Have we learned anything from recent Ebola outbreaks?

An outbreak of Ebola in West Africa was greeted with a mixture of hysteria from the press and then followed by compassion from the public in western nations, but could the epidemic have been prevented? How much of the disaster can be attributed to pre-existing conditions? Will we see similar disasters in the future?

The lack of preparedness to cope with any outbreak of this nature was revealed through the lack of advanced health care systems in the countries affected. Some even lacked basic health care facilities following years of conflict between different ethnic groups and outbreaks of civil war. Health care facilities are often destroyed in war, along with any infrastructure for transport and distribution. A lack of running water, a lack of trained staff, and a lack of basic medicines was also revealed in some regions. A lack of understanding about the spread of disease and precautions that were likely to be effective was also apparent. The question must now be asked, will any of these problems be addressed now that we have seen the effects of Ebola?

Whilst conflict can be blamed for the lack of facilities there is also a need to examine other aspects of governance in these areas. The form of government is often didactic and authoritarian, there are frequent reports of high levels of corruption, there are ‘deals’ with foreign investors that effectively transfer ownership of land overseas without compensation to those who made a living from the land. Looking a little deeper and beyond the confines of West African countries we can see similar issues in many other African nations, conflict in Libya, Tunisia, Egypt, Sudan and Somalia, to name just a few. Are we learning anything about these situations?

The initial media response to Ebola was to call for movement restrictions, to put up the shutters and to adopt the fortress approach to ‘keep Ebola out’. Some of this hysteria was echoed inside the chambers of congress in the USA, and in parliament in the UK. Fortunately, through the efforts of ‘Doctors without Borders’ and other NGO groups a response did take place, to provide centers for treatment, to provide health care workers and to provide equipment. The question now is whether the temporary response can be turned into something permanent, the establishing of a better health care system, the development of transport infrastructure, the training of professionals, and whether there is a means of financing this.

For developed nations there are also questions to be asked about both medical research and about training. Why should an outbreak of Ebola on this magnitude be required before the matter of developing vaccines and anti-virals becomes urgent? There are many tropical diseases that also need to be addressed. Often developed nations use developing countries as a source of labor, recruiting health workers for their own needs rather than training them for the developing nations. This is particularly evident in the UK.

Ebola also revealed a lack of trust from many communities in West Africa, often attributed to the exploitation these communities had to withstand during colonial occupation. That exploitation still continues through the actions of some foreign companies. The authoritarian approach lives on, with villagers often responding by trying to hide outbreaks and hide bodies, though care providers did achieve much in educating communities and trying to understand other cultures to counteract some of the initial heavy-handed responses such as demands that bodies be incinerated rather than buried with respect.

The lesson that needed to be learned is that the solution to the Ebola crisis has to be within the countries affected through development of adequate facilities and supporting infrastructure. That cannot be achieved without assistance from the developed world, in terms of finance, materials and in training to provide skills. Ebola has revealed what is needed, but are we responding in that way?

Sadly all the signs are that we have missed the opportunity to learn from the outbreak. Whilst the development of some health care facilities will occur we still have to wait and see whether it will be on the scale that is needed, and whether care can be provided not just for Ebola patients but to combat other diseases including malaria and measles.

However, the opportunity to respond differently is being missed. This is evidenced by the way in which the developed nations have responded to conflict in both parts of Africa and the near-East. A steady stream of refugees, often labelled migrants to disguise their displacement, is flowing across borders and into Europe on a scale not seen since the second World War. The reaction has been similar to the first reactions with Ebola. The first response has been to ‘put up the shutters’ and try and prevent movement, this has also been accompanied by the hysteria generated by the media, and even the inappropriate descriptions of ‘swarms of migrants’ by a political leader. The second stage of the response is a level of compassion, the understanding that refugees cannot be left to drown in dangerous waters, that there is a need for shelter and food. What is missing suggests we have not understood the lessons from Ebola, namely that the solutions lie within those countries affected by conflict and disasters.

The outlook is not bleak, for by revealing the nature of the problem the Ebola outbreak also gives developed nations the opportunity to rethink their approach to helping developing nations progress through better education, better healthcare, better infrastructure and an economy that is not simply exploited by foreign interests.