At the end of March 2014, the nongovernmental organization Médecins Sans Frontières warned that an Ebola virus disease outbreak on the border between Guinea and Liberia could unleash an epidemic of unprecedented scale. Its capacity still limited after a 14-year civil war, Liberia’s government was struggling to mobilize and coordinate the extra assistance its health ministry needed to respond. How to recruit, train, protect, and pay a labor force that included government employees, temporary workers, and many international volunteers were central concerns. In the best of times, coordinating this kind of skills supply chain would be challenging. But from June to the end of August, conditions became increasingly difficult. As the infection spread, many health workers died. In the absence of facilities and equipment that could provide protection, fear slowed recruitment—a problem made worse by severely constrained medical evacuation services and reduced airline access. Mobilizing personnel to respond raised questions about how to fulfill a duty of care toward employees, adhere to commitments to equality, and promote longer-term institutional sustainability. The Liberian government, UN agencies, and a wide variety of other organizations worked together to identify and deploy essential skills, develop shared practices, and find ways to pay Liberian temporary workers whose support was essential. UN organizations alone recruited and deployed 19,367 staff during the crisis, including Liberians, but questions remained about how to best meet the ethical and practical challenges that arose.
David Paterson and Jennifer Widner drafted this case study with advice from Béatrice Godefroy.
Princeton University’s Grand Challenges program supported the research and development of this case study, which is part of a series on public management challenges in the West African Ebola outbreak response.