Ebola – The Complex Crisis

Global Health Emergency for the world but a Complex Humanitarian Crisis for Sierra Leone, Liberia and Guinea.

The world continues to consider the crises in Sierra Leone, Liberia, and Guinea a Global Health Emergency when all the signs are apparent that the current Ebola outbreak is already a complex Humanitarian Crisis of unparalleled proportions.

The two descriptions provoke significantly different responses and require different solutions.

It is increasingly apparent that the current crisis is no longer just a matter of health procedures, practices and programmes. It goes beyond the purview of health specialists and even the institutional health-related arrangements in place may no longer be appropriate. At the risk of being branded alarmist, we should note that the measures being taken to contain Ebola have widespread and severely negative implications for the livelihoods and security of the rest of the population. Closure of businesses (even if temporary), layoffs, the need to stock supplies at home, the trauma and stress of being quarantined with infected neighbors and friends, inadequate supply of electricity, claims of force majeure by subcontractors forcing the closure of larger operations, all constitute the material for disastrous humanitarian crises. Riots may not be far off – indeed some have already occurred in Liberia. The police may not be able to handle them – also because of fear of being infected too. There is no doubt that there will be long-term effects.

A complex humanitarian crisis is often linked to conflict, and there is a general acceptance of the failure of state authority; hence, the adoption of special measures to supplement and/or complement the state authority. As the number of quarantined areas increase, as the threat of infection in urban slums grows, the States’ capacities may begin to buckle under the stress. The consequences may not be different from what has so far been confined to Hollywood movies: riots, breakdown of law and order, with longer-term sharp decline, if not collapse of these economies. The world must act now.

The arrival of several health personnel from partner countries to help is very welcome but experience elsewhere confirms that successful utilization of these support require considerable logistics and coordination capacities – something in short supply in all three countries. Furthermore, no one can now predict the medium term impact on the fledgling but remarkable growth that these countries were beginning to show.

This is a Complex Humanitarian Crises and the world must react accordingly.
I propose the following:
1. The declaration of a Complex Humanitarian Crisis and the immediate appointment of an experienced Humanitarian Coordinator with all the necessary logistics including air ambulances and other material support to complement what is on the ground for all three countries.
2. Because UN procedures may take some time, there should be consideration to the deployment of military aid from within and outside the region to help deliver supply and coordinate logistics.
3. Design of immediate response measures to deal with the short and long term impact on the livelihoods of the populations and the economy in general.
4. Special measures to deal with quarantined areas and houses not only in terms of food supplies but also the psycho-social forces playing out within these zones.
5. The organisatiion of a special and urgent resource mobilization meeting to provide rapid response to the needs identified including the funding requested by WHO