Surviving Ebola: Public perceptions of governance and the outbreak response in Liberia

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Executive summary

The findings in this report are based on data collected through an in-depth process of desk and field research – including interviews with experts in Liberia, focus group discussions (FGDs) held in heavily affected communities and a survey of 200 Liberians. The research aimed to understand the experiences and perceptions of Liberians in the wake of the Ebola virus outbreak. The research looked at non-health impacts of the outbreak, the response to the outbreak, the reasons for denial of the virus’ existence and seriousness, and overall perceptions towards government. Based on these findings, this report makes the following conclusions.

• There are negative perceptions concerning the performance and trustworthiness of the government: The government received an average score of 2.2 (indicating ‘poor’) when a pool of 200 Liberian survey respondents were asked to rate the government in terms of ‘how well the government is doing for you’ on a scale of 1 to 5. When they were asked to give a rating for the ‘trustworthiness’ of various institutions, the government again fared poorly. On the same scale of 1 to 5, the lowest marks were given to the Liberia National Police (LNP) (1.5), government officials (1.7) and legislators (1.9).1 • There is a sentiment of anger at the government’s initial efforts to combat the outbreak, mostly due to delayed and ineffective early measures: A total of 81% of survey respondents reported being ‘angry’ at the government’s response efforts, mainly due to its perceived slowness. Despite Liberia’s eventual success in combating Ebola, the early phase of the outbreak was marked by logistical shortfalls and a haphazard containment strategy. While some interviewees also questioned the international community’s delayed response, survey respondents expressed greater dissatisfaction with the government’s efforts than they did with international efforts.2

• Grassroots initiatives by Liberian community structures played a vital role in preventing the worst-case scenario from coming to pass: Interviews with high-ranking figures in the government’s Ebola Taskforce revealed a shift in philosophy from top-down, authoritative measures to an approach that emphasised two-way communication and mutual respect with affected communities. Evidence points to the actions of Liberian community members – many of which were not directed by the government – as critical in reducing transmission rates.3

• There was no widespread violence or instability resulting from the outbreak: While some commentators feared that popular frustration with inadequate government efforts to contain the outbreak could result in violence or other forms of large-scale confrontation between citizens and the state, the crisis generally did not have a significant security dimension. Aside from one high-profile incident, Liberians were mostly compliant with the measures imposed to address and combat the spread of Ebola.4

• The worst impacts of the Ebola crisis have been felt by the poor, who report loss of income, difficulty accessing medical services and traumatic feelings of fear: Over 42% of survey respondents said they had lost their jobs due to Ebola and 55% said they had lost income. The most heavily affected neighbourhoods in Monrovia tended to be those that were also the most densely populated, under-serviced and economically deprived. Survivors of the disease have faced stigma and reduced employment opportunities. Those who were involved in hospitality work and the informal market were hit particularly hard during the crisis.5

Now that the Ebola crisis has come to a close in Liberia, it is imperative that the lessons of the outbreak are carefully examined and straightforwardly discussed by the government, its international partners, civil society organisations (CSOs) and community members in the country. Particular attention must be paid to the underlying social dynamics that enabled the outbreak to evade detection and delayed effective response by public health officials until it was too late. These dynamics are intimately connected to the political processes of peacebuilding and responsive governance, as they touch on issues of public trust, the fairness of Liberian institutions, and social and economic marginalisation.

Moving forward, post-Ebola policy-making and aid delivery must take into account the need to repair the bonds between Liberians and their government, in order to strengthen good governance and accountability. Projects that seek to strengthen health services, promote good governance and rebuild service delivery must incorporate civil society and beneficiary communities into planning and decision-making, ensuring that they play an active role in accountability measures and project implementation. Relying entirely on legislators or government officials to represent the interests of Liberians who are the intended beneficiaries of aid programming risks reinforcing the mistrust described in this report. Strengthening peacebuilding measures must be paramount in the post- Ebola phase. This will require direct engagement with poor and marginalised communities, and must involve soliciting their input into how the government and donors can assist in building a more stable, fair and equitable society in Liberia.

International Alert recommends that:

• Aid programming includes a monitoring role for civil society and the active involvement of communities in how projects are designed and implemented.

• The mistrust described in this report and exposed during the Ebola crisis is proactively addressed by determining its causes and including community representatives in the development of solutions. This will require a combination of participatory research and dialogue, which will have most legitimacy if it is initiated within civil society or by government, and supported by donors and international agencies.

• Multi-stakeholder dialogues are held, bringing together CSOs, government representatives and affected communities to discuss what lies behind the weaknesses in the state–society compact and trust between citizens and government that contributed to Ebola, and how these should be addressed. Recommendations that emerge from this process should be integrated into partnership agreements between donors and the Liberian government, inform national recovery prioritisation and planning, and be integrated into national development strategies that are funded, implemented and monitored.

• Measures are taken to ensure that security forces exercise restraint in handling demonstrations and protests.

• Independent anti-corruption bodies such as the General Auditing Commission (GAC) and the Liberia Anti-Corruption Commission are strengthened and adequately financed, so that they are free from political interference and able to successfully bring cases against offenders.

• Donors speak out against issues of corruption, and that they and the government should meaningfully support the right and capacity of the press and civil society to criticise public officials without consequence.

• Specific support is provided to those most affected by the crisis – survivors, the bereaved, and those who have lost income, jobs and education opportunities – to recover and reintegrate.