Ebola: a human catastrophe

Recently the WHO officially declared the ebola epidemic in West Africa to be an international health emergency. This current outbreak is the worst ever.

So far the death toll has almost reached 1,000 and there may well have been more than 2,000 cases. Now the disease looks like gaining an important foothold in Nigeria.

In addition, the outbreak has evoked extraordinary scenes of panic and mass hysteria.

In the last week news has come through of ZMapp an experimental ebola drug developed by a San Diego Company, Mapp Biopharmaceutical. But could such a drug be scaled up fast enough to meet the demand in West Africa and if so would it be made widely available outside America?

The answer is most probably no in both cases. In the first place it takes considerable time to mass produce and test new anti-viral drugs. In the second place, it is highly unlikely that even if supplies of the drug were made available that it would be possible to vaccinate anything more than a tiny percentage of all those at risk in West Africa.

One might perhaps ask as to whether such a drug would have been developed at such speed had it not been for the threat of cases spreading to the USA or elsewhere in the developed world.

Given all this we have little choice but to place our confidence in containing the epidemic by directing sufficient resources to conventional and well tried public health measures such as rapid diagnosis, strict isolation and quarantine of suspected cases, cleansing and disinfecting, and security focused nursing by properly trained and equipped staff. If a specific drug does become more widely available although in restricted amounts, there seems little doubt that it should be directed to doctors, nurses and other staff currently treating patients throughout West Africa.

When all is said and done it should be realized that ebola is a virus especially noted for its deadliness. Unlike influenza, it is not spread by airborne droplets but rather by contact with body fluids, the infection is not particularly contagious and as far as we can gather, there is no evidence of it mutating into something more deadly.

But like SARS and Avian Flu it is the human reaction that ebola has engendered that makes it stand out as much as the simple number of cases and deaths.

For most people throughout Africa ebola is a mysterious and frightening disease. Fear, hysteria and panic have become widespread throughout parts of West and Central Africa and even show some signs of spreading further afield. In such circumstances people have fled and/or resorted to popular and traditional cures or sought divine intervention.

Only recently text messages and social media reports in Lagos claimed that to prevent and cure ebola people simply needed to drink salt water and/or have a hot bath mixed with salt. In Liberia the President recently declared three days of fast and prayer and many people gathered in churches and on street corners to implore divine intervention. A Methodist pastor also admonished Liberians for their sins of homosexuality, drinking, adultery and fornication linking such things to the present epidemic.

Throughout West Africa traditional beliefs and superstitions have greatly complicated efforts to contain the epidemic and many have come to believe that ebola is directly related to Western intervention and medicine. Medical staff attired in alien goggles, masks and layers of protective biohazard clothing, long gloves and gumboots, have further raised local fears and led to local hysteria and angry scenes as people have confronted health workers accusing them of killing patients.

In Freetown, hundreds of people marched on a local clinic following allegations that the ebola virus had been simply invented to hide cannibalistic rituals. Tightly wrapped bodies buried in mass graves have added to local fears. In some parts of West Africa health workers in groups like the Red Cross have been forced to suspend their activities and leave due to local hostility. Throughout much of West Africa many health workers have been shunned and accused of spreading the disease.

Like all epidemics the media is having a field day and in many ways has added to the widespread fear and panic. Throughout Africa and much of the world we have been daily confronted by headlines such as "Red Alert", the "Ebola Crisis", "Ebola Out of Control", "Ebola Evolving into a Natural Disaster", "God is Angry with Liberia", as well as by confronting pictures of people in makeshift hospital wards, of bodies being left by the roadside, of bodies being carried by masked and gowned health teams and of people praying along the roadside.

Cartoons are also to the fore such as the one in the Sydney Daily Telegraph on the 31^st of July which depicted Africa as a giant death's skull.

Throughout West Africa the spread of ebola has been driven by cultural beliefs and public health failures.

Part of the problem has been our inability to fully understand how ordinary people regard risk in their lives and how such attitudes are governed by cultural, traditional and personal beliefs.

We should learn from this.