Tag Archives: ebola

Why Can’t US Help Solve Ebola Outbreak without ‘Waging War’ and ‘Sending Troops’?

Published on CommonDreams, Sept. 17, 2014

A fact sheet released on Tuesday by the White House outlines an expanded government commitment in response to the Ebola epidemic in West Africa. “[T]he humanitarian crisis there is a top national security priority for the United States.  In order to contain and combat it, we are partnering with the United Nations and other international partners to help the Governments of Guinea, Liberia, Sierra Leone, Nigeria, and Senegal respond just as we fortify our defenses at home.”  The President’s plan includes the deployment of 3,000 troops to the region. “The United States will leverage the unique capabilities of the U.S. military and broader uniformed services to help bring the epidemic under control. These efforts will entail command and control, logistics expertise, training, and engineering support.”

The President’s plan was quickly lauded with headlines announcing that the US has declared war on Ebola, and that the US plans to send troops to tackle Ebola .

I am, like most everyone else, pleased that the United States has finally, if belatedly, decided to send substantial resources to assist the impoverished communities and nations bearing the brunt of this infectious disease. Yet I can’t help but be put off by the militarization of the response.

The newly declared “war on Ebola” troubles me on several levels. First, I’m not convinced that sending uniformed troops to regions that have suffered excruciating armed conflicts over the past decades is a move designed to inspire trust or hope among the local population. One wonders how these troops will be used: Will they don shields and helmets while forcing residents of poor neighborhoods to stay put or to move to mobile treatment centers?  Will they carry weapons? Will the appearance of foreign soldiers frighten urban residents into fleeing into the countryside?

Turning our attention inward, I am concerned that we come to rely on our military as the only governmental agency capable of responding to any sort of crisis. Do we not have the resources within national health agencies to respond to major health crises?

Military organizations and military culture are not the best way to respond to human suffering. Our America inclination to frame social problems in terms of war underpins our troubled history of crusades to stamp out vices and diseases (the two words often are used interchangeably) ranging from alcoholism to obesity to cancer. Declaring war on disease sends the message that the sufferer is somehow at fault and wars on disease too easily turn into wars on those who embody the disease. Over the past decades, our disastrous national campaign against drugs has been framed as the “war on drugs.” This set of racially charged policies, more aptly described as a “war on drug users,” and has led to local police departments being armed with military equipment (including tanks) and, tragically, to the highest rate of incarceration in the world.

While we might find comfort in the belief that with sufficient technology we can conquer any foe, the world is far more complicated than that. Even if military and medical might could eliminate every single trace of the virus in West Africa, the conditions that made the region vulnerable to the rapid spread of a new infectious disease remain in place. These conditions include deforestation and environmental degradation, rapid movements of populations into overcrowded cities, and yes – wars and other political operations that eat up resources that in other circumstances could go into building a viable and stable public health infrastructure.

Snapshots from Ferguson and Liberia: Something’s Happening HERE

The two images reprinted below have appeared widely in media outlets over the past weeks. Eerily similar? Both show armed police or soldiers carrying shields facing off against unarmed people of color. Without careful perusal, it’s hard to tell which caption belongs with which photo.

liberia

ferguson

“Liberian Soldiers Seal Slum to Halt Ebola” Associated Press, Aug. 20, 2014

“Photo Essay: Police and Protesters in Ferguson” St. Louis Post-Dispatch  Aug. 14, 2014

The Stories Behind the Photos

In Liberia’s capital city last week, residents of a densely populated, poor neighborhood protested when security forces sealed off their community as a quarantine measure in response to the Ebola outbreak. According to reports, residents asserted that not only had they been cut off from their homes but also that they were being disproportionately exposed to the virus because sick people from outside their community were being brought into an Ebola screening center set up in their neighborhood by the government.

In Ferguson, Missouri, when residents took to the streets to protest the shooting by a police officer of Michael Brown – an unarmed African-American youth, thousands of law enforcement officers as well as National Guard were deployed to contain the demonstrators. As of this writing, several hundred protesters have been arrested.

Poverty, Inequality and The Burden of Disease

Liberia is among the poorer nations of the world. In 2012 the gross national income per capita was $580; 75 babies out of 1000 could be expected to die before the age of five; and the total annual expenditure on healthcare was a meager $102 per capita. The top causes of mortality in Liberia include malaria, diarrhea, respiratory infections, AIDS and malnutrition.  Neither money nor the burden of disease is distributed evenly in Liberia. As calculated by the GINI index, Liberia is one of the least economically egalitarian countries in the world.

Fifteen years ago, Ferguson was a predominantly white middle class suburb of St. Louis. By 2010, the population was two-thirds black . Elizabeth Kneebone, a fellow at the Brookings Institution, notes that in 2014 every Ferguson neighborhood but one has a poverty rate over 20%, “the point at which typical social ills associated with poverty like poor health outcomes, high crime rates and failing schools start to appear.”

In the state of Missouri, the rate of poverty among Black men is twice that of white men (22.5% vs. 11.6%). Among Missouri women, 24.3% of Black women vs. 14.5% of white women are living in poverty. In St. Louis County (where Ferguson is located), the rate of emergency room visits due to asthma among children under 15 years is 52% higher than the overall rate for the state. (High rates of childhood asthma are associated with environmental pollution and substandard living conditions.) The rate of infant mortality is 9% higher than the state’s rate and 21% higher than the U.S. national rate. The rate of babies born with a low birth weight (an excellent indicator of women’s overall health status and of the child’s future health status) is 8% higher than the state’s rate, and 20% higher than the national rate.

The Legacy of Injustice: War on the Poor and the Ill

Liberians are struggling with the aftermath of two recent civil wars. “Liberian scholars offer a range of explanations for the years of conflict including ethnic divisions, predatory elites who abused power, a corrupt political system, and economic disparities. The Truth and Reconciliation Commission found that underlying those proximate causes, the seeds of conflict were sown by the historical decision to establish Liberia as a state divided between natives and settlers, and the use of force to sustain the settlers’ hegemony.” While many Liberians are incarcerated for the “crime” of being poor or disliked by the police, perpetrators of crimes against humanity during the civil war have not been punished. Following the civil wars, according to Amnesty International, “Senators, Deputy Ministers, police officials, Special Security Service agents and Liberia National Police officers were allegedly engaged in or ordered beatings, looting, arbitrary arrests, abductions, shootings, ritualistic killings and other abuses. In most cases, no investigations were carried out and no action was taken against alleged perpetrators. … Law enforcement forces were reported to have unlawfully arrested and detained people and to have used torture and other ill-treatment, including during attempts to extort money on the streets. … Conditions in police lock-ups were appalling, with juveniles and adults routinely held together. Detainees were often subject to abuse by police and other detainees. … The formal justice system often failed to deliver fair trials and due process. Lengthy pre-trial detention beyond that allowed by law was the norm, with roughly 90 per cent of prisoners being pre-trial detainees. As well as corruption and inefficiency, the system suffered from lack of transport, court facilities, lawyers and qualified judges.”

Residents of Ferguson are struggling with the historical legacy of legally sanctioned racial discrimination, nearly four decades of ‘trickle-down’ economics that have eliminated middle and working-class jobs in the mid-west and throughout the country, and housing policies that price low-income Americans out of the housing market and segregate people of color in densely populated neighborhoods with lousy schools and housing and crumbling infrastructures.

Ferguson residents are also struggling with what Michelle Alexander aptly calls the “New Jim Crow” – decades-long ‘tough on crime’ policies that primarily targeted men of color and have led to the United States claiming the highest incarceration rate of any nation in the world. In 2012, one out of every 200 Missouri residents was in prison or jail serving a sentence of one year or longer. And, unlike in much of the rest of the country, Missouri’s prison population actually rose 1.3% in 2012. Incarceration rates for white men in Missouri in 2012 were 650.6 per 100,000. Among black men in it was nearly six times that: 3,640 per 100,000. Law enforcement personnel, like members of all three branches of government in Missouri, are overwhelmingly white.

Last year, Ferguson used municipal court fines to fund 20.2 percent of the city’s $12.75 million budget. (Just two years earlier, municipal court fines had accounted for only 12.3 percent of the city’s revenues.) Incarceration rates specifically for Ferguson are not available. But, statistics posted on the Ferguson municipal website hint at the facts on the ground. In 2012 (the last year for which data are posted) Ferguson exhibited a striking gender imbalance in its population.

Male population 9,279  (43.9%)
Female population 11,856  (56.1%)

Women do live longer than men in most of the world, but the gender disparity in Ferguson is more in line with war zones – with countries like Liberia that have experienced lengthy civil wars — than with American “suburbs.” If I had to make an educated guess as to the whereabouts of the missing men I’d guess dead or in jail. The face-off in the photo above certainly makes that guess plausible.

For What It’s Worth

We Americans like to believe that “this kind of thing” could never happen “here.” We’re shocked by the egregious killing of a young man in Ferguson, by the outraged community response and by the overtly militarized law-enforcement response. We’re less shocked by the circumstances surrounding the outbreak of Ebola in places like Liberia. But – as we’ve seen over the past few weeks – the systemic inequalities that give rise to poverty  and disease “over there” also drive anger, distrust and mass incarceration right here in America.

With a nod to the Buffalo Springfield’s 1966 masterpiece: “There’s something happening here / What it is ‘IS’ exactly clear / There’s a man with a gun over there / Telling me I got to beware / I think it’s time we stop, children, what’s that sound / Everybody look what’s going down.”

Please check out my new book Can’t Catch a Break: Gender, Jail, Drugs, and the Limits of Personal Responsibility

And for more on the social context of responses to the Ebola outbreak check out: Ebola and US and Ebola, Secret Serums and Me

Ebola, Secret Serums and Me

An earlier version of this post entitled “Ebola, Monsanto and Me” contained several factual errors. I thank the dedicated readers for pointing them out. Please be sure to use this version for circulation and re-posting.

During the first months of the growing Ebola outbreak in West Africa, other than on NPR it was hard to find any American thoughtful media coverage of this historic public health tragedy. In mid-July I attributed this apathy to several factors: the “otherness” of Africans; a sense that “it couldn’t happen here;” compassion fatigue, especially regarding Africa and Africans; and our own American disinterest in developing and supporting public health infrastructures.  Still today, this kind of “reporting” goes uncritiqued in the mainstream media: “Apparently, the Ebola virus now enveloping three West African nations wouldn’t have developed into an outbreak if not for the people’s ignorance and belief in witchcraft.” I’m hard-put deciding what appalls me most: The not-so-thinly-veiled racism and xenophobia (“people’s ignorance”), the uninformed dismissal of traditional healing practices (“witchcraft”) that effectively treat many illnesses and that are available before and after foreign aid workers swoop in, or the failure to recognize the role of poverty, malnutrition and deforestation in making a region ripe for the spread of disease.

But that’s old news. Ebola has finally grabbed American headlines with two new developments. First, two Americans working in Africa have become infected and – with the help of super-advanced aviation technology – have been flown back to the United States. Second, these two Americans are being treated with a wonder drug “secret serum” that “likely saved” them.

Now we Americans may not care about water purification or sewage treatment systems, but we sure do love secret serums. Hollywood has made millions from that plot line. Indeed, secret serums are such a shoo-in that I’m thinking of writing a blockbuster script about a secret serum that cures poverty (or at least my own poverty!).

But Ebola is no laughing matter. Except, of course, for the pharmaceutical companies poised to profit when the highly touted secret serum goes on the market.

Let me be clear. I am delighted to see that a medication that may cure Ebola is in the pipelines. And I am thrilled to see that the two Americans who received the serum seem to be recovering. But we’d be putting our heads in the sand to think that an untested drug used on two otherwise healthy and well-nourished people who received the highest quality care at every step of the way means much of anything in regard to the realities on the ground in West Africa. We can’t celebrate the great achievement in developing a potential cure for Ebola without considering the legacy that helped Ebola emerge and spread.

Poverty and environmental degradation — all too often the consequences of global economic policies — set the stage for outbreaks of disease. Deforestation with herbicides such as Agent Orange and RoundUp facilitate the spread of disease. Unlike traditional methods of weed control in which farmers and gardeners selectively remove particular plants in order to allow room for the desired crop to thrive, these herbicides typically are spray bombed from airplanes, indiscriminately wiping out plant growth over large areas and often enter the respiratory systems of the people who live in those areas. While the jury is still out, prominent zoologists and virologists hypothesize that emergent infectious diseases such as Ebola may jump from animal to human populations when eco-systems are disrupted, causing new intensities of human – animal contact. According to Nathan D. Wolfe of the Johns Hopkins School of Hygiene and Public Health, “Human activities that occur in lowland tropical forests, such as ecotourism, logging, and the hunting of wild vertebrates have the potential to increase the frequency of microbial emergence.” Coupled with the densely populated living quarters in urban settings that allow for diseases to spread quickly, and malnourished bodies that are less able to fight off infection, the Ebola outbreak seems almost predictable.

I’m not a big believer in conspiracies. I tend to think that just like us good guys, the bad guys are too busy in-fighting to pull off super-duper clandestine hoaxes. And I believe most people who work for even the greediest large corporations rarely intend to hurt others — but their bosses have certainly benefited from it. We need to recognize that the chemicals that made West Africa fertile for the spread of Ebola were highly profitable for the West, and the new miracle drugs to cure Ebola promise to be equally profitable. In these days of giant multi-national corporations it’s virtually impossible to parse out who manufactures what. But from my outsider sociologist perspective what I see is this: Poison the earth with herbicides and when the soil is ruined for everyone else, there’s even more money to be made patenting and selling GMO seeds that can grow in soil no longer suited to traditional agricultural and horticultural techniques. Convince mothers in poor countries to buy infant formula so that mom can come work at their poverty-wage factory, and then sell antibiotics when baby becomes sick because mom can’t afford clean water to mix the formula. Push cigarettes (especially in poor neighborhoods, as R.J. Reynolds does with its Kool brand cigarettes) and acquire Kentucky Bioprocessing to develop post-exposure Ebola serum.

So, on the unlikely chance that my secret serum blockbuster doesn’t work out, here’s another idea. Maybe I’ll start a company that entices people into buying tons and tons of sugary snacks. I’ll have my day-shift workers produce the snacks at factories I’ll build in states where my friendly congressmen and senators have eliminated worker safety regulations and labor unions. Savvy entrepreneur that I am, I’ll have my night-shift workers produce diabetes medication that all of those eaters of my sugary foods will need to take for their rest of their lives. And, just to cover my bases, I’ll require my workers to switch between twelve-hour day and twelve-hour night shifts. That way I can be sure that during any given twenty-four hour period a bunch of them will need pills to be able to sleep or pills to be able to stay awake. With my profits from those pills I think I’ll build a privately owned prison to house all of those criminals caught using illicit uppers or downers. In the crowded prison, tuberculosis and other infectious diseases will easily spread, expanding the market for the antibiotics produced in the factories I’ll open up in countries that don’t have pesky things like minimum wages. Oh – and just to dot my ‘i’s and cross my ‘t’s, I’ll be sure that the prison canteen sells my sugary snacks at twice the price at which they are sold on the open market.

I love it when a plan comes together!

Ebola and US

I wrote a piece on the Ebola outbreak for Salon.com.

For more, follow this link.

Here is an excerpt:

The United States, according to the CDC, has sent a seven-person team to help in Guinea, and provided protective clothing and equipment for healthcare workers in all three countries. In the grand scheme of things, that is a minimal amount of aid – echoed by the minimal coverage the outbreak has garnered in U.S. media. (Far more attention was afforded GOP Congressman Phil Gingrey’s outlandish and factually implausible comments about refugee children crossing the border bringing Ebola into the United States from Central America.)

There is more than one way to interpret America’s disinterest. One is racism — the sense that the people dying of Ebola are so different from “us” that we really can’t identify with them. Another is compassion fatigue. Isn’t there always some horrible disease afflicting Africa and Africans?

Indeed, many of the Englishlanguage articles that have been written about the Ebola outbreak focus on “ignorant” and “superstitious” Africans who give more credence to witchcraft than to modern medicine.

 

For another post of interest, follow this link:  The Medicalization of the Death and Other Penalties