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Friday 1 August 2014

Pandemic:

Why The Ebola Virus Was An Outbreak Waiting To Happen

Without getting into the medical aspects I would like to focus on why the spread of this highly contagious virus - and others to come - are inevitable in most parts of Africa, South America and many parts of the Caucasuses and South East Asia.  Guinea, Liberia and Sierra Leone, all  in West Africa, are the identified countries most recently affected by the outbreak.
The President of Liberia, Ellen Johnson Sirleaf, has called on the world to provide medical and human resources. While I have no doubt that such can bring some respite I must question the fundamental basis upon which societies such as, for example, Liberia, are constructed.
I must be careful here not to associate any racist element to what I am going to say as it is based solely on personal similar observations on  different continents - The Caucuses (Eurasia), Africa, Central and South America and South East Asia.

I would also like to say that, in my opinion, there are no more courageous people in the world today than the medical, the aid workers and the volunteers tending the dying and afflicted in such regions and whose own chances of survival (non-infection) are well below the 40% level.
My observations suggest systemic failures in the organization of such societies with regard to GDP/GNP allocations for public health and education services, community hygiene (including sanitation), clean drinking water, health services and education.
[I should add that Western donor nations and international development bodies (through the United Nations,
World Bank and other Institutes) including those of  the United States and, to a lesser extent, the European Union, place particular emphasis on the development and expansion of private healthcare and the privatization of, essential health, education, water provision services in such developing countries which lack basic infrastructures - hence ensuring that health, hygiene and illness associated with impoverishment and the absence of such, will, in the long-term, inevitably be victims of circumstance - resulting in disease, malnutrition and illnesses long associated with poverty and lack of such essential basics provisions.]
For centuries (up until today) whole communities in the impoverished world are highly susceptible to water borne diseases and such rarely reported viral contamination outbreaks.  They are rarely reported because proper local, regional and national health alter monitoring, crises response and statistics are non-existent.

Before racists jump on the bandwagon it should be said that up until the 1950s in many parts of what is now regarded as developed Western Europe such outbreaks, for the very reasons given above, were very common.  In some countries polio and tuberculosis were rife.  Food contamination and poisoning were rife
amongst the poor in certain parts of Western Europe as were diseases associated with poverty and unsanitary living conditions.  Deaths of children from contamination of water, food, lack of proper hygiene and basic medical care for infants were all too frequent occurrences in previous centuries.  The high morbidity and mortality rates for reasons of lack of basic hygiene and disease prevention, were therefore rife throughout Western Europe.
So to look down on these unfortunate countries or to regard them as 'backward' is not just false but ignores centuries of suffering throughout Europe for similar reasons.
My concern is that such international bodies, donor nations and countries afflicted today need to get their priorities right with regard to basic hygiene, sanitation, food processing with quality control, and, above all, health education and changes in lifestyles with an appreciation of the health dangers and how such can be minimized at local, regional and national levels.   Such are the real causes of these problems and until African, Asian, South American and Caucasian politicians appreciate the national priority for health and education and their role in disease prevention then sadly such mass outbreaks of infectious diseases will continue, albeit sporadically, until one specific mutated (and mutating), airborne, highly  transmissible virus causes a pandemic worldwide.  Such education should, in the case of highly infectious and transmissible viruses, include the promotion of change of tribal customs and traditional practices which could, inadvertently, be resulting in hibernated (semi-dormant) stasis of such viruses, ripe and poised for future outbreak, either under specific environmental conditions, cross-contamination, or factors which, by virtue of the lack of eduction, would result in unwitting exposure, contamination and human or species infection.
There is often a very wide chasm between politicians, health professionals, and academics in many parts of the developing world with the former unable or unwilling to take proper counsel or indeed to take counsel but refuse to allocate adequate resources to implement national health and education policies for all the nation, independent of the ability of individuals to pay for healthcare.  Many African countries, rather than take responsibility for transparency and proper budget allocation (easily achievable if levels of corrupt practices were reduced) prefer instead to call on international bodies to 'subsidize' both health and education.
Developed countries are usually willing, directly or indirectly (through NGOs and international bodies) to oblige - especially where there are coherent political, military, strategic or extractive resources to be traded-off.
There is a conceptual void in the way our financial systems are firewalled and organized to either fail to perceive (or simply are programmed to ignore) the 'benefits' of  universal healthcare and universal education.
So the systemic failure starts at the very top.
There is no financial incentive from, for example, The World Bank to allocate resources for, say, a sewage and rain drain off system for a whole village, town or city.   They would (rightly) argue that this must be a responsibility of national government as part of a national health and sanitation plan.  But condemning masses of people to live in filth and without adequate healthcare whilst at the same time servicing the privileged, is an ultimate recipe for mass transmission of infectious diseases and one to provide vibrant mediums for the mass spreading of viruses - ultimately  worldwide.
In this instance the outbreak is confined to West Africa but unhealthy individuals and  the potential for contamination of aspects of the food chain from contaminated land, to harvesting to processing to dispatch worldwide are all increased because of the inability of politicians (and international financial institutions) to appreciate the priority of developing countries to adequately budget for their masses, preferring instead to focus on developmental aid which, on the whole, is (if not directly) indirectly financially beneficial to the elite in recipient countries and not matching nor caring to enquire as to whether national plans - with State allocation of resources for hygiene and sanitation - are already operationally and effectively in place.   There simply is no 'market' for 'free' universal health care and 'free' education in developing societies.
African politicians, through lack of education themselves, assume that such should be 'subsidized' by the United Nations or other private institutions from the developed world, not understanding the true value of education and preferring instead to allocate resources to, what we would regard as, non-essential services (or indeed simply allocating financial resources to, self-aggrandisement, scenarios)
Health care, public sanitation and education are often perceived by Third World (Developing World) politicians to be either the function of  rich benefactors from the private sector or international institutions and organizations and not that of local politicians.
Most African countries leaders' lack the foresight (or education) to see the benefits of health care and eduction for their mass populations in the sense that they themselves are unwilling to invest significant proportions of the GNP/GDP in their development. (There are about ten exceptions to this rule on the African continent - including countries in the Muslim Arab North, Rwanda- near the middle, just below the Equator, and in the Christian and Animist African South.)
Because of this dysfunctional perception by both politicians, transnational organizations and corporations in donor countries providing funds in the developed world, and also the politicians in these developing countries, in my opinion, all measures taken to contain the spread of Ebola, will be, at best,  limited to containment, without addressing the root causes of the problem, as outlined above. 

The good news (of sorts!;if you want to call it good news!) is that after a worldwide pandemic, perhaps resulting in the deaths of  tens of millions of people (if not more) in the areas identified above (and likely well beyond these geographic areas, oblivious to border security controls) the world might then get it's house in order, universally, for the first time in recent history, and politicians who now have had the 'benefit' of  'personal experience' of such tragedy, might now have added motivation to proactively refocus their priorities to ensure such horrors can never happen again.

A good example of what I am saying is the response to the HIV/AIDS.  I want to again take Africa as one of many examples of bad practice - an alarmist response by many countries to an emergency situation requiring very clear thinking, research, analysis and planned coordinated health, educational, economic, social and scientific initiatives. The reaction of most African and Muslim Arab countries societies politicians and spiritual leaders has been to suppress (or evocate for the suppression) of Gay Men and Lesbian Women rather than join the global research into fighting the HIV virus.  The exceptions being South Africa (on the African continent) and Israel (in the Levant/ Middle East) which are actively engaged in national and global research projects.
Rwanda is also taking very positive steps which avoid stigmatization and focus on education, community health initiatives and is also constructively engaged internationally.

So what I want to again emphasize is, taking this specific virus (HIV) as an example, there is still no guarantee that, even after the deaths of millions, tens or hundreds of millions, world bodies, multinational and transnational corporations, politicians and religious leaders will indeed change their ways of thinking and recalibrate priorities towards proactive disease prevention, universal health care and education for their mass (or depleted) populations.


Addendum
The co-discoverer of the Ebola Virus, Professor Peter Piot, has said that the risk of transmission by proximity to a victim is minimal (1).   I am in no position to disagree with such an eminent person as Professor Piot.  What I do question is that, given the unsanitary conditions and lack of proper healthcare and infrastructural facilities across most of the under-developed (and parts of the developing) world together with other factors mentioned above, whether it is better to err on the side of caution than otherwise.
What the article also fails to point out is that, where you have highly infectious viruses affecting remote communities, in the era before modern transportation and communication, remote villages or tribal household communities may well have been completely overwhelmed (wiped out) before the virus itself could reach areas of population densities.
I am convinced that this is a forerunner for a more serious global pandemic to be caused by an artificial (synthetic) or mutated cross-species virus or complex of viruses, which, at some nearer point in time, will overwhelm this planet.
I again question as to whether, even after such a catastrophe, the lessons will have been learnt.

Patrick Emek

(1)
Ebola Co-Discoverer Professor Peter Piot:
''I would Sit Next to an Infected Person on the Train'' by Lydia Smith
http://www.ibtimes.co.uk/ebola-discoverer-peter-piot-i-would-sit-next-infected-person-tube-1459154

Note: Professor David Heymann was the other Co-Discoverer of the Ebola Virus    (P.E. August 27th , 2014)

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