THE EBOLA EPIDEMIC IN WEST AFRICA: AN ISSUE OF JUSTICE?
The Ebola virus existed in the region for nearly a decade before the first animal-to-human transmissions took place. The opportunities for exposure of humans to Ebola from wild animals increased when people were driven by companies and governments even deeper into remote and unknown ecosystems, because their normal habitat was taken for exploitation of natural resources like gold and diamonds. After the civil war in the region a reconstruction of society only took place through profit-oriented economic cooperation. Civil society and churches attempted to rebuild social trust based on sound public values, but such an approach never appealed to the governments. Instead, the government focused essentially on economic growth. This explains the continuous unhealed trauma of the population, their deep mistrust to everything linked to government, to external assistance, to the military. All these socioeconomic and psychological factors pave the way to the mushrooming of all sorts of infectious diseases.
The Ebola epidemic spread because people in the tri-country area where the outbreak started close to Gueckedou in Guinea were used to moving across borders and to organizing based on their common cultural affiliations. In the beginning the international response thought the borders would be sufficient to contain the spread. The phenomenon of migration was not considered by the international community. In particular it was overlooked that people in desperate situations looked for help in the capital cities. In addition, the initial response ignores people’s culture which contributes to the spread of the epidemic. It is inhumane to forbid participation of relatives in funerals as was the case in Liberia until mid-September.
The healthcare system in the region was under-resourced both in human resources and equipment. The first patients were misdiagnosed with Cholera or complicated Malaria. Unaware of the danger the health services cared for Ebola patients without protection. Hygiene and lack of quality care is a common problem in African health facilities, but it was even worse in the affected countries. This has been documented for years by WHO, saying for instance that in Liberia only 10% of minimal human resources work in the health sector. We are faced with countries that do not have, as Paul Farmer recently said, “the staff, the stuff and the system.” The question is this: where has everyone been? This is not new! The people of the three affected countries lacked adequate health systems before the epidemic. Can weak health systems that failed to confront ordinary diseases be able to cope with Ebola? In addition to medical interventions, can we deny that in order to address the “fundamental causes” of such a massive vulnerability to pathogens, there is need for deep structural interventions? Where does the money go that is destined to improve health systems?
Due to the activities of profit-seeking companies, poor people are driven into ecosystems which are not safe. Yet, when a terrible epidemic occurs they are isolated from the whole world. The first reaction to what happened in these three West African countries can be summarized as follows: as long as those Africans stay where they die, no problem; we don’t care. Why don’t we let them die, because we only develop the cure for our infected people. Sorry, we only care when we are also threatened by the disease. The “we” and “they” language is divisive and undermining, especially to those who are on the losing side of the global exchange. How are we to face what Pope Francis called “the globalization of indifference” which is sustained by the fratricidal culture of inequality and exclusion? How are we to face to globalization of disease if we don’t help others?
What is happening in Liberia, Sierra Leone and Guinea—countries where there is an intense mining activity—is not only an epidemic but an assault on human worth by the forces of neoliberalism and by local forces. The Ebola epidemic, like other epidemics caused by infectious diseases, follows the path of poverty and inequality. It is a path laid down by a history of colonialism, racism, social exclusion and global capital. To fully capture what is going on in these three countries, we should not rely on simplistic analyses of the situation. Our analysis ought to be biosocial to avoid erasing biology and history. We need to use adequate conceptual tools ranging from those of political economy and history to cultural studies.
Jacquineau Azetsop is a Cameroonian Jesuit. He is associate professor in the Faculty of Social Sciences of the Pontifical Gregorian University.