As scary as Ebola has been in a physical and psychological sense, over the Halloween weekend it became more frightening in a sociocultural sense. The relevance of the complete bio-psycho-social model of medicine and psychiatry comes to the fore.
Over a century ago, Joseph Conrad wrote the famous short novel, "Heart of Darkness." Overtly, it is about the travels of one man into the depths of Central Africa in search of Mr. Kurtz, a journalist who has become worshipped by a tribe of "savages." Along the way, it exposes the racism of European imperialism. As Kurtz dies after he is found in somewhat of a psychotic state, he whispers: "The horror! The horror!" Critics claimed the book dehumanized Africans.
Could modern remnants of this portrayal be beginning to emerge with Ebola? The first suggestion may be in the first person diagnosed with Ebola in the United States, Thomas Duncan. After his death, suspicions of discrimination emerged after he, a Liberian immigrant without health insurance, was turned away from the emergency room in a Dallas hospital. Of course, the opposing explanation is that the hospital was just too unfamiliar with what the early presentation of Ebola might be. So far he is the only patient to die in the United States from Ebola.
Of possible related concern are some social reactions. Angelique Kidjo, a popular singer known as "Mother Africa," has been called "Mama Ebola" ahead of her upcoming concert at Carnegie Hall in New York. Those returning to the United Sates from Africa are being stigmatized, even if they had no health or healthcare connection with Ebola.
Those in behavioral healthcare in the United States have fought long and hard to eliminate the discrimination and racism against poor minorities, most especially African Americans. Some progress has been made, but now is the time to use our knowledge and skills of cultural competency to help counter anyone's heart of darkness regarding Africa and Ebola. There is more than enough fear of Ebola itself; let's work to stop the spread of that fear to the Black community.