The outbreak of Ebola in west Africa has caused global hysteria and fear. Human rights should be our focus instead.
In recent weeks, two Ebola-infected American missionaries, were selected to receive “compassionate” doses of an experimental serum, ZMapp, as their patients languished with little more than paracetemol and rehydrants for comfort. When the Americans were flown back to the US to receive further care, the Centre for Disease Control and Prevention was flooded with hateful emails and phone calls from people appalled that the Centre would allow these conduits of disease back into the country. Public figures like Donald Trump called for the US to revoke the rights of Ebola-infected citizens to return and cried out on Twitter “GET THEM OUT OF HERE!” and “SECURE THE BORDER! BUILD A WALL!”
We have learnt the hard way with HIV/AIDS that this type of dehumanising discourse is one of the most harmful phenomena in dealing with an epidemic effectively. This hysteria exacerbates stigma, ignorance and superstition and drives persons who are in need of treatment and care into the shadows, away from knowledge and resources needed to reduce harm to themselves and others.
The discourse also normalises our acceptance of a post-9-11 state of exception in which we are all too quick to assume that human rights law has little to no role to play and that rights protections are in conflict with public safety goals. As with terrorism, the debate is charged with the current that we must trade our human rights (or, more likely, the rights of others) for our safety and survival. In this climate, it is not only important that human rights remain central to the public health discourse but it is also important how we conceptualise human rights.
First, individual human rights protections are necessities not hindrances to advance public health during emergencies like the Ebola epidemic. The notion of conflict with rights need not be assumed as a point of departure.
The bioethicist, George Annas, argues that where involuntary quarantining was used to control the SARS outbreak it was largely ineffective because it caused people to mistrust authorities and to stay away from treatment facilities, making the epidemic harder to control. Medical practitioners and aid workers working with Ebola in west Africa have reported great difficulty in earning the trust of local communities. People distrust these outsiders dressed in spacesuits. They see that people die when they go to quarantine and treatment facilities, and they die alone. If submission to quarantine was forced in this climate of fear, it must be assumed that it could drive vulnerable persons further away, restraining the ability of healthcare professionals to control the virus’ spread. It remains vital to respect voluntary submission to treatment as a right of the sufferer, incited through education and compassion, not fear, force and stigma.
Human rights also give us a framework to understand how the denial of seemingly unconnected rights and freedoms to some communities, heightens our collective insecurity. Epidemics like Ebola highlight how globalised public health has become. Like HIV, Ebola magnifies our greatest weaknesses, thriving off the intersections of poverty, race, political, social and geographic isolation, poor education, and broken medical economies. For as long as some of us remain excluded, we are all vulnerable. This means that we need to look at power, not only as it is exercised between patient and caregiver but more globally too, if we hope to prevent future crises.
Second, human rights law provides opportunities to manage potential conflict, when it does occur, between individual rights and public health aspirations and sets the boundaries for challenging ethical debates in a time of crisis.
A human rights discourse informs our discomfort when two white American lives are privileged in the receipt of potentially life-saving treatment. While there are many medical-ethical questions to consider in the provision of untested and unapproved medicine during an epidemic, our starting point in that debate must be equality, not discrimination on the basis of national or social origin and race.
A rights-based approach to public health further demands that where we are absolutely confronted with a conflict between the free will of an informed individual and the health and well-being of the group, any restrictions on the individual’s rights must be considered through the measured lens that human rights law provides. This means that forced treatment or quarantine in the height of a health emergency requires a high level of justification. It means the least restrictive means must be applied in the execution of a rights-infringing method of control, and that this must be done transparently, respecting the right of the individual to contest the decision being applied against her will. Communities who are subject to any restrictions on their freedoms during an epidemic must be included in these decisions.
Finally, human rights in the time of Ebola demands that we actively stand against what Paul Wolpe has described as the “second epidemic”: the mass disintegration of compassion. Compassion is a difficult disposition to retain amidst a climate of crisis, hysteria and exceptionalism. The insistence of treating everyone, equally, with dignity and due regard for their autonomy is a reflex that obedience to the discipline of keeping human rights in the picture will help us to master.
Human rights are indispensable tools in global public health emergencies like the present Ebola epidemic. A discourse of rights and a compassionate understanding of our shared vulnerabilities is the most pragmatic approach to resolve these types of crises and to prevent future epidemics.
A shortened version of this piece was published in the Business Day on 19 August 2014.
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2 RESPONSES TO “HUMAN RIGHTS IN THE TIME OF EBOLA”
- Bee Marrah says: 25 AUGUST, 2014 AT 8:44 PM Thanks for raising those critical concerns.
- I totally agree with you. The current fight against ebola in Sierra Leone is seriously undermined by the cruel, inhuman and degrading treatment or punishment meted out to victims, suspects and their families and house holds. That is why a number of Human Rights Defenders have launched an initiative called DIGNITY CAMPAIGN FOR EBOLA VICTIMS in Sierra Leone and are currently engaged in carrying out advocacy activities in various parts of the country.
- WE will not relent until ebola victims receive the dignified treatment they deserve because its the only way we can chase away the virus. REPLY