Ebola and Civil War
The United States media coverage of Ebola has gone rampant after a nurse contracted the disease while treating an American citizen who had recently to Ebola in Texas, despite wearing protective gear and abiding by CDC procedures. She was even given the okay to fly despite having a fever of 99.5 degrees Fahrenheit because she didn’t meet the benchmark of 100.4 degrees Fahrenheit that would have caused her to fall into the “high-risk” classification. To make matters worse, the Dallas hospital where the nurse worked apologized for “mistakes” in the treatment of the patient who recently died.
Ebola has obviously affected our lives here in America. Even if we aren’t frequent flyers, Ebola has become a buzzword and has remained as a trending topic on sites like Facebook and Twitter. But the effect of Ebola in Liberia is enough to potentially precipitate another civil war.
Dr. Martha Zarway has lived through the Ebola outbreak and Liberia’s civil war, a civil war that killed 250,000 people and ravaged the country for fourteen years. But despite the fact that Ebola has killed over 2,000 people, only a fraction of the death toll of the civil war, she says that Ebola is almost more scary because “There’s no way to hide.”
When Anthony Bourdain visited Liberia in 2010 to film an episode of No Reservations, he asked Bishop Francis Thomas how things are going, if things are getting better after the end of a brutal civil war. Bishop Thomas said, “Yes, stable government, growing democracy. We can sit like this and take our drinks and eat without running and dodging bullets.”
If Bourdain were to return to Monrovia, things would be much, much different. If you think the CTA is bad, think again. The people of Monrovia depend on public transportation — buses, cars, taxis, and motorcycles. But now that the state of Monrovia has put restrictions on public transportation to try to limit transmission of Ebola, commuters are stuck waiting.
The BBC describes the infrastructure of Liberia as “in ruins.” If the economy’s infrastructure is in ruins, it’s not hard to guess what the state of the public health infrastructure is like.
The effect of a 14-year civil war is daunting. The civil war destroyed Liberia’s infrastructure almost completely. And although, as Bishop Francis said, they may not be dodging bullets while eating and drinking, the effects of the civil war are still felt. During the conflict, doctors, nurses and other health workers left the country seeking safety. This left only 30 physicians to serve a population of 3 million.
In addition, major bilateral and multilateral donors often have focused on HIV/AIDS and malaria. So although rates of HIV/AIDS and malaria have decreased because of the influx of millions of dollars, the public health infrastructure is not more resilient.
Liberian information minister said the lack of international response may force Liberia, and neighboring Sierra Leone, to be thrown back into the throes of a civil war. The already existing shortage of medical workers has been negatively affected by fear surrounding Ebola. Many family members of those who have died from Ebola blame curses. And if family members blame curses, they may be reluctant to seek medical help if they develop symptoms of Ebola, thereby keeping Ebola cases under the radar and out of health care providers’ reach.
And it’s not only in Liberia that people blame external sources for Ebola. Cyril Broderick, associate professor in the Department of Agriculture and Natural Resources at Delware State University, cites “Reports narrate the US Department of Defense (DoD) funding Ebola trials on humans, trials which started just before the Ebola outbreak in Guinea and Sierra Leone.” Furthermore, Delaware State University has released a statement declaring “The university is not going to abridge his First Amendment rights to give his opinion about the issues of the day.”
Is there hope for Liberia? Despite the death toll of Ebola approaching 70%, there is hope for combatting Ebola. R0 of a disease is the number of people that one sick person will infect on average. Ebola has an R0 of 2. The World Health Organization has discussed bringing a vaccine to the ground zero of Ebola without having tested its effectiveness. Normally, a vaccine would take months if not years before it gains approval for use.
Maybe we can learn from Firestone. Firestone has a rubber plantation in Harbel, Liberia. Those affiliated with Firestone make up 80,000 people. In March, there was a case of Ebola and, at first, Firestone employees tried to get the woman to Monrovia. But since Monrovia lacked the capacity to serve this woman, Firestone ended up making its clinic. Dr. Flannery of the CDC credits Firestone’s success to its ability to monitoring those who may have come into contact with the virus.
But right now, the Ebola outbreak is “winning the race,” according to Anthony Banbury, head of the UN’s Ebola mission, and it’s up to the international community to help Liberia win the race and to reconsider the importance of primary care infrastructure.
