
Battling Ebola in a war zone - etiam
https://www.nature.com/articles/d41586-019-01432-y
======
dade_
I admire MSF / Doctors without Borders. I can only imagine the hopelessness of
finding oneself in the middle of a war zone, with some horrible infection or
injury. In a world with far too much talking, it is always great to see people
actually doing something.

[https://www.doctorswithoutborders.ca/article/ebola-amid-
tens...](https://www.doctorswithoutborders.ca/article/ebola-amid-tensions-
democratic-republic-congo-msf-scales-outbreak-response-and-patient-care)

~~~
zachguo
MSF is on Amazon Smile too.
[https://smile.amazon.com/gp/chpf/homepage?q=doctors+without+...](https://smile.amazon.com/gp/chpf/homepage?q=doctors+without+borders&orig=%2F&ie=UTF-8)

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heraclius
One plausible explanation of high rates of conflict in the DRC is the Belgian
approach to colonisation.

> At the outset, only groups officially acknowledged as indigenous were
> entitled to a native authority, and with it the right to a tribal ‘homeland’
> administered by chiefs appointed from within their own ranks. Not only were
> non-indigenous groups denied this right; they were required to pay tribute
> to ‘indigenous’ chiefs in the native authority where they lived. The
> colonial system thus rested on a dual system of institutionalised
> discrimination dressed up as cultural difference: by race in the cities and
> tribe in the countryside. The native authority system continues today to
> create suspicion and animosity between two politically defined groups – one
> indigenous, the other not – and to set the scene for violence. What used to
> be called tribalism – and is now called ethnic conflict – is the expression
> of a structural contradiction between the economics of a market system and
> the politics of a residual colonial system. Markets move people, and not
> simply products of labour, across boundaries, but a colonial mechanism such
> as the native authority disenfranchises anyone who crosses tribal
> boundaries, as millions of Congolese were obliged to do, in the service of a
> fluid migrant labour system. This contradiction was at its most acute in the
> southern province of Katanga and the eastern provinces of Ituri and Kivu.
> With independence from Belgium in 1960, there was a prophetic round of
> ethnic cleansing in Katanga and Kasai, repeated on a more dramatic scale in
> 1992-93, and shortly afterwards in Ituri and Kivu.⁰

Since independence, the DRC has seen millions of deaths due to conflicts
largely caused by ethnic strife, principally during the Second Congolese War,
which alone appears to have caused approximately 4 million deaths.¹

In this context it seems that Ebola is not particularly threatening;
certainly, if one views human conflict as a disease, it has not killed
particularly many. The principal conclusion from this conflict, I should
think, is that the DRC is quite vulnerable to the spread of other diseases
that are even more infectious.

Transport in the DRC is notoriously difficult. Many “roads” are not visible
either on Google Earth or in attempting to use “remote sensing”². There may
therefore be some hope that the spread of a more dangerous infectious disease
could help to reduce conflict by increasing fear of contact between
populations. As things stand, it seems that most contact consists of violence
instead of useful things such as trade. If the jungle cannot stop the
militias, perhaps disease can. (It admittedly failed to do so during the
Plague of Justinian.)

0\. Mahmood Mamdani, “The Invention of the Indigène”, in: _London Review of
Books_ (20th Jan. 2011), pp. 31-3, [https://www.lrb.co.uk/v33/n02/mahmood-
mamdani/the-invention-...](https://www.lrb.co.uk/v33/n02/mahmood-mamdani/the-
invention-of-the-indigene)

1\. Benjamin Coghlan et al, “Mortality in the Democratic Republic of the
Congo: A Nationwide Survey”, in: _The Lancet_ 367.9504 (Jan. 2006), pp. 44-51,
DOI 10.1016/S0140-6736(06)67923-3

2\. DR Congo Snapshot: Roads in the DR Congo—Democratic Republic of the Congo,
[https://reliefweb.int/report/democratic-republic-congo/dr-
co...](https://reliefweb.int/report/democratic-republic-congo/dr-congo-
snapshot-roads-dr-congo)

~~~
hutzlibu
I appreciate your insights into Congo, but I doubt that the fear of disease
and therefore of strangers, is a suistainable base for all peace. Rather the
opposite. One reason more to fear and hate the neighbours.

~~~
heraclius
I agree that hatred would be increased. Peace would only follow from disease
where:

1\. one can avoid infection by avoiding proximity (so no waterborne disease
for example),

2\. knowledge of this is widespread,

3\. avoidance of proximity is feasible, and

4\. the increase in hatred is not sufficient to remove fear of death.

However, I think that most of these conditions are met in large parts of the
DRC, apart from (1), where there is no such disease yet.

EDIT: Also (2) is endangered by the spread of unscientific beliefs; presumably
political actors wouldn’t be attempting to convince others that Ebola doesn’t
exist were there no possibility of succeeding in this venture.

