The decision by President Obama to commit significant military assets to help combat the Ebola outbreak in West Africa is an encouraging development in an international response that has been, at best, inadequate. Committing American service men and women in support of the effort to control the outbreak offers one of the most compelling messages to date of how seriously the United States government regards the outbreak. Hopefully, this example of high-profile American leadership will encourage other members of the international community to accord the Ebola crisis the attention – and the response – that it deserves.
Even with American military assistance, the effort that is going to be necessary to underpin any effective response is a daunting one. I am not referring to doctors, nurses, health workers, or even isolation wards and treatment facilities. I am referring to the massive logistics effort that will be necessary to enable any effort to control the rapidly accelerating outbreak. Médecins Sans Frontières (MSF), also known as Doctors Without Borders, understands this very well, as recent statements endorsing the need for an international military response indicate.
I will address the requirements in Liberia, since that is the area that I know best. I was also fortunate to get a frank and detailed update on the situation there recently from a senior Liberian government official.
To be quite specific here, what is needed is a massive logistics effort to establish the necessary capabilities for the reception, staging, and onward transportation of the literally thousands of tons of equipment and supplies – per day – that will be necessary to stop the rapidly accelerating growth of the outbreak. To give an idea of the scale necessary, one of the immediate objectives of this effort ought to be placing a full box of surgical gloves, goggles, masks, and gowns in every inhabited structure in Liberia – EVERY ONE – from walled residence compounds on the outskirts of Monrovia to every mud hut and temporary shelter in the outlying counties.
This effort will require taking over Monrovia Freeport, the port of Buchanan, and Roberts International Field, and establishing the necessary port and airhead operations capabilities, ground handling, and cargo offloading and staging for onward transportation of equipment and supplies to sites throughout Liberia. Re-opening Spriggs-Payne Airport to international cargo flights will be essential. Ground transportation – involving vehicles, spare parts imported, motor pools, and maintenance bays – will need to be provided in order to distribute equipment and supplies throughout those limited areas of Liberia that are served by reliable, all-weather roads.
Substantial contract air lift must also be procured – both transcontinental (civilian IL-76 heavy transports, for example) to augment surface shipping of the critical supplies and equipment, and local lift (civilian MI-8 cargo helicopters, for example) to transport equipment and supplies to the majority of rural Liberia not served by a reliable road network. These assets will require local support on the ground in Liberia; pilots, maintenance crews, fuel depots and tankers, for example.
Forward operating bases will need to be established in every Liberian county, and in areas in and around Monrovia. Each forward operating base will need its own ground transport, power, lights, communications, storage, temporary shelters, maintenance facilities, and fuel facilities. These bases will not simply provide desperately needed direct support to medical teams and local isolation wards operating in their immediate areas; they will also become the hubs for distribution of food, water, and needed relief supplies to communities throughout Liberia that are in desperate need of the necessities of life.
Without this enabling logistics structure, the courageous health workers fighting the fires of the outbreak on the front lines will not be able to do their jobs. Families with family members stricken by the disease will not be able to provide even the most basic care to their loved ones, or take the necessary precautions to avoid infection themselves. Communities suffering from the outbreak will not be able to undertake the simple public health measures necessary to limit the spread of the disease.
In an editorial in the Washington Post, the international president of Doctors Without Borders recently evoked the image of running into a burning house to save the residents in describing what is needed to stop this horrible disease. MSF doctors and local health workers are already in that burning house, doing their best, at great personal risk, to save the residents. We need to join them, before we find ourselves in need of rescuing as well. This outbreak is not going to burn itself out. Absent immediate, large scale intervention in support of the states struggling to contain the outbreak, the effects of the fire will be at our own front doors sooner rather than later.
Thomas Dempsey is Professor of National Security Studies at the Africa Center for Strategic Studies.
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