While the humanitarian community is still struggling to help end the Ebola epidemic, talk about lessons learned and the need for critical evaluations have been on the way for some time already. Here, I suggest that humanitarians must pay keen attention to the post-Ebola narrative of military victory that is currently emerging. To see the deployment of military personnel, strategies and tactics as the game changer is unfair, because it invisibilises the resilience of the nationals of Ebola affected countries, as well as the efforts of local health workers and (some) humanitarians to address and control the outbreak. However, this narrative also has important strategic consequences for patterns of funding and intervention in future health emergencies.
Hence, in the midst of the avalanche of self-criticism that humanitarians will probably bury themselves in, they must also find the time to push for a fair and comprehensive assessment of the military component of the Ebola response: what did humanitarians ask the military to do? Who decided on the parameters of the military response and what was the response? What role did the military play in gaining control of the outbreak? How effective was the response compared to the resources spent?
On September 2nd 2014, Médecins Sans Frontières (MSF) asked for civilian and military medical capacity to be deployed to deal with the growing crisis. Joanne Liu, the International President of MSF, told the UN that that the further spread of the disease ‘will not be prevented without a massive deployment’. Speaking to the British Medical Journal, Liu suggested that ‘the military are the only body that can be deployed in the numbers needed now and that can organize things fast.’ MSF insisted that military personnel should not be used for containment, quarantine or crowd control. AFRICOM’s (the US Armed Forces command for military operations in Africa) response in Liberia involved an estimated 3,000 forces that were mostly withdrawn by late February 2015. In Sierra Leone, the British government deployed 700 military personnel.
While MSF’s call for military aid elicited concern and controversy over ‘the militarisation of humanitarian aid’, the fact that it was MSF’s call rationalised and re-emphasised the global public understanding of Ebola as an existential threat, where a military response had become the last straw after the failure of the international community and civil society. This type of imagery was eagerly embraced by Western politicians but also appears to have been doing some useful work for the military itself, as indicated by how AFRICOM now promotes Ebola as an opportunity for medical innovation.
The pragmatic questions may well be the most sensitive ones: did the military response really save the day, and if so, at which cost? Moreover, was this a reasonable cost compared to what a robust public health response would have amounted to? As noted by commentators back in September 2014, framing the U.S. response to Ebola as a national security issue could make it easier to ‘hide’ information from the public and more difficult to assess the effectiveness of the response. Previous military attempts at doing humanitarian logistics have been criticised for being slow, inappropriate or costly (think Kosovo). As a rule, the military spend significant amounts of resources on force protection. This time around, too, the military came late and left early.
In the case of Ebola, MSF made some assumptions about the ability of the military to deliver logistics and medical expertise in a timely, useful and efficient manner: MSF’s initial assumption was that ‘with the massive investment and knowing how much they are afraid of bioterrorism, they have some knowledge about highly contagious diseases.’ Were these expectations fulfilled, for example with respect to delivering biohazard competence? In short, we need to see some evidence that the military deployment was a game changer.
Yet, beyond a necessary tally of costs and benefits, attention must also be given to the ways in which a military medical response inevitably brings on its own dynamics and imaginaries. For one, I think there are significant problems with deploying a language of warfare (and humanitarians have done it a lot too): it risks turning infected people and their caretakers into objects of fear and stigma. It may also transform the local populations into threat actors and source of infections for our ‘troops’. A militarised language may also help rationalise weaponised responses to violence against health workers, and forceful enforcement of quarantines, particularly of slums and poor people’s dwellings. Tuning into the command and control rhetoric may also just be a way for international actors to look better: WHO now proposes to train staff with ‘military precision’.
In a certain sense, the Ebola response is steeped in historical responses to African health problems. Commentators point out that the idea that militarised medical responses to humanitarian crises are problematic, is a relatively new way of seeing things: historically, charity has always been a military issue in times of war and humanitarian aid today appears to be much less militarised. But while the neat mapping of military deployments upon old colonial territories seems to have been perceived as a significant advantage, we should also remember that colonial military medicine often saw public health as a governing device, and was used as a coercive control measure, for example through quarantining populations. Back in September, the UN declared Ebola to be a threat against international peace and security, just like HIV/AIDS a decade and a half before. But as observed by Alex de Waal, epidemics do not cause security crises and societal collapse.
In sum, a political and/or popular perception of militarised responses as the only ‘effective’ response to health emergencies will detrimentally impact investment in basic health care and related information systems. It also legitimises preparedness at the expense of prevention, thus deepening the linkage between the Ebola response and the Global War on Terror. It is problematic if funding for ‘bioterrorism preparedness’ is justified by pointing to the Ebola response; potentially with future military medical interventions at the horizon taking place to justify the expense. Furthermore, framing militarised health responses as humanitarian interventions may also confer legitimacy on armed humanitarian interventions.
These are the kind of questions I hope the humanitarian community will discuss. Critical debate must not be quelled by allegations that this is ungrateful or offensive to military sensibilities. Humanitarian actors must understand the consequences of a publically accepted narrative focused on how the Western military degraded and destroyed the Ebola crisis. They must also be able to present a competing narrative that is both sufficiently complex and compelling, and which will enable us to provide a better response to the next public health crisis.