Ebola deaths: Failure of statesWritten by Odimegwu Onwumere
On Thursday, June 9 this year, Liberia formally rolled out the drums in celebration of their being Ebola – free.
According to medical science, Ebola is an infectious and generally fatal disease marked by fever and severe internal bleeding, spread through contact with infected body fluids by a filovirus (Ebola virus), whose normal host species is unknown.
In 2014, this strange virus wrecked countries in the West African sub-region, leading to 11,300 deaths and 28, 000 cases. To a larger degree, this huge casualty failure could have been avoided. From all indications, the Ebola spiral was largely as a failure of states in their quick response.
For some school of thoughts it is rather strange that Liberia is celebrating her Ebola free status some two years after the virus struck havoc in the country.
The last Ebola patient in the country was declared negative on 4 December 2015, and the country was declared Ebola free by the World Health Organization, WHO, an agency of the United Nations, UN, on 14 January 2016.
On the last count, a total of 4, 800 citizens lost their lives in Liberia, to Ebola. Again, like any other West African countries that were ravaged by the virus, the alarming rate of death was due to the gassy response of government.
“By October 2014, Guinea, Sierra Leone, and Liberia had lost more than 4,000 lives to Ebola due to boring response by governments,” Zaya Yeebo, a Ghanaian journalist and commentator on Pan African affairs, said on December 4, 2014.
Another leading voice on the subject matter, Crisis Group, an international group working to prevent conflict worldwide, said, “The international reaction was equally problematic and rightly criticized as dysfunctional and inadequate by many observers. Early warnings were largely ignored until cases began cropping up in the U.S., WHO, which had stalled for far too long on declaring an international health emergency, then proved incapable of mounting an effective response. The Security Council was forced to create a new body to scale up and coordinate operations – with variable results – the UN Mission for Ebola Emergency Response (UNMEER).”
Years of neglect
Since 1970s, Ebola had been and the response remained weak. Yeebo said that there was a claim by Kofi Annan, a former Secretary General of the UN that the response was weak, because the virus was affecting Africans.
The journalist said that the claim was rather questionable with a view that the West perhaps hadn’t a glimpse idea that Ebola would leave the shores of West Africa and penetrate Europe and America.
The reason, according to Patrick Martin from World Socialist website, “The giant pharmaceutical companies that control medical research saw little profit in saving the lives of impoverished villagers in rural Africa.”
“So far, we know that research has been conducted on possible cures and vaccines funded by the US Pentagon, for dubious reasons. The US claims that this research was to protect ‘US soldiers who might be deployed to the jungles of central Africa. How many US bases are located in Central Africa to warrant this approach? However, claims that the Ebola research carried out by the US Pentagon as an antidote to ‘whether the virus could be weaponised for use against potential enemies’ in my view, seems more credible. The chickens have come home to roost,” Yeebo opined.
The Ebola epidemic was coming at a time West Africa was recovering from decades of conflicts. This pummeled health infrastructures. Continuing, Yeebo added, "In the 1980s through the 1990s, these countries implemented neo-liberal reforms imposed by Bretton Wood Institutions, International Monetary Fund, IMF, and World Bank, whereby welfare systems were abandoned in exchange for donor support."
There was lack of accountability in Ebola funding in the countries, the civil society initiatives that bridge socio-political bonding and help create a more shared approach to crisis response were not fully incorporated into the response team, health systems were weak.
"It was only after the second wave of Ebola cases threatened the very stability of the affected countries that authorities took concerted action (with the help of Non-Governmental Organizations, NGOs, international agencies on the ground and donors), starting with the engagement of community leaders. Particularly in Liberia, they slowly learned what did not work and how to better communicate appropriate precautions and necessary cultural changes, eg, handling of deceased relatives that finally helped bring the epidemic under control," Africa Report, 28 Oct 2015, said.
Using Ebola to resolve geopolitical interests
Across West Africa and the world, travel bans were placed in severely affected countries as anxiousness about Ebola hyped in 2014. Liberia, Sierra Leone and Guinea were the most hit with Nigeria on the flaccid.
Ten countries, including the United States and Spain, were affected, and the world recorded more than 28,000 cases as was articled.
During the 2014 Ebola epidemic, West African countries, which were officially declared of Ebola on 22 March 2014 in Guinea, six countries in West Africa (Guinea, Liberia, Mali, Nigeria, Senegal and Sierra Leone) were severely affected.
Quoting Martin, Yeebo said, “What makes the Ebola virus disease even more worrying is the fact that the United States, Britain and other countries are using this crisis to resolve their geopolitical interests. The US sent in 4,000 troops (marines) to Liberia. President is calling on his top guards to prepare to ‘intervene’. On the other hand, the UK government has also announced its intention to send 3,000 soldiers to Sierra Leone. Historically, American Marines are routinely used to restore public order or enforce consent.”
He asked, “If these countries are not at war, and there is no civil disobedience, why send in troops instead of doctors and nurses? In contrast, Cuba sent 160 Doctors and nurses to Sierra Leone, and will send additional 296 health care workers to Liberia and Guinea. The approach of the Cuban government is humanitarian whilst the approach by the US and UK governments is militaristic, seeking to exploit the crisis for geopolitical reasons. The real agenda of Washington is to secure a basis for its Africa Command (AFRICOM), up to now excluded from the continent by local opposition, thus advancing the interests of American imperialism against its rivals, particularly China.”
Lack of clarity on response efforts
Kim Yi Dionne of Washington Post on July 15, 2014, reported that government did not help matters with responses to the epidemic.
Dionne said, “A significant challenge in responding to public health problems is coordinating across these actors. Part of the challenge is the lack of clarity on who should lead response efforts. Ultimately, the success or failure of the Ebola response relies on the ordinary people who are at risk of becoming infected.”
Political parties hijacked the response for vain glory, there was greater lack of cross-border cooperation and information sharing on the health crisis, the UN Security Council barely paid close attention to the governance challenges in these countries where citizens’ trust in their governments and institutions was elusive; there was vacuum in the Economic Community of West Africa, ECOWAS, regional health surveillance, communication and coordination mechanisms.
Dionne noted that on June 30, 2014, Liberian President Ellen Johnson Sirleaf declared that government would put-on-trial anyone “reported to be holding suspected Ebola cases in homes or prayer houses.” Similarly, Sierra Leone President Ernest Bai Koroma had also made such statement as Sirleaf’s.
The Washington Post’s reporter argued, “The statements were mischievous and capable of brewing increase in traffic of assumed Ebola cases to formal health institutions, where people can be properly isolated, subsequently allowing others who may have come into contact with a suspected case to be traced; ultimately curbing the outbreak’s spread. But is the threat of prosecution the best motivation for increasing health-seeking behaviour? If a government is ill-equipped to provide basic health services in far-flung regions of the country, how equipped is that same government to prosecute evasion of health care?”
However, the apprehension all over the world by July 2014 was that Africa will not be getting over her Ebola outbreak very soon. But she did, upon that there was poor health infrastructure in the affected countries. Before then, Sierra Leone and Liberia had been destroyed by wars and refugees fled into Guinea where health services were already poor. There was dearth of health personnel in these countries with Liberia having just 0.014 doctors per 1,000 people.
From March 2014, Doctors Without Borders (Médecins Sans Frontières), MSF, teams treated 10,376 patients in West Africa including 3,804 patients in Guinea, with the authorities saying that 110 health workers died from the virus in the country.
Sources say “Doctors Without Borders/Medecins Sans Frontières (MSF)” sent a specialized team to Gueckedou on March 18 2012, just six days after another of their teams already in Guinea (working on a malaria project) had learned from Guinea’s Health Ministry about what was then characterized as a “mysterious disease.” Conversely, with respect to coordinating response across the countries, there seems to have been greater delay. For example, it was not until July 2 2012 that the WHO convened a special meeting bringing together health ministries and partners involved in the Ebola outbreak to discuss a collective response. Only today is the WHO activating operations at a Sub-Regional Outbreak Coordination Center it recently established in Conakry."
Bold steps taken
Despite the glaring shortcomings, health workers took blood samples for Ebola virus testing at screening marquees. Jingles, campaigns and the media were awash, all sensitizing the masses to wash their hands and know measures to address any suspected victim of the virus. Local ministries of health of Liberia, Guinea, and Sierra Leone, Nigeria, WHO, (MSF, CDC, UNICEF, Institute Pasteur, European Mobile Laboratory Project (funded by the European Union), all responded.
At many public places, sterilizers were mounted at the entrances. People cleaned their hands with them. In 2012, Uganda recorded what analysts said was one of the more successful Ebola responses in history after the epidemic claimed 17 lives among 24 confirmed cases. The country had set up CDC, a lab at Uganda’s Virus Research Institute specifically tasked with the rapid diagnosis of viral hemorrhagic fevers (including Ebola) two years before the 2012 outbreak. Six days into the 2000 Uganda Ebola outbreak, donor community enhanced the Ugandan government Ebola budget (adding $400,000 to the government’s $285,000).
West Africa not sleeping
Upon the certification that Liberia is free from the virus, responses and sensitizations are still ongoing for any eventual outbreak across West Africa.
Sorbor George, chief of communication at the ministry in Liberia, told AFP, “We have been carrying on a sensitization campaign. This campaign will continue, and we will still be in readiness to contain any eventual outbreak.”
It is hoped they will walk their talks in order to avoid more agonizing deaths.