To understand how an epidemic starts, think first of public health principles. Epidemics can be stopped long before an infection starts, by looking at patterns of groups of people. See what is visible.
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See the difference between colonial divisions and physical geography. Multiple countries have the epidemic, but see that West African Ebola came from one forested mountain area where the national boundaries of Guinea, Liberia and Sierra Leone meet. These countries were an attempt to answer “the Negro problem” of the 19th century: As technology began to replace the work of slaves, their families remained a visible reminder of that awkward history. Blacks from Britain, especially London, were sent to Sierra Leone. The United States sent their shiploads to Liberia. The last slave ships were routed to Guinea and other coastal areas.
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See who held 20th century power here and in other colonies. This was not an effort to reunite families. Instead, it was a convenient way for a country to export what shouldn’t be seen. The underlying model was colonizing. These returnees were no longer connected with the sending country.
Although missionary organizations addressed some needs, most of the visible infrastructure—roads, rail lines and ports—came from foreign businesses. Immense volumes move: tons of bauxite shipped out every day, mountain-sized iron ore deposits. Smaller volumes, but of greater value, are moved in diamonds and illegal gold mining. The “small volume” wealth is attractive to groups that want to work around monitored banks.
Business interests don’t have on their radar the needs of locals: literacy, roads, basic health care (bandages, clean water), and stable access to land to grow their own food.
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See how the fires are fanned. Planes, trains and ships that arrive to export raw materials come full with cargo to exchange. Guns are needed to guard business interests. When guns are expensive, all-purpose machetes are available. This does not help average health status or positive conflict resolution skills.
Sometimes we can’t avoid the pictures of the dead. So we try to send more guns and some brave missionaries. But when that fails, maybe mountains of cast-off clothes, random educational and health materials will “help them help themselves.” I do not fault the aid given, but what I see is “stuff sent” to cover the problem instead of the hard work of seeing people and seeing how things work. Is it naïve to then be surprised when we see patterns we consider “corrupt?”
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See the challenge of rebuilding after civil war. See the shaken remnant of professionals trying to hold 21st century structures together. See hospitals, roads, and communications technology deteriorate because there are more immediate priorities for manpower and resources. See the similarity between the refugees from violence and villagers approached by haz-mat-suited strangers who take sick relatives, not allowing final farewells. See how survivors of chaos ignore broadcast words of warning or reassurance, “just trust us,” and in an over-practiced routine head for a safer place.
The only thing that’s different in this Ebola epidemic is that the usual tactics aren’t adequate when there are such severe deficits of both medical resources and interpersonal trust. Where societies are more stable, the usual interventions are making progress—like in Nigeria and Senegal—or preventing disease—like in Ghana and all the countries bordering it.
We are feeling safe here in Ghana. As time passes, preparations advance and knowledge about the invisible virus increases.
