It was recently reported that residents of slums in Liberia and Sierra Leone have been placed under military-enforced quarantines: nobody in, nobody out.
The ebola crisis has been reasonably visible in western media, and there was some discussion of the uncomfortable fact that the lives of several white aid workers were saved by an antidote too scarce to be widely deployed. But I am surprised that there hasn't been a bigger western reaction to the tactics that seem to be in use to control the disease in the African countries it is affecting.
I've read that the ebola crisis is a reminder of the dangers of allowing the WHO to become too weak to mount an effective and timely response. And I've read quite a lot about how the scale of the problem is hugely exacerbated by the weakness of the healthcare systems in the countries involved. There is widespread mistrust of healthcare workers, poor systems of communication....oh and a long term lack of financial motivation for pharmaceutical companies to come up with drugs and vaccines for resident diseases.
Only now the rest of the world is worried about ebola getting on a plane and becoming our problem too, so we have finally mobilised and decided to send help their way. Only, what kind of help are we sending? Obama is sending 3,000 military personnel, the UK 750 troops. Its reported that the purpose here is to provide logistical support and erect healthcare facilities to 'boost the number of beds'. But I can't help worrying that it all sounds a bit, well, violent.
The virus is reported to have something like a 70% mortality rate and, in the absence of effective vaccines or sufficient infrastructure to support the administration of treatments of the Zmapp type, the most that medical staff seem to be able to do for the affected is to isolate them, keep them hydrated, and try to find out who they have been in contact with. The soldiers aren't going to be setting up any drips, so I'm guessing they'll be more in the role of enforcing isolation and imposing restrictions on the people who have been contacted.
Basically, if you've got symptoms you're probably going to die, and all the healthcare workers can really do is make a guess about which of your loved ones are going to die also. It's not surprising that people are reluctant to come forward. So we send in soldiers, "specialists in logistics to assist in patient transportation". I fear that these soldiers are not headed over there to help the victims, but only to fence them in.
With high rates of transmission, low rates of reporting and no cure, hoping to contain the virus by relying on victims to report who they have had contact with seems pretty hopeless. When there is no hope of saving victims, the game becomes all about containment. But there are two goals in this, which trade off against each other viciously. On the one hand, we want to save as many potential victims as possible. On the other, we want to maximise the completeness with which the containment is carried out. So where do we draw the lines, and how deep do we dig them?
Anyone familiar with the zombie/deadly virus disaster genre will see the horrific humanitarian consequences. To save humanity you have to seal off the area. Everyone inside is doomed. All the uninfected innocents trapped inside face a futile scramble to escape, and most are lost along the way. By some fluke or act or heroism, some particularly worthy innocent is saved.......along with various more corrupt exceptions and, inevitably, some infected along with them (which paves the way for the next film in which the containment zone gets bigger).
As you watch these films you feel the injustice, the despair, the abandonment of those written off.
Now imagine all this in real life. The Liberian West Point quarantine was lifted after deadly clashes "led to running battles between residents and the security forces". A 15-year-old boy caught in the violence died after suffering bullet wounds to both legs. Many residents sneaked out of West Point by paying bribes to
soldiers and police officers. Prices of food and basic goods
doubled, causing living conditions in the slum to degrade further.
Many experts have pointed out that quarantining a slum is an ineffective response to the Ebola crisis. But why aren't more people shouting about the ethical failings of a policy which imprisons and imperils so many innocents? What would we say if these were white people condemned to die, selected for death by economic situation rather than by symptoms? How would our tactics differ if such a crisis occurred in the western world?