In late 2014, the outbreak of Ebola virus disease (EVD) in West Africa
was at its peak. Th ose infected numbered in the tens of thousands.
“Hotspots” with multiple cases appeared across four nations, both in
overcrowded major cities and in isolated rural villages. Hospitals were
overfl owing. Th ere were insuffi cient laboratory facilities and trained
health care workers to diagnose cases swiftly; and disintegrated or absent
public infrastructure in all domains, from roads and sewers to epidemiologists
and health promoters, hampered international responders. Nurses
and doctors—already far overstretched, and servicing absurd populations
at a ratio of 1:1000 even before the outbreak—were often among the fi rst
infected and dead.