Ebola: How the world’s focus has shifted

“Nobody in West Africa had ever seen ebola before and they were scared. They were really, really scared.”

According to American physician Dr. Aileen Marty, this is what the recent ebola epidemic looks like from the ground.She says the residents of Nigeria, where she was stationed, were afraid of the droves of people coming into their homes in Hazmat suits. They were afraid of losing their family. They were afraid of being taken away to die.

“You have to treat people with respect and dignity. You have to make sure they don’t think, that you think they’re just some kind of a monster so you have to be wearing a suit around them,” she says.

Marty went to Nigeria as part of the World Health Organization mission as soon as the government put out the call for help. Her training with the American Navy, as well as her experience working with dangerous pathogens made her feel up to the job. But even her training couldn’t prepare her for what she found once she got there.

“We had an ebola patient because of the lack of screens get bitten by a mosquito and come down with malaria while she was recuperating from ebola,” Marty says.

These are the type of challenges that come with working in this unique geographical location. Although Nigeria was recently declared ebola-free by the WHO, Sierra Leone, Liberia and Guinea continue to be devastated by the disease. The first cases of ebola virus disease, which is transmitted by bodily fluids, and has an approximately 50% fatality rate, according to the WHO, were reported in March of 2014.

As Marty points out, the overall situation has since deteriorated, partly due to the lack of donor support and supplies. According to her, the mission in Nigeria was lacking basic personal protective equipment, sanitizers, gloves, re-hydration fluids, mosquito nets and more.

Despite the lack of resources, the international community is shifting their focus to protecting the home-front. The climate of fear still persists in West Africa, but now, the panic is spreading around the globe too.

According to an ebola risk perception survey conducted in Ontario by the Carleton University Survey Centre, 45 percent of Ontarians are concerned about there being a large scale ebola outbreak in Canada within the next year. A similar study conducted in the U.S. by Harvard University stated that 39 percent of Americans had the same fear. This sense of unease seems to have seeped into the public policy of both countries.

Canadian Minister of Health Rona Ambrose announced on Oct. 8, 2014, that six Canadian airports would begin screening passengers travelling from ebola-affected countries. On Oct. 11, 2014 the first airport screenings in the U.S. began at New York’s JFK airport.

Ambrose’s Oct. 15, 2014 statement noted that all travellers arriving in Canada from an affected country will be passed into the hands of a quarantine officer for a mandatory health assessment. This will include “targeted temperature screenings,” according to Ambrose, as well as a mandatory list of questions.

While increased precautions are certainly taking place in North America, not everyone is convinced that they are necessary.

“We’ve had very few cases, this will be horrendously expensive and that money is not being spent on stemming the epidemic where it is killing people,” says Jean Daudelin, a Carleton University professor of International Affairs.

And it is killing people.

The World Health Organization says that almost 10,000 people have been infected. Of those, almost half have died. The actual number of deaths may be as much as three times higher than reported, according to the WHO.

Of these fatalities, only 4 took place outside of West Africa. One in the United States, two in Spain and one in Germany, according to the Centre for Disease Control and Prevention. Despite this, waves of panic and paranoia seem to be sweeping the Western world.

“The threat is in West Africa, the focus should be West Africa,” says John Rainford, director of The Warning Project and co-publisher of the Ontario risk perception survey.

John Schram is the former High Commissioner to Sierra Leone and ambassador to Liberia. He says that the question isn’t of deciding which country is more important, but of finding a balance.

“We have to watch both and I don’t think it’s a case of saying one is more important than the other,” he says. “They both have to be tackled and if screening people at airports will help, then I guess we better do it.”

As the United States and Canada work to ease public panic with screening measures and border controls , the Liberian Ministry of Health and Social Welfare says that it lacks 80,000 body bags, 2.3 million boxes of protective gloves, and 990,000 personal protective suits to meet their need over the next six months.

The international community has sent aid to ebola-affected countries. Prime Minister Harper noted Canada’s contribution of $2.5 million in a speech in the House of Commons on Oct. 20, 2014. Still, many critics say it is not enough.

“If we want to keep the health of Canadians safe, we have to stop that epidemic in Africa,” says Dr. Jay Keystone. “Not be sitting here doing feel-good things.”

Keystone is a Toronto physician who specializes in tropical and infectious diseases. He is also the former president of the International Society of Travel Medicine. He says the screening processes put in place in 11 North American airports are “mostly a waste of time.”

According to Keystone, it would be easy to get past the screenings. The incubation period of the virus is 21 days. He says this means that someone could come through the airport on day five of the infection, for example, and not show any symptoms until day 18. It is also important to consider that people could lie about their exposure.

“You are not going to disclose you have ebola or that you’ve been in close contact because, frankly, you’re terrified that they’re going to send you back or put you in quarantine,” he notes.

Since the screening process could be so ineffective, says Keystone, why not put the resources into somewhere that actually needs them? He even notes that the international community’s motives need not be completely altruistic either.

“So many are dying and if we can stop the epidemic, it will also keep us safe. That’s selfishly what we need to do.”

But is the focus on the home-front defences against ebola actually selfish?

Valerie Percival doesn’t think so. Percival is a professor of International Affairs at Carleton University and the former High Commissioner for Refugees at the United Nations. Her area of study focuses on health and conflict, which gives her a unique perspective into the ongoing crisis.

“I think that putting in place screening at Canadian airports is going to make Canadians feel more secure and I don’t think that’s necessarily a bad thing,” she says.

Percival doesn’t deny the dire circumstances in West Africa. The effects on the socio-economic structure of the affected countries will be devastating, she says. When the epidemic eventually ends there will be a huge increase in the fragility of the affected West African states.

But Percival doesn’t think we should neglect the home-front either.

“I think that it’s sort of necessary in the current global environment that the government is sending a message to Canadians that they’re doing everything in their power to ensure that they’re protected.”

Even some of those who are critical of the screening procedures admit that some good may come out of the Western world’s fear. Daudelin notes that what the world has learned in this epidemic will help to strengthen organization, infrastructure, institutional organizations and education campaigns for future crises. Because if there is one thing that most experts can agree on, it’s that we didn’t act fast enough.

“I think the whole world community… rests ashamed of themselves and how long it took to respond to the ebola crisis,” says Rainford.

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