The Effect of American Military Intervention in the 2014 West Africa Ebola

Outbreak

Savannah Maxwell

May 8, 2015

POLS 413

Literature Review

Since the first case of the Ebola virus was discovered in the 1970’s, the virus has

continued to rear it’s ugly head time and time again, creating multiple outbreaks amongst

humans and Ape and Chimpanzee populations in Central and West Africa. When does a disease

become so dangerous that it warrants more than the healthcare intervention that a country can

provide? The nearly forty-year history of the Ebola virus is the perfect setting in which to

examine this particular concept.

What we know about the Ebola Virus is growing everyday, given that the virus has a

fairly short history in scientific context, only having been discovered nearly forty years ago in

the Democratic Republic of the Congo (formerly Zaire). (Peters, LeDuc Pg. 9) The Ebola virus

triggers hemorrhagic fever in its host, causing the patient to suffer bleeding (notably internal in

the gastrointestinal tract), high fever, soar throat, and inconsolable abdominal pain. So what

makes Ebola so deadly? These symptoms appear to be easy to control from an outsider

viewpoint, but often it is that the virus wears the host’s system down so far that their organ

systems can no longer fight and begin to shut down. The best means for fighting Ebola is simply

system support such as fluids and oxygen. What makes Ebola the deadly virus that it is known as

is how quickly the virus tends to spread. Ebola is spread through the contact with the bodily

fluids of a person infected with the virus. In environments where hygiene is not necessarily a

priority, or where access to proper medical care is available, the virus is able to flourish and

spread rapidly from person to person. The early epidemics of Ebola in Zaire provided evidence

early on of the just how deadly the Ebola virus had the potential to become if an outbreak was

allowed to get out of hand and not under control early on. The outbreak in Zaire had a case-

fatality rate of 88% (Heymann et. al. Pg. 372). Access to proper medical equipment, medical

care, and sanitation is essential during an Ebola outbreak. Unfortunately this is not always

accessible in rural (or even urban) areas of Africa where the Ebola virus tends to have a

prevalent presence. The Ebola Zaire (1976) outbreak would not have been as fatal were there

access to clean needles. It was found that the disease was spread in a hospital by the sharing of a

needle used on an infected person with other hospital patients. (Heymann et. al. Pg. 372)

One of the major issues present when there is an outbreak of Ebola is the access to

sanitation and sanitary medical supplies. Up until 2014, there had been little to no outside

intervention in any previous Ebola outbreak (save for what help the WHO offered). The most

attention given to Ebola up until 2014 was during an outbreak of Ebola-Reston in 1989 at a

primate facility in Reston, Virginia where monkeys that had been imported became ill with the

virus. The virus was then seen again at this same site in 1996 (Peters, Leduc, Pg.9). Until the

outbreaks in Virginia, the United States government had turned a relatively blind eye to the

Ebola virus and the havoc it had wrecked in the Democratic Republic of the Congo and Sudan.

An outbreak, large in comparison to previous, in the DRC city of Kikwit in 1995 was the largest

outbreak at the time that had been observed. More than 300 people fell ill with the virus in this

particular incident. The WHO was contacted regarding the mysterious illness that had plagued so

many, and when the samples were sent to the CDC, Ebola Hemorrhagic Fever was confirmed to

be the culprit. (Bwaka et. al. Pg. 1). Also in 1995, an outbreak in Mosango, DRC showed a

different side to the virus, the side that could be controlled with proper hygienic practices among

medical personnel and in hospitals. The outbreak remained small because of the conditions at the

hospital in Mosango. The sanitary conditions under which the patients were seen and treated, as

well as the way in which waste was disposed of provided the proper environment for the virus to

be stopped in its tracks. (Ndambi et. al. Pg 8). Another example of poor health measures

resulting in a lengthy outbreak is the outbreak of Ebola in Gabon in the years of 1994-1997. The

lack of health care supply, sanitation, and medical workers posed quite the challenge in fighting

back against the virus during the Gabon outbreaks. (Georges et. al. Pg 65).

The consensus amongst the examination of past Ebola outbreaks is the need for

consistent and quality medical care and sanitation in any incident of Ebola being diagnosed. The

way to stop the virus is through sanitary health care measures, unfortunately the regions in which

Ebola presents itself do not consistently have access to quality medical care and proper sanitary

medical practices, posing a need for outside intervention.

Research Design

The effect of the use of the American military for civilian purposes has been observed in

many instances, but never in such a way that shows the effect that the American military can

have during an epidemic of a deadly disease in another country, operating on foreign soil. The

Ebola virus has wrecked havoc in the West African countries of Liberia, Sierra Leone, and

Guinea. With casualties of over 9,000, the outbreak of Ebola in West Africa has no doubt been

the most deadly of the virus’ history. With the outbreak of Ebola threatening not just domestic

security in West Africa, but international security and the health of other countries, President

Obama announced the deployment of United States military servicemen and women to help aid

medical workers in areas most affected by the virus with the hopes of ending the further spread

of the virus.

In order to determine whether or not American military intervention in the West African

Ebola outbreak (2014) significantly contributed to the slowing of the spread of the Ebola virus in

Guinea, Sierra Leone, and Liberia, there are several sets of data that will need to be looked at and

studied to determine just the effect that the American intervention has made on the epidemic and

conditions in West Africa. United States military intervention in the Ebola outbreak has not only

had an effect on the ground in West Africa because of the American military servicemen and

women that were sent to aid in the crisis, but also because of the influence that the decision to

send American military to aid in ending the epidemic had on the decision made by other

countries to send aid to West Africa.

For this particular study, only the data concerning the timeline of the spread of the Ebola

virus in the outbreak in West Africa before United States military intervention, and the timeline

of the spread of the Ebola virus in West Africa when United States military intervention began to

current times will be used to provide answers to the research question. The independent variable

of the study is United States military intervention in the Ebola outbreak in the West African

countries of Guinea, Sierra Leone and Liberia, while the dependent variable of the study is the

spread of the Ebola virus and death counts in the Ebola outbreak in the West African countries of

Guinea, Sierra Leone, and Liberia. Data concerning the current West African Ebola outbreak in

Guinea, the only country of the three most affected that did not experience any intervention by

the United States military is used for comparison.

To measure the independent and the dependent variables of the study, a few different

sources were used to gather data on the current Ebola outbreak and past Ebola outbreaks, namely

the Center for Disease Control at www.cdc.gov and the European Center for Disease Control at

ecdc.europa.eu. Using the data provided concerning the amount of cases of Ebola in comparison

to the timeline of the outbreak, the effect of United States military intervention in terms of the

spread of the Ebola virus will be determined.

Data Analysis

In the case of the ongoing West African Ebola outbreak, the most important pieces of

data to analyze are the death count and case counts for each of the three main countries in West

Africa that were affected by the outbreak; Liberia, Sierra Leone, and Guinea. By placing the data

found through the European Center for Disease Control website into graphs where the data is

shown over time, the leveling off of death counts after American intervention in Liberia can be

seen in comparison to the death count in Guinea, where there was very little to no American

military intervention in the crisis. In the graphs below, the death counts for the three most

affected countries are displayed over time.

Figure 1: The death count for the ongoing Ebola Outbreak in Guinea is displayed for the

dates ranging from March 2014 to March 2015.

80   141   193   303  339   430  

710  1018  

1327  1739  

1937  2127  2279  

0  

500  

1000  

1500  

2000  

2500  

Num

ber  of  Cases  

Guinea  Monthly  Death  Count  

Figure 2: The death count for the ongoing Ebola Outbreak in Liberia is displayed for the

dates ranging from March 2014 to March 2015.

Figure 3: The death count for the ongoing Ebola Outbreak in Sierra Leone is displayed

for the dates ranging from March 2014 to March 2015.

0   0   9   65   156  694  

1998  

2697  3155  

3423  3739  

4057  4301  

0  500  1000  1500  2000  2500  3000  3500  4000  4500  5000  

Num

ber  of  Cases  

Liberia  Monthly  Death  Count  

0   0   6   99   233   422  622  

1510   1583  

2827  3274  

3530  3764  

0  500  1000  1500  2000  2500  3000  3500  4000  

Num

ber  of  Cases  

Sierra  Leone  Death  Count  

American military intervention in Sierra Leone and Liberia (main base for the relief efforts was

based out of Liberia) began in mid October of 2014. In the graphs displayed above, the death

count from the outbreak continues to rise even through November, but in Sierra Leone’s case

through much of December as well. After this time however, which I would like to refer to as an

“adjustment period”, the death count for Liberia and Sierra Leone largely begins to level off and

slow down, aligned with the timing of the arrival of American military aid to West Africa. Also

aligned with this is the death count in Guinea. Guinea, where the outbreak began, was not

affected as greatly as Sierra Leone and Liberia with the spread of the Virus; therefore the

American aid was concentrated in Liberia and Sierra Leone, which I believe the data accurately

shows.

Though the death count leveled off in correct correlation to the timing of American aid, it

can be argued that there were many other factors involved with the death rate of the Virus

slowing in the two most affected countries of Liberia and Sierra Leone. When President Barack

Obama announced that the United States would be sending American military to aid in the relief

efforts, many other international governments also became involved in the relief efforts

including countries such as China and Cuba. With this in mind however, the connection between

the death rate of the virus slowing in Liberia and Sierra Leone where the majority of the

American military aid was sent, and the death rate of the virus remaining relatively the same in

Guinea where little American military aid was sent cannot be denied.

The death rate of the virus was significantly lowered and appears to have leveled off, and

in addition to this, the rate of new confirmed cases also appears to have lowered and leveled off

in Sierra Leone and Liberia while remaining relatively high and stable in Guinea, consistent with

the death count data. I believe this to be a result of several different factors. Firstly, the main

effort of American military aid for the Ebola outbreak was to build hospitals and provide medical

services and supplies to hospitals to aid those that were infected. In addition to this, educational

services were offered by the American military officials that were sent to aid in the outbreak in

order to better educate medical personnel that were directly involved in treating Ebola patients to

create a more uniform set of information distributed to medical personnel on how to safely and

effectively treat patients infected with the virus. Therefore, with most aid that was sent for the

relief efforts going towards those persons that were already ill with the virus, not much was done

on the part of the American military to essentially stop the spread of the virus, but by lowering

the death rate of the virus, a lowering of the infection rate of the virus should in essence happen

as well, as shown below in the graphs of Case Count data.

In the graphs below, the case counts for the outbreak for the three most affected countries

are displayed in graph form over time.

Figure 4: The case counts for the ongoing Ebola outbreak in Guinea is displayed over

time from January 2014 to March 2015.

10   39   122   218  291   413   460  

648  1157  

1667  2164  

2730  2959  

3205  3459  

0  500  1000  1500  2000  2500  3000  3500  4000  

Num

ber  of  Cases  

Guinea  Monthly  Case  Count  Increase  

Figure 5: The case counts for the ongoing Ebola outbreak in Liberia is displayed over

time from January 2014 to March 2015.

Figure 6: The case counts for the ongoing Ebola outbreak in Sierra Leone is displayed

over time from January 2014 to March 2015.

0   0   12   0   12   107   329  1378  

3696  

6525  7650  8018  

8729  9265  9602  

0  

2000  

4000  

6000  

8000  

10000  

12000  Num

ber  of  Cases  

Liberia  Monthly  Case  Count  Increase  

0   0   0   0   50   239   533  1026  

2304  

5338  

7312  

9633  10707  11443  

11866  

0  

2000  

4000  

6000  

8000  

10000  

12000  

14000  

Num

ber  of  Cases  

Sierra  Leone  Monthly  Case  Counts  

As earlier mentioned, figures 4-6 do in fact show a slow in the spread of the virus and newly

confirmed cases. Based on the graphs and the data, American military intervention does appear

to have affected the spread of the virus and the reduction in deaths from the virus.

Conclusion(s)

Each of the affected countries—Guinea, Liberia, and Sierra Leone—experienced a rapid

increase in virus infection rates from October-December 2014. While the spike was experienced,

Liberia and Sierra Leone—the two countries that received aid from the American military during

the crisis, experience a significant drop in case increase and death increase each month following

this spike. The American military did not intervene in Guinea’s efforts to stop the spread of the

virus, and the data that was collected reflects this. Though Guinea also experienced the same

spike in cases and deaths from October-December 2014, the rate of the spread of the virus in

Guinea did not decrease after the speak, instead it continued to remain at a steady rate rather than

slowing down.

At the time that America intervened in the crisis and sent aid to West Africa, an

international movement started and after American aid had arrived, much other international aid

began to arrive. With this in mind, though there may have been other contributing factors, the

correlation between the decrease in death and infection rates in Liberia and Sierra Leone to the

arrival of American military aid cannot be denied. Though access is currently limited, it is

possible that with more comprehensive data regarding the American military intervention in the

West African Ebola crisis a more concrete conclusion can be reached as to whether or not the

American military sparked a decline in infection and death rates in Liberia and Sierra Leone.

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