BENJAMIN AWUVAFOGE/KOFI ANNAN INTERNATIONAL PEACEKEEPING TRAINING CENTRE
The understanding of security often is limited to armed conflict or violent situations. Hence, most governments’ security planning is focused on the military and police to the exclusion of important sectors such as health and sanitation. This narrow conception of security has complicated the fight against disease in Africa.
According to scholar Mohammed Ayoob, security is defined in relation to internal and external vulnerabilities that can significantly weaken territorial and institutional state structures and regimes. That means anything that poses a threat to the survival and life of an individual is a security issue.
The lack of basic sanitation, coupled with effects of conflict such as the destruction of a country’s infrastructure and health systems, impede attempts to effectively fight disease outbreaks. It’s not surprising that the World Health Organization (WHO) observed that many of the countries most severely affected by the recent Ebola outbreak have weak health systems and lack human and infrastructural resources after long periods of conflict and instability.
Infection control and hygiene are major issues. Soap and clean water are unavailable in some areas. Alcohol-based hand rubs are needed on a large scale. Isolation facilities are vital to contain Ebola, as are labs for testing because of the importance of rapid diagnosis. In some places, isolation is nothing more than an area behind a curtain.
Sanitation deficiencies also undermine public health. WHO’s Department of Public Health and Environment says that although 1.8 billion people have gotten access to basic sanitation facilities since 1990, more than 2.5 billion people — about 37 percent of the world population — still lack that access.
Ghana, like many African countries, has a problem with waste and garbage disposal, particularly around the capital, Accra. Waste-collection bins often overflow at city transport stations, and public urination and defecation are not uncommon. Cholera outbreaks occur regularly during the rainy season in Ghana and elsewhere, underscoring the importance of proper waste handling and disposal. In 2014, Ghana’s cholera outbreak infected more than 27,900 people and killed 217, according to the U.S. Centers for Disease Control and Prevention. The disease is spread when water is contaminated by human waste. As the cholera outbreak was ongoing, President John Dramani Mahama called on municipal authorities and citizens to take part in regular cleanups. He also stressed the need for hand-washing and pledged to distribute free garbage bins to all households so waste didn’t end up in the gutters.
It is said that prevention is better than a cure, and this is true in the fight against disease. The nature of Ebola being a contact-based disease that is not spread through the air makes it an ideal target for prevention. Prevention mechanisms are cost-effective and include wearing protective clothing and washing with products such as soap and chlorine. By contrast, treatment is resource-intensive and often unsuccessful. For example, a 70-bed Ebola management center in Bong County, Liberia, cost $170,000 to build and about $1 million per month to operate.
Although early 2015 has shown promising signs in the fight against Ebola, African leaders still must learn important lessons from the outbreak. Now is the time for them to re-examine their perception of security issues, especially to redirect government expenditures to other important, yet basic, sectors such as health and sanitation. The job of the security sector is to prevent the loss of human lives. If national leaders can reorient priorities in the coming years and widen their understanding of security, more lives could be saved.
Benjamin Awuvafoge completed his master’s degree in Gender, Peace and Security in March 2015 at the Kofi Annan International Peacekeeping Training Centre in Accra.