The 2014 Ebola outbreak is very relevant to the study of Medicine, Health and Society because the curriculum asks students to look at the cultural, economic, social and political factors that impact health. Ebola is a great case study for students of MHS, or any student interested in global health and development, because Ebola shows us, very clearly, that this is not “just a health crisis, it’s a social and economic one too”. Knowing that, I have two main concerns: First, this understanding of Ebola as a problem of infrastructure that impacts development is not what’s being portrayed in American media. Second, several of the issues that we are confronting in today’s Ebola outbreak are not new issues; in fact, we’ve dealt with many of them even in our recent history. So my question is, why haven’t we learned more from past outbreaks and epidemics? How did we, as a seasoned global health community, let the Ebola epidemic get to where it is today?
Touching on my first point, there seems to be a misrepresentation of where the problem actually lies. US news tells you that this is a problem of hospitals being ill prepared, hospital protective gear being insufficient, and maybe some might even point to individual action based on how the stories of the few Americans infected have been portrayed. But, this is a problem of infrastructure. Now, I’m not going to comment too much on the role of the America media in modern health crises, because that could be a panel discussion of its own, but I would say that it’s not very easy for the typical American accessing the news to really learn about Ebola– the narrative of Ebola that is most accessible for Americans is not the story that we need to be telling. This can have a major impact on our understanding of the virus, and the mobilization of our response efforts.
The real problem is that the affected countries in West Africa do not have the basic infrastructure to contain the Ebola epidemic. These are countries ranked lowest in global development, some coming out of civil war, with fragile economies already. As we can see, the Ebola virus has the potential to threaten the stability of an entire country.
Moving on to my second point, something that frustrates me is why in confronting today’s Ebola outbreak are we dealing with the same issues and challenges that we faced with past disease outbreaks or epidemics? It begs the question, why haven’t we learned our lessons? The easiest comparison here is between Ebola and HIV/AIDS. And one glaring example of these similarities is the UN Security Council’s Resolution on Ebola in September. Here we have an international peace and security organization responding to a health crisis because they recognize that Ebola is a threat to peace keeping and development. We haven’t seen the UN Security Council meet for a health crisis since the HIV/AIDS epidemic. Clearly, we have seen a health issue of this magnitude before.
I argue that we lack informed progress in dealing with the current outbreak both at the systemic level and at the individual level. On the individual level, we are seeing high levels of stigmatization of patients and health care workers in the US and West Africa. As we learned in the past with highly stigmatized disease, specifically HIV/AIDS, our response to a disease outbreak is severely hindered if our public perceptions and our government action penalize or stigmatize doctors, health workers and patients. We need a public sentiment of reason and compassion, rather than fear, in order to increase understanding of the virus and encourage thoughtful response. Here, we are seeing Ebola stigmatization with the stories of mandatory quarantines, regulations clashing at the national and state level, stories of parents pulling their children out of schools, and I even read a story of a hairdresser in Brooklyn refusing to see her client of six years because she started working at Bellevue hospital. This form of ‘othering’ is not new, and this is why many AIDS activists are feeling a strong sense of déjà vu, (or as my mom calls it, deja ‘ew’).
In the current Ebola outbreak, we are seeing stigmatization of the individual, but also of entire places. These range from Bellevue and Texas Health Presbyterian hospitals, to the stigmatization of the entire continent of Africa. There’s a lot of misinformation about travel to and from Africa, travel within Africa, and also about African people, specifically Liberians, in the US. This is quite similar to how “Haiti itself became stigmatized during the HIV epidemic”.
Now, at the systemic level– and this is where I might be the most concerned—is that here we are dealing with an international health crisis, but the organization with the authority and clout to deal with these health crises, the WHO Pandemics and Epidemic Unit, is itself constrained. Stated most succinctly, the WHO’s budget going into the epidemic was too small for it’s responsibilities. Further, we’ve seen that we aren’t successful in mobilizing emergency funds fast enough. So, in sum, my question is, how many bodies will it take for the global health community to adequately prepare for a crisis like this? Will Ebola be the health crisis that forces us to learn these lessons? My guess is that it will not, because the current epidemic doesn’t impact the economies of wealthy nations enough to really scare people into action, but I’m certainly hopeful that we will return to the idea of health as a human right in considering our response to this outbreak. We can hope that the Ebola crisis will be a turning point for WHO reform, so that by the time the Ebola outbreak of 2014 becomes a chapter in the books that students like me are reading, we can say that it spurred a greater call to action.
 Sanburn, J. (2014, Oct 29). Ebola brings another fear: Xenophobia. Time. Retrieved from: http://time.com/3544130/ebola-panic-xenophobia/ Konneh, A. (2014, October 10). Ebola isn’t just a health crisis – it’s a social and economic one too. The Guardian. Retrieved from: http://www.theguardian.com/commentisfree/2014/oct/10/ebola-liberia-catastrophe-generation-poverty