TUBMANBURG, Liberia — Near the hillside shelter where dozens of men and women died of Ebola, a row of green U.S. military tents sit atop a vast expanse of imported gravel. The generators hum; chlorinated water churns in brand-new containers; surveillance cameras send a live feed to a large-screen television.
There’s only one thing missing from this state-of-the-art Ebola treatment center: Ebola patients.
The U.S. military sent about 3,000 troops to West Africa to build centers like this one in recent months. They were intended as a crucial safeguard against an epidemic that flared in unpredictable, deadly waves. But as the outbreak fades in Liberia, it has become clear that the disease had already drastically subsided before the first American centers were completed. Several of the U.S.-built units haven’t seen a single patient infected with Ebola.
It now appears that the alarming epidemiological predictions that in large part prompted the U.S. aid effort here were far too bleak. Although future flare-ups of the disease are possible, the near-empty Ebola centers tell the story of an aggressive American military and civilian response that occurred too late to help the bulk of the more than 8,300 Liberians who became infected. Last week, even as international aid organizations built yet more Ebola centers, there was an average of less than one new case reported in Liberia per day.
“If they had been built when we needed them, it wouldn’t have been too much,” said Moses Massaquoi, the Liberian government’s chairman for Ebola case management. “But they were too late.”
It was impossible to predict the decline in the Ebola caseload last September, when the U.S. Centers for Disease Control and Prevention suggested a worst-case scenario of 1.4 million victims in West Africa. At that point, the American military’s logistical and engineering prowess appeared to be urgently needed — even if critics said the assistance was slow to arrive.
“With that kind of dire prediction from the CDC, and not having seen anything like this before, we had to try everything at our disposal,” said Douglas Mercado, the top USAID official in Liberia.
U.S. officials reject the suggestion that resources were misallocated.
“A lot of people are evaluating the strategy based on what we know today, not what we knew at the time,” said Maj. Gen. Gary Volesky, the top U.S. military officer in Liberia.
Before the center opened in Tubmanburg on Nov. 18, there were about 200 suspected or confirmed Ebola victims in the town, many of whom died while awaiting treatment. Since the U.S. facility opened, 46 suspected or confirmed cases have been admitted.
In Monrovia, 45 miles away and the heart of the outbreak, the scenes of suffering Ebola patients shocked the world. At the height of the epidemic, the afflicted writhed in the streets. There was a shortage of bed space at treatment centers for months. The international community, led by the United States, responded with a massive construction and assistance campaign — including American engineers, Cuban doctors, African Union health workers and many others — that turned out to be far in excess of what was necessary.
There are now seven Ebola treatment centers in greater Monrovia. Most of them were completed after the epidemic began to abate. Surplus tents now store excess supplies: mattresses, food and medicine for patients who never arrived. There are so few patients and so many available beds that a USAID-funded Ebola center, opened in October, will soon close its doors. Three other centers will be shuttered at least temporarily.
Paradoxically, isolation centers are still being built, mostly by UNICEF.
“It just makes no sense,” said Laurence Sailly, the head of mission for the Doctors Without Borders aid group in Liberia.