The Ebola fighters

Not everything Time magazine does is awful. It has an excellent long piece on The Ebola Fighters as part of its Person of the Year feature. (The only trouble is it’s a huge pain in the ass to read because it gives you only a tiny window of written material at a time, and there seems to be no way to convert to the printable version. Apparently that’s fabulous for people reading on phones, but I’m not reading on a phone. grump)

A sample:

Why, in short, was the battle against Ebola left for month after crucial month to a ragged army of volunteers and near volunteers: doctors who wouldn’t quit even as their colleagues fell ill and died; nurses comforting patients while standing in slurries of mud, vomit and feces; ambulance drivers facing down hostile crowds to transport passengers teeming with the virus; investigators tracing chains of infection through slums hot with disease; workers stoically zipping contagious corpses into body bags in the sun; patients meeting death in lonely isolation to protect others from infection?

According to official counts, more than 17,800 people have been infected with Ebola virus in this epidemic and more than 6,300 have died since this outbreak’s first known case in rural Guinea in December 2013. Many on the front lines believe the actual numbers are much higher—and in any event, they continue to rise steeply. The virus has traveled to Europe and North America, where the resulting fear exceeded any actual threat to public health. In West Africa, however, the impact has been catastrophic. The number of Liberians with jobs fell by nearly half as businesses and markets closed in fear of Ebola. Sierra Leone’s meager health care network simply collapsed: Ebola patients were told by the government to stay home rather than look for a hospital bed. In Guinea, the epidemic stoked distrust of government and aid workers. Medical missionaries were driven from villages by violence and threats.

Mistakes were made.

…the MSF team determined that something new and dangerous was going on in the borderlands. Previous Ebola outbreaks had been isolated in a single area, but now the virus was widespread. As MSF’s Liu puts it, “Already there were multiple locations of clusters” up to 100 miles (160 km) apart. In raw numbers, the Ebola outbreak might have seemed small compared with the chronic contagions of cholera and malaria in West Africa. But an epidemic of Ebola, with its ghastly effects, could corrode civil society by spreading panic. The disease leaped to the top of MSF’s priorities.

But few officials wanted to hear it. Liu recalls fruitless conversations in March with ministries of health in the region, “pushing them and telling them that this was going to be different.” Again and again, health officials complained that the doctors—not the disease—would panic the populace. “We were quickly told by a variety of agencies that we were crying wolf,” Liu says.

One skeptic—perhaps the most influential and thus the most disastrous—was WHO, the health arm of the U.N. Underfunded and overly bureaucratic, WHO is, in the eyes of its many critics, woefully inadequate in dealing with rapidly emerging threats like Ebola. Worse perhaps, the agency’s local representatives are notoriously jealous of their turf and prerogatives. At this same critical moment, WHO offices in West Africa turned away a team of experts from the CDC working in Guinea, insisting that their help was not needed, says CDC director Dr. Thomas Frieden. The CDC, a large and very well-regarded public-health agency, is unsurpassed in its capacity for action, maintaining some 2,000 field workers in 60 countries around the world. Those workers in turn can often summon resources from the U.S. to smother epidemics in their infancy abroad.

Teamwork at this early moment might have saved thousands of lives and ultimately billions of dollars in direct and indirect costs stemming from the Ebola epidemic. Instead, WHO closed the door, says Frieden.

I didn’t know that. I don’t know if it’s true or just something rivals say about rivals – maybe the WHO would say the same about the CDC and MSF. If it is true, it’s a massive tragedy.


  1. quixote says

    It’s true, unfortunately. WHO didn’t do one tenth enough. But there was also nothing stopping the CDC and European health organizations and US and European governments from making a lot more noise about it way back in March. I doubt very much the turf battles would have continued if, say Obama, Merkel, Hollande and Cameron had said something loud and clear about it. Even less so if they’d sent their national resources to help, as Obama finally did some time in September (?). Much too late, in any case.

    It was obvious to me, with nothing but an ordinary biologist’s understanding of Ebola and epidemiology, back in February-March that this was an all-hands-on-deck emergency. All the Western authorities were asleep at the switch. Not just WHO.

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