The Complexity of Ebola & Its Misrepresentation in the West, by Theresa Ammann

After two months, I left Liberia and my Liberian host-family shortly before what has now officially been termed Ebola Outbreak #2, full of worries what was yet to come. When ebola first entered Liberia in March, I was bewildered at the initial response of the Government of Liberia (GoL) and the inaction of the International community, so much that the later rapid escalation of Outbreak #2 did not come as a surprise. To me, the ebola outbreak has become a marker of the fragility of the Liberian state and the biased mentality of International decision-makers and media. While ebola will lead to many far-reaching consequences that one can only speculate about at this point, one thing is for sure, the historically deeply-entrenched Liberian distrust in public authorities will only be worsened by this.

Governments Initial Response

When ebola first entered Liberia in the end March, the GoL decided to leave its people in the dark about the unfolding events which firstly, lead to the publishing of rumours in Liberia’s news media and secondly, did not improve already-strained public relations to Government agencies. On the 25th of March, newspapers proclaimed that ebola had entered Liberia and a day later Monrovia. However, the following day the Minister of Information, Culture, and Tourism, Lewis Brown declared ebola did not exist at all in Liberia as the cases in Foya had only been Guineans who had crossed the border to seek help in Liberian health facilities.

By the time the GoL decided to take action in early April, it was already too late, and people no longer knew what to believe in. Undeniably, the GoL’s delayed response was partly due to a severe lack of finances, logistics, and health equipment (e.g., Personal Protective Equipment, chlorine for disinfection, etc.). This inability to respond and inform the population was made clear to me when one of my friends working in the GoL told met that the GoL’s major radio station had been down for the first 2 weeks of the ebola outbreak as they had run out of funds for generator fuel. And when this forced the GoL to go to the International community for financial assistance, this only confirmed the fear of many Liberians: ebola was simply a fabrication by government officials to ensure that their own pockets continued to be filled with money.

Yet, the GoL’s delayed reaction was not only due to a lack of resources but also a seeming lack of interest. The debate about whether to declare a state of emergency and close the borders was already up and running in the Senate in late-March, yet a US$10.3 million extension of the National Election’s Commission’s (NEC) budget was passed within a day. An understandable move seeing that the October 2014 Senatorial Elections would have had to be suspended without the necessary funding available which would inevitably have forced the current Government out of power. As one of my informants said quite fittingly in April, “You know what they are citing? Onions and pepper coming from there [i.e., Guinea] so we cannot close it [i.e., the border]! You telling me onion and pepper are better then the lives of my people??

The International Communitys Initial Response

Needless to say, not all of the blame can be placed on the GoL, in fact, the response of the International community has been slow and inadequate. It was not until the end of July when two American doctors contracted ebola that the World Health Organisation (WHO) entered the scene, up until that point three countries had solely depended on the help of two humanitarian relief agencies, namely Médecins Sans Frontières (MSF) and Samaritan’s Purse. When help finally arrived, it seemed that the WHO had not learnt from mistakes made in previous outbreak situations; for instance, one of my informants told me that on a visit to Sinoe, he found dozens of ebola-warning text messages on his brother’s cellphone, who—like many others living in rural Liberia—is illiterate. While the international reaction to ebola has in many ways proven to be culturally insensitive the worst has probably been to simply bury the dead bodies without allowing the families to practice their important traditional funeral rites. It should consequently not be surprising that people would decide against handing their loved-ones over to ebola treatment centres out of fear that they will never see them again, but it is even more so understandable when reports are beginning to surface that the health and food conditions in the Quarantine Centres are so deploring that they worsen the health of the ebola victims even further.

Peoples Initial Reactions

Liberians have lived government corruption for decades, if not even centuries, and have, therefore, learnt not to trust public authorities and instead turn to traditional beliefs and religion. Liberians had never before experienced anything like ebola and, thus, had no idea how to respond to such a virus. The natural response for most Liberians was to either turn to religion and prayer in the hope to be spared, or to disregard recommendations made by the GoL and WHO and shake off ebola as a lie since such agencies could not be trusted. When Liberians were asked to avoid bodily contact, particularly in form of sexual relations, this sparked a small outrage and some people cited their human rights in order to discard such recommendations. Personally, this disbelief in the existence of ebola and the lack of awareness was best exemplified when I walked by an Emergency Response Unit officer waving his machine gun while exclaiming to his colleagues, “I not afraid of ebola! I ready to shoot!” Walking down the road, I could not stop asking myself, “The sick person? Or ebola itself?”

To any Liberia-unknowing person, it would probably have been strange to wake up at 4:30am to the songs and prayer from a nearby church where people gave up their lives to God for protection from ebola, yet to me it all made a whole lot of sense. Religion is a source of strength and hope which is not easily elaborated for a Western setting, but I would argue that Liberians have long learnt not to trust public authorities and to instead turn to the Church. Public prayer against ebola has become even more frequent since then.

However, as my Liberian family tells me, much has changed over the last three months and especially in the last two weeks many have started to respond by adhering to recommendations and quarantining themselves.

However, the societal consequences of ebola become more wide-ranging with every day. Victims of ebola (both infected people and survivors) and their families are ostracised by their communities out of fear of contamination. Additionally, a new factor has entered the sad arena: hunger. Self-quarantining and imposed road blocks due to the state of emergency have now led to an inadequate supply of food into certain counties and sharp increases in food prices now mean that food is either unavailable physically or financially.

While the GoL has at least finally decided that its citizens are more important than onion and pepper, it continues to surprise with actions such as the dumping of bodies into community wetland leaving people afraid of water contamination. It is accordingly not surprising that vigilante groups in some communities have started to attempt to provide some safety from ebola (e.g., quarantining or expulsion of infected people) that they failed to receive from the state. Such rage at the inefficiency of the GoL has even led a man who lost his brother to ebola to burn part of the Health Ministry.

The Consequences for Liberia

The ebola outbreak has highlighted a failure of the Liberian health system and the state at large. The high number of infected health workers points to a lack of resources and logistics. As health clinics become more deserted out of health workers’ contamination fear, ebola has created an even worse health issue: a vast array of “normal” illness, such as diarrhoea, malaria, flu, etc., are now left untreated at a time when they are usually especially predominant (i.e., the rainy season).

While ebola has already had a harmful impact on Liberia’s already suffering economy, it seems likely that the worst is still to come. If claims of the Finance Minister, Amara Konneh, were to be correct and educational funding cuts will have to make do for budget deficits, then ebola would harm Liberia in ways much more far-reaching and detrimental than many imagine at this Point.

A Harsh Verdict for the International Community

While WHO has finally become involved in West Africa after the infection of two American doctors and one Spanish priest, their infections have also led to a slow retreat of the International community (e.g., MSF has just withdrawn its Foya treatment unit and Samaritan’s Purse has fully pulled out of Liberia); a move which will evidently leave Liberian health workers alone with the issue.

The fact that WHO intervened so late in the outbreak and that the International community waited to pass a verdict on the use of an experimental drug for West Africans—-even though they had already given it to the two Americans and the Spanish priest—made their statement quite clear: Western nationals are worth more than Africans. I am not out to argue that the unknown side-effects of this drug should be disregarded or that the mere availability of the drug would end the ebola crisis, I rather want to point out that such questions seemed unessential when the West was considering the lives of its own citizens. I would, therefore, argue that it would in fact have been unethical of the WHO to not make the drug widely available. You cannot provide a life-saving vaccine for a selected few, while the number of cases continues to rise steadily and will soon enough climb over a benchmark of two-thousand victims.

The sad and unavoidable truth remains: Europe and America did not care about ebola until we feared it to stand on our own doorsteps. However, the idea that ebola could pose an epidemic threat in the West seems bizarre and more than highly unlikely to me. If one only compares the photos from the facilities in Ebola Treatment Centres in West Africa to those in Atlanta—where the two American health workers are currently quarantined—it becomes quickly obvious that we have the means, logistics, and resources to counteract such an epidemic.

The Western media has in this regard portrayed an extremely unbalanced picture of the situation. While the horror of the Liberian experiences were underreported, the media only seemed to focus on the “imminent” threat of ebola spreading to our parts of the world due to the “ignorance” of Liberians—and Sierra Leoneans and Guineans). This disproportion clearly highlights that we only seem to care about world’s crisis and conflicts when our own wellbeing is at stake.

Concluding Remarks

The ebola crisis has highlighted the GoL’s inefficiency and much understandable resulting public distrust, but some might even argue that Liberia outed itself as a failed state. In this sense, Liberia’s health insecurity has consequently pointed out aspects of severe political and economic insecurity, and a general state of human insecurity. As Leymah Gbowee already pointed out, ebola might threaten the achievements of the last peaceful decade. This threat increases with every day that goes by where the Government is becoming increasingly overwhelmed with the amount of dead lying by the roadside. At this point, the estimated number of ebola victims is clearly only the tip of the iceberg.

I absolutely agree with Susan Shepler: the Western media needs to stop to condone Liberians and other West Africans for their “ignorance”. Liberians are not ignorant, they are unknowing about how to deal with ebola and this is because the GoL and the International community failed to act adequately and promptly at the very onset of the ebola outbreak. Ebola has only reinforced distrust in public authorities amongst the Liberians; distrust which goes back to a long history of Government corruption and ill performance. It is only understandable that relatives are unwilling to give up their loved ones to untrustworthy and incapable authorities especially when they fear that they will never see them again. When Government fails them, people have learnt to turn to their usual sources of solace and hope, namely the Church and the family, and who could hold that against them?

Theresa Ammann is a PhD Student in Human Security at Aarhus University, Denmark. Her project concerns a gendered analysis of Liberian peacebuilding with a special focus on female ex-combatants.

(Disclaimer: Throughout this paper, I have chosen to use such over-arching terms as “GoL”, and the “International community” to refer to the decision-makers and those in power)

5 Comments

  1. Agree with most of your comments and recommend our book Ebola, Culture, and Politics because it describes several of the very same issues in previous outbreaks. One statement I would question “Liberians had never before experienced anything like ebola and, thus, had no idea how to respond to such a virus.” Measles, smallpox, meningitis, just to name a few have probably been experienced by some. Local folks are not blank slates when it comes to dealing with deadly infectious diseases.

    • Thanks for the recommendation Barry, I shall definitely read your book. I also agree with you, people aren’t blank slates in regards to infectious diseases. I guess I should have written “Liberians had never before experienced ebola” not “anything like ebola.” Thank you for the comment, I really appreciate it.

  2. Dear Theresa; What a condemning piece of text, full of assigned blame. An ironic title the used for something the is herself kinda of guilty of; underestimating the complexity of the situation and the misinterpretation. In regards of the treatment. ZMAP as it is called (the experimental drugs) is not a vaccin! Is a cocktail of monoclonal antibodies, which are not always that easy to generate on a large scale in a short time period (since the drug is in an experimental phase) and furthermore it would be completely unethical to use an unapproved drug on a wide scale, it comes with a complex form of consenting. Imagine what happens if the drugs have serious side effects, would that benefit a community that already has a low amount of thrust in government related agencies? I am the last person to call people naieve but Liberia is has a general low level of education, before and even during this outbreak some people still believe ebola is not real of made up. Also see the vice documentary on the issue of eating bush meat; https://www.youtube.com/watch?v=XasTcDsDfMg

    • Dear Amrish,
      Thanks a lot for pointing out the typo. You’re absolutely right, ZMapp (http://www.mappbio.com/zmapinfo.pdf) is an “experimental drug” not a “vaccine.” I was meant to change this but obviously must have missed it. Sorry for that.

      However, in regards to ZMapp’s side effects, like I already said in my article: ” I am not out to argue that the unknown side-effects of this drug should be disregarded or that the mere availability of the drug would end the ebola crisis, I rather want to point out that such questions seemed unessential when the West was considering the lives of its own citizens.”

      I also watched the VICE documentary with great interest, and it provides a perfect example of many of the crucial arguments which I make throughout my article. The docu is extremely biased in countless ways but most importantly (1) in its sole focus on “non-ebola believing” Liberians, (2) its neglect of extreme Government corruption and subsequent mistrust in public authorities, and (3) its unbalanced representation of Liberians. For example, the journalist never asks the market-woman why she continues to sell bushmeat. Selling bushmeat is most likely her only source of income (if not that of her entire family) and to stop selling bushmeat would, therefore, mean an imminent threat to their wellbeing. Also, I truly don’t see how the popularity of Shadow’s song ‘Ebola in Town’ “is an indicator that most Liberians aren’t too concerned with ebola even as it continues to spread.” This seems to be an unfounded causation since his song actually warns of ebola (i.e., “ebola in town, don’t touch your friend!”).

      As I already pointed out in my article, I absolutely agree with you, some Liberians still don’t believe in the existence of ebola, but as I already wrote then, I believe that this makes sense in the context of Liberia where trust in public authorities is extremely low, for multiple very good reasons that I have already named in the article.

      Thanks for your comments, and I hope this answered your questions.

  3. Sorry for my late reply, and thanks for taking the time to answer 🙂 The Vice documentary was made before recent outbreaks if I am not mistaken 🙂

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