Protective clothing essential for health workers dealing with Ebola victims

At first, they thought it would be contained.

The world looked on as the feeble healthcare systems in Liberia, Sierra Leone and Guinea fought a losing battle against the world's deadliest Ebola outbreak in history. The disease flared up, infecting more, killing more and reaching Nigeria and Senegal. Foreigners started to flee, neighbors closed borders and countries far from the West African region started to ban flights from the impacted countries. It was all a mad scramble.

China was among the first responders from the international community. Back in April, Beijing announced it would send in medical kits and cash worth $5 million. Initially, the money was able to boost prevention in Guinea, where the disease had broken out in March, and then in Liberia and Sierra Leone.

But by the time other members of the international community began to step in to help with containment, the viral disease had become a moving target. 

Worst in history

"Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it. Leaders are failing to come to grips with this transnational threat," Dr. Joanne Liu, President of international medical humanitarian organization MÄdecins Sans FrontiÅres (MSF), told the UN Security Council in a September briefing. "Ebola treatment centers are reduced to places where people go to die alone. It is impossible to keep up with the sheer number of infected people pouring into facilities. In Sierra Leone, infectious bodies are rotting in the streets."

The figure of the infected rose from 300 in April to 900 in June, then jumping to 2,000 at the end of July. On October 1, the World Health Organization (WHO) reported 3,338 dead out of 7,178 cases in West Africa. WHO Director General Margaret Chan admitted the spread of the disease "is unprecedented."

Although the speed of Ebola's spread and fatalities is unprecedented, the official death toll calculation so far shows it is no worse than diarrhea, which killed 1.5 million people in 2013 alone, or tuberculosis, according to the WHO. The U.S. Centers for Disease Control and Prevention estimates between 550,000 and 1.4 million people in West Africa may be infected with Ebola by January 2015.

So how did things get this bad? It all began in March in the Guckedu Triangle, a region south of Guinea bordering Sierra Leone and Liberia. Emergency workers say the porous borders there, families straddling boundaries, and ill-equipped health systems fueled the spread of the disease. Then systems started to shut down, government offices got overwhelmed and the death toll rose.

Dr. Wanjiru Waithira was among the 100 medical responders the MSF sent to Sierra Leone to help combat the disease. Her tale of the situation is sad.

"Things are practically shutting down. Children are not going to school; you don't go out because it is not even allowed. People cannot move freely and you cannot go to crowded places," she told ChinAfrica. "The biggest challenge [is] the lack of enough personnel on the ground. It appears the hysteria the outbreak caused was the fuel for the epidemic." 

Going beyond health

The effect of the outbreak has now gone beyond health issues. The Sierra Leone national soccer team, for instance, was prevented from entering the Seychelles to play in the qualifying match for the African Cup of Nations. The Liberian team was ordered by opponent Cote d'Ivoire to select only "foreign-based" players before they could be allowed to Abidjan, the largest city of Cote d'Ivoire.

"I fear that if the epidemic really deepens, its effects on the economies in the region could lead to an extended political crisis," said American political analyst Jay Ulfelder, who specializes in civil unrest and forecasting. "I'm now hopeful that the turn in global attention will halt acceleration and help stem the epidemic before it reaches that stage."

When the outbreak got out of hand in July, some countries in Africa, including Kenya, banned flights from Liberia and Sierra Leone. After years of either civil war or military rule, Liberia, Sierra Leone and Guinea have only recently started to stabilize. The ripple effect of the bans was the cost of living going up.

"Basic items like food are not just expensive, they are scarce to find. We need to travel longer distances to find them. Then there is quarantine, meaning people cannot travel beyond their villages," said Makanfa Kamara, a Liberian blogger.

The Sierra Leonean Government was so incensed that its presidential advisor Ibrahim Ben Kargbo announced the government would "review relations" with those closing borders to the country. "It gives the impression that we are pariah states, which is not the case," he told state broadcaster Sierra Leone Broadcasting Corp., stressing that the Ebola epidemic was not a crime.

The ban on flights locked out those who could go in, and locked in those who wanted to get out. It even hurt WHO response programs. "It is important that flights continue because the chances of spreading Ebola through air travel are minimal," advocated Dr. Custodia Mandhate, the WHO representative in Nairobi. "If airlines continue to cancel flights, I am afraid medical supplies, or even personnel, will have to be delayed."

The extent of this impact is reflected in an August memo by Karin Landgren, Special Representative of the UN Secretary General for the Liberian Mission (UNMIL). The memo stated there will be a UN air service for personnel in Liberia as a shuttle flight between neighboring countries. "The UNMIL leadership and the UN headquarters continue to discuss options to maximize staff safety and support," she wrote. 

Isolation no answer

Experts emphasize the epidemic needs a global effort rather than isolation. "Even though the disease is affecting five countries in West Africa, the impact is felt across the continent; thus the need for a united effort," observed Eric Musau, a research analyst at the Standard Investment Bank in Kenya, who specializes in African economies.

"Ultimately, isolating countries and regions cannot be a solution as it curtails help to those regions. It also does not prevent outbreaks through other means. Our humanity can be demonstrated only if we support one another in resolving the issue."

On his tour of the countries affected, Africa Development Bank President Donald Kaberuka said the hysteria behind closing borders was political.

"I understand the countries which are posing restrictions, but let us do so based only on medical evidence and not on political imperatives," he said in a video message on the bank's website in September. "Revenues are down, foreign exchange levels are down, markets are not functioning, airlines are not coming in, projects are being canceled, and business people have left - that is very, very damaging."

Some analysts like Ulfelder say the international community took so long to react because of other global issues, such as the instability in Iraq, Syria and the Middle East. The disease is not becoming a priority.

In September, the UN Security Council, in its first emergency meeting on a public health crisis, declared the Ebola outbreak in West Africa a threat to peace and security. The decision to create a UN emergency health mission to the Ebola-hit region became the first in history.  

Two days after this declaration, China announced it had sent medical kits and other equipment worth $32.6 million in additional funds to combat Ebola. The World Bank Group is also mobilizing a $400-million financing package for the countries hardest hit by the crisis, to be used for essential equipment and to train health workers. European countries too have pledged to step up aid for Ebola-affected countries, spurred on after a nurse in Spain became the first person to contract Ebola outside Africa in October.

The United States is deploying 3,200 troops to oversee the construction of Ebola treatment units across Liberia with at least 17,100 beds and facilitating their staffing. The announcement was made in the wake of a Dallas man becoming the first person diagnosed with Ebola in the United States in September.

With no confirmed vaccine or cure, the disease has now truly become an international priority.

(Reporting from Kenya)