Last Wednesday night I attended Thomas Eric Duncan's memorial service at my church.
As you may know, Thomas Eric Duncan (known by his friends as Eric) came to the U.S. to marry Louise, a member of my church. Louise and Eric had first met in refugee camp in the early 1990s and had a son. After they separated Louise moved to the states, where she has been living for sixteen years. In late September, Eric came to the U.S. so that they could start a life together, and he could reconnect with his son. He is remembered in his community as a man who liked to joke with his neighbors. Who was always around to give a helping hand.
I want to talk about how we honor the memory of Thomas Eric Duncan.
Eric died because he was trying to save the life of a woman, Marthalene, who was seven months pregnant. (Eric was already hospitalized in Dallas before tests revealed that Marthalene had died of Ebola.) He was exposed to Ebola because our global community responded painfully slowly to stop the ongoing transmission. In early September "Doctors Without Borders" said their work in Liberia was like "fighting a forest fire with spray bottles."
I want us to talk about justice for Thomas Eric Duncan's family. Not just his family in the U.S., but also his family in Liberia.
Back in Liberia's capitol, Monrovia, nine of Eric's neighbors are dead or are dying. Eric was renting a tin roofed room, and many of these neighbors lived in rooms in the same building -- his local family.
If Eric's brother showed flu like symptoms and went to the hospital, there's a chance he wouldn't even have a treatment bed. In a rural area, the health facility might not have gloves.
Thomas Eric Duncan lived in a state with a crumbling health care system -- a health care system radically different from ours. Before the epidemic, Liberia had 50 doctors for 4 million people.
The belated global efforts to tackle the spread of Ebola are a critical first step -- but it's not enough. Now is an incredible opportunity to secure the resources needed to build up the infrastructure in Liberia's health care system in the long term.
Fears of Ebola among staff members and patients have paralyzed much of the city's health system. It's easy to see why; an estimated ten percent of the dead have been health care workers. Individuals are afraid to go to the hospital. Clinics are turning non-Ebola patients away.
If Eric's sister was pregnant and delivering her baby it is likely her stories would be similar to 32-year-old Comfort Fayiah. Unable to afford the prohibitively high cost of one of the few private clinics still in operation, Comfort gave birth in the dirt outside her small, whitewashed church. Liberia has one of the highest maternal mortality rates in the world. Comfort survived, but her story doesn't end there.
There's a one in five chance her children will die before their fifth birthday. The greatest risks to them are all things we take for granted in the U.S. -- having clean drinking water and basic childhood vaccines.
To honor Thomas Eric Duncan's memory we need to act. Liberians should have enough beds in their hospital to care for the sick. They should not have to choose between treating Ebola patients and turning away pregnant mothers at health facilities. This outbreak shouldn't be the reason why hospitals are finally stocked with gloves.
We need to stand for this simple truth: where you live should not determine whether you live.
We need to support the immediate response efforts: making sure there are enough treatment beds, emergency health care workers, and community care kits. But we also need to increase our support for long term health infrastructure in West Africa: investing in better water and sanitation, R&D for vaccines, and more skilled medical personnel.
The returns to public health investment are huge -- in a globalized world it just makes economic sense. U.N. leaders now estimate they need $1 billion to contain Ebola, ten times the amount they predicted one month ago due to our slow global response.
Prior to the outbreak of Ebola, Liberia only had funds to invest $50 per person annually in health care. Strengthening Liberia's health care system before the crisis would have reduced the spread of Ebola and increased the likelihood that children, like Comfort's baby, would live past their fifth birthday. It could have saved money, but even more importantly it would have saved lives.
Our foreign aid contributions are staggeringly small. Americans think we spend about a quarter of our budget on foreign aid. Last year we spent less than one percent. And global health is just a fraction of our foreign aid budget. To put this in perspective, we spent 30 times more on military defense than our entire foreign aid budget. Our spending on foreign aid is the equivalent of what US spends on romance novels and video games annually.
Thomas Eric Duncan died trying to save the life of a pregnant woman. He didn't try to save her just because she was a victim of Ebola. He tried to save her because she was a fellow human being. If we want to honor his memory, and comfort his family, shouldn't we try to save the lives of Liberians too?