The World Health Organization announced this week that the death toll in West Africa due to the outbreak of Ebola has reached 1,900 and continues to skyrocket. Among the greatest challenges for medical experts working to contain the outbreak has been the high levels of distrust of Western medicine in African communities, something one expert blames on “paternalism.”
Since the Ebola outbreak began spreading out of Guinea and into Liberia, Sierra Leone and, to a lesser extent, Nigeria, medical personnel began facing increased hostility from locals who refused to believe the Ebola virus existed, or deemed it a government plot to ask the international community for charitable donations. In rural communities in Guinea, families often take their ailing relatives to traditional herbalists, both for medical care and safekeeping from Western doctors. Families in Liberia have attacked authorities who have banned some traditional burial practices for fear of contagion risk, and in Monrovia slums quarantined to prevent a major outbreak in the capital, mobs have violently attacked both authorities and medical personnel.
Liberians have kidnapped Ebola patients out of hospitals, fearing that it is the medical personnel, and not the virus, who are killing their family members. Last week, a group of young men who do not believe in the Ebola virus dug up the coffin of a woman believed to have died of Ebola and placed it in the middle of a highly-trafficked road in Monrovia in protest.
Speaking to Agence France-Presse, Senegalese professor Cheikh Ibrahima Niang explains that this behavior, which appears highly irrational to many in the West with a different understanding of science, is in part of a product of distrust stemming from anti-colonialism. “The virus is biological, but the virus alone is not the epidemic,” he explains, noting that the “context” in which the virus has begun to spread is “favorable” for an epidemic.
“When people say that Ebola does not exist, they are rebelling against something,” he explains. “They are in situations where they were not consulted and feel that they are treated with a lot of paternalism.” Niang added that many feel that medical procedures are not in their best interest, but, rather, “being imposed on them.”
Experts appear to agree that local distrust is as significant a factor to the spread of Ebola as the potency of the virus itself. Writing in The Lancet, Dr. José Martin-Moreno notes that doctors working for international organizations struggle with “a deep-seated and understandable mistrust of both government institutions (foreign and domestic) and external aid,” competing against “traditional faith healers, community elders, and others” that have been in the communities for decades for the trust of ill people and their families.
The international public health group Doctors without Borders has condemned the international community’s response to the virus as “almost zero,” noting that most nations with the resources to help West Africa have instead invested in keeping West Africans out of their countries, or short-term solutions that do not help build medical infrastructure of educate the population. Many have faulted the Obama administration for being insufficiently pro-active in using the United States’ resources to distribute humanitarian aid in the region.