When the first Ebola case reached U.S. soil last month, the world finally began to pay attention—but not in the right way. In December 2013 the Ebola virus appeared for the first time in rural Guinea. No one imagined then that it would set-off the devastation that is sweeping across West Africa or the hysteria that has engulfed the world. Closed borders, evacuated expats, canceled flights, quarantined neighborhoods, biological warfare (re: CNN’s poorly chosen headlines): all of it seems more akin to a science fiction movie than a real public health challenge. To be sure, Ebola is a dangerous disease with no treatment or vaccine. What is worse is that we know so little about it, including how the pathogen that until recently was only found in Central and East Africa arrived in West Africa. It is clear, however, that the way in which the outbreak is portrayed in popular media has contributed to confusion, fear and a panicked response, which have only exacerbated an already desperate situation.
Read any article on the Ebola outbreak in West Africa these days and I guarantee you will come across references to Africans eating wild animals, people hiding infected family members from health workers, patients being taken to witch doctors for treatment, or conspiracy theories about how the disease is man-made. The half-truths and out-of-context information inserted into the reports we read or hear about Ebola are implicitly making one point: that it is African primitivism which is to blame for the outbreak (or to quote Bernie Goldberg on Fox News: “Many Africans are Backward People”). These overly sensationalized stories and outright racist commentaries divert our attention from the real threat to saving lives: collective inaction and apathy.
What we don’t hear about (or hardly so) are the underlying causes that have made this outbreak seemingly uncontrollable—reasons that are disappointingly mundane and don’t make for a front-page story, like this one on Newsweek, fittingly entitled “A Back Door For Ebola: Smuggled Bushmeat Could Spark a US Epidemic”, complete with an image of a chimpanzee on the cover. Essentially, the root of the crisis is the tenuous economic and political state that the countries which have been hardest-hit by the outbreak—Guinea, Liberia and Sierra Leone—find themselves in. Among the least developed places, decades of civil war have only recently given way to fragile stability and slow economic growth in this part of the world. Now more than ever, the hard won economic and peace gains experienced in these countries over the past decade seem to be in jeopardy.
Grappling with an Ebola outbreak in any place is a challenge, but in this context it is nothing short of a nightmare. Healthcare systems in many West African countries were already feeble and unable to address basic health concerns, let alone deal with a public health crisis of this magnitude. In Liberia, a nation of 4.3 million people, there were only 50 doctors in the entire country before Ebola began ravaging medical workers. The World Health Organization estimates that an injection of $1 billion would be needed to mobilize an effective response to the outbreak that could be contained in 6-9 months, in the best-case scenario. Support has been trickling in from other countries but the response has been too slow. To date, aid organizations like Medecins Sans Frontiers, which are at the heart of the response, have been running on limited resources, turning people believed to have contracted the virus away on a daily basis because there is no more room in their health centers. The CDC warns that if the international community doesn’t spring into action soon, the window of opportunity for getting the outbreak under control will quickly close.
Mobilizing funds is the straightforward part. Then there is the politics. The lack of trust in government is likely the biggest culprit for the rapid spread of Ebola in West Africa, as described in this excellent piece about Liberia. “The lesson that the big people in government cannot or will not protect you is one Liberians have learned over a long hard history of exploitation, corruption and war.” The story is not much different in Sierra Leone or Guinea. Though important improvements in governance have been made and West African states are working under extreme pressure to curb the outbreak, the collective memory of betrayal and disappointment has not faded away so easily.
Imagine, one day you are told that there is a dangerous, highly contagious, foreign virus that is spreading through everyday human contact in your community; that quarantining your sick loved ones or your entire neighborhood is in your best interests; that there is no cure for the virus but miraculously some foreigners who had contracted it were able to take a pill that saved them. Who would not have a hard time believing this, entrusting their lives in the hands of their leaders and fully cooperating in a response? Perhaps the majority of us would not be so dubious of our governments, but we must recognize that our behaviors and beliefs are shaped by a certain privileged experience: how many have spent the majority of their lives in a system where government has failed its citizens miserably, time and time again?
My point is that if we really care to understand the Ebola outbreak and seek to support the countries affected by it in a meaningful way, then we must look past all the dramatized, hyped-up, sensationalized stories and recognize that context matters; politics and economic development matter. In an op-ed blasting the international community’s weak response to the outbreak in West Africa, World Bank head, Jim Yong Kim, and humanitarian activist, Paul Farmer, noted that “If the Ebola epidemic devastating the countries of Guinea, Liberia and Sierra Leone had instead struck Washington, New York or Boston, there is no doubt that the health systems in place could contain and then eliminate the disease”. Though the forecast for West Africa is more sobering, the outbreak is not insurmountable. With international support and a coordinated response the fatality rate could be brought down from 50% to 20% and the epidemic eventually contained.
Yet, so far, the main concern of countries that have not been affected badly by the outbreak has been how do we keep Ebola out, not how can we help end this. In the wake of the first U.S. Ebola case, American lawmakers are urging for travel bans on Guinea, Liberia and Sierra Leone, despite the fact that medical experts say imposing travel bans will only make things worse in these countries. And so, every time we react to news of Ebola with fear, panic and stigmatization, we miss the opportunity to respond with empathy, support and thoughtfulness. Meanwhile, people continue to die needlessly, and the problem continues to snowball with 1,000 new cases emerging each week.