An ounce of prevention is worth a pound of cure, but the Ebola crisis shows this lesson is still lost on the institutions that control the global public health agenda.
By the time West Africa’s Ebola outbreak has run its course, as many as 20,000 lives will be extinguished. But not by the disease alone; people are dying from neglect: neglect by the intergovernmental bodies that were their last lifeline; neglect by the bureaucratized international aid and financial institutions that have by turns enchained and abandoned the Global South.
The weight of Ebola on the hardest-hit countries, Liberia, Guinea and Sierra Leone, has now left those at the front lines of the epidemic facing unprecedented pressure, laboring around the clock to fill the resource gaps that enable the virus to thrive.
Facilities often lack the most basic protective gear. David Boys, deputy general secretary of Public Services International (PSI), a union federation representing 20 million public workers, says via e-mail: “the current level of resources is totally inadequate, staff are not trained to handle this type of infection.” Amid institutionalized impoverishment, “Many health workers are not being paid their wages, and those wages are too low to begin with.”
The occupational hazards of this care labor sows an ethical crisis: doctors and nurses are being forced to choose between protecting their own lives, and providing the care to which they are professionally committed. Back in July, Baryou Wallace of the Collaborating Civil Society & Trade Union Institutions of Liberia warned of a fatal lack of coordination in the government response, complaining publicly that the health ministry “cannot find the time to discuss with health workers leaders about a way of resolving the crisis, so that together we can all join the fight against the Ebola disease.” Today, it is both tragic and understandable that critical personnel in Liberia and Sierra Leone have been pushed to strike in desperation.