What Life Was Like on the Ground During the Ebola Crisis

In anticipation of the upcoming fourth season of our HBO show, which will premiere February 5 at 11 PM, we are releasing all of season three for free online along with updates to the stories. Today’s installment follows up on a dispatch called “Evolution of a Plague,” about the devastating Ebola outbreak that swept through West Africa last summer. Watch the episode below:

The first case of Ebola was documented on March 23, 2014, and in the months following, this single case grew into the worst outbreak of the disease since its official discovery in the late 1970s. Over 11,000 people died and over 28,000 were infected—mostly in Libera, Sierra Leone, Mali, Guinea, and Nigeria. Now, almost two years later, the regions of West Africa afflicted with the disease have been officially declared Ebola-free.

Last year, after the initial media panic over the outbreak had died down, VICE News correspondent Danny Gold went to West Africa to see how the evolution of the disease and its treatment was progressing, whether international authorities like the World Health Organization (WHO) had learned anything from their initial mishandling of the epidemic, and if local and global organizations were now properly prepared for subsequent outbreaks. With West Africa recently being declared Ebola-free by the WHO, we sat down with Danny to hear what it was like to be on the ground in the midst of this crisis, and if what he saw there made him believe that the world will respond more quickly and efficiently to future epidemics.

VICE: What was the most surprising thing you saw when you were in West Africa?
Danny Gold: The most surprising thing was just the confusion, and the lack of a coherent plan. No one really knew what was going on, there was a total lack of coordination. So you had situations where people would be getting sick and they just didn’t know where to go or what to do. They would try to seek guidance for that, but there was no one with the capabilities to answer those basic questions. Everyone was just so completely overwhelmed. It was shocking to see such a failure of the system.

When you were on the ground in the hardest-hit areas, what was the thing that made you the angriest or the most frustrated?
Just seeing people that were trying to do the right thing by going to the treatment centers, and not being able to be treated. There was a lot of fear of this disease and a lack of knowledge amongst many of the communities and the treatment centers held this stigma—that when people went there to get help, they ended up dead. So seeing people overcome that stigma and that fear, go to these centers and then still not be able to get treated—not through any fault of the hospitals or the aid workers, but because the system was so overwhelmed, that was incredibly frustrating to witness.

What kept people going? What gave people hope that this situation could be resolved?
I think you had a lot of efforts among local communities in these countries that really took it upon themselves to organize. They realized that no one was going to come in and save the day. The US military and the international community arrived late, but when they did come, obviously they were a great help because of their vast resources. However, it really fell to the communities that we saw—the aid workers, the people who were doing the burials—who really took it upon themselves to organize and help out at great personal risk to their health. Spending time with them really gives you hope—not just for the handling of that situation, but for humanity as well.

When you were down there, were you scared of getting infected?
Not in the beginning. I’d spoken to a lot of journalists, and I think that the fear of transmission was super overblown. As long as you avoided bodily contact, as long as you avoided any transmission of fluids, you were, for the most part, OK. So the fear wasn’t there in the beginning. Definitely when you’re lying awake at night, you’re wondering, Did I get too close? When I got back to the US, I did have that 21-day period where any rumbling in my stomach, any slight fever or slight heat that I felt in my body, made me start freaking out.

There can certainly be a tendency in the media during global events like this to give into fear-mongering. How did you and your producers try to avoid this kind of coverage?
It was difficult. On the one hand, you want people to be aware of how bad the situation is, but you don’t want people to think that these countries were zombie lands. Daily life continued in most of these places because it had to. Finding the middle ground is important because people will take what what they see in the media and use it to confirm their stereotypes or fears.

So we tried to show that members of the local community were taking it upon themselves to fight this disease—that people were doing their best, even though the situation was very serious.

Less than half an hour is a very limited time to cover this entire crisis. Was there anything that you wanted to, but weren’t able to include in the episode?
There was a doctor who we interviewed in Sierra Leone when they were facing a very large outbreak who had the disease himself, beat it, and then decided that he needed to give back to his community by going back to the clinic and working to help cure people. There were a few stories like that that I think were just really important to tell about people who got sick, received really great treatment from their colleagues and their neighbors, and then took it upon themselves, afterwards, to go back and to help people in the same situation.

What are the most significant updates or breakthroughs that have happened since you were in West Africa?
The most significant update is that as of January 13, 2016, the WHO has declared all of the countries affected by the outbreak to be Ebola-free. The question, though, is: What’s going on with the infrastructure of these countries right now? Are they prepared for another sort of outbreak? Is the world prepared for another outbreak, whether it’s Ebola or something else? I think this was a wake-up call for a lot of the world and the question remains: Will there be the proper amount of follow-through? I think that’s the most important thing to pay attention to right now: how the global community will handle outbreaks like this in the future.

Overall when you were there, did you feel like the epidemic was being handled successfully? What were the major failings?
I think that there was just a lack of communication on all levels. I think that there were definitely issues with government corruption in a lot of the areas we were in, and a lack of infrastructure. I think the international community got on the case way too late. A lot of lives could have been saved if it had jumped on this earlier, especially the World Health Organization. It really, really messed up early on and tried to downplay the whole thing so as not to provoke global fears, and local governments went along with that. I think that set a horrible precedent, and potentially allowed these massive outbreaks to take place. But I think that the communities did rebound. People eventually began reacting properly, but unfortunately, it was at a point where a lot of people had already died.

What was the relationship between the international community and the people on the ground? Was that relationship functional?
No. It didn’t seem functional. There were a lot of issues where you had groups of people coming in from the outside with excellent tactics on to how to fight the disease, but they didn’t take into account the culture of the areas that they were in. Things like burial culture, or the culture of the way people are cared for in these countries differs from other parts of the world, and so it was hard to convince people to put aside their traditions even if it meant saving lives. It’s a very complicated and delicate negotiation. And that just doesn’t apply to West Africa, that applies to everywhere in the world. If you came to the US and told people, “Don’t take care of your loved ones because you’re only going to get sick,” I think there’d be a lot of doubt and skepticism here as well. So I think that lack of sensitivity was a really glaring mistake.

Do you feel that we are better prepared for a future outbreak now?
Yes, I think we are. It’s a shame that some people had to lose their lives for us to get better prepared. The question now is: How much better prepared are we? There are some experts who said that we were lucky that this outbreak was Ebola because it is a really hard disease to transmit. If the day comes when it’s a disease that’s airborne, or that’s easy to transmit through other methods than fluids or touching, then we could be in a lot of trouble.

We had these built-in defense mechanisms 40 years ago, where you couldn’t get from rural West Africa—where diseases like this can come from sometimes—to New York City within 24 hours. You can do that now because of the ease of air travel. In these more remote areas, there wasn’t great transportation even 20 years ago, but now people can ride their motorbikes to a capital city from a small village in 12 to 14 hours. So these built-in defense mechanisms against these outbreaks are gone, and it’s debatable whether or not the technology that we have to fight these diseases has caught up.

After to speaking to experts and people on the ground in affected areas, is there one thing that we could do differently next time around that would have the greatest impact in preventing or treating these types of diseases?
You need a high-powered fixer, like the Ebola response coordinator we spoke to, Ron Klain. You need someone like a corporate CEO who works for a company like DHL or Coca-Cola. They have these insane distribution networks and know how to solve massive problems in the most efficient ways. You have to listen to doctors and scientists, but you need these people who know how to manage and put practices in place to get things done quickly.

This interview has been condensed and edited for clarity.

Follow Dory Carr-Harris on Twitter.