Wednesday, 27 August 2014

Law in the time of Ebola

The human tragedy unfolding in Africa, as multiple countries attempt to contain the most widespread Ebola outbreak ever, is as fascinating as it is frightening.

But I doubt many of us would consider the legal implications that would arise in dealing with a pandemic.  The situation in Liberia shows how society can break down on many levels when facing an almost-incurable contagion.  And I got a small glimpse of it through a blog post on our internal network for the government.

B.C. has asked that I not use his name and I will respect his wishes; he is a policy adviser at another ministry and is in Liberia for a year working on strategic planning in the justice sector.  I asked if I could repost his blog for my friends in the legal community to see.

It's also a stark reminder to us of what could happen to our own society should another influenza epidemic, similar to the one of 1918 to 1920, take place.  At that time, it was estimated that 3 to 5% of the entire world's population died due to the H1N1 strain of the flu.  In today's numbers, that equals almost 2 million Canadians and 16 million Americans.

Aside from what those numbers would mean to our health care systems, think about what it would mean for business productivity and civil order.  It sends a shiver down my spine, that's for sure!

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When I arrived in Liberia on July 14, the World Health Organization was reporting that the total number of confirmed and suspected cases of Ebola in the country was 174 and the total number of deaths was 106.

As of this writing the total number was 972 cases with 576 deaths.

My work here includes overseeing the strategic planning for the justice and security sector reform work that the UN has been doing in Liberia since 2003.

There are a couple of key areas where progress has been lagging:

·         constitutional reform
·         the reconciliation of traditional justice practices with the statutory rule of law system
·         the operation of the criminal justice system
·         the incorporation of human rights perspective in the broader rule of law instruments
·         the legislative reform agenda

It is difficult to gain traction on big issues like these at the best of times but, as you might imagine, it is even more difficult during the middle of an Ebola crisis.

Last week we met with the minister of justice, and then this week the chief justice.  They were, to say the least, deeply impatient with any efforts we made to raise issues of system transformation.  At first take, it might be hard to disagree with them.  This is a time of crisis when justice issues should take a back seat to the public health imperative, right?

Not in Liberia.

Responding to the crisis has put the health care system under incredible strain.

Before international media attention focused its capricious lens on what was happening here hospitals - unable to deal with the technical and psychological challenges of treating Ebola – had started to close.

It is a disease that targets the intimacy and dedication of family caring for loved ones and doctors and nurses tending their patients.  The vast majority of people who have been infected are related to existing patients.  And, heroically, over 60 front-line health care workers have died.

By the time it became apparent that this was not something that could be easily contained, the health care system was decimated and demoralised.

Adding to the problem are age-old cultural, geographic and economic divides that are the very fault lines that produced the conflict.  There is a deep suspicion towards government and its institutions here, and generations of mistrust between the indigenous people, ethnic minorities and the poor against the wealthy elite who rule the country.

Early efforts to communicate about the dangers of Ebola were seen as targeting traditional burial practices – dead bodies are highly infectious – or as a conspiracy.  So, when health officials arrived to remove the sick and the dead, in some villages, they were challenged or threatened.

In early August, when it began to become clear to everyone here that the outbreak was bigger and growing faster than the health system here could contain, the president declared a state of emergency.

This gave her the power to deploy the army to enforce measures to fight Ebola.  Those of us working in the justice and security sector had concerns about how this would work.

·         Would there be civilian control of the army?
·         How will their presence and role be communicated to a populace that associates the national army with violence and bloodshed?
·         What are the human rights implications of using the military to quarantine entire villages?
When you’re a hammer, everything looks like a nail.  And sure enough, last week the army was called out to help quarantine a high-density, low income neighbourhood in Monrovia called West Point.

No one had engaged with community leaders to explain what was happening and residents began to challenge the blockade.  The army started firing.  There are many different versions of what happened but, either from bullets or from the press of the crowd, people were injured and a 15 year-old boy may have died.

So the link between Ebola and justice and security is more direct than you might first think.  Part of my job is look at how the UN mission can respond quickly and effectively to these issues.

All the while the spread of the disease continues.  What started out as one of the biggest public health challenges the world has seen for some time, is now an even bigger public health challenge.

It is becoming likely that the long term effect of the outbreak in the country will include food shortages, economic devastation and the possibility of a broader humanitarian crisis.  This country’s hard won peace and security and the well-being of its civilian population will be put under significant strain.

I had plans of arranging an OPS specific fundraising effort.  I thought maybe we could raise some money to buy an ambulance or provide medical equipment and supplies for front-line workers.

But the truth is, at this point, I can’t guarantee the money will go where it is most needed.

Instead, I ask you to consider giving a small donation to one of the front-line groups fighting the outbreak.  There are many groups but I can personally vouch for the importance of Médecins San Frontières.  Visit their website to make a donation and direct it specifically to their Ebola work.

http://www.doctorswithoutborders.org/

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