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Ebola: Fear, Paralysis, Solidarity, Justice


Jay Naidoo is founding General Secretary of Cosatu, former minister in the Nelson Mandela government and former chair of Gain, a global foundation fighting malnutrition in the world.

No one had heard of the tiny village of Meliandou, Southern Guinea before; a place where time has stood still, untouched by the technology revolution; nestled in the forests which over generations sustained the hunter gatherers. Life was simple for a long time; it was a life many of us yearn for – away from the treadmill of life in the city. That lasted until that ecosystem changed dramatically.

Civil wars broke out in neighbouring Liberia and Sierra Leone. Refugees poured over the border. The population exploded, the traditional forests suffered, slaughtered by timber companies to meet construction needs. The mining conglomerates poured in investment in a reckless rush to exploit the huge natural resources. In the context of political intrigues and instability in government, it became the flashpoint of a disaster waiting to happen.

In December last year, that simple and ordinary life came to an abrupt end when the Ebola virus claimed its first fatality of this current epidemic, brought there probably by infected fruit bats that feed on the village’s remaining mango and palm trees. Ebola, one of the deadliest viruses in medical science, is now a catastrophic epidemic raging across the region of West Africa with a massive breakout in Guinea, Liberia and Sierra Leone.

The Ebola virus has no specific cure and the mortality rates are up to 90%. Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area and for so long.

Glaringly, the world waited three months before reaction. The World Health Organisation’s capacity to respond urgently is undermined because of large budget cuts that member states imposed as part of the austerity measures caused by the financial crisis. The well-established procedure for curtailing Ebola outbreaks, isolating those infected and closely monitoring those who had contact with them, took time to implement.

In Liberia, for example, there were only 51 doctors in 2010. Health care workers were decimated as they lacked protective gear or were ill – trained to tackle a virus that can survive on surfaces or any object contaminated with bodily fluids, like a latex glove or a hypodermic needle. More than 200 health workers in the three worst-affected countries have been killed and 375 infected.

A WHO situation report said the number of beds for patients was “grossly and visibly inadequate” and the deteriorating situation was making good clinical care for any illness increasingly difficult. Care systems have begun to buckle under the pressure of the Ebola outbreak, with hospitals either overflowing or closed to stop its spread as agencies struggle to staff treatment centres.

More than 6,200 people in Guinea, Liberia, Nigeria, Senegal and Sierra Leone have contracted Ebola since March, according to the World Health Organisation, making this the biggest outbreak on record. More than 3,000 people have died. The US Center for Disease Control and Prevention said that in a worst-case scenario, cases could reach 1.4 million in four months.

People are extremely mobile. It is difficult to track down those who had had contact with the infected people. Vehicles carrying highly contagious Ebola corpses to villages or town cemeteries end up contaminated, causing flaring up of cases in in different places. Sick patients are being turned away from health centres due to the lack of beds, and families are traumatised by medical orders to pull away from sick relatives.

In large city slums, it is virtually impossible to find those who had contact with patients, no matter how great the effort. It is a matter of life and death that the virus does not reach the mega-cities like Lagos or beyond to Kinshasa, Nairobi or Johannesburg. This requires a united African response.

Two weeks ago in New York, I sat in a meeting of senior decision makers in Africa. The picture was grim. The African response was half-hearted and equally late. Countries responded by closing down borders and suspending air travel. Solidarity was pitched out of the window. A senior leader in the emergency aid world said, “This is the worst humanitarian crisis I have seen. Corpses are piling up in mortuaries. They are rotting in the fields. They carry the greatest risks of the epidemic exploding. And children whose parents have died are increasingly being rejected by the communities because of the concurrent stigma.”

Health systems in the worst-hit countries of Liberia, Sierra Leone and Guinea have been overwhelmed and the United Nations has repeatedly appealed for more doctors, nurses, medical equipment and supplies to be sent to West Africa. Doctors and nurses are finally volunteering to fight the Ebola virus in West Africa after a long period of paralyzing fear in which almost none stepped forward. But local people have to be trained – a big problem being that many local hires cannot go home at night because their families are afraid.

Whatever the predictions are, there is an exponential rise in casualties. And the response is nowhere near the scale needed to face this threat. In fact, estimates are that we need twenty times the resources. World leaders were asked during the recent United Nations meeting in New York to pledge urgently needed aid to battle Ebola in West Africa, as Sierra Leone quarantined one million people in a desperate bid to beat back the deadly virus.

“The world can and must stop Ebola now,” Ban Ki-Moon said in his address to the meeting. “Today, it is time for the international community to step up.” Sierra Leone took the drastic step of putting more than one million people in five districts under quarantine – the largest open-ended lockdown in the Ebola outbreak.

“My country is at the battlefront of one of the biggest life and death challenges facing the global human community,” Sierra Leone’s president, Ernest Bai Koroma, told the meeting by video link from Freetown.

“Ebola is not only a disease of Sierra Leone and its neighbours, it is a disease of the world,” said President Ellen Johnson-Sirleaf of Liberia, the worst-hit country. “We are fighting back.” The Liberian president recalled that her country was emerging from years of conflict and that the epidemic threatened to wipe out peace gains.

Dr Joanne Liu, president of Doctors Without Borders, which treats more patients than any other entity, said: “If we had 1,700 staffed beds right now, we could maybe turn the tide. When we hear the pledges, we ask for timelines. Some say eight to 10 weeks. They’re going to wake up to a much bigger problem at Christmas.”

The first American troops with orders to build 17,100-bed hospitals are arriving in Liberia now. Other countries, particularly Britain and France, are under pressure to do the same in Sierra Leone and Guinea.

Cuba said it would send nearly 300 more doctors and nurses to West Africa to help fight the Ebola epidemic. This will raise to 461 the number of Cuban medical personnel that the country will send to battle the disease.

While there has been limited support from some African countries, it does beg the question of what commitment we have to Pan African solidarity.

In a world which is full of prejudice: Africa is a country.

At the same time major gains made in these post-conflict societies are being undermined. The citizens of Guinea, Liberia and Sierra Leone are not our enemy. The Ebola virus is, and it respects no borders. The economic impact of the crisis will not just be felt in West Africa, it will be continental. What the countries affected need is solidarity and concrete support, especially medical personnel and medical equipment.

The affected governments need political and financial support. Our failure to act now, as the rest of Africa, cannot be the foundation of our ‘Africa Rising’ narrative. Our narrative should be about action in social solidarity, human dignity and justice with our African brothers and sisters in West Africa. DM