Ebola – West Africa – A Global BioSecurity Risk

According to Dr. Tom Frieden, the director of the U.S. Center for Disease Control and Prevention, the world is currently facing “The…
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ebolaWritten by Rosi Kern

According to Dr. Tom Frieden, the director of the U.S. Center for Disease Control and Prevention, the world is currently facing “The biggest and most complex Ebola outbreak in history,” with at least four countries being affected by the deadly virus. Whereas the virus, whose outbreak first occurred in West Africa’s Guinea in March this year, initially only spread within West Africa (Sierra Leone, Liberia and Nigeria), the first European and North American victims were repatriated to their home countries last week to receive treatment. Furthermore, suspected Ebola cases have been reported in Saudi Arabia and Benin recently.

Ebola is a hemorrhagic fever that first emerged in 1976 in 55 villages near the headwaters of the Ebola River (Congo) after which the virus was named, killing 9 out of every 10 people it infected. Ebola is transmitted through direct contact with an infected person or through body fluids (sweat, blood, coughs etc.) from an infected person. The disease manifests itself in the form of fever, diarrhoea and bleeding. There is neither a cure nor a vaccination against the disease with about 60%-90% of infected cases bound to die.

Even though Africa has witnessed several outbreaks since 1976, the current one exceeds the death toll of the previous ones by far and has been the first spreading across countries with devastating effects on the national infrastructure such as the economy, educational and health sectors, not even to mention the much needed FDI prospects of the countries at concern.

The health security situation is worsened by an apparent lack of trust by the local population in their own governments and medical staff. Warnings against the consumption and selling of bush meat for instance have largely fallen on deaf ears with an inherent belief of the local populations that Ebola either must be a myth or a scam on behalf of corrupt politicians to deprive them of their most basic needs and livelihoods. Furthermore, there is a great deal of self-denial regarding the disease either by the victims or their relatives putting more lives at risk.

In many cases victims refuse hospitalization opting for traditional healers instead. A lack of trust in hospitals or medical centres and their medical staff, which has contributed to the rapid spreading of the disease considerably, have been heightened by the white protective clothes worn by doctors and nurses that appear very alien to locals. Given that few of the victims admitted to hospitals make it back alive, the imposed quarantine that prohibits relatives from visiting the sick ones contradicting local customs, as well as medical staff contaminating the diseases in dozens of cases themselves while attending patients and dying in the process of it, has eroded confidence in the health sector further. As a result single incidents reported that relatives broke into quarantined wards to remove their sick relatives from hospitals forcefully.

To illustrate with an example, Sierra Leone declared an outbreak of Ebola on 24th May, 2014, which was diagnosed in the Kissi Teng Chiefdom in the Kailahun districts. It’s earliest victims included a traditional healer and a Health practitioner and since then, close to 620 patients have been diagnosed of the disease and more than 200 deaths have been confirmed.

Not long ago a young man was diagnosed of the infection in Kenema, but later left Kenema and travelled to Bo with his mother. After spending 3 days in Bo City, in a crowded compound, he was spotted and identified as a victim of Ebola on the run. As a result he fled to Freetown with his Mother. Whilst in Freetown, he was been treated by a nurse for typhoid Fever. Because of the duration of incubation, it is yet difficult to ascertain how many other people he has had contact with and that might have been contaminated the disease in either Bo or Freetown.

If not properly contained, West Africa risks reversing most of the recent development gains it has made in the area of health care, education and economy. Already most frontline health workers are in constant dread of treating patients, for fear that they may be carrying the Ebola virus, which they can pass on to them. Most nurses have stopped assisting pregnant women with delivery.

ebolaIn Liberia for example the entire health sector is on the verge of collapse with medical staff going on strike as well as hospitals and medical centres shutting down entirely thus leaving large chunks of the population without access to any health care. As a result Ebola inevitably will cause secondary deaths meaning death based on curable diseases such as flues, typhoid or malaria and else because of the lack of operating medical facilities.

With the declared ‘state of emergency’ in Sierra Leone, Nigeria and Liberia martial laws are partly in place that disable students from attending schools and universities. Furthermore, market places and large congregations have been prohibited temporarily leaving thousands of families without an income. Considering that international health experts and virologist assume that it will take several months to contain the virus, the effects of those measures upon the economy and education will be long lasting. West African countries, and Sierra Leone and Liberia in particular, already rank among the world’s least developed countries.

Consequently the risk of rising political instability in countries that are just about to recover from the consequences of brutal civil wars is significant. In Sierra Leone the government has tasked the military recently to entirely quarantine two districts in order to prevent anyone from going in or out to halt the spreading of the virus.

Though necessary to contain Ebola, it is precisely methods like this that serve as stark reminder of the dark days of the civil war for locals. A lack of trust in the government coupled with being cut of from vital water and food supplies due to the quarantine, the situation is bound to explode as time drags on. Unless governments manage to educate and sensitize affected communities about the necessity of these measures while ensuring their most basic needs (food and water) are taken care of sufficiently, the risk of civil unrest will grow by the day.

Despite significant business interactions between West African countries, that are often rich in natural resources, and the rest of the world, not to mention the presence of large Lebanese, British, Chinese and other expat communities, the international community’s response has been rather slow. Individual airlines such as British Airways recently decided to suspend flights to West Africa in response to Ebola. And with the first suspected Ebola victim having died in Saudi Arabia upon his return from a business trip in Sierra Leone, the government will not extend haj visas to Muslim pilgrims from West Africa until further notice.

Despite the World Heath Organization’s decision to step up its assistance to fight Ebola and to declare it as an international state of emergency in August as well as the US-government to deploy a team of 50 health experts to West Africa in order to contain the disease, local organizations in West Africa are increasingly growing desperate in light of the worsening Ebola disaster.

Containing the epidemic and preventing its spread not just within the affected countries but globally, is of crucial importance but so far has proven to to be very challenging due to a lack of awareness and education among the populations in West Africa. Hence, there is an urgent need to heighten education in each country.

Many NGOs are striving to improve education regarding this frightening outbreak but also to help the authorities and healthcare workers manage the outbreak. One such NGO working in Sierra Leone for the past 4 years is Unlimited Partnership (www.unlimitedpartnership.org) is keen to use its experience and skills to help improve the economic and educational lives of marginalized communities and thereby help reduce the further spreading of this deadly disease and others.

The Unlimited Partnership is working closely with a local partner, Caritas Sierra Leone (http://www.caritas.org/where-we-are/africa/sierra-leone/), whose health community works will implement the project on the ground. The project is attempting to raise awareness about Ebola especially among impoverished rural communities that have no access to Ebola education based on radio or TV documentaries and where no intervention has been taking place so far.

Additionally the project also includes the establishment of centres where the relatives of sick ones can seek counselling, support and advise. With this initiative Unlimited Partnership and Caritas seek to prevent the spreading of Ebola and to enhance health-seeking behaviour in rural and urban areas.

As always financial support is needed and donations to support the project can be made to the following bank account: Unlimited Partnership, Münchner Bank 
BIC GENODEF1M01 IBAN DE 27701900000001187430. Companies interested to support the initiative can get in touch for further information on [email protected] and be listed as a sponsor on the NGO’s website.

For more information, or to get in touch with Rosi Kern, please call +44 (0)1543 250456 or email [email protected]

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