Liberia has been hit hardest by the Ebola outbreak. It makes sense to focus much attention to this country, as well as its neighbours Sierra Leone and Guinea. But Ebola is not just a crisis for Liberia Sierra Leone, or Guinea. The devastation it creates in these severely affected countries is also felt in the entire West-African region and beyond. The outbreak of the incurable disease across the region is certainly a medical crisis, but so much more. It also has political, economic, gender and security dimensions. To understand Ebola’s regional impact and continual threat, a longer-term understanding of the underlying issues is needed.
The humanitarian crisis
Governments across the globe are currently seeking ways to contain the outbreak. The United States is setting up emergency hospitals in the region, China is sending a laboratory, Japan is providing experimental drugs. However, a key challenge remains in strengthening health care facilities in remote areas across the region. One of the reasons for the spread of the virus is that people seek refuge with family members in neighbouring countries as quarantine centres are full. Without doubt, Ebola is also a gender issue. Women are hit harder, mainly because they are the ones who take care of the victims.
After the apparent successful containment of the disease in March, the second wave of Ebola started with Liberians seeking care from relatives in Guinea. Some of the initial measures to stop the disease from having spreading to other regions were to close borders and to cancel flights. These measures have not stopped the number of victims skyrocketing over the last three weeks with rapid cross border contamination.
Although it seems logical, the international response to the disease is humanitarian in nature, this is only part of the solution. An effective long-term response must recognise the severe political and economic damage wrought by the crisis on the region.
The recent Ebola outbreak exposes the deficiencies of West-Africa’s public healthcare, infrastructure and security provisions. Liberia, the country where two civil wars tore down structures of governance and stopped development for years, has been hardest hit. Other countries are also struggling as rapid urbanisation exceeds the capacity of governments to invest in public infrastructure and health services. This has undermined effective responses to the spread of the disease.
The crisis is compounded by local people’s mistrust of state health services and western medics. They too often rely on insufficient treatment at home or on traditional healers, which has contributed to further contamination. While most international donors support centralized health care, a few international organizations have started to educate local traditional and religious healers on adequate responses to outbreaks of disease.
Ebola has a devastating effect on the economies of the countries it has impacted. This is felt in many sectors and further impedes solutions to the crisis. It has both immediate consequences and long-term implications. The recent strikes of medical staff at Monrovia’s central hospital and at a major Ebola treatment centre in Sierra Leone diminished capacity to cope. In the long-term the disruption caused will have devastating effects on the countries’ economic development. Liberia's Finance Minister said the outbreak had already cost his country's economy US$12 million between April and June. The World Bank has estimated that the outbreak has reduced Liberian GDP by 3.4 %. Sierra Leone’s growth expectations have been reduced from 11.3% in annual GDP growth to 7.0%. The agricultural, mining and service sectors have been particularly hard hit. However, tourism and the informal economy has also suffered. As a result food prices are increasing, if food is available at all. Food shortages have accelerated as people store food as a precautionary measure. In other quarantined areas food is left to rot as farmers are afraid to leave their homes to go to the market. Food shortages increase the risk of violent outbreak, which poses a further threat to stability in the region.
Towards a regional understanding of the Ebola crisis
The crisis has a regional dimension as Ebola significantly impacts on the entire West-African economy. The underlying causes rapid spread of the disease are not just medical, but also have political, economic and security dimensions. The effects are felt at all levels - local, national, regional and global. Thus, the Ebola outbreak can only be fully understood and stopped when it integrates these political, economic and security dimensions into solutions across geographical areas and over time.
It is crucially important to understand, track and anticipate the consequences as the destabilizing effects of the Ebola crisis can spill over to other unstable countries in the region. Earlier experiences in Mali have shown that underlying many conflicts in the region is profound instability. Its root causes can be simmering below the surface for decades only to be triggered by some internal or external factors, or a combination of both. The Ebola epidemic has the potential to not only infect thousands of people, but to ignite social unrest and conflict which will severely undermine efforts to contain the crisis.
ASC Information portal on Ebola
The ASC has launched an information portal on the 2014 outbreak of Ebola (EVD, Ebola Virus Disease) in Africa. On the portal, you will find information from international health organizations like the World Health Organization and Doctors without Borders, government institutions of several (African) countries, news feeds and maps of the outbreak. The Information Portal will be updated regularly.
Photo credit main picture: European Commission DG ECHO