It was a bright Sunday morning in March 2014 when the first case of Ebola was diagnosed in Harbel, a town of some 80,000 people in the West African country of Liberia. An outbreak of the disease had been reported by the World Health Organisation a few weeks earlier in neighbouring Guinea and the virus had been carried to Harbel by a woman who had been caring for a sick relative in the north of the country, close to the border.
Had this been in any other settlement in Liberia, attempts might have been made to transfer the woman to a hospital in the capital, but being so early in the outbreak there were no facilities available to treat her, and she would have been left to be cared for by locals, with potentially disastrous consequences: Ebola, which has a death rate of around 50%, spreads through direct contact with others and thrives in populated environments where patients can’t be isolated. But Harbel is not the average settlement in Liberia: it is a company town built around a huge rubber plantation that was founded in 1926 by the Firestone Tire and Rubber Company and it is still operated by the Firestone subsidiary of Bridgestone Americas Inc.
When Firestone executives learned of the woman’s diagnosis, they quickly realised that, with no government facilities available, they would have to handle the situation themselves right there in Harbel. They immediately quarantined the woman’s family and began constructing an isolation ward for Ebola patients at the company hospital, to where the patient was transferred on Tuesday, two days after having been diagnosed. And while the woman did succumb to her illness, the prompt and decisive action was rewarded: the outbreak was contained and no one else was infected.
Throughout Liberia, however, and especially in Monrovia, the capital, Ebola did spread, and by August, clinics around the plantation reported that patients with symptoms of with the disease were showing up looking for treatment. Ebola now became the focal point of everything in Harbel. Firestone expanded the hospital’s isolation ward and produced a containment programme which included transforming the town’s schools into quarantine centres where hundreds of people who might have been exposed to the virus were (voluntarily) isolated. By the middle of October, 30 people had died at the Firestone hospital and 18 survivors had been discharged – but no new cases had been reported inside the plantation for weeks. Firestone had, once again, stopped the outbreak from spreading. Sadly, others weren’t so lucky: though the outbreak was contained to West Africa, it took until the end of 2015 before the WHO eventually declared Guinea, Sierra Leone and Liberia free of Ebola, by which time the virus had claimed more than 6,000 lives.
As the world yet again braces itself for the possibility of a pandemic, this time in the form of the more contagious, but less deadly, Coronavirus, it is worth remembering the achievement of Firestone in containing the Ebola outbreak in Harbel, which stand as an example of what can be accomplished by decentralised, privately organised disease prevention. Global pandemics are a central planners dream, with vast budgets made available to mobilise the apparatus of the state and emergency powers introduced to seize property and order changes in behaviour by fiat. But private ownership provides an effective means of managing the spread of contagious diseases: the desire to protect the value of your property gives an incentive for swift and decisive action and the right to refuse admission onto your property unless certain rules are adhered to is a powerful method for containment.
Truly decentralised decision-making ensures actions are determined rationally in response to local risk levels. Governments, on the other hand, intervene to centralise decisions and assume draconian power. This is almost universally taken as a given to be the only way contagious viruses can be stopped from sweeping the world and causing global pandemics – but while global cooperation is certainly needed to battle diseases such as Ebola or Coronavirus, as Firestone proved in Liberia in 2014, decentralised, privately funded and managed disease prevention can be determined, organised and highly effective.