Ebola in Africa: Deforestation, Poverty, Human Error, and Health Care

Why Does Ebola Happen in Africa?

Experts believe the virus is naturally endemic to Africa’s tropics and spreads through contact with infected nonhuman primates, particularly bats. They are also aware that the disease can be stopped by containing outbreaks in geographically confined areas.

But what explains the persistent presence of Ebola in the countries hardest hit by this epidemic?

Deforestation

In 1976, the Ebola virus was first discovered in two outbreaks: one in Zaire and another in Sudan (now South Sudan). Initially, public health officials assumed that they were linked. But subsequent virological analyses proved that the two epidemics were caused by genetically distinct viruses.

Forests are cleared to make room for agriculture, especially lucrative cash crops like cocoa. In fact, three-quarters of the world’s cocoa comes from four African countries: Cote d’Ivoire, Ghana, Nigeria, and Cameroon.

A lack of forest management has also contributed to deforestation. Many trees are cut down for their timber, which is used to build homes and furniture. Others are cleared for their pulp, a vital component of paper.

As a result, Africa is home to some of the largest areas of forest destruction. But this doesn’t have to be the case. We can impact change by protecting and conserving Africa’s forests. By doing so, we can also mitigate climate change.

Poverty

The most recent Ebola outbreak killed thousands of people in West Africa from 2014 to 2016. Unlike flu or measles, which can be spread through air, Ebola is transmitted by direct contact. Health care workers must wear face masks, gloves and gowns to avoid contacting the virus. People in high-transmission areas are warned to avoid physical contact such as hugs or handshakes. Cultural beliefs and practices also contribute to a fast-spreading outbreak. For example, adherence to ancestral funeral and burial rites often brings relatives into contact with the sick.

The Ebola crisis revealed weaknesses in the health systems of Guinea, Liberia and Sierra Leone. These weaknesses stem from international lending policies enforced by the International Monetary Fund that require governments to sacrifice funding for their own public health systems and critical infrastructure development. These policies have left these countries with inadequate resources to respond quickly and adequately to the complex needs of an emerging epidemic.

Human Error

In the case of Ebola virus disease, human error contributed to the escalation of the outbreak. The health systems in Guinea, Liberia and Sierra Leone were understaffed and ill-equipped to handle the crisis. The public was distrustful of the health system, and some rushed to help sick family members without following proper safety precautions.

The virus spread easily between people who had close contact with an infected person who had symptoms. It also infected patients when health workers injected them with drugs that weren’t sterilized, or when they handled unwashed body fluids like sweat, saliva, blood and faeces. The infection could also spread through the air, or when someone touched a tree, fruit, bat or dog that had contaminated its fur or paws with infected fluids. Cultural beliefs and practices also played a role. These include burial rituals that bring families together, and the value of compassion in the face of illness. In this environment, technical interventions can clash with the culture and ultimately fail.

Health Care

In West Africa, the virus preyed on deep-seated cultural traits of compassion for the ill and ceremonial care for the dead. Many people were infected when they rushed, unprotected, to aid sick patients lying on the ground or in waiting rooms. Others were infected when they attended funerals or other ceremonies that involved contact with the bodies of the dead. Health-care workers, whose jobs require close contact with patients and strict infection control procedures, have also become infected through these practices.

Despite the disruption caused by Ebola, most medical anthropologists agree that the communities affected in Guinea, Sierra Leone and Liberia need basic health services, including vaccination, malaria diagnosis and treatment, and antenatal and post-partum care for pregnant women. However, the reduction in health-care workers and their ability to perform routine duties has resulted in a nationwide decrease in facility deliveries and cesarean sections. This decrease is likely to have a lasting negative impact on maternal and newborn health.

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