Ebola Outbreak In Conflict Zone Creates New Challenges For Aggie Responders
Texas A&M University has long been at the forefront of some of the world’s most pressing issues.
But when two Aggies recently travelled to Africa to serve on the front line of one of the latest Ebola outbreak responses, they found themselves in a unique situation, even for seasoned emergency response and pandemic experts—dealing with Ebola in the middle of a conflict zone.
A senior fellow with the Scowcroft Institute of International Affairs at Texas A&M, Joseph Fair was called to the Democratic Republic of the Congo (DRC) as a team leader for the International Medical Corps (IMC) to assist with what was called the Mbandaka Ebola outbreak, when, only a couple of days after his arrival, that outbreak ended.
“I was there as what you’d call the clean-up crew for the International Medical Corps’ mission, which was still a very important one. It was to train and equip frontline health workers in how to prevent and control infection within the hospital setting, especially their hospital settings, in particular, which are low resource—they lack what we would consider fundamental basic supplies like gloves, needles, et cetera,” Fair said.
During that time, however, a new outbreak was declared and Fair was transferred to Burundi, which shares borders with Uganda and Rwanda in eastern Africa, an area that has been a site of conflict for at least 20 years.
“There have been a lot of rebel groups operating in the area since the end of the Rwanda genocide—so government forces, United Nations forces, and rebel and armed groups—all with various different fractions. Putting all that together, we had a whole new scenario with the new Ebola outbreak,” Fair said.
During the almost two months Fair was in Africa, he worked with the International Medical Corps on training and equipping other frontline health workers, as well as to build an Ebola treatment center that will allow those frontline workers to take on additional cases from the area.
Fair also was joined in the DRC by Scott Lillibridge, MD, director of the AgriLife Global Health and Innovation Center. A former senior medical epidemiologists with the Centers for Disease Control & Prevention (CDC), Lillibridge provided the International Medical Corps and the World Health Organization (WHO) consortium executive-level management skills for leadership in surveillance and disease control.
“Virtually all our humanitarian responses have been associated with civil wars over the past 30 years. When it comes to routine disaster relief or humanitarian services, we can usually work through neutral parties on both sides of the conflict, with organizations that are acceptable to both,” Lillibridge said. “However, an infectious disease outbreak really doesn’t respect any of these boundaries controlled by one faction or another. This is one of the where an Ebola response occurred during an active conflict. As Peter Selama of the United Nations stated, we have perhaps the ‘perfect storm’ for continued transmission.”
Fair said while they didn’t experience any violence, strict travel guidelines and visible security problems made working toward ending the outbreak much more difficult.
“You can’t get out to do the investigations. You have to know who touched whom, who was in contact with whom, and be able to track those people down and isolate them if they’re sick, and get them to treatment centers to potentially save their lives,” he said. The chances of them living without it are very low.”
“Some of these mega-cities may have 20-25 million people, and you’d like to stop the epidemic before the disease is established within the urban area,” Lillibridge added.
Gerald Parker, associate dean for Global One Health in the Texas A&M College of Veterinary Medicine & Biomedical Sciences (CVM) and a senior fellow for the Scowcroft Institute’s pandemic and biosecurity policy programs, said that dealing with the complexities associated with emerging, high-consequence infectious diseases in conflict zones could very well become the norm, one that humanitarian responders and policy leaders will have to learn to navigate.
Parker, Fair, and Lillibridge anticipate that through the work they’re doing in their respective colleges and universities in partnership with the International Medical Corps, Texas A&M will continue to be a leader in researching new policy options for these kinds of conditions, as well as in supporting the burgeoning one health security needs around the world.
“This will require new policy options,” he said. “In the future, we may have to have the U.S. military respond to provide logistics and security for humanitarian workers beyond what was done during the 2014-2016 Ebola outbreak. We were lucky in that outbreak because the military forces that did deploy from the United States, United Kingdom, and France were strategic allies. But in the future, military responses from other nations are likely to include strategic adversaries.”
“I think we’re building a lot of the core capacities by leveraging the unique expertise that we have there in Texas, and we’re building a very operational preparedness and response capability,” Fair said. “Both at Texas A&M, the home campus, but also with colleagues at Galveston and those centered in the whole state, there’s expertise and capabilities that are only going to be further needed in the world and become more and more important. Partnering with groups like International Medical Corps, that’s how Texas A&M is growing that response capability around the world and providing new education, research, and service opportunities for our students and faculty to work on today’s global challenges.”
