Zola Guna s contribution-notes from a friend Ebola is terrifying because nearly everyone who gets it will die. But before we give in completely to the scaremongering here is some information to help put things into perspective. This is from a close friend who is a PhD in anthropology. She studied in Kenya and has lived in various countries in Africa since. She is also a partner in Global Health Insights. These words are not my own. This was written entirely by Beth Ann Pratt in response to a question by a friend on her Facebook page: Ebola can live on surfaces for no more than 2 hours. But this is on surfaces where a critically ill patient has been in contact. The patient has to be at the stage where they are expelling body fluids. The people who are getting sick from Ebola are not getting sick from touching door handles. They are getting sick from cleaning and wiping down critically ill patients’ vomit, diarrhoea, blood, and then transferring the body fluids to their nose, eyes, mouth or open skin abrasions. With Ebola, patients expel fluids at very very very high volumes. The fluid loss is enormous. That is why patients die, they lose huge amounts of fluids, their blood pressure collapses, and they go into shock. Even if you just got Ebola on your leg...it doesnt just penetrate your skin. There has to be a breach on your skin. A cut. Or it has to enter an orifice. Its not aerosolized…so it cannot be inhaled. It cannot enter respiratory cells b/c it lacks proteins on its surface to attach to the surface of epithelial cells in the respiratory system and enter them (Let me give a comparison: its just like how HIV is specialized to enter only immune system cells. HIV cannot enter just any cells, only those cells with CD4 proteins on the surface and these cells are primarily immune system cells. Similarly Flu is adapted to respiratory cells. Ebola is the same way, it is adapted to enter certain cells and not others). One way many medical personnel get Ebola is when they virus transfers to their eyes, which are wet with tears. Either they get sprayed in the eyes by vomit, blood, etc., or they touch or wipe their eyes with body fluid-contaminated gloves or sleeves of their suit. And they are more likely to touch and wipe their eyes when they are really hot and sweaty (b/c are wearing protective suits in a hot climate and are wiping away sweat) or really tired (because they are dealing with a medical crisis and havent slept). They make a mistake and they wipe their eyes. Alternately, they touch their face, eyes, mouth, or nose directly after removing protective gear, or b/c they are so tired, they forget to take things off in the correct order. So that is how people get sick. But, look, if you could get Ebola from a door handle or a cup, it would have wiped out whole countries. Ebola first was discovered in the early 1970s. There have been 25 outbreaks before the one there is now. All were contained. They were contained by African health workers and African Ministries of Health, with support from international technical agencies, but NOT with huge amounts of money and NOT with huge amounts of equipment. That it is not being contained in Guinea, Sierra Leone, and Liberia is not because it “easily spreads” so to speak. It’s not the swine flu which affected 20% of the planet’s population. Its because of the political, historic, and social context of those countries. Ebola broke out in those districts that were the epicentre of both the Sierra Leone and Liberian civil wars…wars which Guinea was heavily involved in. It broke out in populations of former rebel movements. Where people’s trust in government and public institutions is virtually nil. And where surveillance is difficult to carry out. The first case was on December 6th, and Ebola was not identified until mid-March. It was misidentified as Lassa virus (which, btw, those three countries have actually done a pretty amazing job building capacity to contain…which is why they made the mistake…they thought it was the disease they had been planning for, not something new). And when it was identified, people did not want to go to clinics and hospitals b/c they saw people dying there and they didn’t trust the public sector. The public sector then failed to reach out to communities, sowing further distrust. People kept caring for people in their homes and burying people, without proper protection. They only took people to the hospital when the disease was FAR advanced. When the patient WAS contagious…vomiting and bleeding. If they had trusted the health system, if the health system had reached out to them, if patients had been brought in earlier BEFORE they were spewing body fluids, if religious leaders had been engaged and people had been given alternatives to burial, if governments had identified the outbreak earlier and if the international technical support had been mobilized in March, not in July/August, then this would have been a much different story in these countries. Just like it WILL be a much different story in Europe and the US. Just like it HAS been a much different story in Nigeria, Senegal, and DRC. Just like it WAS a much different story in Uganda.
Posted on: Fri, 17 Oct 2014 14:00:01 +0000
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