In the “Democracy Now” interview, Dr. Paul Farmer continually brought up the “lack of staff, stuff and systems” in less developed countries as having a key role in the severity of outbreaks such as the 2014 Ebola wave. Further, it was mentioned in the video that the WHO budget for drug treatment research and outbreak response has been cut down by 50 percent within the past four years (Amy Goodman). Resulting from the decreased resources available, many countries are suffering from deadly diseases in addition to little to no outside help when these crises emerge. This deliberate lack of outside help and resources is an example of structural violence. As Annie Wilkinson and Melissa Leach, two researchers at the Institute of Development Studies suggest, “Structural violence refers to the way institutions and practices inflict avoidable harm by impairing basic human needs” (African Affairs).
When patients are put into quarantine, they are not being taken care of as we see in Western medicine, rather they are maintained until the disease passes—in most cases, this results in a loss of life due to the hemorrhagic fever because they do not experience clean hospitals and do not have an opportunity to readily try experimental drugs. This is due to the lack of health care workers, lack of proper protection and other materials needed in their area. If critical materials are needed and are not supplied, then the only option to stop or contain the outbreak, as Dr. Paul Farmer suggests, “… is an emergency-type response. But then again, how are [these countries] building local capacity to do that so these epidemics don’t spread?” In Liberia, this “emergency response” is shutting down and quarantining entire cities for as long as 21 days (the amount of time for Ebola symptoms to show). It is necessary to consider the lives of all who are then forced to stay in that area, with no outside contact and limited resources. The probability of contracting the disease is much higher in isolation, and passing back and forth of the disease can in turn speed up the rate of mutations of the Ebola or Marburg virus. Gary Kobinger, researcher with the Public Health Agency of Canada, has conducted studies on the possibility of airborne Ebola outbreaks in the past (5.1, Greenfieldboyce, NPR). Although no evidence has been found to support this, the possibility of mutations following Liberia’s present and possibly future quarantines could make this a very real possibility.
The measures these countries take is looked at by the Western world as a desperate attempt to prevent further spread of the disease at the potential cost of every citizen’s life in that restricted area. (I mean seriously, we see these kinds of things in zombie movies!) But then, we must ask ourselves what else could a country do that doesn’t have adequate health facilities, health workers or supplies for all who are ill? They are out of options and out of resources. The only way to prevent this is not to cut crises management budgets, but to increase the amount of resources sent into the country while it is on travel restriction, to minimize the spread of disease and maximize the help that is needed. There isn’t any reason why the world should watch these countries suffer, and only take action when these diseases become a “visible threat” to us (5.2 Farmer, Paul. pg 155-171)
Annie Wilkinson and Melissa Leach. Briefing: Ebola- Myths, Realities, and Structural Violence. Afr Aff (Lond) first published online December 4, 2014 doi:10.1093/afraf/adu080
Gire, Stephen K., Augustine Goba, Kristian G. Andersen, Rachel S. Sealfon, and Daniel J. Park. Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. 6202nd ed. Vol. 345. N.p.: Science, 2014. http://science.sciencemag.org/content/345/6202/1369.short.