Thomas Eric Duncan, and Deconstructing the Ebola Crisis in the U.S.

Thomas Eric Duncan

Thomas Eric Duncan's death was characterized by institutional incompetence and racism, not Ebola. Photo by zennie62 (flickr).

In 2014, the Ebola virus devastated western Africa. That fall, the American public panicked over the possibility of an Ebola outbreak in the United States. Americans stocked up on emergency supplies, avoided public spaces for fear of contracting the virus, and clamored for a vaccine. Though the episode and accompanying media spectacle had largely passed by November 2014, it exposed ongoing problems with the country’s response to disease and its obligations to the world. This is clear from the misplaced priorities of politicians and institutions—informed by racism and classism—and poor reporting from the media.

The government’s ability to address an outbreak was hurt by austerity at the local, state, and federal level. The federal government cut the budgets of the Centers for Disease Control and the National Institutes for Health. The cuts hurt the U.S.’s ability to respond to infection and de-prioritized funding for research on Ebola vaccines. Specifically, this resulted in state and local governments cutting the funding of public health initiatives and preparedness, and the federal government did not provide sufficient money or resources to fight the disease in Africa. Austerity is not just discredited economic policy: it also has very clear negative effects on public safety and health.

As anxiety grew over the possibility of an outbreak, American media and politicians focused attention on rapidly developing a vaccine. Understandably, Americans wanted a way to immediately secure themselves from virus. But Ebola can and should be easily contained by well-functioning public health infrastructure. A vaccine is not necessary or even as effective, and vaccinating the population of the U.S. is more expensive and difficult than preventing an outbreak in the first place. The desire for a vaccine is also very individualistic: people urgently seek to secure only themselves through vaccination. Although vaccination can protect others in the long term via herd immunity, in this case vaccination may reduce the desire or need for an adequate public health response.

The focus on developing a vaccine thus played into the anxieties of people who would have the greatest access to a vaccine (such as wealthy or well-connected people) and shifted focus away from cuts to our public health infrastructure — cuts that many of the same people supported and may still support. Vaccination, too, removes the practical need for economically secure Americans to address the Ebola epidemic in western Africa, leaving only a moral obligation. This displays a lack of education on public health problems, a failure of the media to educate, and a shift in focus toward a solution that is less effective, and therefore more likely to result in death for those without easy access to vaccinations.

The people fueling this panic have rightly been condemned. Vox, for example, reminded people that the only way to contract Ebola is through direct contact with fluids from an infected person. This condemnation has a darker side, however. Vox also displayed this chart of the leading causes of death in Africa, which shows that Ebola resulted in relatively few deaths:

Leading Causes of Death in Africa

Vox’s misleading and unhelpful attempt to convince us that Ebola was less of a problem than some were making it out to be.

There were many similar visual representations that showed the virus affecting relatively few people and almost no one in the U.S. These narratives minimize the virus and its effects, which have resulted in thousands of lives lost in a very short time. The deaths and harm from Ebola are also qualitatively different than those from other causes of death. Ebola is easily preventable, but it is infectious, virulent for all ages, and deadly. It’s not useful to compare it to heart disease, which occurs late in one’s life and is predictable and not sudden, or to road injuries, which can’t spread across a continent. In the U.S., there is also an expectation that the government would be able to contain the virus completely; the panic over the virus, while unwarranted, was an understandable response to the government’s public health failure. People expected the government to be able to respond to Ebola effectively, and consider deaths from Ebola unacceptable. They don’t expect the government to be able to substantially reduce road deaths, which are unfortunately normalized. The narratives from Vox and others seek to be a serious alternative to panic but use suspect analyses that misrepresent the virus and its effects. (The same unhelpful narratives are now fueling those who view gun violence as inconsequential when compared to other causes of death.)

Lastly, the U.S. should not tolerate preventable deaths in general, and it should seek to prevent them in poor countries where the local government cannot: life in those countries is as important as life in the U.S. In addition, poor countries are poor for understandable reasons, and the U.S. is responsible for that poverty via its part in encouraging colonialism and neocolonialism (although it’s important to note that the U.S. should still help poor countries even if it were entirely blameless for their poverty).

Instead, the “othering” of these countries and their people was central to the U.S.’s response to the Ebola crisis. The U.S. considered banning travel to affected countries and instituted mandatory screenings, both policies that are contrary to public health guidance and that make it more likely that Ebola will be spread. As Ebola faded from the spotlight in the U.S., coverage of the ongoing epidemic became almost nonexistent even as the World Health Organization declared Ebola “the most severe acute public health emergency seen in modern times.”

In the U.S., we turned the circumstances of the first victim, Thomas Eric Duncan, into a media circus. Duncan was dehumanized unlike any other Ebola patients, including Craig Spencer, the doctor who brought the virus to New York: “the unemployed foreign black man [Duncan] was rhetorically positioned as a criminal, a terrorist, an animal…[t]he wealthy, white American doctor is a humanitarian hero.” Duncan was threatened with criminal charges in Liberia and in the U.S, insinuating he brought the virus to the U.S. with criminal intent; he was accused of lying about his exposure to Ebola even though he was unaware of his exposure via a pregnant woman he assisted in an act of kindness; and his sickness spurred discussion of “putting down” those infected. Duncan was also mistreated at Texas Health Presbyterian Hospital Dallas, the hospital he visited and where he later died.

The degree of the hospital’s negligence was severe and its treatment of Duncan was unique to all U.S. Ebola patients. The hospital “botched [his] release from the emergency room,” “delayed testing and delayed treatment,” and “den[ied]…experimental drugs that have been available to every other case of Ebola treated in the U.S.” His family goes on to say that the hospital “invited death every step of the way.” Duncan’s family will not be adequately compensated for the hospital’s role in his death either as Texas Republicans have placed severe limits on the amounts awarded in medical malpractice lawsuits. The disparities in Duncan’s portrayal in the media and his medical treatment are undoubtedly because he was black and easily othered. It should be clear that no circumstances justify Duncan’s treatment, but it is also important to note that Duncan’s last few months of life are characterized by his integrity, kindness, love, and devotion to his family, contrasting the prevailing narrative of his life.

As Duncan lied dying in the hospital, media coverage focused on the unlikely possibility of widespread infection in the U.S. and not on his desperate situation, the hospital’s negligence, or the effects of our government’s austerity policies in the U.S. and abroad. Now that the fear of the virus in the U.S. has subsided, the U.S. needs to address the shortcomings in our response to the threat of Ebola. It can do this by adequately funding its public health infrastructure at all levels and points and fight epidemics abroad, because of Americans’ moral responsibility first and the practical use second. The country also should understand and address how othering affects responses to these crises, what this attitude says about our society, and how it harms the people that are dehumanized.

While the media’s perspective will change over time in response to the public’s attitudes, the media and institutions — hospitals, the justice system, and government in general — must be held accountable now for their mistakes and seek to prevent their reoccurrence.

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