Enforcing travel bans, canceling safaris, and subjecting U.S. college students to health checks all show how ridiculous the global response to the outbreak has become.
- By Kim Yi Dionne<p> Kim Yi Dionne is an assistant professor of government at Smith College. She studies health and politics in Africa. You can follow her on Twitter at @dadakim. </p>
The Ebola outbreak in West Africa has already claimed nearly 1,900 lives and will likely claim many more in the coming months. Explanations for what has allowed the epidemic to flourish so destructively abound: Many critics, from media pundits to global health scholars and advocates, blame the governments of affected countries, particularly Liberia, which tried but failed to use soldiers and police to enforce a quarantine in one Monrovia neighborhood heavily affected by Ebola. Meanwhile, the international agency coordinating relief efforts, the World Health Organization (WHO), has been criticized for its "painfully" slow response to the disease’s spread. And a great deal of denigration has been lobbed at the very people navigating the Ebola outbreak — those trying to avoid infection. West Africans are characterized by the international media as being ignorant about contagion or incapable of disrupting dangerous "cultural practices," such as "eating animals found dead in the forest, or bush meat," according to a former WHO official writing for National Geographic.
But responses to Ebola far from the hot zone are equally deserving of scrutiny. Travel bans to and from affected countries and treatment of migrants from those countries, for instance, highlight discouraging Western perceptions of Ebola as an "African" problem from which foreigners can ably shield themselves by reducing contact with those associated with the disease. Indeed, these actions and decisions are emblematic of the stark moral shortcomings in international responses to the outbreak.
Multiple airlines have canceled flights to Guinea, Sierra Leone, and Liberia, the three countries most heavily affected by Ebola. Likewise, shipping services to and from affected countries have been disrupted. The first airlines to cancel service were regional carriers. Major international carriers, including Emirates Airline, British Airways, Kenya Airways, and Air France, soon followed suit. (Brussels Airlines and Royal Air Maroc of Morocco continue to provide service in the three countries.) Korean Air went so far as to discontinue flights to Nairobi, despite its distance from the outbreak’s epicenter — and the fact that Kenya has had no Ebola cases. A group of Brazilian executives canceled a trip last month to Namibia, which, like Kenya, is nowhere near the outbreak. Map-challenged tourists are also canceling their trips to Kenya and South Africa. One market research company expects that flight bookings to sub-Saharan Africa could drop as much as 50 percent over the next four months.
These travel bans and elective decisions not to take trips are in response to the outbreak’s arrival in Nigeria, which happened when Patrick Sawyer, a Liberian-American working as a consultant for the Liberian Ministry of Finance, flew to Lagos from Liberia for a business trip, even though he was ill and had come into contact with a suspected Ebola victim. Sawyer later died in a Nigerian hospital. All of Nigeria’s Ebola cases can be traced back to Sawyer. In Nigeria, according to the WHO, 21 people have been infected, seven of whom have died. Had Patrick Sawyer never been allowed to board a plane, these infections and deaths may have been averted.
But this incident of someone with Ebola getting on a plane is exceptional — especially now that airports in affected countries are screening departing travelers. And even then, the risk of Ebola transmission during air travel is low. Contracting Ebola requires contact with bodily fluids — blood, vomit, and feces, to name a few. The most likely way to get infected with Ebola is to care for an infected person, and this is why so many health workers and family caregivers are getting sick and dying. As President Barack Obama remarked on Tuesday, sitting next to someone on public transportation is not the likely route to getting sick. The WHO has been emphatic in repeating this and urging the lifting of travel restrictions to heavily affected countries.
At best, travel bans may only postpone the international spread of Ebola. Researchers used data on daily airline passenger traffic and information about Ebola transmission during the current outbreak to simulate the potential for the disease to spread to other countries. Based on this simulation, they estimate that cutting back flights to the affected countries does not necessarily reduce the risk of international spread, but rather, delays it by several weeks.
What travel bans do in the immediate term is seriously handicap the response to Ebola. On Tuesday, the head of the U.S. Centers for Disease Control and Prevention (CDC), Tom Frieden, lamented that fewer flights mean medical personnel are having difficulty traveling to affected countries, a problem he experienced firsthand when his original flight to West Africa was canceled. Travel restrictions also wreak havoc on local economies: Limiting the movement of people and goods has driven food prices sky-high, fueling concerns about food shortages. In Monrovia, there has been a sharp decline in market food supplies and costs have increased rapidly. For example, the price of cassava, a staple, increased 150 percent in the first two weeks of August.
Meanwhile, in the United States, people have greatly overreacted to Ebola — that is, they have overreacted to the disease as a threat to Americans. Consider the "precautionary plans" to deal with Ebola, conceived by some U.S. colleges and universities. For example, the University of Illinois has said it will pull aside its 30 Nigerian students "for a temperature check and private Ebola discussion." There is no report that faculty, staff, or students who are not Nigerian but who may have traveled to Nigeria — or another affected country in West Africa — will be similarly screened. And the University of Illinois isn’t alone in this: Other colleges, such as Boston University and the University of Akron, are also subjecting West African students to special screening.
This is problematic on at least two levels: First, screening only Nigerian students is mostly theater, because it is incredibly unlikely that a Nigerian traveling to the United States would have been exposed to Ebola, let alone infected by it. Nigeria has outperformed its neighbors’ Ebola response. This includes better tracing of people who have been exposed to an infected individual. What’s more, there have been very few cases of Ebola reported in Nigeria: only 21 out of a population of 169 million. Second, psychology research on attitudes toward immigrants suggests that singling out Nigerian students — or any West African students, for that matter — will only amplify prejudicial, xenophobic reactions toward them. Screening students based solely on national origin but not subjecting all potentially exposed university community members is essentially engaging in what is known as "othering," or viewing and treating a group of people as intrinsically different. Psychology research suggests that associating a "foreign population" with disease will only promote social exclusion; it also finds that beliefs associating foreigners with disease can be passed down to the next generation. In other words, what colleges and universities are doing could have a long and troubling trail of effects, none of which will do a thing to prevent Ebola transmission.
Such responses to Ebola are only perpetuating unsubstantiated concerns about the risk of infection in places where the outbreak will likely never spread. Despite there being no transmission within U.S. borders, multiple polls find that roughly 40 percent of Americans think there will be a large outbreak in the country. This response stems from fear, particularly fear of the unknown. It doesn’t help, of course, that pundits and social media influencers engage in fear-mongering rhetoric. Factual information about the incredibly low risk of Ebola in the United States has to compete against the likes of Donald Trump, with 2.6 million Twitter followers, calling for all flights from West Africa to be halted.
Instead of aggressively supporting or even partnering with those fighting the outbreak on the front lines, many governments and other international actors are acting defensively, treating Ebola as a disease they can protect themselves against by limiting their interaction with affected countries and suspecting anyone with ties to West Africa of being a possible vector. But restricting travel and subjecting university students to temperature checks suggests foreigners are ignorant about how Ebola works — just as the media have (at times condescendingly) described so many West Africans as being.
One of the few international organizations responding in earnest to the Ebola outbreak, Doctors Without Borders (MSF), has rightfully urged a redirection of efforts: "It is shortsighted of developed nations to limit their response to the potential arrival of one infected patient on their territory," the leaders of MSF-Switzerland wrote last week. "If the aim is to avoid further spread of the epidemic, we have to control transmission of the virus. And this is only possible by caring for patients in West Africa."