AsianScientist (Mar. 30, 2015) – A year has come and gone since the Ebola epidemic spiraled out of control in West Africa. On 23rd March 2015, Médecins sans Frontières (MSF) released a scathing statement regarding the Ebola crisis to the World Health Organization (WHO). The document describes MSF’s early warnings of Ebola spreading in Guinea, denial by governments in affected countries, and the unprecedented steps that MSF was made to take in light of inaction from the WHO and governments.
In October 2014, I bore witness to the media frenzy take took place on campus here at Yale with at the admission of a potential “Ebola” case at the Yale-New Haven hospital. The admitted patient had just returned from Liberia and had fallen ill with flu-like symptoms. He tested negative for Ebola, but his story was widely reported in the New York Times.
The furor that the United States experienced with “Ebola fever” was on par with the frenzy at the peak of the HIV/AIDS epidemic in the 1980s. Sadly, immediately after the American mid-term elections in November 2014, Ebola was pushed from headline news to the bottom of the health section. The epidemic still rages on in West Africa while the rest of the world has conveniently forgotten about it.
West Africa and the wider world
We have forgotten that people are still dying. As of March 2015, more than 10,000 people have died in Liberia, Guinea, Sierra Leone, Nigeria, the United States, Spain and Mali. We have forgotten that the Ebola epidemic is certainly one of unprecedented proportions, and one that will take a long time to settle.
The problem is that the wider world never took the Ebola epidemic seriously in the first place. The failure of the WHO and other international health organizations is one of the main reasons why the epidemic raged out of control so quickly. Early on, the WHO failed to realize the gravity of the situation. The outbreak, as argued by the MSF and other organizations, could have been quelled if the WHO had responded more quickly.
The Ebola outbreak ought to have received the same attention as other viruses did: SARS, H1N1, measles, typhoid, to name a few.
We have forgotten that West Africa is still a large part of the globe. After all, what ramifications could a West African outbreak have on the rest of the world? Africa is, in the minds of many, a far-off monolithic continent where giraffes and lions live. On the contrary, Africa is none of that. With increased air and cross-border travel within and outside of the continent, the consequences of a global Ebola pandemic would be disastrous. This outbreak has shown that Ebola is certainly not a disease to be taken lightly, and that modern travel and conveniences are easy vehicles for the spread of disease.
If anything, the failure of the WHO to adequately respond to the outbreak has shown that dependence on outside help cannot be the only solution. However, this is an extremely difficult task given the social and economic situation of the three affected states.
Deficiencies in the health system
Dr. Paul Farmer, Harvard Medical School professor and founder of Partners in Health, has called the Ebola epidemic the “terrorism of poverty.”
Sierra Leone and Liberia’s governments are fractured as the countries have just emerged from decades of civil war. These are fragile states that have little structure in their health systems. Even before the outbreak, Liberia’s physician to patient ratio was 1:80,000.
Further compounding the problem are the presence of other communicable diseases like malaria and typhoid, in addition to food insecurity and social disruption. Against such a backdrop, basic necessities such as disposable gloves and even food are scarce.
In the short term, food and basic medical supplies must be provided for the current epidemic to be solved. In the long term, I take the same stance as as Dr. Peter Piot, a former UNAIDs head and Ebola expert. He argues that health systems must be strengthened, as this is a more economically viable and efficient solution to providing short-term aid. I could not agree more.
Lest we forget
Last semester, I attended a talk by a polio vaccine expert working in USAID. She spoke about the eradication of polio and her role in it, specifically emphasizing on the community aspect of her role. At the end of the talk, I asked her if she thought the Ebola epidemic could have been curtailed in a similar manner.
She then said to me, “I hope that you will do a better job than the WHO”.
Her words will stay with me for a long, long time as I ready to graduate as a public health professional this May.
The failure to address this outbreak reveals a terrible Achilles’ heel among global health actors. It serves as a clarion call for unity, organization and less politicking. It spells the need to emphasize on community health, and the need to strengthen local health systems from the simple provision of personal protective equipment to the systemic training of health workers.
Even before the outbreak ends, we must look to preventing the next one. We cannot forget what West Africa has taught us. The next outbreak may just be around the corner.
This article is from a monthly column called Our Small World. Click here to see the other articles in this series.
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Copyright: Asian Scientist Magazine; Photo: Global Panorama/Flickr/CC.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.
