The state of votes
"Band-aid" to cure an epidemic
The aid that came too late
Lyse Mauvais | 1970. January 01. 00:00
On the 18th of September, the UN Security Council adopted a resolution against Ebola, describing it as a “threat for peace”. Reacting mediatically to the crisis is now a necessity; in a globalized and mediatized world, we have learnt to live by the pulse of the social media and our leaders have mastered the art of getting the most out of the hype created by a crisis. But we cannot let the international community get away with communicating itself out of a tricky health situation.
Let’s go back to the roots of the problem. Far from appearing overnight, Ebola has been a recurrent health issue in Western and Central Africa – and probably long before its discovery in 1976. Ebola appears in isolated and impoverished populations, through repeated contact and consumption of bats, prompted either by hunger or habit. Ebola has never raised any concerns or major issues internationally; every few years or so, a “small” epidemic wipes out individuals in very localized and forlorn areas – or so we like to think. Despite being extremely deadly (52% mortality), Ebola was not a health issue for most people until the epidemic of 2014 brought it to the front scene. As a matter of fact, there was only one laboratory engaged in any form of active vaccine research on the virus prior to 2014. This lack of medical and research interest around Ebola cannot, in strictly rational terms, be blamed: Ebola simply did not “kill enough people” and propagate widely enough to justify investments in research.
As we said, Ebola was not a health concern for the first world. Rest assured, it still isn’t. In most of the Western world, the health systems are efficient enough to guarantee good isolation of the patients and containment of the disease. This is not to minimize the concern of course felt by individuals across the world: everyone wants to avoid a spread of Ebola and its complications. What makes Ebola a curse in Liberia and Sierra Leone is the fact that the lack of infrastructure does not allow for separation between patients and their families, and the state is thus unable to implement effective control of the disease. The fact that Nigeria has successfully managed to bring its own epidemic under control has been widely ignored by the international community.
Thus, Ebola’s insignificance for the world outside from West Africa explains the lack of international reactions and support during the beginning of the outbreak…but then how do we interpret the cascade of measures announced precipitately by American and European governments once the disease started raising fears abroad?
American and European support to “Ebola countries” can hardly be judged significant. Obama first announced a series of late measures: sending troops in order to maintain order in Liberia, constructing dispensaries… These measures are emblematic and meant to reassure the American public opinion and create the image of a strong and active president. At the ground level, they mean little: Liberia is not a failed, falling or destroyed state, and the support of the US army might be a temporal logistical relief, but it will not create order or infrastructure in the countryside, where it is most needed. As for the last minute building of dispensaries, it is typical of all these “band-aid” measures that our governments like so much: there is a reassuring element in announcing investments and infrastructure development, but these measures cannot be effective when they are rushed and unplanned…Sadly the dispensaries will mean nothing without the means to staff and furnish them, without the roads to build and reach them, without transportation to reach out to the populations, without sufficient political will and involvement in affected countries. These symbolic measures cannot mask the fundamental lack of investment done in the health system of affected countries over the past fifty years: one band-aid has never been known to cure gangrene.
The second group of measures widely taken by the international community seek to contain the spread of Ebola by restricting circulation in and out of infected countries. South Africa now forbids entry of individuals coming from these countries, while various other nations have suddenly started giving out visas even more sparingly… Ebola is a virus born in poor, isolated, rural areas of Africa, and raised in poor, rural, isolated and infrastructure-lacking communities. Away from these conditions, Ebola is no longer a threat. Yet we prefer to ignore this fact. We try to convince ourselves that by keeping “Ebola countries” sufficiently isolated, we are containing the virus: not only does this ignore the ground reality of porous bush frontiers, it is also an inherently flawed vision. Cutting Ebola countries away from the world insulates them further, complicates exchanges and access to logistical and medicinal relief, and isolates contaminated populations from the view and concerns of the global public opinion – probably the main factor prompting international support for their ordeal today. In the end, Ebola still rages on, but we feel that at least, it rages on far away.
It is important to recognize the efforts –albeit late- that the international community developed over the fight against Ebola. But more importantly, it is crucial to critically assess the scope, meaning, and efficiency of these efforts. It is crucial because people die every day of various diseases whose spread is linked to poor infrastructures, and these deaths –and further epidemics similar to Ebola- are preventable. The key to prevention, however, is anticipation, and we cannot let the international community get away with communicating itself out of a tricky health situation; we have a duty to be more demanding, more requiring, and to obtain from our leaders the investments and commitments that are really necessary in order to address the challenges of today and of the years to come. Don’t let the UN get away with giving you band-aid; demand penicillin.
Louis Gaucher | 2014. December 07. 20:00
The main problem regarding this deadly disease is that help from the international community has been given very late in the struggle against Ebola. Because of this late response from the international community, we are now facing a menacing situation, where more than 5000 deaths have been recorded.
Before jumping to conclusions about how international efforts should be used to stop the disease, let’s see what Ebola is. This virus is a type of hemorrhagic fever, characterized by high temperature and internal or external hemorrhages. It first appeared in 1976 in Yambuku (In former Zaïre), a village close to the Ebola River, where the name comes from. This virus is a deadly one. Lethal rate varies from 25% to 90% (this year, its rate for Guinea is 60%), depending on the cells of the virus one caught. It is also very contagious. An individual can contract Ebola because of direct contacts with an infected person or body fluids like saliva, blood or sweat (and many more...). Hence, funeral rituals in Africa which consist in touching the deceased person are a source of spreading of the virus. For a virus as contagious as that one, international help needs to be carefully prepared to avoid an epidemic.
One of the problems is that medical staff is indeed in the forefront of the struggle. This medical staff, accounts for more than 500 cases that have been discovered, and for more than 300 deaths. It would be vital to prepare the doctors, the nurses who are going to aid in the infected areas to avoid this massacre.
Another serious problem is that the help has been very late in the struggle against Ebola. To be this late has lead to a bigger spread of the virus, and an epidemic is more difficult to stop.
The epidemic started in December 2013. At the beginning, the WHO minimized the impact of the virus. It is not before August 8, 2014 that the WHO declared Ebola as an “international public health emergency”. By the end of August, the disease had already made 1500 deaths. During December 2013 and August 2014, the states concerned by the epidemic were isolated in this struggle, with just the help of some NGOs like Médecins Sans Frontières (MSF) which were surveying the virus.
Thus, because of this late response of the international community, we are now facing a situation where more than 5000 deaths have been recorded.
Luckily, the mobilization is now slowly catching up with the spreading of the virus. Since September and October, wealthiest countries are investing more and more resources such that the WHO announced a decrease of the number of new cases in Liberia, the 6 of November. This decrease in Liberia is not only symbolic. Indeed, Liberia has been one of the most concerned countries since the beginning of the epidemic. This means that the international help began to obstruct the spread of the virus.
Indeed, more and more means are deployed on the field. Firstly, economic means, which are are not useless.
The best response to Ebola however would be the development of the infrastructure of western African countries. Actually, wealthy countries are not in danger of Ebola, because they can react very quickly, isolate the patients, and cure them because they have the resources to do so. Thus, they prevent the spreading of the virus and, in most cases, quick treatement also prevents the death of the infected person. Hence, such a development of the infrastructure in those countries would block the progression of Ebola.
That is why Obama asks his Congress to release 6 billion dollars for the reaction against Ebola. That is why the European Union set aside a billion euros in late October and that is why Japan increased its participation from 40 million dollars to 140 million dollars.
Moreover, international help is fortunately growing on the front. 1000 American soldiers are already deployed, principally in Liberia. They have to train local medical staffs to the struggle and to build, with the Liberian army, a hospital near the international airport which will welcome the infected members of the nursing staff. Great-Britain sent 750 men and a medical ship. France is going to build 3 medical centers in Guinea, as China is building one in Liberia. China is also sending 160 doctors, as Cuba which deploys impressive means such as sending 160 doctors, with more than 200 ready to come to fight against Ebola. All these actions lead to a progressive stabilization of the epidemic.
As Nigeria proved, the virus is stoppable. To do so, sick people have to be quickly isolated and quickly treated. Lots of medicines or vaccines are being tested in Europe and in the United States. MSF is testing 3 treatments on the field. But results are not expected before 2015. Meanwhile, we have to contain the virus and avoid its propagation. Thus, it is essential to detect sick people very early, before the symptoms are strongly declared and so the patient extremely contagious. That is why French researchers have developed a quick diagnosis test to detect the virus. That is also why, as Nigeria did, the mobilization has to be strong at each level of the administration of a state.
Ernest Bai Koroma, the president of Sierra Leone, told some local persons in charge of rural areas deeply affected by the spread of the disease to “stop the hypocrisy in the struggle against Ebola”, imploring them to stop the funeral rituals in which people touch the deceased person to stop the propagation of the virus.
In a nutshell, the international response to Ebola has been late and is still late. However, It becomes more and more efficient and already had results in slowing down the propagation of Ebola in Liberia. Moreover, countries are now preparing the post-2014 Ebola epidemic, launching the anti-Ebola specific mission in Accra under UN command or also by using social sciences to study what happened during this epidemic and understand how to react next time.
However, the best response in future to any epidemic would be the development of infrastructure in Africa and a quick international response.
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