“In the hardest hit countries, an exponentially rising caseload threatens to push governments to the brink of state failure… None of us experienced in containing outbreaks has ever seen, in our lifetimes, an emergency of this scale, with this degree of suffering, and with this magnitude of cascading consequences. This is not just an outbreak. This is not just a public health crisis. This is a social crisis, a humanitarian crisis, an economic crisis, an economic crisis, and a threat to national security well beyond the outbreak zones.”
-Dr Margaret Chan, Director General of the World Health Organisation
The current outbreak of Ebola in West Africa is a perfect example of the startling reflection that activity on a microscopic scale within a single human being can within weeks create a humanitarian threat spanning entire nations. The scope of the tragedy is far wider than the personal losses behind each statistic. The impact is largest economically and socially, and the political ramifications of border closure are complex and have had inhibited the work of medical staff and aid workers by restricting the areas accessible by travel.
On the socio-economic level, this epidemic is crippling. Tourism and travel industries in the affected countries have been disrupted with the closure of airports and land borders in attempts to contain the virus, and even after re-opening are likely to suffer for some time. However, Ebola is disrupting key functions of these African economies that stretch beyond tourism and travel. In the regional grip of panic and recession, jobs are far harder to come by, and the problem is only exacerbated by mounting hospital fees for the infected, as well as the grim addition of funeral costs. Domestic trade and business is also impaired, as confusion in the public as to how the virus spreads disrupts many meetings and transactions. Subsistence farmers have managed to experience minimal economic disruptions, but many who work in the informal sectors for daily pay are less fortunate. Such nation-wide economic paralysis occurring in the most affected countries undoubtedly requires international support, most of which is just arriving now, six months into the crisis.
Several states have prohibited travel to and from the affected area, including South Africa, Saudi Arabia and Kenya, as well as the Ivory Coast, which sits adjacent to Guinea and Liberia. Trade has ceased almost completely, with the international food industry especially affected by the outbreak, due to the fact that Ebola can be transmitted, like many diseases, through contact with infected animal products. Border closure might appear to be a quick solution, but such political isolationism is counter-intuitive.
“Shutting a land border sounds simple,” explained Dr Ewan Wilkinson, Professor of Global Public Health at the University of Chester’s Faculty of Health and Social Care, “but it might only delay the infection spreading. Most international borders are porous, as they tend not to have secure fences all along them – so if people really want to cross, say to get back home, they will. The important thing is to stop the spread locally and that will prevent it crossing the border.” By closing borders and prohibiting travel to and from the affected nations, a government merely increases its infrastructural vulnerability, as evidenced by the current instability in Liberia. The measure neither protects domestic citizens from the virus, as no border closure can be implemented totally, nor does it improve the foreign state’s speed with which it stops the spread of the virus within its borders. The enforcement of border closure by foreign governments adds to the likelihood that the virus will become a wider predicament because the border closures and travel bans are prohibiting skilled medical professions into the region. These medical staffers are needed to support a weakened and insufficient health network in the region that was not prepared to handle an Ebola outbreak, and this unpreparedness contributed to the virus’ rapid spread. In Sierra Leone and Liberia; health networks remain underdeveloped because both states are still undergoing a process of recovery from civil wars in the 1990s.
To contain the outbreak, states must work more effectively at the local level. Here, Dr Wilkinson argued, the most significant obstacle to effectively containing the outbreak is the local beliefs concerning disease and medication. “Being in the UK, we make enormous assumptions about peoples’ understanding and beliefs,” he said. “In the UK, most people accept the biomedical approach to disease and therefore the scientific cause and effect. But in many other countries western medicine only does so much.” The disconnect there is between the medical support being provided by trained local professionals and foreign aid workers, contrasted against the traditional, often mystical approach taken by many West Africans at the heart of the outbreak. It augments suspicion towards the masked and white-suited foreign workers, as seen in the brutal murder of a team of aid workers in Guinea last week, and hampers the local level of containment.
Reports and updates of this year’s outbreak are littered with the word ‘unprecedented’, and the term applies to more aspects than one. The outbreak is indeed unparalleled not only in death toll, but in the number of cases of infection, the speed of the virus’s proliferation, and its geographical reach. At the time of writing, the death toll has just exceeded 3,000, which includes 600 from Sierra Leone, a nation with a population equal to Scotland. While Senegal, Guinea and Nigeria have also hosted a relatively small number of Ebola deaths, Liberia is the worst affected, with nearly 2,000 recorded fatalities amongst a population of just over 4 million. In spite of the devastation, however, the situation is certainly not hopeless. The UN Security Council has officially discouraged border closure after passing Resolution 2177 (2014), with strong agreement from the African Union and Economic Community of West African States, and while containment is assuredly possible, it will only take time, investment, and the continued relentless self-sacrifice by both local and foreign relief workers.