American source Vox discloses 7 main reasons why this year’s outbreak of the deadly tropical virus Ebola has rapidly turned into epidemic causing thousands of deaths in West Africa.
While Nigeria is considered to be the state, which currently manages to contain Ebola spread, the virus keeps seizing new countries, with the World Health Organization (WHO) saying the number of those infected might soon hit 20,000.
Why has this year’s epidemic run out of control so quickly already claiming more lives than all the previous Ebola outbreaks in total (since 1976)? Which factors cause Ebola persistence? Understanding these factors is the key lesson for the future.
Reason 1: Public-health campaigns long overdue
In Uganda that had experienced several EVD outbreaks in the past, people are aware of the dangers and symptoms the virus poses and nobody would hide infection cases but would immediately report them to the health bodies. Ugandans would also not leave homes if fear of infection and, again, fully cooperate with surveillance officials.
Dr. Anthony Mbonye, Uganda’s director of health services commented on the current situation in other African countries affected by the epidemic:
“They responded too slowly to make the community aware of the disease.”
Ishmeal Alfred Charles, who has been working on the Ebola front-line in Freetown, Sierra Leone, added that he had witnessed low level of awareness among people. According to Charles, the authorities realized the seriousness of the situation only when the respectable Dr. Sheik Umar Khan died of the virus in the end of July.
“That’s when the political wheels (started turning) and the government started putting resources together to help.”
Reason 2: Affected countries experience high level of illiteracy
In the countries suffering most from Ebola, Guinea, Liberia, and Sierra Leone, a lot of people can’t read. And this is not a problem which can be solved in one day. Raising awareness over health issues is not easy in the areas where people are simply illiterate.
Reason 3: Rumours about Ebola
Ebola rumour mill was launched by illiteracy, poor access to the virus-related information and overdue social campaigning, and was fueled by the peoples’ fears. As there is currently no approved Ebola vaccine in the world, myths and stories about supposed cures have spread fast: Ebola can be cured with hot chocolate, coffee, raw onions, etc.
It will be recalled that Nigerian rumour suggested that the virus could be cured with salt water, which resulted in even worse havoc. Scores of people were were hospitalized and several died as a result of believing false information.
Reason 4: Poverty
Sierra Leone, Liberia, and Guinea are some of the poorest countries in Africa with fragile health systems. With non-substantial budgets provided for healthcare, specifically $100 per person per year on health in most of West Africa, it was hard to contain epidemic.
Professor at the Tulane University School of Public Health and Tropical Medicine Daniel Bausch, said:
“If you’re in a hospital in Sierra Leone or Guinea, it might not be unusual to say, ‘I need gloves to examine this patient,’ and have someone tell you, ‘We don’t have gloves in the hospital today,’ or ‘We’re out of clean needles,’ – all the sorts of things you need to protect against Ebola.”
In such situations health workers, the ones exposed to high-risk of infection, do not want to continue with treating patients and even walk off the job.
An incident related to the problem occurred this week in Nigeria’s Bayelsa State when the hospital workers refused to treat the accident victim fearing she might have Ebola.
Reason 5: Spotty disease surveillance networks in the affected countries
Estrella Lasry the tropical medicines adviser for MSF said:
“We’re dealing with countries with very poor health systems to start with. That goes from setting up surveillance systems through setting up networks of community health workers… We can prevent spread by putting the appropriate measures in place so we can identify Ebola and stopping transmission as quickly as possible.”
By contrast, in Uganda there are robust disease surveillance systems, which means suspected cases can be quickly identified and reported and will be quickly spread through the surveillance network
Reason 6: Slow global response
health law professor at Georgetown University Lawrence Gostin explained that the WHO had not declared emergency until August, while the first international spread had occurred 5 month before.
“Ebola is a very preventable disease. We’ve had over 20 previous outbreaks and we managed to contain all of them.”
According to the expert, the whole situation also showed weaknesses of the world’s global systems in responding to such epidemics. Thus, he recommended in this article to act as follows in case of future outbreaks:
“How could this Ebola outbreak have been averted and what could states and the international community do to prevent the next epidemic? The answer is not untested drugs, mass quarantines, or even humanitarian relief. If the real reasons the outbreak turned into a tragedy of these proportions are human resource shortages and fragile health systems, the solution is to fix these inherent structural deficiencies.”
Reason 7: “Traveler factor”
In this outbreak, badly hit Guinea, Liberia, and Sierra Leone shared very porous borders, where the disease could easily hop across in people moving around for work or to go to the market.
According to Dr. Bausch however this situation also reminds the rest of the world that we live in an increasingly interconnected planet.
“Even from the most remote areas of our world, people are getting more and more connected, sometimes nationally, sometimes internationally… The various different features of this outbreak —where we have an outbreak cutting across international boundaries, involving urban areas — we can think of this as the new norm and we have to be concerned this can happen every time because of the connectivity of places.”
It is none of a secret that Nigeria’s first case of Ebola, also recognized as index case, was Patrick Sawyer who traveled from Liberia to Lagos. Moreover the disease “traveled” from Lagos to Port Harcourt, Rivers State, already with the Nigerian diplomat, which resulted in another wave of infections in the country.
