The most severe outbreak of Ebola is currently raging in West Africa, claiming an estimated (or underestimated) 2,630 lives and infecting at least 5,357 people as of Thursday, September 19th (WHO). Countries such as Liberia, Sierra Leone, Guinea, and now Senegal and Nigeria are having tremendous difficulty managing a disease with inadequate healthcare and welfare systems. These West African nations, in particular Guinea and Sierra Leone, are among the poorest in the world, when judging by percent living below the poverty line, GDP, HIV/AIDS prevalence, unemployment, life expectancy and infant mortality (all accessible through World Bank data). These factors have allowed a relatively containable disease to spurn out of control.
Ebola is not transmitted through the air or by water, but through contact with blood or bodily fluids (CDC). Thus, the director of the CDC, Tom Friden, has little fear of the virus’ introduction or spread in the United States. He stated in a September 2nd CDC Telebriefing, “We have helped laboratories around the U.S. become able to test for Ebola safely and accurately. That’s in place now so that testing can be done quickly. We don’t think Ebola would spread widely within the U.S. Routine health care infection control would probably prevent most transmission.”. Hospitals in the United States are adequately funded and numerous, and supplemented by a coordinated and extensive CDC, and other government agencies. The spreading of Ebola in West Africa has been so rapid due to the lack of these medical and governmental infrastructures.
For comparison I now draw to the continent of Europe, where a country like Greece has seen a painful collapse in government welfare and social programs, especially in the public healthcare sector. Under strictly imposed austerity measures, layoffs and closures of hospitals have been implemented throughout Greece in outstanding numbers. In 2013, 2,500 state hospital employees were laid off and remaining staff were given major cuts in funding making crucial hospitals provisions scarce, elongating remaining employees hours, and increasing contact with more patients. Hospital and healthcare center closures have occurred throughout the country. Marc Sprenger, the director of the European Centre for Disease Prevention and Control (ECDC) was appalled visiting Greek healthcare centers in 2012, describing “I have seen places…where the financial situation did not allow even for basic requirements like gloves, gowns and alcohol wipes”. Hospitals are pressured with lack of staff as well as basic medical materials. Reuters reports “staff cuts mean as many as 90 to 100 patients a day wait in corridors with many unable to get treatment. In the chaos, some go untreated or come back again when they are far more seriously ill” (Kelland). In 2014, the Greek government announced and additional layoffs of 15,000 public sector workers, directly affecting 8,000 healthcare professionals with an undisclosed amount of hospital closures.
The collapsing healthcare system, an increase in HIV/AIDS cases over the last four years, (up 52% from 2010-2011), and the highest rate of unemployment in Europe, 27%, makes Greece fertile ground for an epidemic like Ebola to spread. Greece deals with many of the same infrastructural deficits as these West African nations collapsing under Ebola, as well as experiencing high unemployment and poverty. In addition, Greece is a central entrance point to Europe for migrants from Africa and the Middle East and the geographical factor only makes this case more troublesome. Often in areas of medical geography, diseases can be mapped by many variables. I believe Ebola has the potential to spread among impoverished nations throughout Africa, and could reach Europe’s most structurally and economically vulnerable nation.
Written by Selene Lawrence, an Undergraduate Geography student at Hunter College, City University of New York.
Kelland, Kate. “Basic Hygiene at risk in debt-stricken Greek Hospitals”. Rueters. 4. December 2012.http://www.reuters.com/article/2012/12/04/us-greece-austerity-disease-idUSBRE8B30NR20121204