All these things are whirling together in Liberia. And that’s when Ebola can kill you even when you don’t have Ebola. Fear of disease couples with so much dire need. Over and over again, health workers say the same thing: “You don’t know who is who.”

So it’s safer not to help anyone at all.

Liberia’s President Ellen Johnson Sirleaf foresaw precisely this problem. “The epidemic is having a chilling effect on the overall health care delivery,” Sireaf said, when she declared a state of emergency nearly two weeks ago. “Out of fear of being infected with the disease, health care practitioners are afraid to accept new patients, especially in community clinics all across the country. Consequently, many common diseases which are especially prevalent during the rainy season, such as malaria, typhoid, and common cold, are going untreated and may lead to unnecessary and preventable deaths.”

She overlooked pregnancy. Liberia has one of the highest rates of maternal death in the world. Giving birth here is always risky, even when you can count on a clinic being open.