On EBOLA (written by Dr. Sarah Ashitey of Artemis Medical Society). The last few days have seen plenty of uproar surrounding the current ebola epidemic in West Africa with the media throwing the public into a frenzy, sparking unprecedented fear in the US over two American aid workers returning for treatment. Truth be told, the ebola virus wouldn’t stand a chance in the United States and here is why: While the ebola virus is deadly (we have all by now heard about its 90% mortally rate and blood spewing out of every orifice) it is receiving more credit than it truly deserves. Unlike other viruses like influenza that keep us on our toes every time we turn around a corner, the ebola virus has essentially remained the same since its been known to man. We also know very well that unlike other viruses it’s not very good at infecting. One has to come into direct contact with body fluids to get the disease. In a way, it’s quick deadly nature further sabotages itself because without its host, it cannot spread and these inherent factors have been the reason why other ebola epidemics have terminated with much fewer casualties. The current epidemic however in West Africa is different, and it’s not because ebola has changed. A number of unique factors have contributed to the devastation of this current epidemic including fear and distrust among the natives even leading to violence, porous borders between the affected countries, limited resources and infrastructure in the poor countries affected, culture and context. On fear and distrust: since its onset, natives in the affected areas have fostered various theories about the disease including “the white man harvesting body parts of their family members.” Here are some accounts from people on the ground. I’ll post all reference links at the end. “Workers and officials, blamed by panicked populations for spreading the virus, have been threatened with knives, stones and machetes, their vehicles sometimes surrounded by hostile mobs. Log barriers across narrow dirt roads block medical teams from reaching villages where the virus is suspected. Sick and dead villagers, cut off from help, are infecting others.” “In Sierra Leone the families of Ebola virus patients decided to liberate their kin from a treatment center, claiming that the former patients needed “traditional medicine” instead of occidental methods.” “… some of the recently diagnosed would actually flee their homes rather than be branded as a carrier of the virus for fear that his neighbors might harm his family members and destroy his property” On culture: some of the affected tribes have traditions that require close and personal contact with their dead before burial. You can imagine how the virus would continue to spread especially in the villages that have closed themselves off to healthcare workers and public health teams. On resources and infrastructure: the affected countries do not have the luxuries that exist here in the United States. Here, we can dispose off safety gear in biohazard containers. There, they have to disinfect and re-use their equipment. Here, we have ways of identifying people, addresses to find people, the man power and law to enforce procedures, paramedics, a TV in almost every home to make announcements, a higher literacy rate, facilities better equipped for quarantining and so on, and so forth. The 90% mortality rate is also not because nothing can be done to save a life, but rather a reflection of the fact that affected communities have mostly been rural and far from healthcare facilities. In this current epidemic which has infiltrated the cities where hospitals are, early access to treatment has meant a 40% chance of survival (even in the setting of limited resources). Other hemorrhagic fevers, like Lassa fever that kills up to 5000 people in West Africa every year, have been managed in developed countries with much lower mortality rates and experts cite that the ebola virus would be no different. In fact, a few cases of Lassa fever have been managed in the US with no transmission thus far. You see, the moral of this story is not that there’s a mighty virus that’s going to spark a global pandemic but rather the failed efforts of the international community to respond to the outbreak quickly to help curb progress before it reached the cities. Aid workers had been calling for help from the international community with no response. Kent, the American we are all complaining about, also posted an article on his Facebook page a few days before he fell ill making the same cry out to the world for help. One article cites the following: “by June the situation had become so dire that the director of operations of Medecins Sans Frontieres (MSF), Bart Janssens, declared that the situation was “out of control.” He pleaded with the international community for more support, especially in the form of personnel trained in treating Ebola virus, noting the ignorance of the locals in treating the disease” We have fussed a lot about possible exposure (and I don’t want to discredit anyone’s fears) but knowledge helps curb our fear and prepares us to pick up the baton and do our part. During this whole process, I am yet to hear anyone commend the men and women (West African nurses and doctors - including Nancy, Kent and some of the doctors even here on Artemis) who have been fighting our war for us. Patrick Sawyer, the American that died in Nigeria, was due to be in Minnesota for his daughter’s birthday. Again, prompt action from officials in Nigeria ensured that the rest of us would be safe. As it stands, unlike what the media reports, we have made wide strides on the path to finding a cure. Look up BCX4430 and look up ebola virus vaccine which has been known about since 2010! Ebola is not just a West African problem. It is something that the world must tackle together. Are we really unwilling to bear some of the risk, albeit very minute, in working towards keeping all of us safer…? Food for thought. I’ll be the first to point out my personal bias. I know Kent and I am ecstatic beyond measure about this move for him because contrary to what some people say, there’s no way he could get the kind of supportive treatment he needs in Liberia even if we sent stuff down there. It’s not just fresh frozen plasma and blood… It’s blood pressure support, mechanical ventilation, you know… modern ICU care for which none of the locals are trained. On the other hand, I feel sad because his leaving is a symbol of yet one more person who cared for West Africa and the poor pulling out of the region. Sumaritans purse, the main organization that was spearheading the effort in Liberia is scaling down with plans to pull out. The same is happening with MSF. If there’s one thing that I am confident about though, I know that when Kent pulls out of this, he’d help redirect attention where it needs to be - back on our role in helping curb the trend rather than statistics and hysteria over how ebola kills. Knowledge is power. Let’s arm ourselves and our communities with it and extinguish fears which in West Africa only helped perpetuate this epidemic in the first place. Watch the documentary if you have time. Very insightful youtube/watch?v=XasTcDsDfMg time/3069876/ebola-outbreak-truth/ slate/blogs/the_slatest/2014/07/28/ebola_outbreak_doctors_threatened_in_west_africa.html guardianlv/2014/07/ebola-outbreak-in-west-africa-aided-by-ignorance-and-distrust-says-who/#72aWsSBXUzqfI0VH.99://guardianlv/2014/07/ebola-outbreak-in-west-africa-aided-by-ignorance-and-distrust-says-who/#72aWsSBXUzqfI0VH.99://guardianlv/2014/07/ebola-outbreak-in-west-africa-aided-by-ignorance-and-distrust-says-who/#72aWsSBXUzqfI0VH.99
Posted on: Sat, 02 Aug 2014 18:04:37 +0000
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