This region also suffers from what some economists have called the resource curse,
in that it's very, very rich in natural resources, in palm oil,
in gold, in iron ore.
And over the course of history, multinationals have made deals with
governments which, again, have disadvantaged your average person
in communities and have to some extent, brought some advantage to their elites,
but most of the profits have gone elsewhere.
I know best about Liberia, and the classic example in Liberia is
a agreement made with Firestone, the rubber company, the tire company, in 1925,
where Firestone came to control 4% of Liberia's lands with rights to all
the natural resources discovered there, and the state guaranteed labor.
That has also continued today, and we have to talk about, but you also have,
because of the natural resources, in the 80s and 90s and into the early 2000s, this
whole region experienced terrible wars, both civil wars and wars across borders.
The most famous individual being Charles Taylor,
who became president of Liberia in 1997.
And so this whole region was devastated by war.
Guinea received refugees from the surrounding areas,
was a participant, to some extent, in funding militias.
And so you have a damaged relationship between the government and people.
And even, again, in Liberia since 2006, Ellen Johnson Sirleaf,
who won the Nobel Peace Prize, has been president and has made many reforms.
But she too has, in a sense, had to deal with this history
of relationships with multinationals and how to get money for her country.
And so between, for example, 2006 and 2012, the government has signed
$19 million worth of concession agreements in mining, agriculture and forestry.
And there's a growing amount of Liberian land under the control of these foreign
companies which extend to something like a quarter of Liberia, which has changed,
back to Carlos's point, the relationship between people and areas.
So, for example, in the area at the border of Guinea and Liberia, one of the reasons
people are arguing there's been a spread of Ebola is the deforestation there, so
that animals are moving closely into contact with humans.
And so bats, for example, are coming into much greater contact with humans, and
particularly around issues of palm oil, which people use, and also they eat bats.
So historically, there are communities that have eaten bats and
bush meat for hundreds of years with no problem.
And so, given the historic distrust with the government,
including the current governments, and a history of being able to eat these meats,
there was real skepticism when experts came in telling communities that they
shouldn't eat bush meat and that there was this terrible disease.
Because as you had both indicated, this had never been the case.
So I think what I'm really interested in, as we discuss these
really important issues around global health, is to add to the discussion and
understanding of the political economy of the region and of the history so
that there are reasons why people are both skeptical of experts and
are very aware that things like healthcare infrastructures do not exist.
So they have right to worry about whether it makes sense to send their
sick relatives to healthcare centers that they know are very ill equipped and
where most of the healthcare workers have died.
So I think in understanding Ebola as a global health emergency,
I really appreciate the chance to think about how history and political
economy have helped shape the environment in which Ebola is ravaging this region.
But I also think the issues of civil rights and
of individuals, human rights, as citizens of their particular countries, and
also the way that individual countries relate to the world.
And so to me, this is both a political economic question,
a global health question, and a human rights question.
And Debbie, I know you deal with human rights and global health, and so
I'd love to hear your thoughts on that.
>> Well, I think for me one of the big questions that comes up, and you actually
mentioned it, is the relationship between individuals and the state.
And this is really the foundation for
human rights when we think about them in the modern context, is what is
the relationship between individual citizens and the state that governs them?
And we heard, as you talked about, the very complicated histories of these three
countries that have been ravaged by conflict.
And we think about the trust that does or doesn't exist between the state and
individuals.
And so that's a really important piece of this conversation, is that the whole
concept of human rights is based on this social contract between the individual
citizens who are giving power to those that govern, and the exchange.
What is it that government or the state provides for individuals?
And that takes many shapes and many forms, but I also think one of the other things
that we have to bear in mind is kind of the classic human rights debate,
which is between universalism, universal human rights, and cultural relativism.
So we do have to think about cultural specificities.
We do have to think about the practices that are particular to these
particular countries and these particular communities.
And one of the things that we know in the case of Ebola is that, in fact,
some of these practices may have exacerbated
the spread of the disease in the early days of the disease.
So we do have to think about that as we think about human rights as well.
I think another thing that we have to think about it is, then,
what are the obligations of the state to its citizens?
And the first thing is to respect the rights of citizens.
And as we've seen in several states,
including some of the developed states, there was a very quick response to
go to the most extreme public health measure that we have, which is quarantine.
And so this gets into issues of civil rights.
The second obligation of states is to protect citizens, so
protect them from state actors but also non-state actors.
And this becomes really important when we think about the role that NGOs have played
in the Ebola response.
As Carlos mentioned, we don't have health systems in place.
So, in fact, the health systems are really being run by nongovernmental
organizations and international organizations that are coming in.
The countries that we're talking about have been devastated.
Their health systems were weak before conflict, but
after conflict they've been virtually decimated.
In Liberia something like 93% of
healthcare facilities were completely destroyed.
So the capacity of the state itself, as well as the lack of trust between
the state and citizens, as well as the lack of systems,
all contribute to what amounts to human rights violations, in some sense.
And then the third obligation for states is the obligation to fulfill.
That is, what is it that states should be doing,
in the case of something like Ebola, to actually prevent the disease?
And so those are really important elements for us to think about.