An Anarchist Response to Ebola | Part One: What Went Wrong?

Anarchists are part of the global conversation on what’s broken in the world, but when things really fall apart—like with the current Ebola outbreak—is the state the only answer? How might a stateless society respond to a challenge like this one? This article provides an anarchist response to these questions, while highlighting issues that require those of us with anarchist politics to carefully think through our position.

This is part one of a two part series. Part two is available here: Part Two: Envisioning an Anarchist Alternative

Key points:

  • The current Ebola outbreak sprung up in places looted by capitalist industries, warfare among states, and the devaluing of African lives.
  • The absence of health care systems for all produces daily death that dwarfs the current cluster of infections from Ebola.
  • Despite popular perceptions, most of the care for people ailing from Ebola this year is being done by local community members and independently funded, modestly compensated volunteers.

An Anarchist Response to Ebola: Visions and Questions | Part One: What Went Wrong?
by Carwil Bjork-James with Chuck Munson

Anarchists have been leading critics of colonialism and its aftermaths, of militarism, capitalism, and economic policies made by and for corporations. Anarchists have built power in various bottom-up combinations ranging from labor unions in Spain (where anarcho-syndicalists ran the trolleys and the telephone system after the 1936 revolution) to the D-I-Y ethic of anarchists in punk rock communities since the 1980s, who stress that anyone can learn how to play a guitar or build a greywater system. Over the past two decades, we have been active and vocal parts of movements saying “no” to the worst aspects of state and corporate power, wars, police brutality, the WTO and IMF, clearcutting forests, and mountaintop removal.

Yet our voices have been less clear on issues that require collective recognition, large-scale organization, or widely shared services, like universal health care, ending second-class status for undocumented immigrants, or recovering from the 2008 economic meltdown. Too many anarchists offer critique and deconstruction under the banner of anarchism, but don’t speak as anarchists when they put forward large-scale alternatives. Whether by silence or speech, anarchists have contributed to the idea that our solutions are only local, low-tech, and limited.

Part One: Where are we, and how did we get here?

The Ebola virus disease has been known for nearly four decades. Its devastating medical consequences (at least in the absence of prompt, high-level hospital care) have led to virulent, yet brief episodes that affected anywhere from a half-dozen to 500 people, killing most of them. Remote locations and the virus’s origins outside of human society have kept previous outbreaks small, but no one doubted the risk of a widely circulating outbreak like the current epidemic in West Africa. The virus was characterized and necessary isolation procedures recorded, enough knowledge to slow down and contain future outbreaks, if sufficient resources are available. Researchers prepared a vaccine, and confirmed its effectiveness on monkeys—who also suffer from the disease.

That is where preparation stalled a decade ago. Capitalist biotechnology, the current system for funding large-scale public health research like clinical trials for vaccines in the West, saw too small of a market for an Ebola vaccine. Like many critical parts of our lives, protection from infectious disease is subjected to a test of profitability. Measured in dollar terms, African lives didn’t matter.

The current outbreak struck a part of West Africa that was especially vulnerable. Two of the three countries at the heart of the Ebola epidemic lost much of their capacity to care for the sick, the newly born, and the dying through devastating civil wars. These wars in Liberia (1989–97, 1999–2003) and Sierra Leone (1991–2002) drew in parties and governments in all three states, were motivated and sustained by converting resources like diamonds and timber into cash, and attracted outside military intervention. These wars were only the latest chapter in long and painful history. Since the Atlantic slave trade began, foreign money has altered the region, provoking war, claiming captives, and looting its mineral wealth. Guinea contains a quarter of the world’s aluminum ore; Sierra Leone is a leading exporter of diamonds; and Liberia is home to vast palm oil and rubber plantations. These lands’ integration into global circuits of capitalism has been repaid with grinding poverty.

In the 1980s, the capitalist countries that have benefited most from the resources of other lands came to a consensus on how the poorest countries should govern themselves. The so-called Washington Consensus, imposed through the International Monetary Fund, investment banks, and other transnational institutions, required poor countries to “structurally adjust” their economies to pay debts they owed to the countries that had long profited from their wealth. The effects on their health systems have been documented by the World Health Organization: “In health, SAPs affect both the supply of health services (by insisting on cuts in health spending) and the demand for health services (by reducing household income, thus leaving people with less money for health). Studies have shown that SAPs policies have slowed down improvements in, or worsened, the health status of people in countries implementing them. The results reported include worse nutritional status of children, increased incidence of infectious diseases, and higher infant and maternal mortality rates.”

The severe shortage of medical staff extends across Africa. Among all countries in Sub-Saharan Africa, only post-apartheid South Africa has more than one doctor for every two thousand residents. This undersupply of medical services and health infrastructure is shared with a score of other countries marked by war (Afghanistan, Cambodia, Timor-Leste), recent colonialism (Samoa, Fiji, Antigua and Barbuda), and the global color line (Haiti, Guyana, Bolivia). Africa, of course, has been hit by all three. With this shortage and inadequate nutrition for the poorest, comes daily, senseless death.

Global recognition that #BlackLivesMatter means fighting back not just when Black lives are senselessly taken, but when insufficient value and material care are put forward to sustain them. Liberia alone (population 4 million) has about ten thousand unnecessary early childhood deaths and 1400 maternal deaths per year. The fact that Ebola in Liberia is “a crisis situation” but this hecatomb is “not a crisis” is part of the problem. A reallocation of health care resources towards the country would have happened a long time ago under non-capitalist/non-imperial conditions. If West Africa were adequately staffed to keep its youngest children and birthing mothers alive, it would have many of the resources it desperately needs now to prevent a disease that could spread outside the region.

This is the world that responded to the Ebola outbreak, and its largest institutions responded too slowly and too poorly. The outbreak spread from its first infection in December 2013 to around a hundred individuals before the role of the Ebola virus was confirmed in March 2013. Emergency coordination at the international level began in July.

It took the spread of Ebola mortality to more highly valued lives, by race and nationality, and the threat of an ongoing trickle of infected travelers to focus the attention of the wealthy world to the outbreak. Suddenly, it became a crisis. By the time this happened, both local health systems and independent efforts like Doctors Without Borders/Médecins Sans Frontières (MSF) pushed beyond their limits. Even pacifist and state-skeptical experts began calling for an all hands on deck approach, involving states and even militaries to scale up to the necessary level of response. The United States, the United Kingdom, and Cuban governments all made major commitments of resources, with the imperial powers deploying their militaries to provide logistical support for new Ebola treatment centers.

Alongside its efforts to coordinate a medical response, the World Health Organization (WHO) has been explaining how the 2014 outbreak was propelled by broken features of the current world order. In blunt language, WHO Director-General, Dr. Margaret Chan, observed: “First, the outbreak spotlights the dangers of the world’s growing social and economic inequalities. The rich get the best care. The poor are left to die. … decades of neglect of fundamental health systems and services mean that a shock, like an extreme weather event or a disease run wild, can bring a fragile country to its knees.” At the same time, self-critical internal documents reveal that WHO’s Africa regional office failed to comprehend the severity of the epidemic as late as June 2014. Politicized appointments within WHO, bureaucratic delays, and the difficulty of providing doctors with visas to travel where they are needed are all ways that the workings of government hampered rather than helped response.

Through mid-October, literally half of all Ebola patients in the current outbreak have been treated by Doctors Without Borders, a non-state entity funded mostly by 4.9 million individual donors, and staffed by volunteer medical professionals.  Unlike the international state response, MSF was able to begin its work by March 2014. However, by August 15, the organization’s capacity was nearly overwhelmed: “our teams in our Ebola medical centres in Sierra Leone and Liberia are stretched to the breaking point.”

Continue to Part Two: Envisioning an Anarchist Alternative

Images:
Health workers carry out disinfection protocols at a MSF Ebola Treatment Center in Kailahun, Sierra Leone. (photo cc-by-sa European Commission DG-ECHO)
Ebola virus emerging in electron microscope image. (Image cc-by-NAIAD/NIH)