Ebola Hysteria is Enabling the Virus’ Spread

Publication Date: 
Sunday, September 14, 2014

Some crises attract an overwhelming international response. In the immediate aftermath of the 2010 Haiti earthquake, for example, roughly 13,000 NGOs descended upon the island nation. The response to the Ebola outbreak that has spread outward from Liberia, Sierra Leone, and Guinea over the last several months could not be more different. Since the first cases were reported, the World Health Organization (WHO) has issued plaintive calls for more aid and aid workers. The tepid response has a simple explanation: fear. The fear of infection has not only made aid workers think twice about traveling to West Africa, but thinned the ranks of NGOs already on the ground. Rafael Frankfurter, of the Wellbody Alliance, an NGO that offers medical services, put his American volunteers on a plane back to the US shortly after the outbreak began, saying “It’s certainly not in line with our values, because it’s just such a glaring inequality… it’s a very scary place to get sick right now.”

The fact that the Ebola crisis has not prompted a feeding frenzy of international NGOs is not necessarily a bad thing. Indeed, a massive influx of hastily-trained aid workers would likely prove counterproductive, as such people could contribute to the spread of the disease. As Dr. Michael VanRooyen, director of the Harvard Humanitarian Initiative (HHI), said in a recent talk, what is needed is a stout cadre of veteran organizations who have already built operational capacity, and can methodically assist others in doing the same. Liberian officials have echoed this sentiment, saying they have the local volunteers to form the backbone of a public health campaign if the international community is willing to provide technical expertise. A few organizations—notably Médecins Sans Frontières (MSF), International Medical Corps, and Samaritan’s Purse—have answered the call.

Sadly, fear and misinformation have undermined their efforts at every turn. Ebola is not an airborne virus. As such, one can guard against transmission by responsibly using personal protective equipment (PPE)—gloves, facemasks, aprons, etc.—and exercising universal precautions.  The West African countries at the epicenter of the outbreak, however, have underdeveloped medical sectors (Liberia, for example, has roughly 1 physician for every 100,000 citizens), leaving them dependent on outside help for even the most basic supplies. Yet airlines that might have delivered the essential gloves and masks have cancelled flights to West Africa, despite WHO assurances that properly scanned passengers pose little risk.  The UN World Food Program has studied the feasibility of dipping into its food stockpiles elsewhere in Africa to alleviate food insecurity resulting from the epidemic. This plan, too, has been thwarted by ships’ refusals to visit ports in Liberia, Sierra Leone, and Guinea.

Given the dearth of supplies, healthcare workers face an unattractive choice: withdraw, leaving the sick to fend for themselves, or continue working, at heightened risk of infection.  Workers at Phebe Hospital in Liberia made the former choice, going on strike until the government guaranteed them gloves, masks, and health coverage. Many others have made the latter choice—which, according to the WHO, has contributed significantly to the high death toll among humanitarians.

While the Ebola virus has thrived thanks to a deficit of technical medical knowledge and capacity, Dr. VanRooyen warns that it threatens to evolve into a complex humanitarian issue, spanning multiple sectors (e.g. economy, food security, conflict, migration). Indeed, people are already going hungry in areas that have been cordoned off; heavy industry has slowed and cross-border trade has stopped in affected areas, sending West African economies into a tailspin; recently returned members of the Liberian, Sierra Leonean, and Guinean diasporas, respectively, have clamored to return to their overseas residences.

A large-scale, door-to-door public education campaign could prevent the situation from getting any worse. These workers could also contribute to identifying and testing those showing symptoms of Ebola, putting anyone who came in contact with the infected under observation. However, such a campaign would require a massive humanitarian mobilization. Before this can happen, Dr. VanRooyen says, the international community may need to abandon the “spacesuit mentality,” relying instead on common sense and universal precautions. Once this shift takes place, responding to Ebola becomes, in the words of MSF emergency coordinator Lindis Hurum, “a lot like responding to any other disaster”—and neither airlines nor ocean liners should shy away from delivering the material aid to West African hot spots.

Yes, Ebola is a pernicious virus. But, even as it bemoans West African ignorance of how diseases spread, the international community has allowed its own fear of Ebola to grow out of proportion and become a major impediment to an effective humanitarian response.

[Update: At time of posting, Boston-based Partners in Health has just deployed a team of four doctors and two operations staff, who will lay the foundation for a long-term public health project to be carried out by over 100 volunteers.]

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