News on the Ebola outbreak is often overwhelming. With over 4,000 deaths in West Africa and increasing concern in North America, it is tempting to tune out media coverage -- particularly as coverage spans from the outrageously scare-mongering to the intimidatingly technical. But even as the risk of North Americans contracting Ebola remains very small, other issues in health care have become apparent in its wake. More than any threat of Ebola, the politics of racism, care for uninsured people and hospital underfunding pose great risk to the majority of people across Canada and the U.S.
As news of the first Ebola patients in North America came to light, federal health minister Rona Ambrose had comforting words for Canadians. She said, "Our front-line hospitals and clinics do have good training, especially after our experience with SARS, in dealing with infectious disease prevention."
There was a surreal quality to hearing these words at the same time as reports of extremely long wait times in emergency departments across the country were circulating in the media.
It seems to me that the "wait times" crisis in hospitals is the real threat to our collective health. Overwhelmed and under-resourced health-care staff having to manage packed emergency rooms was a problem during the SARS epidemic and will continue to be a problem whether or not people are diagnosed with Ebola in Canada. Medical researchers, physicians and nurses are right to focus on the medical complexities of Ebola. Discovering new treatments and vaccinations, as well as providing equipment and training to avoid contamination are essential. But from a public health standpoint, medical factors are only part of the conversation. Preventing an outbreak of any kind has to look beyond potentially infected individuals and at broader social issues. Unfortunately, this type of discussion rarely happens.
I got a glimpse of the way in which Ebola-prevention panic is playing out in the U.S. when my partner and I travelled to New York in early October. As we moved through the airport toward customs we found multi-hour lineups and strangely, a group of several hundred people being marched around and shouted at by airport staff wearing masks. In the hour and half that we queued, we gathered that there was some sort of Ebola scare. Even more strangely, as soon as we got past the baggage claim, we were greeted by Fox News cameras and reporters yelling, "Were you on flight 9--? Were you on flight 9--?"
And while screaming "NO!" into a Fox News camera is certainly not the worst way to enter the United States, the entire scene was chilling. It wasn't until we were buying train tickets from a particularly chatty staffer that we got the full story. She told us that a flight from Brussels had passengers from a West African country on it. One of these passengers had a fever. Maniacal quarantining of the feverish passenger and Ebola "education" for the rest ensued. As it turned out, no one had Ebola. I felt certain that if I was distressed by my time in the airport, the feverish passenger's journey from the airplane to the hospital must have been traumatic.
This level of hyperbolic fear-mongering only increased two days later, when Thomas Eric Duncan died in Dallas. Duncan "presented" in a Dallas emergency room with a seriously high fever and in a great deal of pain. He also "presented" as a black man with no health insurance. Duncan's nephew, Josphus Weeks, argues that these factors played into the hospital sending him home mere hours later. He believes his uncle did not have to die and his treatment was deplorable.
It would be easy for Canadians to raise a superior eyebrow in the direction of the U.S., but that would be a mistake. Yes, we have public health care. Yes, we won this demand, over and over again. But access to that care is still denied for many people living in this country. Refugees across the country have been blocked from accessing health care by the Harper government. At the same time, Aboriginal people in Canada have been in a decades-long fight to access health care as governments continue to squabble about funding and the creation of programs. Aboriginal children experience twice the rate of disability as non-Aboriginal children while health care for people living on reserve remains "complex and hard to navigate."
We don't need testimony from every individual involved in caring for people with Ebola in the U.S. and for Aboriginal people and refugees in Canada to see the factors that shape health care across North America. Complicated factors beyond those that are clearly medical play a significant role: underfunding that leads to overcrowded hospitals and limited access based on means, race, citizenship and geographical location.
The focus is too often on economics and who is paying for who to receive treatment. I would rather focus on the benefits of equitable health care for everyone who requires it. The Ebola outbreak offers an ideal moment to stop being intimidated by health-care analysis that prioritizes money over people. Everyone deserves equal access to health care as a basic human right. Health-care staff need to be adequately resourced and supported in providing this access. Until health-care equality is a reality, outbreaks of every kind will pose risks that originate as much from political will as from clinical disease.
Next month's column will be on Ontario's private health-care clinic scandal. Join the Toronto and Ontario Health Coalitions to protest private clinics: Friday Nov. 21 at noon, Queen's Park.
Julie Devaney is a health, patient and disability activist based in Toronto. Her rabble column, "Health Breakdown," is an accessible, jargon-free take on the politics behind current health-care stories. You can find her on Twitter: @juliedevaney
Photo: CDC Global Health/flickr
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