Coping With the Threat of Ebola in Monrovia: A Case Study

Coping With the Threat of Ebola in Monrovia: A Case Study by Augustine Manneh Sumo MBA, University of Phoenix, 2013 MPH, California State University – Fullerton, 2007 BS, University of Liberia, 1989 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration – Law and Public Policy Walden University August 2017 Abstract In early 2014, 3 West African states of Guinea, Liberia, and Sierra Leone made news headlines when Ebola virus disease (EVD) ravaged the sub-region. The Liberian government was ill-equipped to efficiently contain EVD outbreak due to inadequate training for hospitals and health care workers. The government’s mandatory cremation policies and the banning of public gatherings significantly contributed to the spread of EVD. EVD infected 10,666 and 4,808 died from the disease in the first 6 months of the epidemic. The purpose of this case study research was to examine the social, economic, and policy factors that contributed to the spread of EVD in the city of Monrovia, Liberia, where one of the largest outbreaks occurred. Using the Bandura Social Cognitive Theory (SCT) as the theoretical framework, in-depth interviews were conducted to explore the phenomenon of 30 participants. The participants included 10 EVD survivors, 10 family caregivers, 2 government officials, 4 nongovernmental organizations staff, 2 academicians, and 2 members from the media. Data were collected through interviews, observations and documentation. Snowball sampling was utilized, and NVivo 10In early 2014, 3 West African states of Guinea, Liberia, and Sierra Leone made news headlines when Ebola virus disease (EVD) ravaged the sub-region. The Liberian government was ill-equipped to efficiently contain EVD outbreak due to inadequate training for hospitals and health care workers. The government’s mandatory cremation policies and the banning of public gatherings significantly contributed to the spread of EVD. EVD infected 10,666 and 4,808 died from the disease in the first 6 months of the epidemic. The purpose of this case study research was to examine the social, economic, and policy factors that contributed to the spread of EVD in the city of Monrovia, Liberia, where one of the largest outbreaks occurred. Using the Bandura Social Cognitive Theory (SCT) as the theoretical framework, in-depth interviews were conducted to explore the phenomenon of 30 participants. The participants included 10 EVD survivors, 10 family caregivers, 2 government officials, 4 nongovernmental organizations staff, 2 academicians, and 2 members from the media. Data were collected through interviews, observations and documentation. Snowball sampling was utilized, and NVivo 10 software was used to code and create themes. The findings show that EVD survivors and family caregivers experienced simultaneous episodes of hoping for their desirable outcomes while at the same time anticipating the worst to happen. This study may positively impact the people of Liberia and the world as a whole by promoting positive social and policy changes. It may provide information for improving future policies and training of healthcare workers and the general public during future EVD outbreaks. Coping With the Threat of Ebola in Monrovia: A Case Study by Augustine Manneh Sumo MBA, University of Phoenix, 2013 MPH, California State University – Fullerton, 2007 BS, University of Liberia, 1989 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration – Law and Public Policy Walden University August 2017 Dedication One day while sitting with my daughter Efe outside of our home in Congo Town, Monrovia, she quietly whispered into my ears and said: “Daddy, you look like a big man in the eyes of many. ” “Go and get it, “she said. I asked her to go and get what? Then she replied, “I want everyone in the world to call you Dr. Sumo. ” You will make a great man in society, she said. Rebecca Efe Sumo may your soul rest in peace. You shared only 19 valuable years with us on earth. Today, I am proud that I followed your dream; I am Dr. Augustine Manneh Sumo. I won’t have made it here without the love, care, values, and encouragement given to me by you. You believed in me when no one did. Celebrating this milestone is difficult without you. Therefore, I hereby dedicate this dissertation to you. Your memory and love will forever live in my heart and the hearts of the many you touched. Your words of encouragement thus agreed with Daniel Keyes, who in his poem entitled; Flowers for Algernon stated: “How many great men didn't know enough, or have enough faith in the creative process and themselves, to let go for the whole mind to work at it? ” My journey has been challenged with the experiences of enduring “pain” in almost every sphere of life. I also dedicate this dissertation to all children around the world who suffered and died from pain. May the pain of every living being be completely cleared away. May I be the doctor and the medicine, and may I be the nurse for all sick beings in the world until everyone is healed (Prayer for world peace by Geshe Acharya Thubten Loden). Acknowledgments I am very grateful to: Dr. Lori Ann Demeter, who has been my chair and the pillar for my academic success. Your patience and entertaining encouragement helped me to complete this long journey. Dr. Timothy Fadgen for taking an interest in my topic of study and supporting me with his wisdom and courage. I am also pleased to acknowledge the followings: Isaac Washington Browne, Stephenett Tono Carr, Joseph Arku Cole, Alex Victor Cummings, Alex Y. Dossen, James S. Kerkula, Georgine Y. Berrian-Massaquoi, Fate Alex Moore, Kervin Piliporlor, Darling Stephine Anderson-Sumo, Albert B. Seh, Jackson T.S. Seton, Moses D. Sandy, Emma Majay Sumo, Evelyn N. Sumo, Hawa Sumo-Sengbe, Leila Sumo, Weanett T. Weah, and Mary J. Weah. Special acknowledgement to Pastor Brad Martin and the wonderful congregation of Trinity Presbyterian Church in Wilmington, Delaware. Special thanks to James and Phyllis Albert, and all those I cannot mention. During my lifetime, I have met people who added positively to my purpose. To those who may have hurt me, I want to acknowledge you because that, which did not kill me, made me a survivor. I thank each of you for playing a role in the achievement of my Ph.D. To my dear daughter, Rebecca Efe Sumo who is not fortunate to celebrate this milestone, I say Rest in Peace in the Lord. To my beloved wife, Darling Stephine Anderson-Sumo, you are indeed a true friend, you rock girl. To Evelyn N. Sumo with whom I started this journey, I say thanks for your support. To Stephenett Tono Carr, April 6, 2016 is unforgettable and I want to thank you for your support. I have learned that life is not about waiting for the storm to pass. Life is about dancing in the rain.