Is the Ebola outbreak so bad because it's in Africa?
Question: what is Ebola?
Unless you've been living in a bubble of your own, I'm sure you'll have heard of the recent Ebola outbreak in Western Africa, specifically concentrated in Sierra Leone, Liberia and Guinea. The outbreak began in Guinea in December 2013, and was formally pronounced a Public Health Emergency of International Concern on 8 August this year (2014). As of this month, WHO estimates that around 8,000 cases (approximately 3,439 deaths) have been diagnosed, making it the most severe outbreak since the virus' discovery in 1973. The Ebola virus is thought to have originated from fruit bats of the Pteropodidae family. It is introduced into the human population via close contact with the blood, secretions, organs or other bodily fluids of infected animals, and is then transmitted from human-to-human through direct contact with blood, secretions, organs or other bodily fluids of infected people, in addition to surfaces and materials contaminated with these fluids. Current research suggests that the virus has a fatality rate of 50%. [For further information on Ebola, see here.]
Question: is the outbreak restricted to African countries?
Although predominantly concentrated in Western Africa, there have been a handful of cases in America and Europe - but it should be noted that these people have travelled/worked in said infected African countries.
Question: so what impact has the location had upon the virus?
Not so much on the virus, as upon its scale. I think that the virus has been exaggerated in both its size and effect by its location in Africa; specifically in consequence of the level of economic development as well as the socio-political culture of the countries. To illustrate my point, I'll focus explicitly on Sierra Leone, Liberia and Guinea. Compare the UK GDP of 2.522 trillion USD (2013) to those of the three aforementioned countries and you get a stark juxtaposition: Guinea boasts a mere 6.193 billion USD (2013), whilst Liberia and Sierra Leone herald only 1.591 billion USD and 4.292 billion USD (both 2013) respectively. The level of economic wealth and development in turn validates the quality and accessibility of infrastructure and services in the country. With such low GDPs, Sierra Leone, Guinea and Liberia all have sparse accessibility to sufficient health care in addition to education regarding the virus, hence are greatly reliant upon external aid. Without these vital facilities, the spread of the virus is both accelerated and magnified beyond easy containment. Were the virus to have broken out in a more economically developed country such as the UK, although the location would have obviously had no effect on the nature of Ebola itself, its spread may have been contained with greater ease and efficiency, thereby reducing the fatality rate.
Equally important, though less predominantly so, is the influence of the socio-political culture of the outbreak's location. In several African cultures, the orthodox treatment for diseases lies in the trust of Witch doctors, otherwise known as traditional healers; consequently, many people have turned to these sources for treatment, which, more often than not, are unreliable. In the rejection of Western aid and health care to treat the virus, with large numbers turning to witch craft - some have even been reported to believe that the disease is a fictitious feat of Western governments, a conspiracy of something non-existent against the Africans - both the spread and fatality of Ebola is amplified. Another socio-political barrier to containing the virus easily is the level of ignorance (this is linked to the aforementioned point, but contextually different in constituents). In Liberia, Sierra Leone and Guinea, the average adult literacy rate is 42.4% (the UK equivalent is 99%). This figure is directly linked to the provision of education for the population, thus where the figure is low, such as is the case in these three countries, the number of qualified health care workers in addition to people who are knowledgeable (about things such as health taught by education) is minimal. Not only has this increased the reliance upon external aid (which, linked with the stigma around Western influence has negative implications for the spread of the virus (not for the virus itself though - this is a cause for celebration in viral land!)), but it has also inadvertently exaggerated the prevalence rate of Ebola as often people who want to help lack the skills/knowledge to do so, moreover individuals themselves lack the understanding to minimise the risk of contraction.
Equally important, though less predominantly so, is the influence of the socio-political culture of the outbreak's location. In several African cultures, the orthodox treatment for diseases lies in the trust of Witch doctors, otherwise known as traditional healers; consequently, many people have turned to these sources for treatment, which, more often than not, are unreliable. In the rejection of Western aid and health care to treat the virus, with large numbers turning to witch craft - some have even been reported to believe that the disease is a fictitious feat of Western governments, a conspiracy of something non-existent against the Africans - both the spread and fatality of Ebola is amplified. Another socio-political barrier to containing the virus easily is the level of ignorance (this is linked to the aforementioned point, but contextually different in constituents). In Liberia, Sierra Leone and Guinea, the average adult literacy rate is 42.4% (the UK equivalent is 99%). This figure is directly linked to the provision of education for the population, thus where the figure is low, such as is the case in these three countries, the number of qualified health care workers in addition to people who are knowledgeable (about things such as health taught by education) is minimal. Not only has this increased the reliance upon external aid (which, linked with the stigma around Western influence has negative implications for the spread of the virus (not for the virus itself though - this is a cause for celebration in viral land!)), but it has also inadvertently exaggerated the prevalence rate of Ebola as often people who want to help lack the skills/knowledge to do so, moreover individuals themselves lack the understanding to minimise the risk of contraction.
Question: so it's the African's own fault that the epidemic is so bad?
No. Absolutely not. The epidemic has merely been exaggerated as a result of the level of economic development of the countries, which is not blameable upon the African's themselves in its entirety. The level of economic (and it is important to recognise that it is economic and perhaps also political development, not other forms of development - although it can be argued that other developmental levels, such as the nature of the social development - which in itself is not bad, but the conventions such as large families and communal housing may exaggerate the spread of the disease - have contributed to Ebola's spread) development itself can be traced back to other factors and influences. Just read my last post on 'Africa' by Richard Dowden.
Side note #1: There were so many tangents in that bracket that I've lost my train of thought. My mind must seem as overactive as Briony's in McEwan's 'Atonement'!
Question: Okay. Let's say that the virus broke out in the UK.
Would it have a fatality rate of 0% then?
Not necessarily. Although the provision of, standard of, and accessibility to health care is substantially better than that in Sierra Leone, Guinea and Liberia, that does not explicitly pertain to the disease being completely under control. It should be noted that although many are currently in development, there is presently no proven vaccine/cure for Ebola. Were the virus to have broken out in the UK, rather than Africa, the spread may arguably have been reduced given less social stigma regarding reality and treatment in addition to a greater availability of facilities to strictly control it.
Question: So, conclusively, Ebola currently has no cure and is concentrated largely, though not exclusively in Western Africa. Its prevalence and effect is not so bad as it is because it is in Africa, but rather both have been arguably exaggerated by its location in Africa, resulting from the level of economic development and socio-political responses to the virus in said affected countries?
Or so I believe. What do you think?
Following the Ebola outbreak via the news, sitting half-awake in the common room at 7:45am each morning, eyes poring over my BBC News app, I've been fascinated by the frequent mention of social stigma and resources related to levels of economic development and their relationship to the virus. I couldn't stop making all these arbitrary, subjective links between things I had read, hence decided to transform the conversation within my mind into pixels on the internet for others to engage with.
Until next time,
C
Side note #2: A stimulating documentary for those interested in the relationship between physical and human Geography... or just the explosive potential of volcanoes - How The Earth Works: Will Iceland Poison the Skies? It follows the Eyjafjallajokull, Katla and Laki volcanoes, all situated in Iceland. Plus, the constant struggle of the commentators to efficiently pronounce 'Eyjafjallajokull' provides plentiful entertainment for rainy Monday evenings.
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