The indirect consequences of Ebola

10 years ago, I recall desperately seeking home content insurance with the threat of Hurricane Dean looming in our midst. Having experienced the lessons of Hurricane Ivan, all 6 insurance company representatives smiled (some laughed) and told me to come back the next week, (once the storm had passed). 

Whilst Cayman was fortunate to escape the wrath of Dean, the same reaction is being faced now by many emergency response delegates responding to the Ebola crisis. Given the current statistics, insuring health workers and volunteers working in the field is being considered a “Big Ask” and whilst most are covered for general health care and accidents, ‘epidemics’ aren’t often covered under such policies. Hence there are a number of personal risking their lives in the fight against Ebola who have no health insurance. So the question is, “How are we protecting/ supporting our ‘front line’ workers and volunteers, (many of whom are unpaid) in carrying out this heroic task? Are we doing enough?”

If the insurance concerns weren’t enough, many are facing other issues. Whilst these very workers are having a real impact on decreasing the spread of Ebola in West Africa, many who return home having completed their ‘assignment’ are not being treated to the ‘hero’s welcome’ they deserve but to fear, rejection and in some cases, isolation by their friends, family and community.

Having attended the IFRC’s Regional Ebola Preparedness Conference last week in Panama, I heard several stories first hand of Red Cross delegates who had recently been working in Ebola Treatment Centres in Sierra Leone, Guinea and Liberia.

One in particular commented that returning home was more difficult then the mission itself. Another delegate from Chad was locked up when he returned home only to be ‘sent back’ to Liberia the next day.Others have returned home to “Western civilization” only to be quarantined or rejected and shunned by their communities. By way of example, Martha, on returning home to Spain was hounded by the media after her neighbor ‘exposed’ her.

Despite taking all necessary precautions (testing her temperature twice daily and being closely monitored etc.), she experienced significant adversity as did her roommate who was refused entry to his school for 21 days despite never stepping foot in West Africa. Whilst I thoroughly appreciate the global concerns about Ebola and the need to take precautionary measures, such treatment is fundamentally unjust, disproportionate and will likely reduce delegates’ ability/ willingness to work in affected countries in the future.

On a different note, countries spending significant expenditure to control their borders/ set up internal emergency response structures etc. is somewhat futile if the root of the cause, the affected countries themselves aren’t being substantially invested in (to prevent the further spread of infection).

Furthermore when so many countries are desperately seeking supplies, namely personal protection gear, masks etc, producers of such items simply can’t keep up with the demand. As a consequence, such equipment is becoming increasingly difficult to access, and whilstmany countries can afford to purchase supplies ‘just in case’, priority must undoubtedly be given to those directly affected today. Unfortunately this isn’t necessarily the case.

Whilst I have already mentioned the ‘stigma’ associated with emergency response delegates and volunteers, stigmatization and racial stereotyping of African nationals is also on the rise with the epidemic.

As so eloquently put by one of the responders from Sierra Leone (JP), the battle of the Red Cross is to:

1) Fight the Ebola virus
2) Provide a voice of reason against fear and stigmatization

Similar to the post 9/11 reaction, it appears in some countries that anyone who has a connection with ‘Africa’ is considered a potential threat whilst in reality the affected areas are in West Africa (Sierra Leone/ Liberia/ Guinea/ Mali) and are microscopic given the size of the African continent.

Whilst Ebola outbreaks have been around since 1976, it is still a largely ‘unknown area’, often phrased “Fearabola”. The epidemic is largely one of fear as opposed to direct science and whilst there is a real and direct threat to those living in affected areas (in particular those caring for the sick or carrying out ritualistic burial procedures), the threat to the rest of the world is not as critical as some media outlets would like us believe. There is a real need for us to attempt to understand the reality surrounding Ebola in order to prevent further spread of fear and stigmatization.

In keeping with the theme of ‘Fearabola’, rumours amongst many nationals in affected countries as to the root cause of the epidemic is rife. By way of example, as described to a Red Cross delegate, the reason why Ebola started was because an ‘invisible plane full of witches crashed in West Africa’, others believe that ‘Ebola was spread by rain drops’ or by ‘Aid workers who want to take over the continent’ or ‘who are carrying out experiments and want to use West African nationals to practice on’. Several delegates had been chased away by locals or had their ambulances burnt and Ebola treatment centres (where they worked) sabotaged.

This sounds disturbing from an outsiders perspective, however who can blame a community when one of its’ members gets sick and are taken away by health workers dressed in ‘alien’ suits who refuse to allow them to say an intimate goodbye to a loved one nor bury family members in accordance with their cultural and religious burial practices? Whilst the reputation of aid workers responding to the crisis is slowly improving and understanding is on the rise, there is still distrust/ denial associated with these ‘aliens’, hence why decreasing the spread of Ebola is rife with numerous issues.

As JP stated, the approach by many response agencies in the field has been a ‘public health’ approach but this alone is insufficient. In the 3 countries most greatly affected, there are significant religious, ethnic, cultural and social aspects that we need to engage in in order that a humanitarian response is effective. We need to be working with community leaders, religious entities and other stakeholders who “know” their own people and who are more likely to be listened to then an outsider.

Just food for thought……..