the switch raised questions about security at one of new york's most advisable landmarks. i'm richelle carey. for updates around the world check out our website with news from around the world go to www.aljazeera.com. thanks for your time. >> an outbreak of the ebola virus has never spread this far, never killed and sickened this many or gotten a foothold in a large urban area. how the response and the nature of the battle changes once it had happened is the inside story. >> hello, i'm ray suarez.

because of the ebola virus is so deadly earlier outbreaks were kind of self limiting. the disease would flare-up in a rural village. almost all the sufferers would die and the virus did not leave any distance to large communities. but this time it's 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 africa's 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 it's borders to certain travelers

thursday. >> south africa is the first africa country that doesn't border the infection zone oppose the travel-related 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 they're scared. look at the patience, and you know their chances are very small. it's 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. it's now a public health issue, now a political one, making it that much harder to solve. why haven't the earlier measures worked this time to stop the spread of this largest-ever 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 don't have much money to spare on medical care. ebola on this program. we begin in nigeria, the largest city in sub-saharan africa, the economic heart of the continent's economy.

only a few thousand ebola sufferers. is it starting to trickle down to the daily lives of people in the country? >> yes, we've seen this outbreak have an immediate impact on people's lives. not just the cross country travel restrictions but you're seeing entire neighborhoods, entire communities guaranteed and barricaded by security forces. this is effecting trade. it's effecting the practice of food. it's causing fuel shortage. these measures have been current productive. what you're 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. they've been angry. they've 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 you're see something burial justices, rights and interests, and culture it wases standing. >> are these country, where it's tough to ge get medical care even when you don't 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 don't have the proper commitment. they don't 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 nigeriaen government. nigeria has a chronic shortage of doctors. only one doctor to every 6,000 patients when the recommended standard by the world's 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. we'll take a quick break when inside story returns we'll 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.

>> you're watching inside story. i'm 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. she's 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 o'neill 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 didn't believe. i mean, that's 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 wouldn't put down the paper and say, it's 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 they're 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 don't think it's 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 wouldn't 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, it's fate or flee. >> and in this case certainly in the case of liberia and sierra leone, they had a government, but it didn't run beyond the boundaries of the capitol, and maybe not even there. it's not like its deep in institutions. it says let's not use the army but let's 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 well-run public health campaign. >> you're watching as the measures between countries and inside countries intensive. it this a strain to west africas to have this type of crisis. >> it's 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 it's getting worse, effects all of us. and we all need to care.

it's in the process of overwhelming them in sierra leone and guinea. i had a conversation with someone who is in sierra leone, and said it's beyond sierra leone's government to respond. all of us need it not be distracted from th 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? >> you're absolutely right. before we can isolate people in rural areas, now it's in three capitol cities. it's now--i hope it doesn't 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 is--there 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.

it's not like we can't 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 don't have the equipment a need to dole with it, personal protective gear. but we're 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. >> we're going to take a short break. just this afternoon the who mentioned that it's probably months before west africa countries get a control of this outbreak. when we come back we'll 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. vé

>> welcome back to inside story on al jazeera america. i'm 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. what--what 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. i'm afraid that those who have not worked on the ground in the areas why these outbreaks are under way don't 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 we're talking about, to reduce the fear and uncertainty. to inform people what the disease is like. to inform them that it's 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 won't 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 loggerheads in previous years. about owning a solution and this is not just as simple as saying we're here to help and everyone says, okay, get. >> no, it isn't. the greatest illustration of that is when we gave the investigational antibody treatment to two americans, and we didn't 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 we're on the ean of the rainy season in west africa and we're looking at hundreds of thousands getting malaria, waterborne diseases,

how do you square this kind of response when you're 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 don't think it's so much that people are kept in their homes. people are afraid to go. they are afraid that that's where the virus is.

they are afraid if someone presents with the symptoms of malaria, for example, that they'll be held as possible ebola patients. it's more fear that's 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 double-whammy of being afraid and having no place to go. >> the economy in these three nations have basically come to a halt. and that's complicating this whole situation.

and these neighborhoods, it's not just the shortage of medical treatment. you're starting to see shortages of clean water, shortages of food. this is a humanitarian assistance disaster in the making. if we don't get in front of it very, very quickly it's 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 trying to understand what the world faces. thank you for joining. that brings us to the end of this edition of inside story. from washington, i'm ray suarez. >> coming up on al jazeera america. the united states launches more airstrikes on the islamic states and iraq. they would have to wade into syria's long civil war. we'll have the latest.

ukraine is accusing russia of invading its territory after a convoy of trucks supposedly filled with aids drove right over the border. and the family of michael brown prepares for the teen's funeral. we have that and more coming up at 6:00 p.m. ♪ i had the intuition about the fact that human beings could heal themselves. >> deepak chopra offers insight about coping with fear and anxiety? >> stress is the stress. i like to think of stress like an ocean. if you are a skillful surfer, every wave is joy. >> bringing about optimal health and wellbeing?