U.S.
Afolabi Sotunde / Reuters
Aid agencies have cautiously welcomed the United States’ announcement that it would deliver aid to health workers in West African countries hit by an Ebola outbreak that has killed at least 2,296 people.
With the deadly virus still raging in Guinea, Liberia and Sierra Leone, some see the intervention of the world’s most powerful military as a last resort — and best hope.
But Doctors Without Borders (MSF) and the World Health Organization (WHO) — while applauding the U.S. move — said they don’t want the security detail for health care workers that President Obama pledged on Sunday.
And some experts have expressed concerns that the involvement of American forces adds an unpredictable element to the public health emergency.
“In this particular case, the Ebola emergency is so severe and the logistical challenges are so serious and seem so insurmountable that you have humanitarian actors that are normally very resistant to any kind of military aid asking for the military to get involved,” said Laura Seay, a Colby College assistant professor of government specializing in African issues.
“This is one of those things where you have to be careful what you wish for,” Seay said, adding that it is important that the U.S. military abide by the local governments' protocols.
The White House’s Sunday announcement marked a major escalation of U.S. involvement in the crisis.
The United Nations’ World Health Organization has said it underestimated the severity of the outbreak — as did other aid groups — but that it had redoubled efforts, cooperation with local governments and appeals for money to make up for lost time.
At least 4,000 people have already been infected, with the mortality rate of the outbreak around 50 percent.
MSF, whose health care workers have fought on the front lines against Ebola, welcomed the promise of supplies and equipment from the U.S. military, but sounded a note of caution in a statement issued on Monday.
“MSF welcomes President Obama's commitment to deploy medical assets to help establish isolation units in the Ebola-affected region, and reiterates the need for this support to be of medical nature only,” the statement read.
“Aid workers do not need additional security support in the affected region,” it added.
WHO also said it does not believe the U.S. military needs to act as a security force, and it does not recommend that it do so.
Meredith Stakem, West Africa aid coordinator for nonprofit organization Catholic Relief Services (CRS), echoed MSF’s view.
Speaking from Dakar, Senegal — the latest country to see a case of the virus — Stakem said that the unprecedented scale of the latest Ebola outbreak requires major supply and logistical services, but that security for doctors wasn’t necessary. She said the mere presence of men with weapons could undermine the entire mission.
“What we don’t want to see is the U.S. military going in with guns and enforcing quarantines. It will prevent their ability to do anything else,” Stakem said, adding that U.S. forces should respect the sovereignty and cultures of the local governments in delivering aid.
The U.S. Department of Defense’s Africa operations center, Africom, did not respond to a request for comment.
Some health workers in the affected region have been attacked by local residents who harbor a deep mistrust of doctors they suspect of spreading the virus themselves. Others believe the outbreak to be a hoax concocted by their governments to wring aid money from donor countries.
Stakem, however, said this aspect of the crisis was fading after successful efforts to prove to residents that doctors are there to help — and that the threat of the virus is real.
“There’s been a big push to make sure people understand what Ebola is,” she said.
More than violence, Ebola itself has so far posed the greatest threat to health care workers, with the latest outbreak having killed at least 120 of them.
To Stakem, the best thing that the U.S. can do is provide necessary supplies — such as field hospitals, which the military knows how to set up — and deliver real results to people who are suffering.
But Obama, in an interview with NBC’s Meet the Press on Sunday, had said confidently that the U.S. would provide necessary security for health workers.
“We’re going to have to get U.S. military assets just to set up, for example, isolation units and equipment there … to provide security for public health workers surging from around the world,” the president said on the talk show, according to the Washington Post.
In his explanation of the U.S. role, Obama sounded a note of warning, saying the disease could mutate and spread faster, “becoming a serious danger to the United States.”
At a news briefing on Tuesday, a Pentagon official declined to provide specifics about other military assets that could be deployed, according to The Washington Post. “We’re continuing to evaluate where to best support the overall effort,” said Michael Lumpkin, assistant secretary of defense for special operations/low-intensity conflicts.
A senior administration official speaking on the condition of anonymity told The Washington Post: “We’re considering options and, to be sure, our response will be commensurate with how the president views this outbreak: as a national security priority.”
Another reason for Washington’s increased interest in the five-month-long outbreak is concern for political and economic stability in the region, according to Colby College’s Seay.
“In American foreign policy, the paramount value is stability,” Seay said. “The United States will do almost anything to promote stability in Africa if it believes it has an interest in doing so.”
Kim Dionne, a professor of government at Smith College who focuses on Africa, said that U.S. military involvement may undermine the very stability that Washington is seeking to maintain.
Dionne said Liberia’s and Sierra Leone’s brutal civil wars fomented a deep-seated suspicion of armed authorities.
“If your response to the outbreak is going to be driven largely by the presence of armed men, it might be impaired by this legacy of civil war,” she said.
Riots broke out in a neighborhood of Liberia’s capital, Monrovia, after military forces attempted to enforce a quarantine in an impoverished neighborhood where uninfected Liberians were also living. The violent protests, amid which a teenage boy was shot, fueled further mistrust of any armed forces' role in the health crisis.
Reports from Monrovia paint a grisly, nightmarish scene, with public health facilities unable to provide even comfort for the terminally ill, and Ebola patients suffering agonizing deaths.
Ebola — a hemorrhagic fever — causes internal bleeding, severe diarrhea and vomiting. Although not airborne like the flu, a mere drop of the bodily fluids infected with the virus can cause fatal exposure. Regional burial practices, some of which involve contact with cadavers, have helped spread the disease.
Dionne said it is sad that it has come to the point where the main reason for providing humanitarian aid is the perception of a threat to the U.S.
“I want people to do more about Ebola, and it's something that can and should be contained, but I’m troubled that it has to be done through the military,” she said.
Seay said that the U.S. military has shown itself professional enough not to respond to civil unrest during foreign events like earthquakes and hurricanes with deadly force. Indeed, she said they could come as a neutral — and overwhelmingly powerful — referee for the delivery of aid.
“I think that most people want fundamentally for this to end for people to stop dying, for the response both of the Liberians and the international community to be adequate,” Seay said.
Meanwhile, in Senegal, Stakem of Catholic Relief Services was waiting for more help to arrive.
“I'm not optimistic yet,” she said. “I'm hoping to be optimistic soon.”
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