BY SOFIA LAPIDES-WILSON
By September 9th, 2014, Liberia had 2,046 cases of Ebola, with 1,224 deaths.[i] 31% of cases were confirmed by lab tests given limited lab materials.[ii] Most hospitals were at maximum capacity, and patients were turned away,returning to their homes to infect their families. By the end of September at least 3,700 children had been orphaned by the epidemic.[iii]
The severe reality of circumstances caused by the epidemic was not reflected in the international interest in Ebola. The international interest in Ebola is shown in the graph below, plotting the frequency of worldwide Google searches for the term “Ebola.” During the months of May, June, and July, worldwide interest in Ebola remained minimal. Point D, the first uptick in international interest, is on August 1, 2014, the day that WHO declared Ebola an international emergency. Interest peaks shortly after Point A on September 30, 2014, when the first case of Ebola was diagnosed in the United States.
These data suggest that Ebola was perceived as a disease of low-income countries that did not affect the West; the international community did not take the problem seriously until the first case appeared in a high-income country.
Yet during the time that the international community did not treat the epidemic as a serious, worldwide problem, the epidemic grew to threaten the political and economic stability of West Africa. The estimated cost of the Ebola outbreak is $33 billion, a staggering figure given that the combined GDP of Liberia, Sierra Leone, and Guinea is just over $13 billion.[iv],[v] Inflation in Liberia soared 12% in 2014, and economic growth is estimated to drop from 5.9% to 2.5%. Gambia derives 16% of its GDP from tourism; the continuing epidemic has caused a vast deterioration of the tourism industry.[vi] Workers have abandoned factories. The capital of Monrovia lived with an Ebola curfew – 11 pm to 6 am – from August, 2014 through February, 2015, and violation of the curfew resulted in imprisonment.[vii]
As the epidemic affects the economy, three-quarters of a million people in Liberia, Sierra Leone, and Guinea are in danger of dying not from Ebola, but hunger.[viii] Many farmers believe that the water they use to irrigate their fields is the source of the disease, and have abandoned their fields.[ix] Moreover, due to curfews and lack of infrastructure, food prices have skyrocketed. The price of cassava in the first week of August, 2014 alone increased by 150%.[x] In some of the areas affected by the epidemic, families already spent upwards of 80% of their income on food; now with the rising prices, people are unable to feed their families.[xi]
Sierra Leone and Liberia recently emerged from civil war, and the instability caused by the outbreak could drive these countries back into civil unrest. As early as September 10th 2014, Liberia’s Defense Minister Brownie Samukai told the UN Defense Council that Ebola poses “a serious threat” to the very existence of his nation.[xii] The Liberian Civil War ended a little over a decade ago in 2003; war remains fresh in the collective cultural memory of the country. The outbreak has led to upsurges in violence and hatred. For example, many churches have declared that Ebola is God’s punishment for the existence of the gay population in Liberia, some going as far as to suggest the death penalty for those who are homosexual.[xiii] The gay population cannot leave their homes because of the possibility of harassment and lynching. This sort of civil violence leaves much of West Africa politically unstable.
When the threat of Ebola reached the United States, the West’s responseswung from indifference to overreaction. In October of 2014, 20% of Americans were “very worried” that they or a loved one would contract the disease.[xiv] A North Carolina teacher who visited South Africa was forced to stay home by her high school for three weeks for fear that she might possibly have Ebola, even though South Africa is nearly 4,000 miles from the outbreak in Western Africa. Students who went on a mission trip to Ethiopia were socially ostracized, and other students in their grade refused to attend school out of fear of contracting Ebola.[xv] One American-Liberian man was asked by his boss if he wanted to leave work for a while, even though this man hadn’t visited Liberia in years.[xvi]
The economic consequences of this overreaction to Ebola spread far beyond West Africa. Tourism in Africa has grown into a $36 billion industry, and directly and indirectly accounted for 7.6% of the continent’s GDP in 2012.[xvii] A World Bank Report on tourism in Africa reports that “tourism is one of the key industries driving the current change” in the development of the African economy.[xviii] Because of the Ebola outbreak, tourism throughout the continent has dropped. Nigeria, which was declared Ebola free on October 20, 2014, has seen drops in occupancy rates of hotels from the usual 65% to below 30%.[xix]
Given Nigeria’s proximity to the epicenter of the epidemic, this makes some sense. But safari bookings in Eastern and Southern Africa also experienced a drop in business ranging anywhere from 20-70%.[xx]Fear of contracting Ebola has driven customers from the market, even though Nairobi and Monrovia are some 3,200 miles apart. 53.3% of the Kenyan GDP relies on service industries, and much of that derives from revenue from tourism.[xxi] A decrease in tourism due to Western misconceptions of Ebola proves particularly harmful at a point when many African countries are emerging as competitive economies and lifting their populations out of poverty.
Public health officials face a challenge and an opportunity. In the case of the Ebola epidemic, irrational fear has led to unnecessary damagingof African economies that rely on tourism. It is the duty of public health officials to turn anxiety into a catalyst rather than an impediment, mustering our economic and political resources to fight disease.
[i]Izadi, Elahe. (2014, September 9). Ebola death toll rises to 2,296 as Liberia struggles to keep up. Washington Post. Retrieved from http://www.washingtonpost.com/news/to-your-health/wp/2014/09/09/ebola-death-roll-rises-to-2296-as-liberia-struggles-to-keep-up/
[ii]Izadi, Elahe. (2014, September 9). Ebola death toll rises to 2,296 as Liberia struggles to keep up. Washington Post. Retrieved from http://www.washingtonpost.com/news/to-your-health/wp/2014/09/09/ebola-death-roll-rises-to-2296-as-liberia-struggles-to-keep-up/
[iv]Guest, Pete. (2014, October 23). Counting the Economic Cost of Ebola. Forbes. Retrieved from http://www.forbes.com/sites/peteguest/2014/10/23/counting-the-economic-cost-of-ebola/
[v]Okonedo, Enase. (2014, October 2014). Ebola’s impact on the West African economy. The Conversation. Retrieved from http://theconversation.com/ebolas-impact-on-the-west-african-economy-33327
[vi] Hussain, Misha and Caspani, Maria. (2014, October 23). Gay community under attack in Liberia over Ebola outbreak. Reuters. Retrieved from http://www.reuters.com/article/2014/10/23/us-foundation-ebola-liberia-gay-idUSKCN0IC1GV20141023?feedType=RSS&feedName=healthNews
[vii] Hussain, Misha and Caspani, Maria. (2014, October 23). Gay community under attack in Liberia over Ebola outbreak. Reuters. Retrieved from http://www.reuters.com/article/2014/10/23/us-foundation-ebola-liberia-gay-idUSKCN0IC1GV20141023?feedType=RSS&feedName=healthNews
[viii] Masters, Sam. (2014, October 16). Ebola outbreak: Famine approaches – bringing a fresh nightmare to West Africa. The Independent. Retrieved from http://www.independent.co.uk/news/world/africa/ebola-outbreak-famine-approaches-toadd-to-west-africas-torment-9799944.html
[ix] Masters, Sam. (2014, October 16). Ebola outbreak: Famine approaches – bringing a fresh nightmare to West Africa. The Independent. Retrieved from http://www.independent.co.uk/news/world/africa/ebola-outbreak-famine-approaches-toadd-to-west-africas-torment-9799944.html
[x] Food and Agriculture Organization of the United Nations. (2014, September 2). West Africa: Ebola outbreak puts harvests at risk, sends food prices shooting up. Retrieved from http://www.fao.org/news/story/en/item/242177/icode/
[xi] Food and Agriculture Organization of the United Nations. (2014, September 2). West Africa: Ebola outbreak puts harvests at risk, sends food prices shooting up. Retrieved from http://www.fao.org/news/story/en/item/242177/icode/
[xii] Lijas, Per. (2014, September 10). Ebola Outbreak Is a ‘Serious Threat’ to Liberia’s Existence, Says Minister. Time. Retrieved from http://time.com/3315000/liberia-ebola-existence-civil-war/
[xiii] Hussain, Misha and Caspani, Maria. (2014, October 23). Gay community under attack in Liberia over Ebola outbreak. Reuters. Retrieved from http://www.reuters.com/article/2014/10/23/us-foundation-ebola-liberia-gay-idUSKCN0IC1GV20141023?feedType=RSS&feedName=healthNews
[xiv] Gregoire, Carolyn. (2014, October 17). Why We’re All So Freaked Out About Ebole. Huffington Post. Retrieved from http://www.huffingtonpost.com/2014/10/17/ebola-fear_n_5992634.html
[xv] Terkel, Amanda. (2014, October 23). Americans Are Really Confused About Which African Countries Have Ebola. Huffington Post. Retrieved from http://www.huffingtonpost.com/2014/10/23/africa-ebola_n_6031204.html
[xvi] Brown, Deneel and Constable, Pamela. (2014, October 16). Washington Post. Retrieved from http://www.washingtonpost.com/local/west-africans-in-washington-say-they-are-being-stigmatized-because-of-ebola-fear/2014/10/16/39442d18-54c6-11e4-892e-602188e70e9c_story.html
[xvii] Christie, Iain, et. al. (2013). Tourism in Africa. World Bank. Retrieved from http://www.worldbank.org/content/dam/Worldbank/document/Africa/Report/africa-tourism-report-2013-overview.pdf
[xviii] Christie, Iain, et. al. (2013). Tourism in Africa. World Bank. Retrieved from http://www.worldbank.org/content/dam/Worldbank/document/Africa/Report/africa-tourism-report-2013-overview.pdf
[xix] Paris, Natalie. (2014, October 20). Ebola fears hurting African tourism. The Telegraph. Retrieved from http://www.telegraph.co.uk/travel/destinations/africaandindianocean/11174041/Ebola-fears-hurting-African-tourism.html
[xx] Paris, Natalie. (2014, October 20). Ebola fears hurting African tourism. The Telegraph. Retrieved from http://www.telegraph.co.uk/travel/destinations/africaandindianocean/11174041/Ebola-fears-hurting-African-tourism.html
[xxi] United States Central Intelligence Agency. (2015). The World Factbook. Retrieved from https://www.cia.gov/library/publications/the-world-factbook/geos/ke.html