Mid august 2014 saw the world health organization declare the deadly EBOLA virus as a public health emergency of international concern. The announcement seemed obvious to many as the conditions in western Africa had gone beyond control and the attention of Global authorities took ample lot of time to gather ground. The announcement came at a time when the ground semantics of the outbreak were completely different from the previous experiences in Congo and the master minds also were not able to figure out the roots of the problem.
If we look at the history of Ebola outbreak the virus was first reported in the Democratic republic of Congo in 1976, majorly in the eastern parts of Africa. Recent developments have been completely different from the previous developments. The virus is now primarily being reported in western Africa. Guinea being the first country affected followed by Sierra Leone, Liberia, and then air travelled to Africa’s second most developing city Lagos (Nigeria). Events further saw death of an individual named Thomas Duncan in Dallas, United States. Thomas Duncan has said to have caught the virus while taking a patient to Ebola treatment centre in Liberia. Sierra Leone and Liberia being poor could not provide necessary medical treatments to the locals and pictures were seen where people had abandoned family members so as to avoid quarantine. Lack of healthcare facilities and workers saw a major steep rise in the death count with total toll of deaths reaching 4500 in the start of October 2014. Several threats to go on strike by HealthCare workers and amid rumours of virus being spread deliberately the recovery processes in all the HealthCare facilities saw a hit. In guinea youths with weapons were seen threating to attack a healthcare facilities. IN early stages of September 2014 United Nations Secretary General called out for “international rescue” and “massive assistance”, as the virus was spreading fast and the situation was getting out of control. By that time the death toll has risen to a count of more than 2000. With the fear growing wide more and more people started coming in to get them checked which lead to a larger shortfall of facilities in western Africa. Fear has gripped in post the death of a Liberian national in United States and the assumption of virus not transcending African boundaries has become a myth. The current condition is different from the past. What history has offered in terms of understanding in the eastern Africa outbreak looks like will make least a difference in the understanding of western Africa outbreak.
Ebola patient zero is expected to be a toddler who contacted the virus in a small village in guinea in December 2013. The toddler is expected to be the patient Zero, who showed signs of vomiting, black stool, high fever. According to a report published in THE New English Journal of medicine, the child died in four days post showing the symptoms. The exact cause of the virus is still not known, however the virus generally in transmitted from animals to humans. The death of toddler was followed by a series of deaths in his family. Toddler’s mother hemorrhaged the following week followed by his elder sister who died near Christmas with same symptoms as the kid. 1st January 2014 saw the death of Grandmother of Toddler with symptoms of high fever infamily’s village in Meliandou in Gueckedou. Relatives, family members, care takers all those who came in close contact of the grandmother became a possible host of the virus and carried out the virus to nearby towns. The Village has close borders to both Sierra Leone and Liberia. The funeral led to spread to virus in nearby villages. Two people who contacted the virus brought it to their villages and then became the cause of spread to heath workers and family members in their village.
Till March all of the events could not catch international attention.10th march saw the health officials in guinea alerting the health ministry about the alarming conditions and the pattern of spread in the market. This saw the Guinean Health officials and scientists from the Guinean capital Conarky came to the front and do an in-depth of the prevailing scenario. Medecins Sans Frontieres (Doctors without Borders) started analysing the affected patters and sending samples back to the parent countries. Shocking revelations came up when the cause of the virus was not Tai Forest Virus as expected by the geographies due to the close proximity to Cote d’Ivore. However it was seen to be a different variant of EBOLA virus itself as the one which was found in east Africa in Congo and Gabon.
Another study which made sparkling revelation on Ebola was the study of genetics of the virus published in science express in August 2014. The study was carried out in SierraLeone with samples of more than 78 patients who got affected between May and June. More than 50 people collaborated in the research with 5 of the co-authors working on the research died till the time research got completed. All the 78 samples have similar sequencing indicating it to be from a same ancestor, the virus was mutating in a prolific manner and varying itself as it moved from one host to another.Lastly the virus was a different variant as the one which was found in Far East in Congo about 10 years ago. So we are not probably looking at a situation when the virus is spreading in Bats in central and western Africa and genetically growing, plus the human spread that is adding to the misery.
The spread is rampant by the time we finish it we don’t know how many more might walk in to a healthcare facility and get diagnosed of Ebola or someone might die a fatal death because of it. Poor healthcare facilities, amid rumors of the virus being man made, insufficient equipment’s for healthcare officials to even protect themselves, weak governance, extremely low per capita income, shortage of Ebola treatment centers and beds. The outbreak has led to a public anxiety where fear has gripped into the local population and people are not ready to quarantine. Family members were seen abandoning their family members on streets so as to not go in quarantine. In a recent report by MEDECINS SANS FRONTIERS forced quarantine for healthworkers returning from African countries might upset the moral of workers and the count of volunteers. Adequately handling the public anxiety and health necessities might be the best way to monitor the situation from the moral perspective of health workers. Forced 21 day quarantine for doctors returning from West Africa will lead to reduction of stay in affected areas; volunteers also will be less inclined to come forward for the same. The WHO should follow similar protocols of treatment in all the countries for people returning from EBOLA affected areas. WHO should avoid policies that deter the moral and perception of MSF volunteers.
Death toll has reached 5000 out of the 10,000 cases reported. The reported figures as per popularconsensus are way below the real mark. With 8 countries seeing death, Mali recently saw death of a 2 year old toddler who went on a trip Guinea.
Zero Down on World SAMWAD
Author : Manu Arora