In a recently converted warehouse in downtown Monrovia, Liberia’s capital city, some 30 Liberian university students are manning a bank of phones. Armed with pens, clipboards and multiple bottles of hand sanitizer, they pick up the constantly ringing receivers in quick succession. “Good afternoon. You have reached the Ebola call center. How may I help you?” It’s the national Liberian Ebola hotline, a toll-free number for residents from all over the country worried about a sick neighbor, a suspicious death in the family or troubling symptoms. It serves a vital link between a public terrified of Ebola and the government who can provide help — but pranksters often get in the way.
The call center opened in early August to address the rapidly escalating number of Ebola cases in the country. Ebola spreads through contact with infected bodily fluids, and transmission most often happens in the home, where family members take care of the ill without adequate protection. To stop that chain of transmission, it is vital to get the sick out of home care and into specially designated centers where they can be treated by trained health care workers in isolation. A call to the hotline, the government promised, would result in the dispatch of an ambulance to take the sick person to a treatment center, or, in the case of someone who died, a dead body management team to pick up the corpse, which is still contagious for days after death, for safe disposal.
But no one was prepared for the volume of response. From the very beginning, the center was receiving thousands of calls a day. The government had neither the ambulances to pick up the ill, nor the space to treat them. Instead of a solution, the hotline became a source of frustration. And the callers took it out on the agents at the other end of the line.
“A lot of people think that we are the doctors, that we are the ambulance drivers, or the dead body teams,” says call center manager Tina Kpan. “All we do is transmit the information, but the public doesn’t understand that, and they take their anger out on us.”
The number of calls has declined to around 1,000 a day, says Kpan, who sports short, spiky dreads and dangling gold earrings. But it’s not exactly cause for hope. “Instead of getting one call for one sick person, we are getting reports of five or six sick people at a time,” Kpan says. The phone center’s statistician says that he is averaging 100 calls a day reporting dead bodies. Some of them are duplicate calls, he says, but the numbers are still growing.
Even if the agents aren’t on the front lines of the fight against Ebola, they still feel the pain. “I am sorry for your loss,” whispered one agent into the phone as she took down details of a recently deceased 34-year-old mother from her 12-year-old daughter. The agent briefly rested her forehead in her hands upon hanging up.“You put yourself in that persons’ shoes, and sometimes you feel like its you that it has happened to,” she says. “Its very frustrating. Sometimes they just die.” On her shirt is stapled a small square of paper marked with her temperature coming into work that morning: 36.1 Celsius.
Not all the calls are about the sick and dying. Some, in a way, are worse: the prank callers. Agents say that 90% of the calls are legitimate, but Kpan pulls out a thick folder filled with the recorded phone numbers of people who called simply to harass the center’s workers. Some make lewd jokes or attempt to pick up the female staffers. Others invite the agents out to eat “bush meat,” the monkey and bat flesh consumed in rural areas in a practice that may have spread Ebola into the human population. Kpan has instructed her agents to record the calls, as she plans to broadcast them on the radio in an attempt to name and shame. One prank caller had the misfortune of calling just as she was making the rounds of the phone banks. Kpan grabbed the phone from the agent.
“You listen here,” she shouted into the mouthpiece. “We are here to pick up calls for sick people, and you are occupying the line. And then the public complains that we are not picking up calls. The very next time you call this number, I will have the police pick you up.”
She slams the phone down, and asks the agent for the number. For the moment, she says, they don’t really have the right to call the police. When they do, she expects the call volume to go down. That may make the agents’ job easier. But it’s unlikely to indicate anything about the course of Ebola in Liberia.