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Large populations across borders affected, over 6800 lives lost, hundreds of new infections daily. Over a billion dollars in estimated expenditure on direct health costs, human resources and logistics from numerous governments, international organizations and not for profit foundations. Millions more have been spent on research on vaccines and drugs.

Little is known on the exact social costs of this illness-a toll too grave to imagine.

History speaks to us of several diseases that have ravaged mankind. From the Bubonic plague of the Middle Ages, to Smallpox, and most recent in human memory – Malaria and HIV, two diseases whose battles we still fight.

Our strategy for tackling pandemics was simple – find the “who”, “why” and “how” of the disease, and science would wrestle it till successful prevention is achieved, or a cure is found.

Ebola shares some similarities with these battles – a seemingly unhalted spread across population groups, a short course of progression and devastating effects. With humanity’s experience at tackling diseases, why would Ebola prove so deadly?

The weakness of existing health systems in the region with the highest mortality rates is the strongest factor. This weakness in health systems is directly attributable to a history of conflict and failed administrations common to the three affected nations.


A recovery from state failure precipitated a dependence on foreign loans with attendant stringent directives -a recent study published stated that these were targeted majorly at boosting the foreign reserves, with less priority given to the much needed development in key sectors particularly healthcare and education.

The long course of underfunding, juxtaposed policies and continued decentralization and privatization have taken a large toll on the human resources available for health.  The WHO Country Health Profiles record Guinea with no doctors per 10,000 population, Liberia as 0.1 per 10,000 and Sierra Leone as 0.2 per 10,000 population. This compares poorly with a regional average of 2.6 per 10,000.

In addition, allegations of misappropriation of funds and a reduced investment in public infrastructure have created problems of inadequate transportation and a reduced access to non-industrialized areas. In Sierra Leone for instance, sixty percent of the population resides in rural areas. The same goes for Liberia and Guinea with figures of fifty-one percent and sixty-four percent respectively.

Furthermore, rising Healthcare costs have resulted in an increase in the patronage of unorthodox health practitioners, a practice that continues to this day. International news feeds over the course of the outbreak ran abuzz with stories of traditional practitioners promising cures and discouraging the population from accessing hospitals.

Supervening cultural and religious norms have also contributed in various ways to this epidemic. Ebola is spread through close physical contact with infected people. For many in the affected countries this is a problem as practices around religion and death involve close physical contact. Hugging is a normal part of religious worship in Liberia and Sierra Leone, and across the region the ritual preparation of bodies for burial involves washing, touching and kissing. Those with the highest status in society are often charged with washing and preparing the body. For a woman this can include braiding the hair, and for a man shaving the head.

This deadly virus has been able to home in on illiteracy, poor health practices and a distrust for governmental intentions, all on a background of administrations undergoing much needed reforms.

The course of the present epidemic is a wake-up call to countries with underdeveloped health systems. The African continent has several peculiarities, manifested in various ways in her nations.  These must be fully resolved to enable better handling of emergencies -health and otherwise. The attendant fears of any epidemic in Africa will not be laid to rest until these gaps are bridged.


Ria Evbuoma.


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