The interaction between pandemics and conflict is one of the under-appreciated dangers of our time. The current Ebola crisis has sparked serious thought about the link between fragile or conflict-prone states and global health.
It is now widely accepted that weak government capacity in emerging societies translates into health systems unable to cope with outbreaks of infectious disease, even in cases of hard-to-transmit viruses such as Ebola. Incapable of containing fast-moving contagions, disease migrates unchecked with the potential to cause massive illness and death both within a country and beyond its borders.
Undoubtedly, this is scary business and merits serious attention. But a pandemic or even a major epidemic is not just a public health problem exacerbated by poor governance and the vestiges of conflict. As recent events in West Africa have demonstrated, large scale spread of disease can have significant consequences on the stability of a country and its likeliness to fall into, or back into, war. The West Africa emergency has raised the level of concern in security circles because of the already fragile state of the countries most severely affected by the outbreak. With public health experts all agreeing that the next world wide pandemic is a when question not an if one, it is useful to consider the different pathways, and their associated conditions, through which such an event can lead to greater societal upheaval, violence, and instability.
Mistrust of government sets the stage for aggression to arise in response to a crisis. Rather than turning to official offices for information and help, people are more likely to suspect those in power of perpetrating the disaster or using it for their own political purposes. As deaths pile up, fear and rumour are given free reign and crowd out saner voices. The recent killing of health and aid workers in rural Guinea is just one example of how misinformation and mistrust can have extreme outcomes. Village youth who attacked and killed the health professionals claimed that the outsiders were there to spread the disease. Village elders backed up this belief by saying that everyone who entered health clinics dies, proving that workers were agents of death. Similar behavior was reported in Liberia where villagers in Lofa county attacked government health workers with knives, cutlasses, and stones, believing that contact with the medical community would kill them.
Similarly, poor government response to a lethal health crisis can tap into simmering grievances and spark a virulent response. Many transition and unstable countries are defined, in part, by large and disgruntled youth populations frustrated with the lagging state of their countries and their concomitant lack of opportunities. Further incompetence exhibited by those with authority in the face of a deadly crisis may serve to tap into these frustrations and lead to demands for reform or radical change. These calls may be peaceful but, more likely, they will take a muscular form. In these situations an over-response by the government to quell the discord may only serve to heighten anger and increase the intensity of the backlash. In states where weak governments are challenged by other nodes of power, or have tenuous control over parts of their country, the recoil is likely to be even more ferocious as challengers use the crisis as a call-to-arms against the government. It is not too big of a stretch to imagine the nightmare that would emerge in a place such as Pakistan if a deadly epidemic were to run wild.
A society riddled with internal divisions or group rivalries is also primed to embrace violence in the face of a severe public health scare. While little has been seen in terms of communal violence in West Africa, past pandemics have shown the ease with which prejudice and negative stereotypes can lead to scapegoating of specific groups and aggression against them. In Europe in the mid-1300s, Jewish people were blamed for the spread of the Black Death and over 200 Jewish communities were attacked or wiped out. More recently, the swine flu outbreak of 2009 saw Mexicans quickly labelled as perpetrators of the disease, which actually originated in the United States. Mexicans living or traveling in other countries were attacked and the United States faced internal pressure from its people to seal the border between the two countries. It is not hard to imagine more virulent reactions taking root in places where tribal, sectarian or ethnic antagonisms exist close to the surface. In such an environment, an unfamiliar, lethal, and rapidly-spreading disease has the potential to reignite latent hostilities and be used as a tool by political entrepreneurs eager to capitalize on discord to promote their own agendas.
The route from pandemic to conflict is not inevitable. However, as the latest Ebola outbreak has highlighted, the dangers are there. At the most rudimentary level, responders — from the local to the international — need to be thinking in advance about how basic trust and peacebuilding measures are built into any preventive action or response. If such measures are not taken, the consequences could be catastrophic. The spread of a rapidly-moving and deadly disease in the best of situations is difficult to control. In an environment of conflict and instability, the challenge becomes unthinkable.
Story by Jessica Wattman.