Photo credit: Pixabay
The national spread of an infectious disease can be a scary time for a population regardless of their internationally-ranked degree of wealth. Imagine hearing about the outbreak of a deadly and uncontrollably ruthless disease and the impact this could potentially have on your life and the lives of those around you. Add in a weak healthcare system where access to proper medicine lies beyond your income and a scenario where no-one around you has been given any information about the severity of the virus and how to control it. Now imagine your livelihood is unstable and you already fear for its survival as it’s the only way you are able to get enough food to feed your children and send them to school. I was working and living with a local family in Sierra Leone on the Western Coast of Africa during March, 2014 when the first case of Ebola was announced in the surrounding areas and I was able to experience these reactions first-hand. Continuing my links with them has allowed me to maintain an insight into the country’s progression through the greatest outbreak of Ebola Virus in the 40 years since its discovery and learn more about the social implications of such a dangerous, infectious disease.
There was little known about Ebola virus before the deadly epidemic of 2014/2015, which was declared by the World Health Organisation (WHO) to be an internationally-concerning state of emergency five months after the initial outbreak. Hysteria surrounding the disease began to spread throughout the world with countries shutting their borders and the control and screening of passengers coming from West African countries becoming tighter. The threat of a disease coming from other places around the world suddenly became very real and people were genuinely fearful. Most people I knew had begun to research the disease and consider what it would do to them if they caught it; what their symptoms would be, and how they could avoid it. News stories about medical professionals becoming infected whilst acting as aid workers or people travelling in exposed countries and returning home seemed to be regularly circulating and there was genuine concern that this might just leak through into European and American borders. It was sad to see that this became the majorly concerning factor for most people, especially within the UK, where their fear lay not in the destruction happening in countries already struggling with their own development but in how their own lives could possibly be affected.
Rebecca’s host brother, Issa, outside their house in Makeni, in the Northern Province
The initial disease-causing virus is thought to originate in fruit bats.  It is common practice in West African countries such as Sierra Leone, and particularly within the outlying communities, to consume ‘bush meat’ of which delicacies include monkey and fruit bats. This is potentially one of the most important reasons for the accelerated spread of the disease since prevention lies in not only improvement in education within these communities, but also the ability to let go of some of their traditional practices and even belief systems. Another factor in early transmission sharing a connection with culture is the act of touching. Sierra Leoneans are renowned, or definitely should be, for their friendliness and genuine love for other people and the way this is expressed is through close contact with each other, even people they have just met. Whilst this makes living there a warm and cherished experience, with regards to an infectious disease this can only lead to problems and again, education is key. However, even from my short time in this environment, it was evident that the infiltration of Western expats and volunteers can seem patronising and disrespectful, no matter the purity of their intentions. Therefore, health professionals coming in to challenge people on an element of their way of life and proposing change can only increase their reluctance to comply. It also highlights a desperate need within these countries where there is a lack of resources, for instance contraception is also an issue, for improvements in health education. This has to be sustainable and come from within after an initial boost given from outside.
Since Ebola Virus victims do not become infectious until they begin to suffer from their symptoms, diagnosis was, for a long time, hard to achieve. Through laboratory analysis, it is clear that the virus causes major problems in the immune system of the patient through a reduction in the number of their white blood cells. Vomiting, diarrhoea and rashes are the most common external symptoms and, in countries where sewage systems are non-existent and basic sanitary conditions are harder to achieve, such as those in Western Africa, these only influence a positive feedback system and encourage the spread of the disease. These awful and uncomfortable symptoms can progress into further complications including external and internal bleeding as well as both kidney and liver malfunction. These final symptoms are what segregate Ebola from so many other viral infections.
Life after Ebola in countries where life previously wasn’t easy has only, predictably, had a negative impact. Many companies, that were newly or only weakly established, collapsed both during and as a result of the outbreak this has led to the devastating loss of many jobs. In a country where the ability to find a paid job without an un-affordable degree was mostly implausible, the loss of a career and access to an income is all the more destructive. My host mother, Ramatu Janneh, ran her own business making and selling flavoured drinks and clean well water as well as being paid to host Voluntary Services Overseas (VSO) volunteers, such as myself. After the epidemic, she stopped receiving money from the charity as no volunteers were coming to live with her any more, but word about how the disease spread hindered the success of her business and she could no longer continue until the country was deemed safe. I received heart-sinking texts from her family, telling me about how her four beautiful children were starting to go hungry and could no longer attend the good school in the city. I was heartbroken for her and all other mothers who had no way of preventing this from happening to their family.
The WHO commented on the epidemic by saying that the worst affected areas were the ones with a lack of resources within their weak healthcare systems and had experienced a war-torn/conflicting environment in the past. The degree of impact of a disease relies largely on the location of its target and their capability to cope. Unfortunately for this case, its target was in the underdeveloped world leading to not only an increase in the loss of lives but in the destruction to any framework of development that had been set in place for the country. Whilst many problems still remained in the affected countries prior to the outbreak with regards to development, the magnified effects eroded some of the hope for what progress was to come in their future. The rise of women’s rights and respect for their contributions to society as well as the development of advocacy for children’s rights to education and violence-free lives provided great expectations for what Sierra Leone, Guinea and Liberia could become and I only hope that this set back is temporary and their development can continue. But most of all, I hope that this provided a major learning curve for the WHO and opened the eyes of those who were fearful of the threat that never came. We are so lucky in what we have here in the UK, with our wonderful NHS, health resources and education, and can remain content in the knowledge that we will be protected if we are ever the target of the Ebola Virus. We cannot afford to take this for granted when other countries are struggling and it couldn’t be more clear that we have a duty to share our knowledge and resources with those who need it the most before something like this devastates nations once again.