Cover image courtesy of Sydney Morning Herald.
–by Drew Diffie–
Abstract
This article examines the success and repercussions of the Red Cross’s actions in Guinea in the response to the Ebola outbreak, which occurred across Western Africa in 2014. The Red Cross played a crucial role in providing aid to the people of Guinea and stopping the spread; however there were also negative actions taken that may have hindered their overall efforts.
Introduction
The Red Cross is one of the most widely recognizable humanitarian organizations in the world. According to their mission statement, the Red Cross strives to “prevent and alleviate human suffering in the face of emergencies by mobilizing the power of volunteers and the generosity of donors[1].” In late 2013 the most deadly outbreak of Ebola virus ever recorded hit West Africa. The international community scrambled to contain the deadly virus, and the Red Cross played a critical role in stopping the spread and treating victims. 6,000 Red Cross workers joined to help by deploying disaster specialists, mapping the virus’s spread, and supporting the global Red Cross network with financial and technical support among other efforts[2]. Red Cross workers were initially met in Guinea with suspicion and hostility and were often victims of attacks from locals who were unsure of their true intentions. It was crucial that the Red Cross workers build trust and relationships with the people they worked with so that they could contain the deadly outbreak of Ebola. Following the success of the containment, it was revealed that a major internal fraudulent scheme occurred during the mission. These negative actions did not necessarily diminish the actions of the overall mission, but certainly left a mark on what otherwise would have been considered a successful mission. This article will investigate the efforts and response of the Red Cross to help Guinea during the Ebola outbreak, as well as examine the irony of the lesser-known fraud that occurred which damaged the efforts in Guinea.
Red Cross in Guinea
Upon arrival in Guinea one of the most difficult challenges the Red Cross faced in containing Ebola was spreading information to Guineans and dispelling myths, while also learning to adhere to local traditions while performing burials for deceased contaminated victims. The Red Cross played a vital role in distributing information to village elders and chiefs to help educate Guineans about the dangers of Ebola and methods necessary to contain the deadly virus[3]. As a result one of the most important aspects, aside from treating Ebola of course, was informing locals on cleanliness practices as well as teaching about the benefits and reasons of disinfecting affected areas. These were crucial steps that had to be taken to contain the spread. Many of the methods used by Red Cross workers were considered foreign, thus leading to confusion of what the motives of the Red Cross workers actually were. The Hazmat suits that many Red Cross workers wore to avoid contamination were considered terrifying in many parts of the country[4]. Having never seen anything like this, skeptical Guineans thought these people were bringing in the virus and spreading it around. It was necessary to have teams that went to cities and villages teaching and informing the people about Ebola.
Reception from Guineans hampered much of the early response to the epidemic, allowing the virus to spread further. Red Cross workers had a difficult time initially building relationships with Guineans due to their skepticism of the outsiders. The early stages were the most difficult as Red Cross workers faced the tasks of gaining the trust of Guineans, while simultaneously trying to stop the spread of Ebola. Red Cross workers in Guinea faced much more frequent and violent resistance than those working in neighboring Sierra Leone and Liberia[5]. Had efforts to contain the spread of Ebola gone more smoothly at the start, it is likely the virus would not have gotten as out of control as it did.
Attacks from skeptical Guineans who were reluctant to receive treatment and health screenings were perhaps the largest difficulty faced by Red Cross workers. The Red Cross estimated that their workers were attacked an average of 10 times per month, which threatened their ability to contain the disease[6]. In West Africa there is still some uncertainty about diseases and their causes, which often leads to skepticism. It was difficult for Red Cross workers to educate locals and help them understand Ebola as a viral infection as opposed to a punishment or curse[7]. In one notable attack in a southeastern village, five health workers and three journalists were killed after trying to distribute information about Ebola[8]. The group was met with extreme hostility upon arriving at the village and attempted to flee. A month prior, the area was the site of riots due to workers attempting to disinfect a market. Most attacks against Red Cross workers were not fatal; however, there were other issues the workers faced due to these occurrences that hindered their ability. Nevertheless Red Cross workers continued their efforts to contain Ebola while working on efforts to teach about cleanliness practices.
General interaction with Red Cross workers was a very big concern for many Guineans. Detecting Ebola in individuals required screenings in treatment centers to determine if victims were infected[9]. In a health center in the town of Gueckedou, only 2 in 10 infected patients survived the disease. Locals feared that screening automatically resulted in death due to high mortality rate. Arriving at a treatment center was seen as death sentence for many who were fearful that contact with the Red Cross health workers, or any outsiders at the time, would lead to death. In one example near Gueckedou, locals destroyed a bridge leading to their village that Red Cross and other workers relied on to enter the village[10]. Not only did aid workers have trouble getting in, outreach teams also had a difficult time reaching and interacting with locals. Outreach teams played a critical role in the mission, as they were crucial in teaching locals about Ebola, why treatment was necessary, and what needed to be done in order to contain the spread. These various attempts to keep outsiders away were in the hopes that Ebola would not come with them. Red Cross workers had to work with the Guineans to build their trust over time.
Apart from the skepticism of Red Cross workers spreading disease, were the concerns over how they handled the bodies of the dead contaminated victims. It was important for the bodies to be buried safely to contain the spread of the deadly virus. However, local rituals are intimate and included washing the bodies among other practices[11]. Funerals and burials are very important in Guinea and West Africa, as there are crucial steps that must be taken to transition from the world of the living to the spiritual world[12]. Cleaning and washing the body are important preparatory steps that must be taken, however these significantly contribute to the spread of Ebola. This was a far different practice than that of the Red Cross workers, which included securely packaging them in plastic bags and putting them in the grave without proper services. There was uncertainty among the locals about what was actually going on. They questioned whether the corpses were being dismembered, thus the reason for covering up the bodies. These actions concerned Guineans and increased the fear they had of Red Cross workers.
Due to the challenges faced working with communities, earning Guinean trust was of the utmost importance to the success of the Red Cross. It was also important to keep workers safe from attacks while spreading information and treating victims. This required changing various tactics to ensure a safe environment for both the Guineans as well as the Red Cross workers. “To respond effectively, we had to change our entire approach to dealing with people who had died and their families,” said Elhadj As Sy, Secretary General of the International Federation of Red Cross and Red Crescent Societies (IFRC). “We stopped talking about ‘dead body management’ and instead started talking about ‘safe and dignified burials’. We talked to communities and did our best to understand their beliefs and priorities. Ultimately, we earned their trust, and this was critical to success[13].” Earning the trust of the people of Guinea was perhaps the most critical part of the mission. Ensuring that the bodies of infected victims were buried in a safe manner that was also considerate of local tradition immensely helped the Red Cross’ mission in Guinea. Once Guineans were satisfied with the burial methods, it made interactions much smoother.
In October 2017 the IFRC discovered that its officials, local bankers, volunteers, and others embezzled more than $6 million in aid funds in Guinea, Sierra Leone, and Liberia[14]. Approximately $1.2 million of that sum was traced to fraud in Guinea. An internal audit discovered the fraud, which included inflated purchase orders, payments to non-existent workers, and padded expense accounts. The Red Cross issued a statement shortly after discovering the incident: “IFRC has zero tolerance for fraud and is committed to full transparency and accountability to our partners and the communities we stand with. This fraud must not in any way diminish the tremendous courage and dedication of thousands of volunteers and staff during the Ebola response who worked tirelessly to save countless lives and support families[15].” These fraudulent acts left a stain on the work that thousands of Red Cross workers contributed to and some even gave their lives for. This was an issue that obviously angered many in the Red Cross due to the work that was put in to contain the deadly spread of Ebola.
In Guinea, Sierra Leone, and Liberia, the areas hit hardest by Ebola and fraud, approximately 17,000 Ebola survivors faced health complications[16]. This act was devastating to the victims in Guinea and the rest of West Africa. This money would have been used to provide treatment to infected individuals and would likely have saved the lives of many. The operations to stop Ebola were costly and to steal millions of dollars no doubt took away money that was much needed. Initially, money was ditributed quickly to fund such areas as logistics, medicine, supplies, and personnel salaries, etc. “In response to the deadly outbreak, IFRC and other humanitarian organizations rapidly established and expanded offices, deployed staff, and procured significant stockpiles of medical and operational supplies,” the IFRC said in a statement[17]. There was initially not enough oversight for the funds that were being distributed due to the rapid response. A small number of Red Cross workers took advantage of this initial lapse of oversight. This continued until an internal audit discovered the misused funds and was able to trace the sources.
It is unclear how many Ebola victims died due to this negligence and how many faced long-term issues. There were claims of shortages in equipment and aid that likely could have been taken care of with some of the money that was stolen. Ebola is a virus that carries many complications. Approximately 30-50% of those infected experience hemorrhagic symptoms[18]. A study from the Centers for Disease Control and Prevention’s Emerging Infectious Diseases journal shows that Ebola survivors suffer severe neurological and psychiatric problems long after they recover form the virus[19]. These problems leave even young victims unable to move half of their bodies, or talk, or pick up their children. Some of the most common problems included migraines, stroke and nerve damage, as well as depression. Had these workers not committed fraud, many victims would have likely been able to receive treatments they desperately needed.
This instance created outrage throughout the Red Cross. The actions that were taken were considered extremely counterproductive and the opposite of the mission of the Red Cross. This is of course not the first time Africans have been taken advantage of or have suffered at the hands of Western disregard. Africans have a history of being victims of Western intervention for centuries. States and churches are perhaps two of the better-known actors that have historically been involved in humanitarianism in Africa. NGOs have a more recent history in Africa and have risen to prominence over the 20th Century.
In “The ‘Invisible’ NGO: US Evangelical Missions in Kenya” Julie Hearn details the rise of NGOs in Africa. According to Hearn, NGOs became prominent actors in Africa following WWI and WWII, with an increase in activity in the 1960s and 1970s[20]. NGOs filled a void of humanitarian needs that weren’t being taken care of by states. Hearn states that in the eyes of the public, “they had become organizations fighting for the interests of the poor in the third world in the face of bureaucratic posturing of governments and international institutions.” NGOs were viewed very favorably among the public and were equally popular among party lines in the US. This remains true today, as the Red Cross is one of the most popular and recognizable NGOs in existence. As Hearn notes, those on the left see NGOs as an opportunity for “ordinary people to take control of development.” Joining an NGO, or a movement, is something that is more achievable than perhaps running for Congress. On the right “NGOs are seen as part of the private sector that is more efficient than the state.” This is certainly true and a good argument to be made. NGOs are generally more focused than states and are likely able to perform specific tasks more efficiently.
This overall positive view of NGOs might lead to a more trustworthy opinion from citizens. Often times many people are reluctant to trust governments due to corruption by politicians or other similar factors. Further, incidents of corruption in government are often in the news and much more scrutinized whereas NGOs receive less attention. During well-known and well-publicized catastrophes, such as the Ebola outbreak in Guinea or various natural disasters, the Red Cross receives an abundance of attention focusing on their actions. This primarily positive attention likely leads people to view NGOs more favorably and thus makes them more trustworthy. When the Ebola outbreak in Guinea occurred, it was covered by news outlets worldwide, and actors from all over came together to assist. However, the fraud that occurred during the outbreak received much less attention. This has been a common theme throughout Africa’s history in interactions with the West. The perceptions and stereotypes Westerners have of Africa often ignore the damage that is left behind. In the example of the Red Cross in Guinea, many people are aware of the good efforts of workers that stopped the deadly virus as it was broadcasted continuously; however, the fraud that occurred received less coverage.
NGOs remain very popular today and continue to be seen as independent groups that are interested in helping those in poor circumstances. However, like the Red Cross in Guinea, there are plenty of examples of NGOs, states, churches, and various outside actors that have been involved in Africa that have taken advantage of various groups in Africa. While Africans have received various forms of help throughout their history, they have also been victims of Western Imperialism that has left numerous dead, injured, displaced, and enslaved. The continued failure of the West to provide humanitarian efforts to Africa without providing extra burden continues to damage Africa today.
Despite the negative impact, the Red Cross was undoubtedly instrumental in providing medical aid to thousand of Guineans and others in nearby countries. However, this does make it even more absurd and ironic that people on the ground in Africa with firsthand experience of epidemics would steal money from the victims–knowing that many will likely die and suffer as a result. As explored earlier, Ebola carries many medical complications that will further deteriorate one’s quality of life should they survive. The Red Cross workers involved in the scheme surely knew how deadly the virus was and the effects it can have afterwards. Stealing money from dying people will be remembered as a prime example of Western intervention in humanitarianism in Africa.
Conclusion
Throughout history Africans have been exploited for their manpower, land, and resources among other things. Westerners’ interventions in Africa continue to be exploitative today. The Red Cross workers that committed fraud stole money from dying Africans that were severely in need of funds to combat Ebola. This small number of individuals left a mark on what was otherwise a favorable mission that saved many lives. It is likely that these instances will continue as long as the West is involved in Africa. The challenges faced by Africans dealing with Westerners will continue, as those involved in humanitarian efforts remain involved in Africa. The methods used by Westerners to take advantage of Africans will likely only become more complex to avert exposure. In the decades ahead it will be interesting to see what actors emerge as the most involved in humanitarian efforts in Africa. There will need to be more accountability in the years ahead to avert similar situations so that when Westerners are involved in Africa they do not bring exploitation along with them.
This post may have been edited by admin for clarity and length.
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