Ebola Outbreaks Public Health Emergencies in Fragile Conflicts Zones and Displaced Populations in Africa

Abstract

Little is documented on conflict and displacement impact on West Africa Ebola Virus disease (EVD) outbreaks. The paper revisits Ebola outbreaks public health emergencies in fragile conflict zones and displaced populations across Africa. Findings showed that the duration of conflict/war events varied one to forty three years. Notably, Darfur war in Sudan and South Sudan lasted between 18-23 years, RD Congo and Guinea incessant political and ethnical or mining conflict instability repeatedly ranging between 2-6 years, Liberia and Sierra Leone 5 and 12 years conflict/war events associated Ebola outbreaks were documented following seven and four years of conflicts from 1989-1996 and 1999-2003 prior to a democracy nation era in Liberia respectively. Worldwide, there have been 28,639 cases of Ebola virus disease and 11,316 deaths as at December, 2016 compared to recent Zika virus outbreaks in Latin America. Ebola outbreak public health emergencies advocacy, community social mobilization and engagement, Ebola awareness, effective and culturally dignified communications, social media and mass media risk communication, community literacy and preparedness, emergency response engagement and participation, access and deployment of digital technology applications (Health map) in surveillance, tracking and monitoring and key traditional burial practice behaviours changes were being translated into positive successes and benefits that geared rapid and effective prevention of further spread and containment activities of West Africa Ebola outbreak. Inter-humanitarian organizations, institutions and other stakeholders including government cooperation and coordinated leadership, commitment and investment were laudable in supporting accountability and transparency in the overall objectives of public health emergency preparedness planning, care management systems in Ebola outbreak centres, public awareness, epidemic early detection and rapid response as well as effective immunization programs implementation to outwit Ebola virus. Sierra Leone conflict lasted from 1991-2002, Guinea recorded frequent relentless instability than Liberia with two major conflict periods from 1989-1996 and 1999-2003. For the first time, we established a statistical significant correlation between duration of war/conflict events and Ebola outbreaks onsets in Africa (P<0.05).Unexpectedly; the total fatality rate in Liberia or Sierra Leone only was greater than the previously reported cumulative EVD cases across Africa since 1976. It is crucial to intensify advocacy on conflicts/wars resolutions to disaster risk reduction framework evidence practice implementation of peace building in fostering health and socioeconomic development and growth. Authors call for the urgent need for concerned commitment and engagement of all stakeholders to develop, implement and strengthening local, national, regional and global public health emergencies evidence practice approaches and strategies including national public health disaster emergency situations insurance models and schemes integration is paramount in disaster high risk prone settings and particular in Africa.