On the morning of Saturday 28th March, MAF Pilot Steven Biggs, was enjoying a cup of coffee in bed, when he was asked to help Liberia’s Ministry of Health with a suspected coronavirus case in the remote town of Zwedru. In MAF’s first ever Covid-19 related mission, Steven flew to the rescue…
Following the country’s lockdown, Liberia’s President George Weah, has declared a state of emergency in a bid to contain the coronavirusoutbreak. Public movement has been restricted to buying essential food and medicine.
MAF’s capability has been reduced to an average of one flight per week, usually transporting doctors, patients and medication – a smoother, faster alternative to Liberia’s pothole ridden roads. An hour and 40-minute flight to the other side of the country could take three days by road in dry season. In wet season, some roads are impassable.
‘A positive diagnosis could be devastating’
Liberia’s Ministry of Health requested MAF’s help to test a suspected coronavirus patient in Zwedru - a remote town near the Ivory Coast border. Steven Biggs, was privileged to pilot MAF’s first coronavirus related flight:
‘It was 7:30am Saturday morning when I was enjoying my first coffee. An hour later I’m at the airport prepping the aircraft shortly before flying to Zwedru with Liberia’s Ministry of Health staff and their test kits.
We arrive an hour and 10 minutes later. If not for our flight, they would have had a 20 hour plus journey on terrible roads, with an overnight stay, then back again – precious time wasted.
If you’re taking a three or four-day round trip just to get a sample back to the capital, Monrovia for testing, if it was positive, how many other people would be infected during that time?
A positive coronavirus diagnosis in remote Liberia could be devastating as there’s very few health facilities there and definitely no intensive care units or ventilators.
Driving a very ill patient to Monrovia where there are hospitals is just not practical because of the duration of the drive and the cost of a taxi would be way too expensive for them.
They would just die and that would be a real disaster. That’s where our MAF aircraft come in handy, which is really wonderful.’
‘Community transfer is a concern’
Fortunately, the female patient tested negative in Zwedru. According to Steve – at the time of writing - there are still no reported cases in that isolated area. In neighbouring Ivory Coast however, the number of cases is increasing and protestors have reportedly destroyed a partially built coronavirus testing centre in the capital, Abidjan.
In other parts of Liberia, where it is more densely populated, Steven says transmission of the disease is becoming more evident:
‘It’s moving so quickly. Cases are starting to jump a lot in a few days. Community transfer is a concern.
In Liberia - as in most African countries - you can’t just expect people to self-isolate or to practice social distancing because there’s 20 people living in one house! If you’ve got a 20 strong family living in a one or two - bedroom shack, how can you possibly stay apart?’
‘There’s no high-level care available for people’
Steven’s wife, Margot, is a qualified nurse who volunteers at the ‘Eternal Love Winning Africa Hospital’ (ELWA) in Monrovia. Even though the capital has marginally better health facilities than remote places like Zwedru, they are still far from adequate:
‘No hospitals here have proper intensive care units - if you need a ventilator, there’s no way of that happening. ELWA hospital has seen a high ratio of coronavirus deaths to infections, compared to the rest of the world. We’re worried that this ratio will continue because there’s no high-level care available for people who need it.
Even if you need stitches, you need to buy the thread, gloves or anything else you need and take it to the hospital so they can help you. Although ELWA hospital is doing its best to provide as much as they can for their staff, my wife, Margot, bought her own box of masks because they’re just not readily available.’
‘The rate of people accessing hospitals has decreased’
People are also afraid of contracting coronavirus from the hospital itself. Many Liberians already have weak immune systems because they have contracted HIV, malaria, typhoid or TB in the past. When you are immunocompromised, there is a greater risk of succumbing to the virus. Witchdoctors are also exacerbating the problem:
‘They peddle the idea that medical doctors are ‘western’ who will give them the disease, so they should avoid the hospital.
The rate of people accessing care has decreased because people are afraid and don’t want to visit. Most of the people who do eventually arrive at hospital are already at death’s door. Others simply can’t get to hospital and just die at home.’
Most Liberians cannot afford to stay at home
In the West, many people have the means of buying food in bulk, which can last several weeks before they need to leave the house again to replenish their supplies. In Liberia however - where many people face daily economic hardship - they simply do not have the resources. Steven says many Liberians have a daily hand-to-mouth existence:
‘The average Liberian can’t just go to the shop and buy things to last for two weeks. One or two people from the same household are on the streets selling donuts, biscuits or whatever they can find, so that they can earn a little bit of money to buy rice to feed their family - how do you expect those people to stay at home?’
A lockdown in Liberia has wider repercussions
A longer lockdown in Liberia could have wider repercussions on food security, peace and humanitarian work. Steven explains:
If the country locks down for three weeks, it can’t sustain itself. Little is manufactured or grown here because of their 30-year civil war. Almost everything is shipped in. Shutting down ports and borders could cause a food shortage, which may lead to civil unrest and rioting, which I think most people are concerned about.
That’s why the vast majority of NGOs have pulled out their people. The main issue is being in a country where - if it locks down - you’re unlikely to experience the same level of security that you would expect in other countries. Very few of MAF’s partners are now left in Liberia.’
Coronavirus testing kits
Reduced resources mean difficult decisions
In a climate of lockdown with reduced flights and fewer partners, MAF has had to prioritise its use of resources during this time. Sadly, it cannot help everyone everywhere at the same time. Godly wisdom is required:
‘The hardest thing is saying no. Sometimes we have to say no to people in need because there are other people who are more desperate, which is heart-breaking. While we’re focusing on coronavirus, which is extremely important, other flights are also important. There are women out there giving birth and dying in the bush because we can’t reach them anymore. We can’t take teams because there are no teams to take.
Sometimes it’s really difficult to know how to properly use our God-given resources. Right now, we need wisdom about how to allocate them. MAF Liberia staff would love prayer for wisdom in our decision making and how to use these resources as effectively as possible in a country where MAF is so vital.
The rainy season is coming
The rainy season is expected to start in May. In a country like Liberia, when it pours, travelling by road is virtually impossible. During this time, MAF will be the only feasible means of transport to take coronavirus test kits and medication to the remotest parts of Liberia. Steven and Margot are in no hurry to leave:
‘I think it’s important that we stay. Margot says that we would need to drag her out kicking and screaming because she knows how vital her work at the hospital is.
The Health Minister phoned us about flying three doctors on an emergency coronavirus medical trip to Grand Cess on the south coast. Me and another pilot are on our way. If it wasn’t for MAF, that wouldn’t happen. It’s not like people can drive or there’s another airline, it’s just us.
It’s important that MAF is here for those emergency flights and I can see us having to fly more in the wet season when there will be a lot more to do.’
‘God has placed MAF in Liberia for a purpose’
Steven concludes by alluding to God’s bigger picture and plan:
'God has placed MAF in Liberia for a purpose - I feel so privileged to be here. Our work here is being noticed by governments and other ‘high up’ people. It’s much appreciated. I just want to thank God, the donors and everyone who would have us here. It’s humbling. All glory be to God.’