The Poverty of Ebola

By Asoka Ranaweera

The writer is a managing partner of a company that advises investors on structuring investments and developing projects in West, East and Central Africa.

Its late afternoon in Lofa County, Liberia, I am standing on a hill overlooking a vast jungle and a series of rolling hills in front of me that I am told is Guinea. We are less than a quarter kilometer from the border and we can see smoke from nearby villages. 

At dawn we left Monrovia the capital and drove for more than 10 hours most of our journey was on unpaved roads a long trip full of twists and turns.

As we progress deeper into the interior I am struck by the level of poverty on display as houses give way to thatched dwellings and young children many of whom are barely dressed play.

As afternoon gives way to early evening we discuss how Lofa County can play an integral role in helping to contribute to Liberia's post-war recovery through agriculture especially since 85% of the population is unemployed.

If agriculture can succeed here it can employ people on a large scale and serve as an example to the rest of the country.

I sense that in this area of unimaginable hardship there is hope for better times and there is a yearning to fundamentally change the direction of Liberia for good. I remember that moment three years ago so well that it seems it was only yesterday.

From 1989 to 2003 Liberia was convulsed by a series of wars and conflicts which spilled over into neighboring Sierra Leone. The wars were brutal and its aftermath left both countries in a severe state of underdevelopment with Liberia especially deeply affected.

When I first came to Liberia in 2006 there was no electricity, running water and/or a sewage system. The country was devoid of physical or human capital and/or infrastructure. Whatever remained intact was rudimentary to say the least. 

I was in northern Liberia as both a witness to and a participant in the story of what today we call 'Africa Rising'.

I was there because of dynamic Liberian American's many of whom have been bold enough to come back to their country in-spite of incredible challenges to create business and transform this place for the better.

Ironically and in a cruel twist of fate just as Liberia was making progress in its post war reconstruction Ebola previously unknown to this part of the world struck hard. As of today Liberia is the most affected of all countries in West Africa.  

Lofa County was for a time the epicenter of the Ebola crisis. Looking back on my visit I can see how Ebola spread so easily within the poor and isolated communities in northern Liberia where basic healthcare is virtually non-existent and where a majority of the people are illiterate.

Ebola thrives on poverty. It survives and spreads easily when people do not have a basic understanding of what they are dealing with or how to react to it. It manifests itself in environments devoid of any health care infrastructure where people are by and large left to their own devices.

It preys on ignorance and on the weak and poor because they do not have the physical or mental facilities to support its arrest. We only need bear witness to the recent outbreak of Ebola at West Point in Monrovia the capital city, which is a large slum where people are densely packed together.

It spread like wild fire aided by people’s lack of understanding of what to do and how to react to the virus.

Although we do not have a cure for Ebola just yet we do know that in order to contain this virus healthcare worker require access to proper protective clothing, equipment and sanitizers.

Meanwhile victims require meticulous care and monitoring to ensure that they are given a chance to survive. And finally the population at large needs to be educated quickly on what to do and what not to do in order to stop contracting and spreading the virus.

In short you need to have a robust healthcare system in place to stop it in its tracks. More than that you need a first rate logistics and organizational effort to create a firm foundation to contain it and then ultimately bring the outbreak to an end.  

Think of it in this way most of the western victims of the virus who were evacuated and had access to first rate medical facilities survived yet more than 2900 Africans including 500 Liberian's have died. The real number of dead especially in Liberia, Guinea and Sierra Leone is probably many times this number.

The situation is getting worse by the day and areas that were thought to be free of the virus have seen relapses. The situation of lapses and relapse is likely to persist in these countries for quite a while given the scarcity of resources that are available to them to combat Ebola.

Just when you think one area has been contained a person sick with Ebola either knowingly and/or unknowingly returns to their community and the whole cycle begins.

The latest estimates of projected cases from the World Health Organization (WHO) makes somber reading with up to 20,000 predicted infections within a matter of weeks. With a fatality rate of 50% or more we can easily extrapolate up to 10,000 dead. More recently WHO says that there could be 1.4 million cases by January 2015.

Meanwhile as the countries sink deeper into the abyss their economies are beginning to suffer even more and that will be very bad news because the cycle of underdevelopment that drove this virus will continue to foster an ideal breeding ground.

It’s instructive to note that to date most of our interest in Ebola has been at a great distance. Let’s face it we still see Africa as a far off place and this virus plays into this viewpoint. However, recent reports from scientists indicate that Ebola has mutated in unexpected ways and that at some point in time it could become airborne. And that’s a nightmare scenario for everyone.

I would venture to guess that the moment there is even a hint of an Ebola outbreak in America or Europe on the scale of what we are witnessing in West Africa right now we would see an overwhelming military type response on the scale we have never witnessed before for a an acute crisis of this nature.

A few days ago President Obama announced a new initiative to deploy U.S. military personnel to Liberia to provide training to local healthcare workers as well as hospital beds. Though, the deployment is a welcome relief especially for Liberia which stands on the brink of near collapse it may not be big enough.

At the very least from a moral perspective if not from altruistic point of view we should have a much more coordinated military type response in Liberia, Sierra Leone and Guinea, the country’s most affected. It should be a regional response and it should be very big.

With first world healthcare capacity, infrastructure and money we should be there in each of these countries complementing the efforts of the WHO, Doctors with Borders and so many other brave NGOs on the frontlines of this battle. If we do not do it now the consequences for all of us could be horrific.

As I reminiscence about my visit to Lofa several years ago and I recall with fond memories the enthusiasm of the people and their desire to change for the better. And it makes me sad to think that people who deserve a chance are struggling on the margins just to survive yet again.

The people of Liberia, Sierra Leone and Guinea are being undone, Ebola, its making them sick, creating havoc on fragile societies and deepening poverty. And all of this is only going to make the cycle of poverty and vulnerability only worse.

We as Americans should not stand by and let the poverty of Ebola win. Only a concerted effort led by the United States of America with equal contributions of military and monetary resources from the international community can help stop Ebola in its tracks.

Like in the Congo where Ebola first originated more than three decades ago, this virus will remain within the communities from which it emerged. This means we will need a long term effort not just to contain it but also to eradicate it.

The consequences of not doing so quite apart from our moral obligations to the people of these countries is that one day Ebola finds itself in a community near you and none of us would really want that to happen.