The 2014 Ebola outbreak is exacerbating tensions between western medicine and competing ideas about health and healing. Residents in some parts of rural affected areas are trying to prevent the intrusion of local health workers, international teams, and government officials who local fears may be spreading the disease. One of the keys to controlling this unprecedented outbreak lies in the hands of health officials in the form of better public education programs.
A history of distrust and reticence against biomedical health care workers -- both those from local and global origins -- can be traced to pre-colonial times. Like their Western counterparts, African medical professionals were not embraced by local populations but faced suspicion. The efforts to expand western biomedical approaches took time and a sustained relationship of trust.
Today, in West Africa (and other parts of the world), those who are sick seek care from different healing systems. In cases of other previous medical outbreaks and other illness, many questioned the efficacy of western medicine in the case of high mortality rates. Ebola has such high rate of death, in this case 60 to 70 percent, this can lead to suspicion especially in rural areas. For this outbreak to subside, we need more cooperation and understanding from all sides.
The current Ebola epidemic in West Africa: Guinea, Sierra Leone, and Liberia have surpassed earlier Ebola epidemics to become the most deadly on record. As of August 4, the World Health Organization has recorded 1663 and 887 deaths. Until two American citizens contracted Ebola, the brunt of the response was on the already constrained resources of Guinea, Liberia and Sierra Leone. These efforts need more coordination and human resources to contain this sub-regional pandemic and to stem it from spreading to neighboring West African countries and beyond.
In this day of connectedness and streamlined globalization, countries outside the immediate sub-region and throughout the globe must be able to recognize and react quickly to prevent new epidemic areas. To respond to the growing rates of infection, citizens of the countries affected by Ebola need to be educated and approached in culturally relevant ways.
At the micro-level, pharmacists, community health workers, and the media can be effective methods of intervention: pharmacists in Senegal, Ethiopia, and other parts of Africa have been intermediaries in various public health campaigns such as HIV/AIDS awareness, anti-street pharmaceutical campaigns, and safe sex practices in the past. Also, community health workers who are provided training and protective gear by local and international public health officials to engage in conversations with communities and try to cultivate more receptive access to treat those afflicted with Ebola infections. Finally, pharmacists and community workers could work individually and in tandem with the media. Also, public campaigns must be available in local languages and dialects such as Pular, Mende and Liberia English in addition to national languages of English and French.
At the macro-level, to help stem the spread of the virus, this continued exchange with regional Ministry of Health officials, other public health personnel and international partners is critical. In addition, it is important that current public health efforts continue and are bolstered through support from global health partners.
Increased support in the form of personnel, medical supplies and coordination may help to slow the spread of the virus from reaching new sites in the West Africa and beyond. The President, Ellen Johnson Sirleaf, has been committed to reducing the outbreak in Liberia. She cancelled a trip to Obama's U.S.-Africa Summit to oversee local intervention. She has closed schools, non-essential government offices, and begun to disinfect large swaths of infrastructure among other things under the administration's National Action Plan. In addition to appealing to Liberian citizens, she acknowledges the importance of cooperation both within and outside the region.
This continuing epidemic highlights West Africa's significance to global public health. Collaborative public health efforts and increased public health education are imperative in containing this outbreak of Ebola and possibly future epidemics.