Ebola treatment and prevention are not the only battles: understanding Ebola-related fear and stigma

Although Ebola Virus Disease (EVD) had already taken hundreds of lives in Liberia, Guinea, and Sierra Leone, it was only declared an 'Public Health Emergency of International Concern' in early August when the world started to panic from the possibility of EVD getting out of African borders -a fear that was spreading much faster than the virus itself (1,2). The underlying causes of this fear, however, go far behind the uncertainties surrounding EVD's pathogenesis and could stem from the past (3). The western perception of associating West Africa with deadly diseases such as malaria, yellow fever and EVD, and representing the region as white man's grave is not just fueled by superstition or ignorance and has roots in history For instance, the yellow fever outbreak in Liberia in the 20s that led to the loss of several prominent American and British medical researchers and instructors, has left the West with painful memories of the region (3). Regardless of past memories, while the transmission mechanism of Ebola is clear, there are irrational fears and overreactions globally. In the United States (U.S.) for example, school officials in New Jersey banned students coming from Rwanda (which is 1,700 miles away from the exposed region) from attending school unless after 21 days of quarantine (5). Similarly, some colleges in Texas rejected applications coming from Nigeria (6). Reports of flight suspensions to the area and imposing restrictions as well as visa denials for those coming from the region have also been ubiquitous (7). Unfortunately, these rejections and shunning behaviours have not only targeted some of the African nations, but have also affected western healthcare providers in close proximity with the patients in quarantine settings in U.S. hospitals (8). On the other hand, fear also exists in West Africa where the local African communities may have concerns and mistrust about the spread of the disease and the western led investigations in their countries. This face of the fear has also deep roots in the past and can be elaborated upon by getting back to our history lesson of the former mentioned yellow fever outbreak in Liberia. When American research teams were sent to the region to collect samples and study the disease, they scared off the locals by using the routes used by European and West