Analysis of the third kind
28 July 2014 10:08 (South Africa)
Africa

Ebola: the epidemic that’s ‘out of control’

  • Simon Allison
  • Africa
simon-ebola-subbedm.jpg

It’s official: The Ebola epidemic in West Africa is spreading faster than anyone can deal with it. There are 518 deaths already, with plenty more expected as governments scramble to provide an effective response. Can anyone stop this deadly virus? By SIMON ALLISON.

In March, the Daily Maverick reported on an outbreak of an Ebola-like virus in Guinea. Already, 61 people had died and the virus had begun to spread, crossing into next door Liberia. Authorities were warning of an impending epidemic, and international health organisations were scrambling to send experts and supplies to help.

Three months later, those dire warnings have become reality. This is an Ebola epidemic, and it’s out of control.

How do we know it’s out of control? That was the phrase used by Dr Bart Janssens, operations director for Doctors Without Borders (MSF). When it comes to deadly infectious diseases, there are no three words in the English language that are more chilling. The humanitarian organisation has sent doctors and nurses to try and contain the epidemic, so far without much success. “This has now become the largest epidemic we have ever faced, in terms of its duration and the numbers of cases,” said Dr Hilde de Clerck, who is working in Guinea for MSF.

On Tuesday, the World Health Organisation said that 50 new cases had been reported from 3-6 July. Of these, 25 were fatal, bringing the total number of deaths to 518 from 884 suspected cases. These were spread among three different countries: Guinea, Liberia and Sierra Leone.

Ebola is a hemorrhagic fever. In other words, it makes you bleed – a lot, and from all sorts of places, both inside and outside the body. This is usually accompanied by fever, vomiting, stomach pain and diarrhea. More often than not, the virus is fatal. Some strains have a mortality rate of 90%. The latest outbreak is marginally less lethal, at around 60%. A small mercy.

No one is quite sure where the disease comes from or how humans contract it. It first appeared in what was then Zaire in the 1970s, and there have been sporadic outbreaks ever since. The most convincing theory, although this has yet to be definitively confirmed, is that fruit bats are its natural host, and that humans pick it up if they come into contact with an infected fruit bat. Leading further credence to this is that residents of the village of Guéckédou in Guinea, where the current outbreak is thought to have begun, do a lot of bat hunting – the flying mammals make a tasty soup.

That soup has now been banned in Guinea, which has also warned against eating rats and monkeys. This is just one of a host of measures introduced to try and curb the spread of the disease – so far, without success.

Several factors conspire against the efforts of health authorities.

The first is a simple lack of knowledge among affected communities, which are usually rural and poorly educated. Ebola only spreads among humans when there is direct contact with an infected person, or when someone is exposed to contaminated objects such as needles. Educating people about how and why the disease spreads is an essential element of slowing its growth.

This, however, is complicated by a lack of trust between affected communities and authorities. And who can blame them? Government services in this part of West Africa are notoriously poor, and the leaders of Guinea, Liberia and Sierra Leone do not exactly have a good track record when it comes to looking out for their people. Health workers in Guinea have reported being met with hostility, and on occasion even blamed for bringing the disease with them. Complicating things further is the local funeral ritual, which requires that bodies be washed before burial. This is an extraordinarily risky activity, but it’s difficult to convince skeptical communities to abandon an ingrained cultural practice.

The porous nature of the borders in this area is also a problem. People regularly cross between countries to trade and visit friends and family. Official crossing points are optional. This makes it very difficult to contain the epidemic within a defined geographical area, which might make it easier to control. There is a little bit of good news on this front, however: last week, representatives from 11 African countries agreed to adopt a common strategy to deal with the Ebola threat.

“Officials committed to better surveillance to detect cases of the virus, enhance cross-border collaboration, better engagement with local communities and closer cooperation with the U.N. World Health Organisation and other partners,” reported Reuters. “Ministers also recommended setting up a sub-regional control centre in Guinea to coordinate technical support.”

This is, however, only the start of a long uphill battle against one of the world’s most deadly viruses – and right now, the virus is winning. DM

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Photo: A Liberian woman reads an Ebola information poster on the prevention of the Ebola epidemic, during UNICEF's sensitization campaign at the Mission for Today Holy Church, in Newkru Town, Monrovia, Liberia, 22 June 2014. EPA/AHMED JALLANZO

  • Simon Allison
  • Africa


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