Of all the thousands of people who have died from the Ebola virus, just eight deaths tell us most about the disaster. These eight dead people embody the scale of epidemic that authorities around the world are facing. In mid-September, local administrators, two medical officers and a preacher, accompanied by three journalists, travelled through remote villages of south-east Guinea, where the outbreak first began. They were attempting to educate the local people about how the disease is spread and how to limit the number of people it infected. But things did not go according to plan.
Instead of delivering their message and moving on to the next village, they went missing. Their bodies were later found in the village latrine. They had been murdered by the villagers. Such violence is not an isolated event. There have been other reports of local people attacking hospitals, aid workers and doctors across West Africa. While these communities are ravaged by the infection, they are distrustful and scared of outsiders. They believe that foreigners are bringing the disease and are petrified of coming into contact with them. There have been reports of youths protecting villages and roads with machetes and slingshots. With crushing poverty comes ignorance, fear and superstition. Many prefer to consult tribal doctors who, in reality, provide no remedy against the illness except hope. One bishop in Liberia has announced that he plans to rid the country of the virus with a mass exorcism using Vimto instead of communion wine.
All of the West African countries under siege from the virus have one thing in common: Extreme poverty. It is this that makes them so susceptible to such an outbreak. Poor sanitation and nutrition have created the perfect storm for the virus to thrive, while poor transport and communication networks have made any coordinated response almost impossible. So volunteers must traipse from village to village in a desperate attempt to educate the people. Not only is it dangerous in countries where the people have learned to be scared and distrustful of officials, it is grossly inefficient and time-consuming. The murders not only speak of a petrified, ignorant population, but they also bear testament to the way the international community has been ignoring the unfolding tragedy. For too long, the only help came from a handful of volunteers and small aid agencies. International health organisations have been woefully, shamefully slow to react.
The World Health Organisation (WHO) failed to heed warnings about the severity of the outbreak for months. It only acknowledged the seriousness of the problem on August 8, when it finally declared a global emergency. The Liberian government has tried to place the blame on its people, arguing that their distrust of health care workers, burial practices and disregard for its advice have worsened the outbreak. However, that is a simplistic view. The people of these poor nations have been let down by their governments, which have failed to prioritise education and infrastructure development — and the world is now witnessing the results.
Had Ebola started in a western country, rather than Africa, the global reaction, including that of the WHO, would have been different. The West’s response has been terrifyingly myopic. In the globalised world, it was only a matter of time before the infection spread to cities and, from there, to other continents. How could we have been so stupid to think that one of the world’s most virulent diseases would not affect us? Currently, each infected person is infecting two more before dying or overcoming the illness. Survival rates are about 50 per cent, dropping to 10 per cent in remote areas with poor water and supplies. The epidemiology comes down to simple maths: It will not be until each infected person infects, on an average, fewer than one that the tide will reverse.
This latest outbreak — by far Ebola’s deadliest to date — may in part be due to the pathological qualities of the virus, but it has sprinted ahead while global health authorities plodded along. We can only hope it is not too late to catch up.
— The Telegraph Group Limited, London, 2014
Dr Max Pemberton writes a medical column for the Daily Telegraph, his latest book, The Doctor Will See You Now is published by Hodder.
