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Ebola and the African Responsibility
The challenge with Ebola is not just the fact that the U.S. and international response was too little, too late as many experts have suggested. The core issue at stake is that the devastating propagation of Ebola in the region is rooted in the long standing culture of corruption and the archaic traditional beliefs that still prevail in countries like Sierra Leone, Liberia and Guinea. As currently designed, international medical and humanitarian assistance cannot address the problem. It is up to Africans themselves to do it. The governments of these three countries and the West Africa regional organization must take decisive action to eradicate the national cultures of corruption and transform the foundation of their social fabric once and for all.
The current outbreak of the Ebola virus has been ravaging the West African countries of Sierra Leone, Liberia and Guinea since March 2014. By the end of October, it had killed more than 5000 people and infected nearly 14,000, according to the Center for Disease Control and Prevention (CDC). [i] In other words, a 7-month period of Ebola has been deadlier for African populations than 10 years of combat operations has been for the U.S. military forces in Afghanistan.
In mid-October 2014, Anthony Banbury, the head of the United Nations Mission for Ebola Emergency Response (UNMEER) warned the Security Council about Ebola: “It is far ahead of us, it is running faster than us, and it is winning the race”. [ii]
This alarming statement raises a simple question. Why were Guinea, Sierra-Leone and Liberia unable to contain the propagation of the virus in the first place? Part of the answer obviously lies in the nonexistence of an effective vaccine, the lack of medical facilities and a too-little-too-late international reaction, as underscored by many Western and African experts.[iii] Nevertheless, this is only the tip of the iceberg. The fight against Ebola is more than just a race against time in West Africa. Ironically, the epidemic can end as fast as it broke out as experienced with the 1976 epidemic in Congo DRC. Even if the outcome gets more positive in the near future, the risk of another outbreak may not be over anytime soon. Indeed, the long term fight against Ebola is also a race against long-standing African political corruption, and failure to transform the foundation of the social structure. Guinea, Sierra-Leone and Liberia are still plagued with poverty, unemployment, political mismanagement and national cultures of corruption. Urban populations are fractured along the lines of the “haves and have nots”. Rural communities, which represent an average of 60% of the population, are still clamped with obstructing ancestral traditional beliefs. Herein lie key root causes of the devastating spread of the Ebola epidemic between March and October 2014.
Ebola and the West African Context
For the past five years the annual growth of the Gross Domestic Product (GDP) of Guinea, Sierra-Leone and Liberia has been skyrocketing at a higher rate than the United States. For more than a decade, massive international aid and remittances from a large diaspora have injected billions of dollars into their national budgets. Yet, these three countries have been unable to transform their economies, and subsequently have failed develop functioning national public health systems or build effective education structures that could have helped contain the epidemic.
As a result, the United Nations (UN) have already acknowledged that Ebola has begun to damage West African economies and threaten a fragile political stability in a region slowly recovering from the 1990s’ bloody civil wars. To avoid infection, mining companies have shut down, farmers have fled their fields, hundreds of shops and schools have closed in the capital cities, and elections have been postponed.
What did we do in the first place to confront the spread of the epidemic? In September 2014, six months after the outbreak in West Africa, the U.S. government opted for a medical and logistical response that focused on Liberia. [iv] As the major supporting element of the U.S. response, the Department of Defense planned to deploy some 4,000 troops--medical, logistic and engineer personnel. [v]
Operation United Assistance however is a humanitarian and medical response that cannot address the aforementioned root causes of the devastating spread of the disease in Liberia, Sierra Leone and Guinea. To be successful, this operation must be backed by significant African effort to correct key flaws in the local political and social systems. National cultures of corruption and incapacitating traditional belief systems are two of them.
National Cultures of Corruption
Sierra Leone, Liberia and Guinea have one thing in common. Plagued with a large political corruption and economic mismanagement, the three countries had almost no performing public health structure available when the 2014 Ebola epidemic broke out. Corruption ingrains every layer of the society and the state. Government bribes, fraudulent business procedures, money laundering, and medical quackery are basic facets of a national culture of corruption.[vi] As seen in other African countries, “the system delights in robbing Peter to pay Paul. Here, a large number of people pay for services that are not provided, and most of the time, do so under duress. At the same time, the system allows the minority to enjoy the services they do not pay for.” [vii] In the past 10 years, a considerable amount of money has disappeared in the labyrinth of corruption. That reality has prevented the states from developing and transforming their medical infrastructure and public health system. Both were still nonexistent or barely functional in March 2014.
According to the World Bank, Africa loses $148 billion annually because of corruption.[viii] Sierra Leone, Liberia and Guinea are no exception. Even though ordinary citizens are not the only ones to be blamed for the culture of corruption that plagued their societies, they still participate in disseminating it. From law enforcement officers taking bribes to custom officers turning a blind eye on smugglers for their own gain, members of local non-governmental organizations (NGOs) receiving cash under the table and government officials embedded in patronage and clientelism, all these ordinary people have fed what has become a national culture of corruption.
All the aforementioned factors have been force multipliers in the deadly propagation of Ebola between April and October 2014. Rural populations and poor communities living in main urban slums were affected. Doctors have lacked resources, medical workers have limited training and education, families have little or no access to basic services, and health facilities were nonexistent. Ironically, when the first anti-Ebola medical teams asked people to clean their hands 8 times per day in order to prevent the infection in September 2014, they were often talking to populations who have no access to running water or basic services.
In that respect, the quick spread of the epidemic has merely revealed the tragic domino effect of local social, political and economic games driven by a culture of corruption. It has also unveiled the heavy weight of ancestral traditional beliefs that have undermined the implementation of rapid and effective Ebola containment procedures, especially in rural areas.
Incapacitating Traditional Beliefs Systems
Traditional beliefs remain prevalent within West African rural communities, which represent some 60% of the populations in Sierra Leone, Liberia and Guinea. Many Christians go to church on Sunday morning and still pay a visit to their family’s witch in the afternoon. These ancestral beliefs often shape social codes and norms. Funerals for instance are critical family events. Rites and procedures stem from a traditional understanding of the universe. It is paramount for a family to stay with the body of the loved one when he or she passes away. In the traditional code, parents have to clean the body and bury it to keep the family and the spirit of the dead connected. Later on, the dead’s spirit will then protect the livings. Abiding by these rites is critical to maintain harmony between the past, the present and the future through the support of the spirits of the ancestors.[ix] In the context of Ebola, medical procedures such as removing the dead for cremating and keeping the families away from the infected bodies are perceived as evil in many rural areas. It is seen by villagers as an attempt to destroy the core identity of the family and the social fabric of the community.
Herein lies another of many challenges facing the current fight to stop the deadly propagation of Ebola. The West African people are a center of gravity of this battle. However, changing the ancestral culture of some 60% of this population who still abide by traditional beliefs and practices seems mission impossible, at least in the short term. This is one of the reasons why the epidemic is currently winning the race.
Several components of these traditional beliefs shape the education of a large segment of the West African urban and rural population.[x] Following these rites help people to ward off the fear of the unknown and of strangers. In August 2014, in the West Point slum of Monrovia, Liberia, a crowd of several hundred local residents, chanting, 'No Ebola in West Point,' drove away an Ebola burial team and its police escort. The mob then forced open an Ebola isolation ward and took the patients out, many saying that the Ebola epidemic was a Western hoax.
In September 2014, eight members of a medical team trying to raise awareness about Ebola were killed in cold blood by villagers using machetes in the rural Guinea. A month earlier, in the same rural part of the country, riots erupted following rumors that medics who were disinfecting a market were actually contaminating people. Villagers also accused the medical teams of Doctors Without Borders of bringing the disease to the area.
Fear is irrational. For many families in rural Sierra Leone, Guinea and Liberia, traditional beliefs are the ultimate rampart to keep Ebola out. Infection is not the only security challenge facing the U.S. service members who deploy to these virus–stricken African countries. Another is to be targeted by angry crowds who will accuse them to be evil doers who are trying to contaminate their neighborhood.
The fast spread of the Ebola virus in Liberia, Sierra Leone and Guinea has unveiled a tragic reality. For years these West African countries have been plagued with massive corruption and poor political governance. Subsequently, the governments failed to set up an effective public health system that would have helped contain the propagation of the virus between March and November 2014. At the same time, 60% of the populations remain driven by incapacitating ancestral beliefs and practices, a phenomenon that also stems from a systemic lack of functioning education system in rural areas. A majority of these populations has consequently sunk into a prevention-averse attitude vis-a-vis Ebola. It has undoubtedly accelerated the spread of the epidemic in the region.
In short, poor governance, corruption and obsolete traditional beliefs are key root causes of the devastating propagation of Ebola in Sierra Leone, Liberia and Guinea. As currently designed, the U.S. and international response is not prepared to address these issues. To effectively contain the propagation of the deadly virus in West Africa, the international medical and humanitarian assistance has to be supported by a significant African effort to transform the pillars of their political, economic and social foundations.
When Samantha Power, the United States Ambassador to the United Nations addressed Guinean officials in Conakry on October 27, 2014, she reminded them of one thing: “We are with you. Together we can beat the epidemic.” In an Ebola environment, “together” means that the West African governments also have to take charge. They need to better coordinate and set up the long term political and economic conditions that will prevent the devastating propagation of a continuing epidemic.
President Obama offered President Ellen Johnson Sirleaf to build as many as 17 Ebola treatment centers with about 1,700 treatment beds, and to provide the country with 400,000 Ebola home health and treatment kits, as well as tens of thousands of kits intended to test whether people have the disease. Operation United Assistance also included some logistical equipment for health workers going to West Africa and “command and control” organizational assistance on how to coordinate the relief work. By the end of October 2014, nearly 1300 U.S. troops and workers from the CDC were deployed to Liberia, building isolation wards, training health care workers and processing laboratory samples in Liberia while setting up a staging area in Senegal to move supplies.
[vi] For a more detailed information on the topic: Richmond & Alpin, Governments Falter in Fight to Curb Corruption, AfroBarometer Report, 13 November 2013
[ix] United States Marine Corps Center for Advanced Operational Culture Learning (CAOCL), Working with African Militaries, 2011