Ebola in Guinea: Revealing the State of the State
From the Series: Ebola in Perspective
While people in this poverty- and conflict-ridden region of West Africa are struggling to meet the Ebola challenge, the international public attention has returned after a decade of pausing its attention, after the civil wars of Sierra Leone and Liberia ended in 2002 and 2003 respectively. But media coverage of Guinea has always been thin. Now it has come to dubious fame as the source of the largest and most widely spread outbreak of Ebola virus disease. Official rates of new infections were lower than in neighboring Sierra Leone and Liberia but have been rising as of September. So what is different with regard to the Ebola response in the country that has been flying under the radar of many Africa- or crisis-observers?
What the Ebola crisis reveals about Guinea, besides precariously weak public health infrastructure, is the workings of a state apparatus that for decades has been basing itself economically on mining revenues and politically on authoritarian population control through military and police. One could argue that the government, otherwise little invested in the wider population’s well-being (only 1.8 percent of GDP was dedicated to public health in 2012), was suddenly forced by humanitarian-minded international scrutiny to contain the outbreak. The otherwise little-regarded national body, so easily ignored by a distant national elite who live their lives largely abroad and certainly far away from the realities of the general population, could now be perceived as a biohazard (to emulate the increasingly militarized tone of the regional Ebola conversation), which cannot be contained and repressed at gunpoint any more. But other nuances need to be taken into consideration to complete the picture.
Guinea has had its issues with international interventions in the past. When large refugee populations interlaced with combatants from neighboring countries' civil wars were accommodated with the support of the UNHCR in the 1990s, the government of the period sensed incursion into domestic politics in the wake of humanitarian and refugee programs and limited some of these organizations' statutes. The government's historic distrust of so-called “foreign elements” was repeatedly disseminated amongst the population that at the time experienced some NGO- or UN-actions as less than helpful for the safeguarding of their own communities' well-being. It therefore does not come as a surprise that reports emerge about local communities in Macenta Prefecture in the Forest Region, at the very heart of the outbreak, who distrust bio-medical infrastructure to the extent that health centers are attacked and NGOs and government health workers are denied access to their villages—a well-established strategy of self-defense against any “foreign element”, whether combatants from neighboring countries, own government representatives, or international health organizations.
Central government agents are often seen as foreign elements all over the countryside, not only in the Forest Region. They rarely leave administrative centers, and if they do, it is to accompany an NGO campaign or police mission. Beyond the increase of ethnicized rhetoric in national politics (which dramatically increased during the 2010 and 2013 national elections) the general population perceives these agents as foreign elements because government agents are so rarely present and are largely associated with the remote governing elite in Conakry. However, at the same time collective memory links them to a very powerful memory of the state forged after independence in 1958. In some areas of Guinea, ideas about the state may prove to be stronger than the actual everyday state presence and capacity to act efficiently on this medical emergency.
This ever-weakening everyday state capacity (according to a Weberian notion of state) reveals itself in public service provisions, or rather the lack thereof. Public (health) infrastructure is barely on working levels and is currently not only under pressure from the Ebola virus disease but also from outbreaks of measles and meningitis—two of the many periodically reoccurring and deadly illnesses that have been met with comparatively swift and routine responses by a collaboration of respective line ministries and NGOs.
With Ebola being new to the region and raising panic in international media circuits, usual routines did not work for the government and revealed how underfunded, under-capacitated and overwhelmed the Guinean public health services are in non-routine contexts. The Guinean government generally reacted slowly, declaring a national emergency only on August 13, with opposition parties accusing the president of using the epidemic for his political interests in the upcoming local elections. But just as slowly do the WHO and the rest of a rather hesitant international community push their gears into action and commit not just words but funds and medical as well as military staff.
At the beginning of September, the Guinean government announced that the virus had spread faster and further than anticipated, affecting areas that had so far not officially registered people infected with Ebola. The Ministry of Health has now also engaged in research into the possible challenges of curbing transmissions, again focusing on the Forest Region, which has already been marked by the government and national public as a significant “other” to the modernization process since independence. Hence, the fear of further exoticization and stigmatization of this region's inhabitants by fellow Guineans augments.
Economic consequences on the macro-economic level are beginning to be felt. Projections for economic growth are slumping with mining companies slowing or closing their operations, therefore limiting the government elite's revenues. The fear of Guineans traveling to neighboring countries can be felt on all levels, including the hampering of vital cross-border trade in staple food stuffs that affects people’s subsistence and their national pride. Upset Guinean voices are calling the government into further action to both intervene in the negative image Guinea has been gaining from being identified as the origin of the amorphous threat and to protect the precarious economic situation most citizens find themselves in.
This crisis finally gives the impression that it cannot be as easily weathered by the Guinean government as other political, economic or health upheavals, which have in the past so often run their course without necessitating changes in state performance. Key to this may actually not be the fact that Guineans are dying of a containable disease—they are doing so from other, more innocuous causes. The difference is that a panic-stricken international community is putting pressure on the Guinean government as this less benign virus represents a threat to regional and global securitized public health far beyond the little known rural and urban quarters of Guinea.