The Aftermath of Ebola

The Ebola outbreak may no longer make front page news in the United States and Liberia may have been declared Ebola free in May, but the consequences of the outbreak are still ever present, and will be for years to come.

The first reported Ebola case was in December 2013 in Guinea. By June of 2014 the outbreak had rapidly spread and the rest of the world was taking note. In May 2015 Liberia was declared Ebola free. Currently, the situation in Guinea and Sierra Leone is improving and each country is now able (from a health care standpoint) to isolate and treat current patients. However, new cases are still being reported in both countries so continued vigilance is paramount.

As the disease itself abates and it is possible to see the light at the end of the tunnel, it is clear that Ebola may be (nearly) gone, but its effects will linger for decades and it has left devastation in its wake.

The CDC estimates that, in the hardest hit countries of Guinea, Liberia, and Sierra Leone, the death toll from Ebola cases is: Guinea: 2,509, Liberia: 4,806, Sierra Leone: 3,947. The total number of cases is hard to track but estimates of total cases, including those that are suspected, probable, and confirmed are as high as 3,784 in Guinea, 10,666 in Liberia, and 13,241 in Sierra Leone (numbers are as of July 17, 2015).

The socio economic consequences of the outbreak are numerous.  Much of the day-to-day workings of the economy ground to a halt as people stayed home or fled jobs in factories, mines, and fields. Panicked investors fled as the disease began to spread. Disruption during the agricultural season caused diminished agricultural yields which had both economic consequences and resulted in severe food insecurity across the region. Internal and regional trade were dramatically affected due to boarder closures and movement restrictions to help staunch the transmission of the disease. Those who survived the outbreak are now left to pick of the pieces of their daily lives and learn to live without loved ones. Parents were left without children, children were left without parents. The courage it would take to find jobs, housing, a support system after watching loved ones die (and possibly being sick oneself) is hard to fathom.

A portion of the damage left in Ebola’s wake includes health care systems and infrastructure. Already weak to begin with, Ebola wreaked havoc on the human and infrastructural health care resources in all three countries. The Economist reports that an estimated 509 health care workers died in Guinea, Liberia, and Sierra Leone. This is an enormous loss of human resources in countries where, before the outbreak, the average doctor to patient ratio was less than 10 doctors per 100,000 people. Looking to the future, one of the biggest health care concerns is the number of children who went unvaccinated during the height of the outbreak. Because of this, vaccine-preventable diseases, such as measles and polio, will contribute, indirectly, to Ebola’s death toll.

To end on a positive note, however, the local and international communities are now left with an opportunity: to remake the systems better than they were before. In many places physical infrastructure, human resources, and other necessary systems will be starting anew. With the right expertise and resources, using best practices and with cooperation among international agencies, private donors, and local governments, among others, health care can be built stronger than before with an eye toward preventing such devastating outbreaks in the future and caring for the day-to-day health needs of the local populations.

For further reading:

Levy

-Marie Levy spent over five years working at American Society for Clinical Pathology in the Global Outreach department.

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