Epidemics
An 'epidemic' is defined as an increase in cases of disease over and above what would normally be expected in a community or region during a specified period. War, displacement, poverty and natural disasters are frequently associated with epidemics, and it is not unusual for humanitarian agencies to be called upon to prevent or contain them, especially in resource-poor settings. Although there is a considerable body of literature critiquing the work of humanitarian agencies on epidemics, it would be misleading to generalize too readily from cases of failure. There are many instances in which they have prevented the occurrence of epidemics, but these achievements have rarely been recorded in any detail and they are hard to assess comparatively. This chapter does not, therefore, attempt to provide a comprehensive overview of humanitarian engagement with epidemics. Instead, the first part of the chapter presents three case studies from Zaire (now the Democratic Republic of the Congo – DRC), Haiti and Somalia. These case studies look behind the narratives of 'failure' and 'success' to explore salient issues which routinely arise for humanitarian agencies working in challenging circumstances. The second part of the chapter then turns to the largest humanitarian programme ever attempted to control an epidemic: the outbreak of Ebola in West Africa between 2013 and 2016. In so doing, it becomes evident that humanitarian programmes, which adapt and respond to the specific social, political and economic contexts in which they are working, tend to be more effective. It is also clear that the nature of humanitarian engagement with epidemics is increasingly being shaped by narratives linking infectious diseases with global security.