2014 Ebola Virus Disease: Factors That Led to the Widespread of the Disease in West Africa
The 2014 West Africa Ebola outbreak is the worst Ebola outbreak to have ever hit the continent of Africa. Prior to 2014, Ebola outbreak had appeared 24 times from the period two strains of Ebola virus disease were discovered in 1976. The virus disease had killed less than 700 people.
The current 2014 Ebola outbreak in West Africa (Guinea, Liberia, Sierra Leone, Nigeria) has killed more than 1,100 people. This virulent disease has infected more than 2,000 people.
A rare disease, Ebola tends to be a deadly infectious disease when it hits a region. It can kill people at rate of up to 90% of those infected. However, questions arise as to how as a rare disease, it went out of control to infect such a large number of people and the resultant deaths.
During the past outbreaks in Uganda, the disease as well contained as it didn’t affect a large percentage of people. This resulted to fewer deaths. What caused such high rate of infection and deaths in this year’s outbreak in West Africa?
Ebola is less of a contagious disease than infectious. Diseases which are spread through air, food or water tend to infect a large percentage of people than Ebola virus disease. This disease is transmitted when a person comes into close contact with an infected person’s body’s fluid or blood. If this is the case, one wouldn’t expect the outbreak to go out of control to such a scale.
What went wrong? The following are the six major reasons that contributed to the spread of the disease at such a large scale from Guinea to the rest of the three countries in West Africa.
Do you think Ebola virus disease can spread beyond Africa?
a) The Deadliest Strain of Ebola Virus Disease – Zaire Ebola Virus
The Zaire Ebola virus is the worst strain of Ebola virus disease. It can kill infected people at a rate of up to 90%. Due to the speedy reaction of the international community, the mortality rate was reduced to 56%. Despite this fact, as per the first week of September over 3000 people were infected resulting to more than 2000 deaths. This shows how deadly this strain of virus is when it hits a region.
Zaire Ebola virus was discovered in 1976 together with Sudan Ebola virus which has a mortality rate of 50%. These two strains of Ebola virus disease are the deadliest types of Ebola viruses when they hit a region.
b) Level of Poverty
The strain of Ebola virus disease, Zaire Ebola virus, hit three countries which are the poorest countries in the world – Guinea, Liberia and Sierra Leone.
The fact some of these countries are still recovering from a decade of civil war makes matters worse. This explains why the government of these countries were unable to counter the disease appropriately to bring it under control. The resources required to fight this disease were lacking such as protective clothing and clean needles.
Out of 187 countries, Liberia, Sierra Leone and Guinea are ranked at positions 174, 177 and 178 respectively according to United Nations Human Development Index.
The majority of people in these countries live below U.S $ 2 a day. In contrast to U.S., in these countries less than US$ 100 is invested in the health care of each citizen while in U.S.” more than $800 U.S. is spent every year on the health care of each citizen.”
c) Poor Health Care Systems (Facilities)
Due to the level of poverty these countries are faced with, the governments of these countries (Liberia, Sierra Leone and Guinea) are unable to provide the required instruments or equipments to health centers. This implies the hospitals lack the necessary equipments or instruments needed when the countries are faced with an outbreak of a disease.
It is sad instruments such as clean needles and syringes were lacking in many health centers (hospitals). This forced health workers to re-use the same needles on other patients. A lot of infection happened in hospitals as needles were reused without sterilizing them. Lack of protective clothing (masks, eye shield, gloves and gowns) led to more than 60 health workers dead as they were vulnerable to contracting the disease from contact with the infected patient’s body fluids and blood including surfaces contaminated with the infected body fluids. Also shortage or lack of protective equipments were lacking which added to the widespread infection.
This coupled with lack of resources to track those who came into close contact with the infected also resulted in lack of reducing infection.
It should be noted the health workers in these countries are underpaid, over-taxed and overworked which created havoc in proper control of the disease.
d) Cultural practices
In many African communities, before the dead are buried they must go through the body cleansing ceremony. This is when food is removed from the stomach including cleaning the dead body using bare hands (not using protective clothing). In some cases, the dead body is placed in the center of the deceased home. This implies the wife (and possibly children) is always in contact with the body.
A person who has died from Ebola’s infection is still contagious as the virus is still in the blood. Consequently, handling of the infected dead body with bare hands leads to infection. This was the case in Guinea.
A percentage of Africans distrust hospitals or health workers preferring to go to herbal doctors or taking care of their sick loved ones at home. They have many and varied reasons as to why they distaste and distrust hospitals or health workers. The majority of this percentage are illiterate therefore they have little knowledge of what happens in hospitals.
In the case of 2014 Ebola outbreak, the loved ones of the infected people preferred to take care of their sick in their homes. Despite the governments’ plea including international community and health workers for the sick to go or be taken to hospitals for treatment, it fell on deaf ears.
Many Africans who are illiterate believe scientists invent diseases in order to make people sick. The reason? In order to get internal organs from the sick people to use to treat others. Others believe it is a ploy of the government to kill them instead of treating them.
It should be noted people also distrusted the government and health workers including international community warning them of eating infected bush meat, especially the dead ones. People especially in Guinea ignored the warnings continuing eating bush meat without inspecting whether the meat were infected or failure to cook the meat in high temperature.
f) African Disease
If a disease is termed as ‘poor’ it implies little to none research will be carried out to find cure or vaccine for the disease. Pharmaceutical companies research for drugs if they are sure to reap profits. Why research a vaccine or drug treatment for a disease which affect poor people and doesn’t occur frequently?
Looking it another way, a vaccine or drug treatment has been proved effective by a scientist or group of scientists (such as the case of polio) after doing clinical trials or tests, however it is upon drug companies to produce those drugs. Will they manufacture them if they know they will reap a small amount of profit to none?
This is clearly indicated by Vox who state, “This shouldn’t be news. Most all of the money for research and development in health comes from the private sector. They naturally have a single focus – making money – and they do that by selling patent-protected products to many people who can and are willing to pay very high monopoly prices. Not by developing medicines and vaccines for the world’s poorest people, like those suffering with Ebola.”
The report ‘Global Report for Research on Infectious Disease of Poverty’ by WHO clearly shows how extensive research is not done on diseases regarded as poor. These diseases include Buruli ulcer, and Chagas disease.
As indicated by the New Yorker, “This system does a reasonable job of getting westerners the drugs they want (albeit often at high prices). But it also leads to enormous underinvestment in certain kind of disease and certain categories of drugs. Diseases that mostly affect poor people in poor countries aren’t a research priority, because it’s unlikely that those markets will ever provide a recent return. So diseases such as malaria and tuberculosis, which together kill two million people a year, have received less attention from pharmaceutical companies than high cholesterol.”
This is the major reason for the 2014 Ebola outbreak. If there was a vaccine or drug treatment, it would have reduced infection and the death rate. This is because the vaccine or drug treatment would be available for the governments of these countries to buy or seek international community to help in purchasing the drugs or vaccine (if they are unable). As it is, this is not the case.
“So we can’t be surprised about the current Ebola outbreak. We can’t lament the fact that there’s no cure or that it’s unstoppable and virulent virus when remedies could be expedited; we just don’t prioritize them over other, more potentially profitable health problems.” (Vox)