Long-Term Effects

The story runs that this Spring, a team of aid workers, some from foreign charities, arrived in the Kailahun region of eastern Sierra Leone with one mission only - to bury bodies of villagers who had just died after being infected with the Ebola virus. The idea was to prevent further infection that was likely if the bodies were handled by local men not wearing protective clothing. Not unusually, the appearance of the aid workers caused panic and chaos. Women and children fled, fearing that the central government in the capital, Freetown, had dispatched the burial team to, instead, deliberately spread the virus; village men, believing in any number of other conspiracy theories, denied that dead bodies existed, and forced the team to leave. They would deal with the disease far more effectively, they were convinced, through the use of traditional healers.

Such is the mistrust of the Sierra Leone government, and of Westerners, particularly within the remote eastern portion of the country that has long been neglected and even repressed by the central authorities. Indeed, in most rural areas of the country, availability of even the most basic government services, and especially access to health-care, is virtually non-existent. Under such conditions, containing the spread of Ebola, which this year has already killed more than 700 people in Sierra Leone and above 1,000 in West Africa as a whole, is much harder. The widespread suspicion of government intentions is the legacy of several decades of corruption, and just bad management of the country's considerable natural resource base (which includes diamonds, titanium, gold and rutile). Political chaos ensued almost immediately after the country became independent from Britain in 1961, eventually leading to a brutal 11-year civil war which, when it finally ended in 2002, left the country devastated, with some 50,000 people dead and over 2 million people displaced into neighboring countries.

More than a decade has passed since the end of this civil war, but its effects are still glaring. Little of the country's infrastructure is re-built; add poverty, fear and hatred of government workers to this mix, and it is hardly surprising that another public-health crisis, in the form of Ebola, and now of international concern, has once again emerged in the region (which includes Liberia to the east and Guinea to the north). In the absence of political and economic development, sustained over the next many years, Ebola outbreaks may well become a chronic condition.