; the power, potential and, indeed, necessity of genuinely partnering with local communities.

Now, will all parties continue this approach of real community engagement, building on the current investment and energy to tackle longstanding issues such as female genital mutilation, school enrolment and immunisation?

Oxfam is in Liberia and Sierra Leone for the long haul. We're continuing to work with communities to build understanding of ebola treatment and how to stay healthy, providing financial support to help families get back on their feet, and helping them guard against infectious diseases by equipping schools and clinics with clean water and sanitation.

Now, national recovery plans need to be finalised and strongly led by the three governments, with a commitment not previously seen. Big international funders need to step up to address health systems and other areas of acute need. If we get it right, ebola could mark the turning point for all those who live in the countries that have suffered so much. If we have learnt about the power of working with poor people rather than for them, we will have made a good start.