By Dr. Helene D. Gayle,
President and CEO of CARE USA
Ebola is a horrific, usually fatal illness, the symptoms of which resemble the most gruesome fiction imaginable. It can cause people without a scratch on their body to bleed to death internally or from bodily orifices. The disease's current outbreak in West Africa is the largest since Ebola was discovered in 1976 -- more than 3,680 have been infected and nearly 1,850 have died.
Still, if illness and death were the only measures of its magnitude, Ebola might not even register in the public discourse. Consider that in Sierra Leone, nearly 10 times as many people died of malaria in a single year (3,611 in 2012) than have so far died of Ebola during the current outbreak (430). Ebola's ferocity comes from its ability, when not contained properly, to attack the vital functions of human society with the same intensity it unleashes on the human body. Responding effectively now requires us to both understand the comprehensive nature of Ebola's assault -- its deadly economic and social side effects -- and to craft a response that is just as comprehensive. If we fail to do so, Ebola will go on killing people long after the virus itself is contained.
The devastating effect Ebola is having on West Africa's fragile economies is already coming into focus. Community-wide quarantines, road blocks, the suspension of international flights and commercial shipping, and the closure of international borders are strangling commerce. Global mining operations, which the governments of Guinea, Sierra Leone and Liberia rely on for operating revenue, are slowing and in some cases completely grinding to a halt. All three countries say the outbreak is putting a deep dent in GDP, while also fueling inflation that is pushing basic necessities further out of reach of the poor.
The outbreak is also crippling the very farms rural West Africans rely on, not only for their livelihoods but also for nourishment. CARE's staff on the ground tells us that recently harvested potatoes aren't making it to market because they're stuck inside quarantine zones. Restrictions on movement and gatherings, enacted to halt the spread of the disease in Sierra Leone, mean that people who normally work in rice fields can't go from village to village for work. With fewer people tending rice fields, Sierra Leoneans expect the crucial upcoming rice harvest to suffer. In a country that already has one of the world's highest rates of malnutrition, having less food will mean more deaths. The only question is how many.
Ebola is also killing people by attacking the national health systems in Guinea, Liberia and Sierra Leone -- three countries that were already having great difficulty meeting the health needs of their people. Liberia's health minister has warned that his country's fragile health system is collapsing because the people who staff it are dead, sick or too afraid to go to work. It may be impossible to count how many people will die of easily treated illnesses or injuries simply because Ebola cut off every avenue of treatment.
One of the most insidious traits of this Ebola outbreak is the way it has undermined family structures by attacking women and girls. The virus itself doesn't discriminate, but in societies where women and girls are relied upon as caregivers, they're disproportionately in the line of fire. The first person to develop Ebola in the current outbreak was a two-year-old boy in Guinea. The next five were his mother, sister and grandmother, followed by a midwife and nurse in their village. According to some estimates, 75 percent of those who have died of Ebola are women and girls. When this epidemic finally wanes, an as yet unknown number of survivors will face the prospect of rebuilding their lives without the very people who are traditionally the foundation of family structures.
The limits on movement and public gatherings imposed to combat this disease may be necessary, but they're only part of what's needed to end Ebola's killing spree. The quarantines should be accompanied by vigorous efforts to make sure people inside the quarantine zones have enough food, water and other vital supplies. Neighboring governments in Africa and around the world need to commit desperately-needed medical resources to the worst-hit regions. After the epidemic is brought under control, governments and aid groups must work to help communities repair the damage and get farms back into production. The U.S. in particular should consider restoring -- or better yet, increasing -- recently cut foreign assistance dedicated to health systems in West Africa.
Prevention isn't just the best cure, it's also the most cost-effective cure. Ebola, after all, is doing lasting damage to communities that were already on the margins of survival. So let's commit to a response that will have lasting benefits for those same communities. Let's invest in stronger health systems that will help prevent future Ebola outbreaks from escalating into international epidemics.
