[Source: PLoS One, full page: (LINK). Abstract, edited.]
Open Access / Peer-reviewed / Research Article
Social Vulnerability and Ebola Virus Disease in Rural Liberia [ ]
John A. Stanturf, Scott L. Goodrick, Melvin L. Warren Jr., Susan Charnley, Christie M. Stegall
Published: September 1, 2015 / DOI: 10.1371/journal.pone.0137208
The Ebola virus disease (EVD) epidemic that has stricken thousands of people in the three West African countries of Liberia, Sierra Leone, and Guinea highlights the lack of adaptive capacity in post-conflict countries. The scarcity of health services in particular renders these populations vulnerable to multiple interacting stressors including food insecurity, climate change, and the cascading effects of disease epidemics such as EVD. However, the spatial distribution of vulnerable rural populations and the individual stressors contributing to their vulnerability are unknown. We developed a Social Vulnerability Classification using census indicators and mapped it at the district scale for Liberia. According to the Classification, we estimate that districts having the highest social vulnerability lie in the north and west of Liberia in Lofa, Bong, Grand Cape Mount, and Bomi Counties. Three of these counties together with the capital Monrovia and surrounding Montserrado and Margibi counties experienced the highest levels of EVD infections in Liberia. Vulnerability has multiple dimensions and a classification developed from multiple variables provides a more holistic view of vulnerability than single indicators such as food insecurity or scarcity of health care facilities. Few rural Liberians are food secure and many cannot reach a medical clinic in <80 minutes. Our results illustrate how census and household survey data, when displayed spatially at a sub-county level, may help highlight the location of the most vulnerable households and populations. Our results can be used to identify vulnerability hotspots where development strategies and allocation of resources to address the underlying causes of vulnerability in Liberia may be warranted. We demonstrate how social vulnerability index approaches can be applied in the context of disease outbreaks, and our methods are relevant elsewhere.
Citation: Stanturf JA, Goodrick SL, Warren ML Jr, Charnley S, Stegall CM (2015) Social Vulnerability and Ebola Virus Disease in Rural Liberia. PLoS ONE 10(9): e0137208. doi:10.1371/journal.pone.0137208
Editor: Osman Alimamy Sankoh, INDEPTH Network, GHANA
Received: February 6, 2015; Accepted: August 14, 2015; Published: September 1, 2015
This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication
Data Availability: The authors do not own the data underlying this study. The census data underlying the social vulnerability classification may be available to other interested researchers by applying to the Director General, Liberia Institute of Statistics and Geo-Information Services (LISGIS) in Monrovia, Liberia (Mr. Johnson Q. Kei, email: firstname.lastname@example.org). The Ebola virus disease data are freely available to all interested parties from the World Health Organizations website, http://www.who.int/csr/disease/ebola/situation-reports/en/.
Funding: Funding for travel was provided to JAS, SLG, and MLW by the Liberia Mission, US Agency, for International Development through the US Forest Service Office of International Programs. All other funding was internal Forest Service appropriated funding from the US Congress. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.