‘I grieve so much’

Liberians expand mental health care in aftermath of Ebola outbreak

MONROVIA, Liberia — Drawn-out deaths. Communities torn apart. Survivor’s guilt. Patrick Fallah says his memories of the days when the Ebola virus swept through Liberia are so awful that he sometimes has trouble focusing on the present.

“Sometimes when I have a flashback of the death of my son and others who died in the Ebola treatment unit, I don’t want to speak to people. I grieve so much that my mind is not really on what I am doing,” said Fallah, 30, who lost his 8month-old son and stepmother and is president of the National Ebola Survivors Network of Liberia.

The trauma of the world’s deadliest Ebola outbreak, which killed more than 11,300, mostly in Liberia, Sierra Leone and Guinea, has left many survivors fighting a battle some worry will never end.

But Liberia, one of the world’s poorest countries and with just one psychiatrist, has announced the ambitious goal of expanding access to mental health care to 70 percent of its population in the next few years.

The World Health Organization declared an end to the Ebola outbreak in June, estimating that more than 10,000 people who had been infected have survived in the three West African countries, including more than 4,000 in Liberia.

As the world’s attention has turned to other crises, many Ebola survivors still face the psychological consequences of the epidemic, feeling guilt over their pasts and worry for their futures without resources to deal with the pain.

Mental health is often an expense far beyond the reach of impoverished countries. Liberia is still struggling to rebuild its basic health services after more than a decade of backto-back civil wars that left a quarter-million people dead, with many killings carried out by drugged, underage fighters notorious for hacking off survivors’ limbs.

Then Ebola arrived, frightening Liberians with its lack of a cure and its transmission through contact with body fluids. Many people became too scared to touch others as the death toll grew.

Now Liberia’s government has announced its ambition to expand mental health care access to its more than 4.2 million people, with help from the U.S.based The Carter Center.

“After the civil war, people didn’t go through enough counseling. You have people already going through post-traumatic depression. Then Ebola came, and that built on what was already going on,” said Dr. Francis Kateh, Liberia’s deputy health minister and chief medical officer.

JEROME DELAY/ASSOCIATED PRESS ARCHIVES A medical worker sprays people being discharged from the Island Clinic Ebola treatment center in Monrovia, Liberia, in 2014. On April 5, bulldozers cleared the remains of a once busy Ebola treatment unit in Liberia, as health care workers, officials and some who were treated there gathered to mark the center's official decommissioning.

ABBAS DULLEH/ASSOCIATED PRESS Patrick Fallah is president of the National Ebola Survivors Network of Liberia. The trauma of the world’s deadliest Ebola outbreak has left many survivors fighting a mental health battle to focus on the present.