Ebola, Security, and Governance in West Africa: Why a Limited Problem Needs a Global Response

facebooktwittergoogle_plusredditpinterestlinkedinmail
A humanitarian aidworker assists in controlling Ebola in West Africa (© European Commission DG ECHO/EU Humanitarian Aid and Civil Protection/Jean-Louis-Mosser)

A humanitarian aidworker assists in controlling Ebola in the West African nation of Guinea (© European Commission DG ECHO/EU Humanitarian Aid and Civil Protection/Jean-Louis-Mosser, Flickr Commons)

The most recent outbreak of Ebola in West Africa is different—and the difference matters not just to the afflicted nations but to all of us. The outbreak is a manifestation of a public health threat to the vital national interests of the entire international community. Even as it is in the midst of a truly heroic response to the outbreak, that community—and the NGOs and humanitarian assistance actors that collaborate with it—must learn the right lessons from the current outbreak, and must do so quickly. Developing better disease monitoring, better early warning systems, more rapid public health response mechanisms, and more robust local public health infrastructure and institutions in at-risk areas throughout Africa are all essential takeaways from the ongoing spate of Ebola cases that continue to multiply across broad areas of West Africa. An additional and important lesson of this outbreak may be that public health stakeholders will themselves require substantial support, primarily of a military nature, in order to access many of the areas in which the outbreak is occurring and to undertake the sustained medical relief effort necessary to contain it. The speed with which this support can be marshaled and deployed may have just as critical an impact on controlling the outbreak as the activities of health professionals combating the disease on the front lines.

This outbreak differs from previous Ebola epidemics in terms of the extent of the afflicted area, how rapidly and how widely the disease has spread, and the degree to which it has frustrated attempts at containment. Many of the reasons for these differences have less to do with the medical characteristics of the disease than with the chronic underdevelopment, lack of adequate health services, poor governance, insecurity, and endemic poverty native to the areas in Liberia, Sierra Leone, and Guinea to which the recent outbreaks have been localized. These same features also characterize the areas in Central and East Africa where previous Ebola flare-ups have occurred, however. Cataloguing and responding to what has changed since past incidences may prove key to containing this one.

In the past, the remote villages most susceptible to Ebola were isolated from each other and from larger surrounding communities, both geographically and in terms of communication. Past outbreaks thus remained largely localized to the villages in which they occurred. Today, Africa is a smaller place, with accelerating migration from rural to urban areas. Migrants to cities from rural areas are concentrated in equally underdeveloped urban peripheries, which have grown so quickly that they have overwhelmed the capacity of African municipalities to provide basic services. As a result, the conditions of chronic underdevelopment, poor health, inadequate services, and insecurity of rural and remote areas have migrated to major urban centers.

Electron micrograph of an Ebola virus viron (from the Centers for Disease Control and Preventions Public Health Image Library, made available on Flickr Commons by Global Panorama)

Electron micrograph of an Ebola virus viron (from the Centers for Disease Control and Preventions Public Health Image Library, made available on Flickr Commons by Global Panorama)

At the same time, the increased use of cell phones on the continent has enabled news of Ebola cases and local outbreaks to spread rapidly, widely disseminating horrific accounts of the disease’s symptoms and high mortality rate. The combination of a continuous stream of firsthand accounts describing the accelerating outbreak and the inability of national and local administrations to respond effectively has generated widespread fear and uncertainty. Local mistrust of deeply corrupt and ineffective state institutions—particularly related to security, but also health services and even a decreased faith in modern medicine itself—have contributed to a “flight” response among communities in which cases of Ebola have appeared.

The movement of what might be termed “health refugees” out of outbreak areas appears to be contributing significantly to the persistence of the most recent Ebola flare-up. Some refugees are no doubt fleeing deeper into the West African bush, using remote paths and tracks that straddle border areas throughout the Mano River region, knowledge of which is ubiquitous due to their use as highways for the fighters and weapons that have accompanied past armed conflicts. Because these pulses of health refugees are remote from seaports and international airports, their movements do not threaten to spread the disease beyond the Mano River region in the immediate future. Unfortunately, they carry a significant—and far more difficult to counter—longer-term risk of spreading the disease more gradually across West Africa, into regions that will be extremely difficult for health workers to gain access to and in which it will be extremely difficult for them to operate effectively.

On the other hand, the mass migration of African citizens to the urban sprawl that surrounds the cities of Monrovia, Freetown, and Conakry is moving the epicenter of the affected region to areas with immediate access to global transportation networks. The international community, national public health organizations, and international health bodies were slow to recognize this risk. (Although the Centers for Disease Control and Prevention in Atlanta, Georgia has recently called for a more urgent and effective response.) Even now, that recognition is largely limited to restricting sea-, air-, and ground-travel across international borders. The humanitarian assistance and disaster response (HADR) community confronts major challenges in combating the outbreak in the dangerous, difficult to access, and poorly served shantytowns that surround national capitols and major cities in the outbreak areas. Population concentrations in these areas are far higher than in their rural counterparts; sanitation problems are correspondingly greater, and options for flight more limited. A major risk given this situation is the potential for a second or even tertiary Ebola outbreak to gestate in these poorly governed and insecure urban areas and gather renewed momentum.

The answer to the question of why the most recent Ebola outbreak should galvanize the international community into action is neither self-evident nor simply humanitarian in nature. It is a question the major actors on the world stage—those nations with the resources, institutions, and capacity to generate the necessary response quickly—must examine and answer critically. After all, as horrific as Ebola is, the number of infected individuals is still fairly limited, and the impact on the developed world—including the nations of Europe and North America, as well as global economic powerhouses like China—has been minimal. On a straightforward yet universally sobering level, however, the international community should move to address the latest outbreak because the same conditions that fostered the rapid spread and persistence of Ebola are likely to have a similar effect on other diseases, which may be far more communicable and pose a much greater threat. Imagine if the disease in question had been similar to the SARS or MERS virus, or even as mundane as a new and particularly virulent strain of influenza. The Spanish Flu infected some 500 million worldwide in 1918, ultimately killing between 50 and 100 million of those afflicted. Were such an outbreak to occur under similar conditions to those of the recent spate of West African Ebola, especially absent early recognition of the extent of the outbreak and timely measures to limit it, a global pandemic could result. In addition to the terrible suffering and loss of life within West African nations, the ongoing epidemic delivers a dire warning about how much worse things could get.

International Aidworkers enter a West African village to combat Ebola ()

International Aidworkers enter a West African village in Guinea to combat Ebola (© European Commission DG ECHO/EU Humanitarian Aid and Civil Protection/Jean-Louis-Mosser, Flickr Commons)

On a level that should be encouraging to the international community, however, the current outbreak also offers an opportunity to develop a better understanding of how pandemic diseases manifest in the dynamic world of the 21st century. As international actors marshal the resources to support the courageous doctors, nurses, and local health workers who are laboring selflessly—and at great personal risk—to contain this outbreak, they must quickly learn how to distribute those human resources more swiftly to the affected areas of greatest need. The world must more rapidly furnish and deploy the equipment, personnel, security, communications, and logistics necessary to enable the effort to contain the outbreak. In the hardest hit areas of West Africa, this will probably require military support: rotary winged aviation, heavy air lift, trucks, fuel, power generation, and shelters, all of the resources necessary to enable an effective public health response. The world can and must learn from this opportunity, as it learned from the 2010 earthquake in Haiti, to collaboratively build more effective mechanisms to quickly identify major outbreaks with pandemic potential and efficiently respond to contain those outbreaks.

A cautionary note must be sounded with respect to deploying military forces in support of the containment effort, however. The use of military forces should be undertaken to support health workers combat the outbreak, not in an attempt to isolate entire affected communities. Unfortunately, the latter appears to have been the initial response of both the Sierra Leonean and Liberian governments. Isolating these communities with military or police forces is likely to further increase the fear and suspicion with which local populations in the area already regard state security services. Moreover, it is unlikely to prevent the continued flight of refugees from affected areas, and may in fact exacerbate them if local residents perceive the state to have abandoned their villages and communities. Instead, both national and international military forces can and should play critical roles in helping health workers reach vulnerable communities. Police officers and military personnel can also collaborate with health workers to better inform the public of common-sense measures to increase infected family and community members’ chances of survival while minimizing the likelihood of immediate caregivers, family, or community members themselves contracting the disease. The cell phones that are ubiquitous in even the most remote villages could become an important tool in this effort.

In the longer term, the states most at risk of serious outbreaks must effectively reduce their vulnerabilities to such diseases. Improving governance, particularly at the local level and in the area of public service delivery, will be essential to realizing this goal. Public health capacity, infrastructure, and surveillance must all improve as well. Security sector reform, focused not just on traditional physical security (including police, justice, and military forces) but on human security for the most at-risk communities, will be a key enabler of more immediate local response efforts. While addressing these issues is the primary responsibility of the states most at risk of a pandemic outbreak, every nation has a vital interest in assisting those states—and the communities within them—to reduce the risk of outbreak and increase regional and global resilience should an outbreak occur. When one’s neighbor’s house is on fire, it is a foolish homeowner who does not run to help put out the flames. And in today’s globalized world, everyone is our neighbor.

 

Disclaimer: This article was prepared and authored in the author’s personal capacity. The opinions expressed herein are the author’s own and are not offered on behalf of the Africa Center for Strategic Studies, the United States government, or any other third party.

facebooktwittergoogle_plusredditpinterestlinkedinmail
Thomas Dempsey

Colonel Thomas Dempsey, U.S. Army (retired) is Assistant Professor and Academic Chair for Security Studies at the Africa Center for Strategic Studies (ACSS). Previously, he served as Professor of Security Sector Reform with the U.S. Army Peacekeeping and Stability Operations Institute (PKSOI), director of reconstruction and training of the Liberian Ministry of National Defense as part of the joint U.S.-Liberian Security Sector Reform Program, Director of African Studies in the Department of National Security and Strategy at the U.S. Army War College, Chief of Africa Branch at the U.S. Defense Intelligence Agency Defense HUMINT Services, and Defense Attaché in Liberia and Sierra Leone. Most recently, Professor Dempsey edited and contributed to Civil Power in Irregular Conflict, which was published in 2010 by the Center for Naval Analyses' Federally Funded Research and Development Center.

61 Comments

  • February 24, 2017

    ig

    Magnificent web site. A lot of useful info here. I’m sending it to
    some pals ans additionally sharing in delicious. And obviously, thanks for your sweat!

  • February 25, 2017

    ig

    I always spent my half an hour to read this website’s articles every day along with a cup of coffee.

  • I am curious to find out what blog system you’re working with?
    I’m experiencing some minor security issues with my latest site and I would like to find
    something more secure. Do you have any solutions?

  • March 11, 2017

    Augusto de Arruda Botelho

    If some one wishes expert view about blogging and site-building after that i
    propose him/her to visit this blog, Keep up the pleasant
    job.

  • March 15, 2017

    nume coupon code

    Machst Du in den Social Networks noch was anderes als nur Links posten?

  • March 18, 2017

    Rebecca Bextel

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    www.furniturefromhome.com

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    AGS Capital

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    www.furniturefromhome.com

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    Furniture From Home

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    BEVERLY DIAMONDS

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    Alan Symons

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 18, 2017

    Beverly Diamonds

    No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • No better a kook bigger than the internet from Furniture From Home, BRIAN WILLIS Brockstar, BROCKSTAR BY BRIAN NELSON WILLIS, Richard Ellenbogen – Beverly Hills Body,LuxSauna, Alan Symons, park ward, nationwide home comfort, AGS Capital and kaonsoftware and the kind. Poggi, Michael Michael Poggi Poggi’s Animal House like.Elite Client Services – Private Client Management Group TRUSTED as well. Furniture From Home Beverly Diamonds Elite Client Services – Private Client Management Group TRUSTED Mountain Business Center LLC, Rebecca Bextel

  • March 19, 2017

    Elton

    I simply couldn’t depart your website before suggesting that I extremely loved the usual info a person provide
    in your visitors? Is gonna be again often in order to check up on new posts

  • BROCKSTAR BY BRIAN NELSON WILLIS SFO probes US lender over missing millions Brockstar Finance

  • March 19, 2017

    Brockstar

    BROCKSTAR BY BRIAN NELSON WILLIS SFO probes US lender over missing millions Brockstar Finance

  • March 20, 2017

    Raina

    Hi, i feel that i noticed you visited my website thus i got
    here to go back the choose?.I’m trying to find
    issues to improve my site!I guess its good enough to make use of a few of your ideas!!

  • March 20, 2017

    Deangelo

    I read this piece of writing completely on the topic of
    the comparison of latest and previous technologies, it’s amazing article.

  • March 20, 2017

    word audio books

    Spot on with this write-up, I truly think this amazing site needs much more attention. I’ll probably be returning to see more, thanks
    for the information!

  • March 20, 2017

    Fay

    Hello there! Do you know if they make any plugins to assist with SEO?
    I’m trying to get my blog to rank for some targeted keywords but
    I’m not seeing very good results. If you know of any please share.
    Thanks!

  • March 21, 2017

    Itamar Serpa Fernandes

    I like the valuable info you provide in your articles.
    I will bookmark your weblog and check again here frequently.
    I am quite certain I’ll learn many new stuff right here!
    Good luck for the next!

  • March 21, 2017

    Danelle

    Thank you for some other wonderful article. The place else could anybody get
    that kind of information in such a perfect means of writing?
    I have a presentation next week, and I’m on the search
    for such info.

  • March 21, 2017

    Brad

    Wonderful goods from you, man. I’ve understand your stuff previous to and you are
    just too fantastic. I actually like what you’ve acquired here, really like what you’re stating
    and the way in which you say it. You make it entertaining and you still care for to keep it sensible.
    I cant wait to read much more from you. This
    is really a wonderful web site.

  • March 21, 2017

    Roberta

    It’s perfect time to make some plans for the longer term and it’s time to be happy.
    I’ve learn this put up and if I may just I wish to suggest you few attention-grabbing things or tips.
    Perhaps you can write next articles regarding this article.
    I desire to read even more things approximately it!

  • Hi, its fastidious paragraph about media print, we all be familiar with media is
    a impressive source of facts.

  • March 21, 2017

    Itamar Serpa Fernandes

    I’m not that much of a online reader to be honest but your sites really
    nice, keep it up! I’ll go ahead and bookmark your website
    to come back in the future. Cheers

  • March 21, 2017

    Mel

    Undeniably believe that which you said. Your favorite reason appeared to be on the internet the easiest thing to be aware of.
    I say to you, I definitely get irked while people think about worries that they just don’t know about.

    You managed to hit the nail upon the top and also defined out
    the whole thing without having side effect
    , people could take a signal. Will probably be back to
    get more. Thanks

  • March 21, 2017

    Jorja

    An interesting discussion is worth comment. I think that you ought to write more on this issue, it may not be a taboo subject but usually people do not talk about these topics.
    To the next! Kind regards!!

  • March 21, 2017

    www.furniturefromhome.com

  • March 22, 2017

    body mass index

    I could not resist commenting. Perfectly written!

  • March 22, 2017

    Beverly Diamonds

  • March 22, 2017

    nationwide home comfort

  • March 22, 2017

    Alan Symons

  • March 22, 2017

    granger whitelaw

  • This is the right web site for anyone who hopes to find out about this topic.

    You realize so much its almost tough to argue
    with you (not that I really would want to…HaHa).
    You certainly put a fresh spin on a topic that’s
    been written about for years. Excellent stuff, just wonderful!

  • March 22, 2017

    Voyage canada

    J’ai passé un super voyage au Canada.

  • March 22, 2017

    Egli Diana Pinto

    Hi there everyone, it’s my first pay a quick visit at this web page, and piece of
    writing is in fact fruitful in support of me, keep up posting these types
    of articles.

  • March 22, 2017

    online forex market

    I got this site from my buddy who told me regarding this website and at the moment this time I am visiting this web site and
    reading very informative articles or reviews at this time.

  • March 23, 2017

    Simon

    This is really interesting, You’re a very skilled blogger.
    I have joined your rss feed and look forward to seeking more of your fantastic post.

    Also, I’ve shared your web site in my social networks!

  • March 23, 2017

    financial obligations

    I have been surfing online more than 2 hours today,
    yet I never found any interesting article like yours.
    It’s pretty worth enough for me. In my opinion, if all website owners and
    bloggers made good content as you did, the web will be a lot more useful
    than ever before.

  • March 23, 2017

    pertaining toenail

    Wow, this piece of writing is pleasant, my younger sister is analyzing these things, thus I am going to convey her.

  • March 24, 2017

    throat bacteria

    I like the valuable info you supply for your articles.
    I’ll bookmark your weblog and check again here regularly.
    I’m somewhat certain I will be informed plenty of new stuff proper here!
    Best of luck for the next!

  • March 24, 2017

    Annabelle

    Hola! I’ve been following your weblog for some time now
    and finally got the bravery to go ahead and give
    you a shout out from Atascocita Texas! Just wanted to mention keep up the great job!

  • March 24, 2017

    Augusto de Arruda Botelho

    You actually make it seem so easy with your presentation but I find this
    matter to be really something that I think I would never understand.
    It seems too complicated and very broad for me. I
    am looking forward for your next post, I will try to get the hang of it!

  • Fastidious respond in return of this difficulty with real arguments and telling the whole
    thing concerning that.

  • March 25, 2017

    car computer exchange

    I read this piece of writing fully on the topic of the comparison of hottest and preceding
    technologies, it’s amazing article.

  • March 25, 2017

    ideal air travel

    Greetings! I’ve been following your website for a while now and finally got the
    courage to go ahead and give you a shout out from Humble
    Tx! Just wanted to say keep up the good work!

  • March 25, 2017

    Mariana

    I’m not sure why but this weblog is loading very slow for me.
    Is anyone else having this issue or is it a issue on my end?
    I’ll check back later on and see if the problem still exists.

  • March 25, 2017

    Maureen

    Why users still use to read news papers when in this technological world everything
    is available on web?

  • March 25, 2017

    prospective advisor

    Good day! This post couldn’t be written any
    better! Reading this post reminds me of my previous room mate!
    He always kept talking about this. I will forward this write-up to him.
    Pretty sure he will have a good read. Thanks for sharing!

  • March 26, 2017

    online business

    What’s up, its fastidious piece of writing on the topic of media print, we
    all be familiar with media is a great source of facts.

  • March 26, 2017

    financial advisors

    Wonderful blog you have here but I was wondering if you knew of any discussion boards that cover
    the same topics talked about here? I’d really love to be a part
    of online community where I can get comments from other experienced people that share the same interest.
    If you have any recommendations, please let me know.
    Many thanks!

  • March 26, 2017

    Rosemary

    I was able to find good info from your blog posts.

  • March 27, 2017

    except credit

    Hello there! This post couldn’t be written any better!
    Reading through this post reminds me of my good old room
    mate! He always kept chatting about this.
    I will forward this page to him. Pretty sure he will have a good read.
    Thanks for sharing!

  • March 27, 2017

    Egli Diana Pinto

    If you want to get a good deal from this piece of writing then you have to apply such techniques to your won web site.

  • March 28, 2017

    spinning exercises

    Undeniably believe that that you said. Your favourite justification seemed to be
    on the web the simplest factor to take into accout of.
    I say to you, I certainly get irked at the same time as folks consider issues that they plainly don’t understand about.
    You managed to hit the nail upon the top and outlined out the entire
    thing without having side-effects , folks can take a signal.

    Will likely be back to get more. Thanks

  • March 29, 2017

    Egli Diana Pinto

    Thank you for the good writeup. It in truth was a enjoyment
    account it. Look complex to far introduced agreeable from you!
    However, how could we keep in touch?

  • March 30, 2017

    spin bikes

    Incredible quest there. What happened after? Good luck!

  • March 30, 2017

    workout routines

    I am curious to find out what blog platform you are utilizing?
    I’m experiencing some minor security problems with
    my latest blog and I’d like to find something more risk-free.
    Do you have any suggestions?

  • March 30, 2017

    Egli Diana Pinto

    Wow, this article is pleasant, my younger sister is analyzing these things, thus I am going to inform her.

Leave a Reply