Africa, Ebola, Fragile states, Guinea, Liberia, Sierra Leone
The Ebola virus has started a vicious journey in each of the countries at the epicenter of the epidemic: Liberia, Guinea, and Sierra Leone. A journey that most likely began in the forest of the Mano river region; resulting in multiple deaths, destruction of families and communities and inexorably destabilizing existing fragile systems (health, education, economic, domestic and cross border trade), as well as state institutions.
The rising human toll of more than 2 700 deaths according to the World Health Organization is worrisome; and the predictions from health officials to contain this virus are not encouraging at the moment. According to most health experts and specialized institutions, the situation in West Africa will deteriorate before getting better (hopefully). Unfortunately, the death toll and to some extent the economic impact are just the visible tip of the iceberg. Currently, the institutional and social impacts of the Ebola epidemic are yet to be understood by government officials and health experts alike.
As I follow reports and comparing the gravity of the epidemic in countries affected so far (Nigeria, Senegal, Liberia, Sierra Leone, Guinea and the Democratic Republic of Congo), I am beginning to see what I will term the “Ebola –Fragility Tandem.” The Ebola-fragility tandem is the dynamic interaction between Ebola and the inability of a country’s public systems and state institutions to perform and respond to the basic needs and expectations of its citizens. It seems to me that, the Ebola virus will worsen in an environment with a weak public and health system, poor urban planning, less educated citizenry and a weak government presence.
The Ebola-fragility tandem becomes even more apparent when one realizes that the most affected countries are also in the list of fragile states in Africa: Liberia, Sierra Leone and Guinea. According to the African Development Bank (AFDB) the mentioned countries are indeed in the list of fragile states in West Africa. There seems to be some correlation (not necessarily causation) between state fragility and the gravity of the epidemic which is impacting many lives and communities.
The scenes of soldiers shooting civilians with real bullets in Mamba point, Liberia, as citizens opposed a hastily decided quarantine; the recent killing of 08 health authorities in N’Zérékoré, Guinea as they were conducting awareness campaigns against the Ebola virus, have become familiar and symptomatic of the insidious effects of this mutually reinforcing Ebola-fragility tandem. While the level of state fragility determines the gravity of the Ebola epidemic; the epidemic worsens state fragility, in a simple but destructive osmosis.
In addition to the measurable impact of Ebola (death toll, economic impact, etc.), the effect on social fabric and state institutions is equally devastating; aggravating the mistrust of citizens towards public institutions health and security in particular, increasing social suspicion and eroding community solidarity. The fact that the epicenter of the current Ebola epidemic is located in the Mano river region, unfortunately reminds me of the Mano river conflict system that wracked that region in 1990s until 2000s with the similar effects on institutions and the social fabric. Today, the Ebola epidemic is merging with factors of fragility; and this collusion is threatening the precarious stability of the Mano river region.
Addressing the Ebola-fragility tandem requires solutions that go beyond the realm of public health to involve other sectors and stakeholders both at the national and regional levels. As money and resources are spent in building health infrastructure and increasing the capacities and number of health workers, it is important to start addressing the underlying structural and institutional factors of fragility that have enable the rapid spread of the epidemic; and which unfortunately have been worsened by it.
So instead of isolating countries affected by the epidemic and stigmatizing their citizens or any traveler who has happened to only transit (few hours) in these countries, as it is currently the case in airports around the world; it is advisable to apply some of the strategies used back in the 1990s and 2000s during the civil wars in Sierra Leone and Liberia. During those periods, these countries were not isolated. Instead, neighboring countries, western powers and the UN Security Council collaborated in a momentum of solidarity, interdependence and cooperation, to address what was then considered a threat to international security.
Fighting the Ebola-fragility tandem is a sustained, comprehensive and holistic endeavor that should not be left in the fragile hands of countries at the epicenter of the epidemic!
Thanks for a good read. I totally agree with your views. Specifically what comes to my mind is how the Ebola epidemics will affect other health outcomes in the nearest future. Reallocation of resources to an epidemics that the region is ill prepared for will surely have a trickle down effect on existing public health ailments, mainly in the most vulnerable group of children.