U.S. troops are trickling in to Liberia to set the stage for a massive deployment to West Africa to help contain the Ebola epidemic.
But details — units, types of personnel, even the branches of service involved — on the brigade-sized humanitarian effort remain sparse.
On Thursday, 15 sailors from Naval Mobile Construction Battalion 133 based in Djibouti prepared to join roughly 100 U.S. military personnel already in the Liberian capital of Monrovia, including mission commander Maj. Gen. Darryl Williams, chief of U.S. Army forces in Africa, to establish a Joint Force Command headquarters and build infrastructure for the effort, called Operation United Assistance.
The Seabees will conduct site surveys and help build a 25-bed hospital to treat infected health care workers, with parts of that facility arriving in Liberia the early next week, Defense Department officials said.
In Liberia, the U.S. military will focus on logistical support for the massive effort to treat victims of the dangerous disease. American troops also will help train civilian medical personnel and build 17 100-bed treatment centers, DoD officials have said.
At least three Air Force C-17s have brought in gear ranging from heavy equipment to supplies, and personnel, including engineers and airfield specialists.
A handful of technical personnel have been in the region since earlier this summer, working in laboratory facilities and providing more than 10,000 Ebola test kits. Military planners also are on the ground as part of a U.S. Agency for International Development Disaster Assistance Response Team.
Marines also have had a contingent in Liberia, working with that country’s armed forces to find sites for the Ebola treatment centers that will arrive as part of Operation Unified Assistance.
That group is a part of Operation Onward Liberty, an effort to help train Liberian troops that has been ongoing since 2009.
Pentagon officials say the overall humanitarian effort will cost up to $1 billion and could last about six months.
Details still sketchy
Some lawmakers have expressed concern over the lack of details emerging from DoD on the mission, with House Appropriations Committee Chairman Rep. Hal Rogers, R-Ky., this week requesting information about the safety of U.S. troops, the impact on other military operations and how funds will be spent.
Speaking to The Associated Press on Wednesday, Rogers said he agreed that expanded funding for the mission is important, but he wants a clear outline of the operation in order to support it.
Among the biggest concerns is any threat to the health of U.S. forces. While Pentagon officials say deployed troops are unlikely to come in contact with the virus, they remain at risk for accidents, security breaches and contracting other illnesses.
Kirby said U.S. troops will wear protective gear and receive specialized training to avoid contracting Ebola, but he acknowledged that other risks remain.
“We’re going to train. We’re going to equip them the best we can. You can never eliminate risk in a military operation. You deal with it. … and the men and women who sign up and serve in the military understand that,” Kirby said.
Aid workers and medical personnel have been attacked in the region. At least eight workers allegedly were murdered in Guinea this month and a Red Cross team disposing of bodies also came under attack Tuesday.
Other threats abound
And there is the possibility of contracting other tropical diseases endemic to the region, including malaria, dengue, the Chikungunya virus — a painful but not fatal disease that causes fever and excruciating joint pain — and more, said Dr. Remington Nevin, a tropical disease specialist and former Army physician conducting research at Johns Hopkins Bloomberg School of Public Health.
“There are well over a million new malaria infections in Liberia annually, in contrast to the few thousand or possibly tens of thousands of Ebola cases,” Nevin said. “Despite the high-profile nature of this mission and the apprehension surrounding it, it is far, far more likely that troops deployed in support of it will contract malaria than Ebola.”
As recently as 2003, when a contingency of 225 Marines deployed to Liberia for a few days, 35 percent developed malaria and of those, more than half had to be evacuated to an advanced military treatment facility.
“This is going to be an exercise in leadership, in ensuring that troops practice aggressive anti-malarial guidelines, such as wearing long sleeves, using nets if they are not sleeping in air-conditioned quarters, taking their daily prophylactic,” Nevin said. “Fortunately, malaria is very easily diagnosed and then can be treated with a safe combination drugs, if it’s recognized for what it is.”
Michael O’Hanlon, a senior fellow at the Brookings Institution, said he is less worried about troops coming under attack or falling ill than he is about the risk of not responding.
The stability of Africa, he said, is at risk, and instability could be a threat to U.S. national security.
“I’m not going to say it’s on the level of needing stability in the Middle East, but when states collapse into violence and anarchy, it creates a vacuum that could contribute to the rise of regimes and organizations that could be a threat to us,” O’Hanlon said.
He added he hopes the U.S. response is large enough to stop a threat that the World Health Organization believes could kill up to 20,000 people. “We’ve already waited too long,” he said.
The current Ebola outbreak has a mortality rate of 50 percent to 70 percent, according to the WHO. As of Sept. 21, almost 6,300 people have been diagnosed in five countries and more than 2,900 have died, including 208 health care workers.
