In a country where public services have virtually collapsed, where about a dozen ambulances are normally available for four million people, saving an Ebola patient often comes down to this: phoning a barrel-chested politician with a taste for Hummers.
Saah Joseph didn’t intend to become the lifeline for victims of the worst Ebola outbreak in history. In February, weeks before the disease hit, the legislator imported six shiny ambulances from central California. His goal was modest – to serve his constituents suffering everyday ailments, and to burnish his reputation in the process.
But now, his personal mobile number is announced on the radio and exchanged by friends in crisis. It is pasted on his six ambulances, near his smiling face. He estimates that he has transported 3,000 patients since April, at least half with Ebola.
Mr Joseph, 38, who has a seat in the lower house of parliament, has created one of the most vital services in this disease-stricken land: his own emergency medical team. He has six more ambulances on the way from California.
The reliance on his fleet is a sign of how poorly prepared Liberians are as the epidemic grows. The country has only 4,901 body bags;it needs 84,841 in the next six months, according to the Health Ministry.
“The government never considered health a priority. I had people begging me for ambulances, and I found a way to get them,” Mr Joseph said.
Aside from Mr Joseph’s fleet, there are only about a dozen private and government ambulances in all of Liberia, and most of them are just cars or trucks with makeshift sirens and lights. Many Ebola victims take taxis to the hospital – posing a huge risk of infection for the vehicles’ next passengers.
When Mulbah Dukuly’s best friend fell ill with Ebola-like symptoms, he called for a government ambulance. It never came. Then he called Mr Joseph, and his crew arrived within an hour at the small apartment in central Monrovia. Wearing full protective gear, they lifted the old man into the ambulance. The crew turned on the siren and raced to the closest treatment centre. “The government isn’t doing this, so I called someone who would,” Mr Dukuly said after the ambulance left.
Mr Joseph has outfitted his team with boxes of protective gear and gallons of disinfectant. They clean the vehicles with chlorinated water. Sometimes he drives the ambulance himself.
When the ambulance supervisor fell ill with Ebola, they carried him to a treatment centre in the same vehicle he once operated. He died days later.
“It’s all we think about. It’s all we talk about – that all of our people are dying,” said Sam Dropleh, 35, an ambulance driver.
The fleet wasn’t supposed to be used this way. For years, residents of Mr Joseph’s electoral district, New Georgia, died of acute injuries or complications from pregnancy as they waited for a government ambulance, or got stuck in Monrovia’s painfully slow traffic.
So Mr Joseph reached out to an American man he had met through church who worked for the emergency response team in Chico, California. The ambulances would be donated if Mr Joseph could pay for them to be shipped to Liberia. He paid $10,000 (£6,200) for the delivery of the first two and collected $20,000, mostly from another legislator. By February, the ambulances were on the streets of Monrovia.
But Mr Joseph is a politician, and the ambulances weren’t just about saving lives. His private fleet was a shrewd advertising campaign that he knew would impress his constituents. There’s a reason his photo is on the side of the vehicles.
In March, the Ebola crisis and Saah Joseph’s political ambitions intersected. By August, each ambulance was carrying dozens of Ebola patients a day.
The US and other foreign donors have helped the Liberian government develop a call centre to dispatch vehicles. But with so many people contracting the disease and so few vehicles, the system often fails.
Even Mr Joseph’s system hasn’t been as responsive as some hoped, largely because of the disastrous state of the country’s hospitals. This week, one of his ambulances spent nearly an entire day transporting two people with non-Ebola illnesses – a man with tuberculosis and a woman who had miscarried and was in need of a blood transfusion.
Not a single hospital would accept the patients, worried that they might have Ebola. The vehicle drove across Liberia to clinics and hospitals. Meanwhile, the crew’s phones lit up with Ebola calls that it couldn’t respond to. Eventually, the patients were driven back to their homes. As it grew dark, the ambulances finally returned to their assigned parking spots, in front of Mr Joseph’s office.
Outside, in big block letters, was the slogan that had landed him in office.
“Saah Joseph: The right person at the right time for the right reason.”
© Washington Post
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