Nations & States Contributing Writer Johnny V. Boykins (JVB) reached out to Leah McManus (LM), an international development and global health specialist, to discuss her experience volunteering for a mission to West Africa during the height of the 2014 Ebola crisis.
Introduction: 2014 Ebola Outbreak
The Ebola outbreak started in Guinea and eventually spread around the world to places like Nigeria, Mali, Senegal, the United Kingdom, Italy, Spain, and the United States. The outbreak hit West Africa the hardest: Guinea, Liberia, and Sierra Leone were devastated by the disease and more than 25,000 people were infected; 11,310 were killed. According to the World Health Organization, the 2014 death toll was seven times as high as all previous Ebola outbreaks combined. It has been characterized as one of the worst public health crises of the last century.
JVB: When did you first decide that you wanted to work in international development?
LM: I first decided that I wanted to work in the field of international development when I was an undergraduate in college. At the time, I thought the best mechanism to alleviate suffering was through international law to influence politics and policy, so I decided to work for an attorney after college to learn more. While the attorney I worked for did not work in the area of international law—not even close—it did make me realize the limitations of such a focused intervention as law. I learned that all those “isms” (Liberalism, Marxism, Realism, Feminism, Constructivism, etc.) we learn in college can be applied in more areas than just law. I knew I needed to learn more if I was going to jump into this field, so I did research on all these areas that I knew went into “building” a country: economics, health, education, environment, culture, history, etc., and I realized that international development was what I needed to study.
JVB: What is your educational level?
JVB: What is your background?
LM: After graduating with my bachelor’s and master’s, and the small stint with the law firm, I joined a small international NGO where I provided technical and programmatic support to a variety of programs. I still do essentially the same thing, but I think I’m much better at it now! Also, I used to work in health systems strengthening at the community level and now I work at the governmental level. I find both equally important but inherently different.
JVB: What is your experience level?
LM: I’ve been working in the international development field for over six years. Even after obtaining my master’s degree, I would still consider myself at the junior level. I’ve traveled extensively and speak French fluently—and do so often for my work. I have so much to learn and so many people to learn from. This is not the kind of job that is something you can pick up through a couple years of hard labor.
JVB: When did you get your start working in the field?
LM: In July 2010, I joined a small NGO on a part-time basis as an unpaid intern. This quickly moved into a full-time internship, where I worked 40 hours per week. However, the role I had created for myself had morphed into a full-time paid position. This was really the launching point for me, and while I had many people telling me, “Leah don’t take that job, the salary is too low and you have a master’s,” I am so thankful for that experience and opportunity. It really helped me build a strong foundation for the field and I learned a lot about the work and who I was, am, and want to be as a professional. I should note that I did receive academic credit for my internships.
JVB: What countries have you worked in?
LM: Liberia, Guinea, Democratic Republic of Congo, Haiti, Mali, and Kenya. While this might not seem like many countries, I would consider these countries to be my main area of focus for the past six years. I’ve traveled to each of these countries several times, and have actually lived in a couple of them. I’ve also supported activities in many other countries as well, such as Botswana, Zambia, Namibia, Ethiopia, Sierra Leone, and Tanzania, among others. These countries are where the bulk of my work has taken place.
In Liberia and Guinea I supported community health programs that included issues like child health, water, sanitation, HIV/AIDS treatment, and family planning. I also supported the development of an SMS communications platform for the Ministry of Health and enhanced a human resource information system.
JVB: What is your connection to West Africa?
LM: My first trip to Africa was to Liberia, which will always be a second home to me. I feel a strong connection there—to the people, the food, the land, the weather, everything.
JVB: When did you first learn about the Ebola crisis?
LM: When I was in DRC in February of 2014 I saw a report on Ebola on CNN International.
JVB: What were your initial thoughts?
LM: I was nervous, but then it seemed to go away. Suddenly, however, everything erupted all at once. I watched in disbelief as it continued to spread; it seemed like no one was doing anything, which for the record was absolutely not true. I was disgusted by how quickly the United States turned to fear West Africa as a result.
JVB: What happened when you arrived in Liberia?
LM: When I first arrived in Liberia, literally the first thing I was told to do was go to the tap and wash my hands with bleach water. Then I had to get my temperature checked. It seemed every time I turned around, I was washing my hands and checking my temperature. I was assigned to the Ministry of Health, and just remember this “organized chaos,” this collaboration that seemed so encouraging even though the situation was so dire and unpredictable.
JVB: How often had you gone to Liberia before the crisis?
LM: Several times a year, for extended periods of time, over the span of three years. However, I hadn’t been in the country for about 18 months by the time I made it back to support the crisis efforts.
JVB: What was your mission in support of the international response?
LM: To develop and deploy an SMS communications platform for the Ministry of Health to be able to communicate directly with health workers and vice versa. I was alone, without a team from my organization and I had to get frantic and overbooked Ministry employees to team up with me to make this work. It was an exhausting experience, but I learned a ton.
JVB: What do you think we missed about the Ebola crisis?
LM: We missed the importance of health systems strengthening. If the health system had been stronger, Ebola would not have been able to proliferate the way it did. This is the common thing that experts say, and I totally agree. As a result of funding priorities, health system strengthening was less emphasized. This is not to fault those who were creating the funding priorities: defining funding priorities is a very long and complicated process.
JVB: What is it like reflecting upon the crisis a couple years out?
LM: It doesn’t seem like two years. I feel like the countries are still working on the policy and planning to build the resiliency in the health system that is needed in case Ebola should rear its nasty head again, which it will. Overall, though, I acknowledge that a lot of mistakes were made, and things could have gone better. What I saw was strong collaboration between agencies that normally don’t collaborate all that well. I witnessed incredible amounts of hard work. Maybe I’m too close to the individuals in this process, so may be a little biased. But with all that being said, I was in awe of their tenacity to combat this disease.
JVB: What are you currently working on?
LM: As of today, I am still supporting the system in Liberia and working on similar iterations for stigma and discrimination for key populations in Haiti, Malawi, and Burundi. I’m also working in the Democratic Republic of the Congo on health information systems development and health workforce staffing norms identification.
JVB: What advice would you give an aspiring development or international aid worker?
LM: First, do not take any experience offered to you for granted. Do not be taken advantage of, but also do not feel entitled to awesome experiences to “save the world.”
Second, you need to remember that you do not know more than your local counterparts working in these developing countries. You need to figure out how to develop locally tailored support systems so that the communities can thrive. You are there for them, to support them, you are not in this line of work for you.
Third, take nothing at face value. Culture, history, culture, context: nothing is as it seems.
JVB: Have you published any articles?
JVB: What are your hobbles…what do you do for fun?
LM: Ha! Not much because of work and travel! I like to ride my bike, run downtown, swim when I can, hike if possible, and drink wine with friends.
JVB: How has working in international development changed your perspective on the world? Africa? The West?
LM: It certainly has, though how exactly is hard to articulate. I think it’s just opened my eyes up to the “grey” space that exists in everything, the complexity of the world.
JVB: What do you expect to be doing in the next five years?
LM: Probably the same thing, I’ll just be better at it!
Image: Ebola Check Point (Creative Commons, October 2014)
Leah McManus, 30, hails from Ann Arbor, Michigan but currently lives in Raleigh, North Carolina. She set off to do her small part in easing the suffering of the world’s most vulnerable people in developing countries. Leah is an international development and global health specialist with a record and resume of accomplishment in healthcare system strengthening at community and national levels. She primarily works in six West African countries but offers services to another dozen throughout Africa and the Caribbean.