As Liberia is declared Ebola free, can Nigeria do more to support its Neighbours?


As the Ebola outbreak is declared over, Chikwe Ihekweazu reflects on the two months that he spent supporting the outbreak response in Liberia and his hopes for a bright future of regional cooperation in West Africa.

Thankfully, Liberia is on its way back. The Ebola outbreak has been declared over, and life is returning to “normal”. The streets are full of activity, and schools have reopened. Across the country, there is an unmistakable sense that people are desperate to get on with their lives.

Dr Alex Gasasira, the WHO country rep. in Liberia, making the announcement that declares Liberia Ebola free

Arriving Monrovia in January 2015, it felt familiar; like a mid-sized Nigerian town – perhaps Abakiliki or Ilorin. The food was familiar – fish, plantain, rice … with lots of red pepper. The electricity situation was still very poor, and most people in Monrovia relied on generators. As we drove past a white compound, the driver explained that it belonged to Charles Taylor. I shuddered as I thought of all the lives lost in a senseless civil war. About half a kilometer down the road, we passed another big white building on the left of Tubman Boulevard. It had “Nigeria House” boldly inscribed on it. It’s the Nigerian High Commission. The driver went on to explain with a sense of gratitude and respect the role that Nigeria had played in Liberia’s history. I could not remember any other country that I had been to where I consistently had received such a warm welcome as in Liberia. I was proud.

The UN still had a military mission in Liberia. In the UN compound, there was a mix of military and police uniformed guys all around. I immediately noticed the uniform of the Nigerian police in the mix. The good work done by Nigeria around the sub-continent is often not recognised enough by Nigerians at home. Monrovia, Liberia’s capital is home to about a third of the 4 million Liberians.  As is almost always the case, I ran into a number of Nigerian colleagues working in the various organisations responding to the outbreak, and we soon formed a tight bond. I slowly found my way around Monrovia.

“ Nigeria House” – The Nigerian High Commission in Monrovia, Liberia

From the outside, with all the horror stories of Ebola in the popular press, it is easy to imagine Liberia as a country on the brink, especially with its history of protracted conflicts and civil war. But there is nothing further from the truth. Yes, it had been ill prepared for an outbreak of this severity and magnitude, as many other countries would have been, but sometimes there is nothing as powerful as grief to unite people in seeking a better future. The most important line of defence for Liberia is to rebuild the confidence of its population in the capacity of its government to prioritize the health of its citizens. This will require a complete turnaround in its health system’s capacity to respond to the “routine” health needs of a population. It’s only by responding to these issues in “peacetime” and building trust, that it will have the capacity to respond better to the next crisis. When a society loses confidence in those to whom they would normally turn to in times of need, they resort to actions that can generally be considered “irrational” and “illogical” and unwittingly spread the disease further.

In order to rebuild their health system, Liberia will need the support of other West African countries, especially Nigeria.  At the beginning of the outbreak, Liberia was widely reported to have about 50 doctors working in the country;  one of the lowest physician-to-population ratios in the world. In Nigeria, there are over 30 medical colleges producing about 3,000 doctors annually. Perhaps, it is time to form strong regional alliances between the various postgraduate colleges in a win-win situation  including training and service for all the countries in the region. The same concept could apply to nursing professionals, pharmacists and medical laboratory scientists. However, this will only work if we are able to go about this with humility and a sense of service, not one of pride and arrogance.  

For Nigeria, it is time to think of our engagement with the sub-continent beyond the military and the police. Not many people may know about the “Technical Aid Corps (TAC)” scheme that was established by the military regime of General Ibrahim Babangida in 1987 (like many other important institutions in Nigeria, it has no website for the public to follow its work). The sole purpose of the scheme is assisting States in Africa, Caribbean and specific regions in their social-economic development effort. Nigerian experts in various fields of human endeavour participate. Its most recent deployments are reported to be Uganda and Rwanda. Rwanda? I can guess what you are thinking! Until we begin to hold these Nigerian institutions to account on how they represent the strategic interests of our country, we cannot expect much to change.

Out of this crisis must emerge a new Liberia. While the stories of dictators, civil war and Ebola are true, they cannot be Liberia’s “single story”. With a beautiful beach front right at the heart of the city, there is no reason for Monrovia not to be the favorite destination of Nigeria’s emerging middle class. As Liberia grows, it will also begin to engage with the various opportunities in Nigeria. The earlier we really begin to see West-Africa for the common market that it should be, the greater the opportunities will be for the continent.

Beachfront in Monrovia

For now, it’s just great that Liberia can get on with the difficult task of nation building.

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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