Because of the ebola virus is so deadly earlier outbreaks were kind of self limiting. The disease would flareup in a rural village. Almost all the sufferers would die and the virus did not leave any distance to large communities. But this time its different. The reassuring prescriptions of last month have not been equal to stopping the spread, stopping the suffering and the dying. Now soldiers are preventing people from moving from place to place. The disease is spreading in dense urban areas. Unaffected countries in west africa are trying to seal themselves off. An escalating struggle against a threatening disease is the inside story. Reporter west africas Ebola Outbreak is the largest every. And with no known cure or vaccine officials are shifting their focus to the strategy of containment. South africa has closed its borders to certain travelers thursday. South africa is the first africa country that doesnt border the infection zone oppose the travelrelated restrictioned. The hardest hit are guinea, liberia and sierra alone. 1300 are believed to have been killed and 2400 are pleased to be infected. In addition to banning air and sea travel to the three countries, closing the borders to help the aid of travelers. We have 15 check points between guinea, liberia and sierra leone. These are the highest emergency areas. But liberia may have taken the most dramatic step in trying to control the virus. The liberian capitol was made into a makeshift quarantine zone. No one is allowed in, and no one is allowed out. Resulting in bess operate Food Shortages and widespread panic. Strained Healthcare Systems and Poor National infrastructure are contributing to ebola s rabid spread. It can only be spread by bodily fluids. You can look people in the eye and see that theyre scared. Look at the patience, and you know their chances are very small. Its horrible. A lack of trust between medical teams, local officials and the public may be making things even worse. For many people in the u. S. And africa alike ebola is something that pro vehicles fear but remains little understood. Its now a Public Health issue, now a political one, making it that much harder to solve. Why havent the earlier measures worked this time to stop the spread of this largestever ebowl had a outbreak . What is different and more challenging about imposing Public Health measures in post conflict zones in countries even in the best of times dont have much money to spare on medical care. Ebola on this program. We begin in nigeria, the largest city in subsaharan africa, the economic heart of the continents economy. Only a few thousand ebola sufferers. Is it starting to trickle down to the daily lives of people in the country . Yes, weve seen this outbreak have an Immediate Impact on peoples lives. Not just the Cross Country travel restrictions but youre seeing entire neighborhoods, entire communities guaranteed and barricaded by security forces. This is effecting trade. Its effecting the practice of food. Its causing fuel shortage. These measures have been current productive. What youre see something people being afraid to go to fell safeties. Health workers in some places not reporting to worship. You see people die from regular innocences who are not going to healthcare centers. And really spreading a sense of panic across communities. Is that panic bringing resistence and making the basic task of trying to stop this outbreak hard, too . Very much so. People have been frustrated. Theyve been angry. Theyve been very suspicious of their governments from previous experiences in the health sector. What you have is essentially the people and government in liberia, in sierra leone trading blame and accusations. You see this anger manifesting itself in that riot that we saw in monrovia and the largest slum there west point, the capitol of liberia. Of course there people have been angry and that has been used as isolation inters. We see how they overrun the makeshift structure. We have seen angry when forces fire upon people who are protesting. 20 people have been killed. In today sierra leone passing a wall that species the two. Year jail term for patient who is riding patients with ebowl da. What this may begin as a Health Crisis it is exposing deep coral. Absolutely. Health workers is will yo say this is a social crisis as muc much as a Health Crisis. They are hiding those sick with ebola in their homes. There is a huge sigma with the disease here in africa. Many view it as a death sentence even though Health Workers say this is not an inevitable death sentence. Early reporting could lead to recovery. But many both believe that. Many believe ebola to be a hoax. And what youre see something burial justices, rights and interests, and culture it wases standing. Are these country, where its tough to get get medical care even when you dont have an outbreak of ebola. Not really, some of the countries that have the worst heat care systems in the world. They are a history of relying on aid and Development Agencies when it comes to the healthcare sector. They dont have the proper commitment. They dont have proper funning for the Healthcare System and they have very poor dr. patient ratio. This is about preparedness, and help to be on the nigeria en government. Nigeria has a chronic shortage of doctors. Only one doctor to every 6,000 patients when the recommended standard by the Worlds Health of course is one doctor to every 600 patients. That gives you an idea about the extent of how these Healthcare Systems are just not prepared in the best of times. Let alone to deal with such a ferocious and deadly disease. Joining us from legos, nigeria, thank you for joining us. Well take a quick break when inside story returns well be joined by medical and Public Health experts who can help us to come up a prescription of west africa as it tries to control the largest outbreak of the deadly ebola virus. Stay with us. On the stream, the usda pulls 770 inspectors from poultry processing plants. Join us on the stream to find out what that means for your food safety. The stream on Al Jazeera America hundreds of days in detention. Al jazeera rejects all the charges and demands immediate release. Thousands calling for their freedom. Its a clear violation of their human rights. We have strongly urged the government to release those journalists. Journalism is not a crime. These young people deserve justice anatomy of a protest. The police look like theyre getting ready to come down the street with militarized Police Departments forces their message. Theyre actually firing canisters of gas. A fractured Community Demands answers what do we want . Justice when do we want it . Now faul lines, Al Jazeera Americas hard hitting. There blocking the door. Ground breaking. Truth seeking. We have to get out of here. Award winning investigative documentary series. Special episode Ferguson City under siege only on Al Jazeera America youre watching inside story. Im ray suarez. The continuing spread of ebola this time on the program after the first set of measures put in place to come bam th combat the spread of the disease simply has not worked. Joining us, professor of International Peace and conflict resolution. Shes recently returned from liberia and sierr sierra leone. From pennsylvania a professor of Security Studies at the Africa Center for strategic studies at the National Defense university. Also joining us from the d. C. Bureau, director of the Oneill Institute for Global Health law. Welcome all. Professor, you were in west africa when this was first starting to pick up steam. Were there things that could have been done to stop it right then . Absolutely. Nice sierra leone in airplane. At that time it had not crossed the border of guinea, and no one pleased it was true. Nobody believed that the virus existed. There were no education efforts to make sure that people knew that ebola was real and dangerous. So when you say didnt believe. I mean, thats the kind of thing that if you pick up a up in somewhere else in the world and read that there was a terrible disease coming, you wouldnt put down the paper and say, its probably not true is there a lack of trust among common people, rank and file sierra leonens in this case. From what they see and hear . Certainly, and the war is part of that, and there is mistrust of the state. The state has often traded in the lives of its people so people through its experience have learned to mistrust a lot of what theyre told to do. We see governments now showing great concern, stepping up the nurse, putting up roadblocks, does this kind of stuff work, at least in the short term, and are there risks involved when a heavy handed response comes into play . If you took the United States and western europe we would not be denying people food and care. Not only does it violate human rights, i just dont think its good Public Health. If we wanted to do a quarantine we would do a smart one. Eled be a very narrow area and provide incentives for people to stay. We wouldnt have armed guards, which are hubble Health Workers who need food, medical care, clean water and really just support the population. Now you can see in the film people are and the idea basically when you face Something Like that, its fate or flee. And in this case certainly in the case of liberia and sierra leone, they had a government, but it didnt run beyond the boundaries of the capitol, and maybe not even there. Its not like its deep in institutions. It says lets not use the army but lets find another way of doing this. What tools do you have at your disposal . We never should have come to this. But if we do come to it, i think we fee need to have International Support to make this more consistent with human rights and Public Health. Right now all of the measures with the National Health regulations have been. I mean in a fragile state, especially ones that have a history of war and things, the first instinct is to use the military, but it is a make, and we need to work with our partners to make it a wellrun Public Health campaign. Youre watching as the measures between countries and inside countries intensive. It this a strain to west africas to have this type of crisis. Its going to have a direct impact on the system. It will have a direct impact on the United States. This outbreak, which is clearly out of control, and its getting worse, effects all of us. And we all need to care. Its in the process of overwhelming them in sierra leone and guinea. I had a conversation with someone who is in sierra leone, and said its beyond sierra leones government to respond. All of us need it not be distracted from the outbreak. If we do in the address this immediately this is going to spread beyond the three countries and it will be much more difficult to stop. Because of the nature of the ebola are we. This is something that used , and are we looking at something that is much more dangerous . Youre absolutely right. Before we can isolate people in rural areas, now its in three capitol cities. Its nowi hope it doesnt get a foot wold in lagos. That would be dangerous. And i estimate it will take six months to bring this under control. What we need to be doing is getting that initial effort, and also preparing for the next one. This isthere have been more than 20 outbreaks of ebola in action, and what we need to do is build up these fragile Health Systems. Ebola is highly preventable. Its not like we cant go in and make sure that happens. Are we ready to do what is necessary to get that kind of measure into those countries. People are complaining that they dont have the equipment a need to dole with it, personal protective gear. But were focusing on these countries unable to address this. While i was there i did see the ministry of health and other Government Agencies doing the best they could. A lot of front line workers really stepping to the plate and getting involved. I think that the International Community needs to get involved and work hand in hand with africas who are really working hard to address this as well. Were going to take a short break. Just this afternoon the who mentioned that its probably months before west africa countries get a control of this outbreak. When we come back well get our best read from our panelists on what to do from here on out. Call this day zero. How do you get your arms around ebola . Stay with us. Al Jazeera America presents its a beginning of a new life for me. I cant keep running from everything. 15 stories one incredible journey edge of eighteen premiers september 7th only on Al Jazeera America welcome back to inside story on Al Jazeera America. Im ray suarez. Our topic today the ebola crisis in west africa as a Public Health, political and social problem. Professor dempsey, as we mentioned these places are still recovery for many years of war. Whatwhat stage are they at . Probably not fully equipped to handle this, but trying very hard as professor mentioned. Yes, i think the point is a very important one. Im afraid that those who have not worked on the ground in the areas why these outbreaks are under way dont really understand how difficult it is to operate in those areas. How challenging it is to get shipments of surgerial masks, surgerial drugger, getting ivs into these areas, and i suspect that it is going to require a military response. It is going to require the kind of capabilities that the military brings to the table not in a security sense but in the ability to move material, to establish communications, to bring generators, water trailers, fuel trucks to put into the hands of those courageous Health Workers who are laboring on the front line at great risk the things they need to do their jobs. There are a couple new stories here, however. One of the new stories is that the penetration of cell phone phones in west africa has changed. You can reach out and touch communities in ways we could not years ago. There is a Public Information campaign to address address what were talking about, to reduce the fear and uncertainty. To inform people what the disease is like. To inform them that its not a death sentence. You have a chance of recovery if you have the appropriate treatment. To understand how to care for your loved ones and communities in ways that wont place you at risk of being ininvestigated yourself. What are the barriers that we need to be undertaking. Are there barriers . High degree of mistruth between the countries. Between countries that often were a at loggerhead s in previous years. About owning a solution and this is not just as simple as saying were here to help and everyone says, okay, get. No, it isnt. The greatest illustration of that is when we gave the investigational antibody treatment to two americans, and we didnt even consult the countries or the governments or the communities on the ground. What is clear is you need to have community engagement. Community participation, community campaigns, involve the communities to care for themselves. Despite all the barriers we can do this. We were able to bring billions of dollars and transform the aids pandemic in a much more difficult and costly way. What this requires personal perfec protective equipment. Isolation chambers, these are things that are affordable and things that will yield dividended into the future. How do you make this kind of effort to address a disease that has killed thousands when were on the ean of the rainy season in west africa and were looking at hundreds of thousands getting malaria , waterborne diseases, how do you square this kind of response when youre already dealing in an area with very local healthcare. You build Health Systems for not just ebola will you ma rar , malaria, heart disease, things that we take for granted, it will help us with ebola but will help us with so much more. Let me turn it to professor. People were kept in their homes and not able to get treatment for other things that are challenging them. I dont think its so much that people are kept in their homes. People are afraid to go. They are afraid that thats where the virus is. They are afraid if someone presents with the symptoms of malaria, for example, that theyll be held as possible ebola patients. Its more fear thats keeping people out of the medical system. In addition Health Workers in these countries, they have stopped going to work because of their own fear. Fear is a huge huge issue, but in these barricaded areas there are very few functioning hospitals or clinics, there is nowhere to go even if they trusted them. You have this double welcome doublewhammy of being afraid and having no place to go. The economy in these three nations have basically come to a halt. And thats complicating this whole situation. And these neighborhoods, its not just the shortage of medical treatment. Youre starting to see shortages of clean water, shortages of food. This is a humanitarian assistance disaster in the making. If we dont get in front of it very, very quickly its going to get much quicker and much, much more difficult to deal with. Thank you for helping us to plain to americans who are still tryi