Hans Rosling in Monrovia, Phone Interview, 2014 Oct. 24

(for Swedish Radio P1, Transcript and translation by Harald Hultqvist)

Reporter: One of those who are working to stem the spread of the virus is Hans Rosling, Professor of Global Health, Karolinska Institute, currently on location in Monrovia, the Liberian capital.

Rep: Good morning.
Hans Rosling: Good morning.

Rep: We understand that you have just produced a new set of numbers for the UN showing the ratio of the spread of Ebola and these are numbers that we have not seen before. What do they show?
Rosling: Well it is not for the UN, but I work for the [Liberian] Ministry of Health. I have got a desk in the room of the state epidemiologist Luce Bawo, so I work directly together with the national leadership of the [fight against the] epidemic.
The figures we are looking at are both reported cases, hospitalized, how many funerals are conducted and how many calls are made to the emergency phones. We try to make an overall assessment, and our view is now that this surge of more and more people getting ill has been discontinued. Now it’s about the same number of people getting sick every day. And this may sound like the numbers should have gone down, but what is very important is that this rise has now been stopped. But in our conclusion lies the fact that in some counties, in some parts of the country, there is an increasing number of cases, and in others it decreases.

Rep: It sounds like you are describing a hopeful development. What is required for it to last?
Rosling: That we get hospitals and enough resources to every county in the country. I would describe this as a wildfire that began in one corner of the country and then spread to the capital. And those are the places where one have now overcome it. Especially where it started one have overcome it and it’s very positive. In the capital it’s bad, but it does not get worse. However, there are small wildfires in every county in the country. This requires resources in a different way. Right now there are no overcrowded hospitals or people dying in the street. But there is quite a job to be done across the country, and particularly at the borders. Liberia borders Côte d’Ivoire and there have been no cross-border cases yet. But as we heard on the news today, most unfortunately a disease transmission to Mali has occurred, Mali being a neighbor two countries away from here.

Rep: If there is a little shift in focus towards what needs to be done to prevent the spread across borders to neighboring countries, what is the action you are talking about?
Rosling: There are two things: one is that the person who is ill must be taken care of so that he or she is isolated and does not infect anyone else, and this is extremely difficult for the families to do at home. Inevitably there will be occasional cases of transmission if one is to take care of these critically ill patients at home. That’s the first one. The second thing needed is a general knowledge in the population about how dangerous this is. It has really been embraced here in the capital. I have never seen a city so orderly during an ongoing crisis. Outside of every shop there is a container with chlorine water and everyone washes their hands. No one shakes hands. You go through a small foot bath to clean your feet too. Actually, we wash hands carefully not only to avoid Ebola, but everyone wants to avoid all other infectious diseases, even myself. You do not want to get a cold or diarrhea when it could be suspected to be Ebola. So there is a huge tightening of behavior. And yet, the city is completely calm, it’s really nice to be here. People are polite. I have never met so many positive smiling people, who say: Thanks for coming, it is great. And yet they work so hard themselves with this. So it’s a very positive feeling to be involved in this work.

Rep: Do you mean that this kind of crisis can also lead to good things in a society?
That might come later, but right now we just have to take care of the present, and that is what people are doing. There is no chaos here, there’s no panic, everyone move on and do their job. I work together with a chauffeur on a daily basis and we have quickly become acquainted, and the people who help me to make my mobile phone work, all these people are very helpful and there is a positive atmosphere.

Rep: If you look at what Liberia needs from the outside world right now?
They need three things. They need help with staff, with persons like me. The domestic state epidemiologist I work with, he is very skilled, very talented, but there are not enough people with that experience. Therefore, we need experts. From people like me to experienced nurses and nursing instructors who can train all those who need training. So, staff is needed. Money is needed. It is unfortunately very expensive to do this quickly, after all the countries are rather big. And then we will need persistence. This is not something that will be over in a month or two. We have to stay for a long time, since the objective is to eradicate this virus from spreading among people. We can not eradicate it among animals but we can eradicate it among the people. It must be done and then you have to hold on for a long time.

Rep: So in conclusion, if you could give any advice, if there are any policy makers who listen to this and have to make decisions?
I do not think there is anything more profitable to do in the world right now than to put an end to this epidemic, because if we do not stop it now, it will be much more expensive later on. So even though it’s not cheap to stop it now, it’s a bargain price to fix it now, compared to doing it later. And those who are able to make their own knowledge available, do it. You will feel positive. I think of these Churchill quotes all the time: this is not the end, it is not the beginning of the end, it’s only the end of the beginning that we see. It will keep on for a long time. And this particular working atmosphere you sense while working here; it surprised me. I thought people would be annoyed and yell at each other and be nervous and cry. No no, it’s really a nice working atmosphere.

Rep: Thank you Hans Rosling.