Ebola Part Two: Ebola and Migration

After a week of expanding my mind further at school, I have more thoughts on the subject of Ebola! So here they are.

One standard practice for trying to prevent the spread of Ebola is to quarantine those who are infected, and sometimes even those who may have been exposed but are not yet displaying symptoms, in order to determine whether they are infected. Quarantine can be an important way to prevent the spread of the disease, when used correctly.

So to some, a logical outgrowth of this logic is to “quarantine” the affected countries by closing borders with them and refusing entry to anyone coming from the affected area.

There are a few reasons why this is actually a terrible idea. One, it assumes that we can actually close a border. Like, for real. With no one coming across.

The U.S. has been militarizing its southern border for years. People still get across. The only difference is, now they are doing it in secret, sometimes through criminal networks, and therefore if one of them is carrying an infectious disease: a.) They are less likely to seek medical attention until it gets really bad, and in the mean time they are more likely to infect others, and b.) We have no way to track who they have come into contact with, which is the most important way to trace the spread of the disease, because everyone who helped them get across the border did it in secret, illegally.

So that is bad. The other shortcoming in current attempts to restrict travel from Ebola-affected areas is the fact that the focus has been on screening flights from the affected areas. The problem with that is the fact that many of those getting infected are poor. They are not going to fly direct from Guinea or Liberia to the U.S. Instead, they are going to follow well-established migratory paths: through Central America (or perhaps North African transit countries if they are trying to get to Europe for treatment.)

These Central American and North African countries don’t have the infrastructure to deal with an outbreak of Ebola or a similar disease. And once again, since these movements are happening through irregular channels, they are going to be harder to track. And a major outbreak in either of those areas could trigger mass migration that would be hard to control. Even though infrastructure in more developed countries like the U.S. might still be able to contain the disease within their borders, that kind of mass migration still has other important impacts related to infrastructure, the provision of services, the economic effects, and security issues.

The general of U.S. Southern Command, John Kelly, has made this exact point.

So I think the biggest takeaway point is that borders are basically irrelevant to the spread of disease. And that means international cooperation is going to have to take center stage in combating this crisis and others like it in the future. An outbreak on another continent can still have ripple effects around the world.

And that is going to mean rethinking how we do foreign aid. International agencies have decried the West African responses to the Ebola outbreak, but part of the problem has been decades of policies urged upon developing countries by Western-back financial institutions, which basically led to an emphasis on the importance of the market in development and the underfunding of infrastructure, including infrastructure for public health. Institutions will have to recognize that public spending plays an important role in keeping a country, and the world, safe and healthy.

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