An epidemic aided by poverty

August 20, 2014

Rebekah Ward and Dora Curry look at the deadly outbreak of Ebola sweeping through West Africa--and how poverty and racism are enabling the spread of the disease.

AS THE deadly disease Ebola spreads throughout West Africa, some in the U.S. have been engaging in fear-mongering and racism. Others are seeing this deadly outbreak as a golden chance to profit off desperation. But what's causing the high death toll is the intersection of Ebola and poverty.

A hemorrhagic fever with symptoms that include headache, vomiting and diarrhea, as well as the signature symptoms of internal and external bleeding, Ebola is caused by a virus that is spread through contact with fluids like saliva, urine, blood and semen. There are no known cases of airborne transmission, unlike other deadly diseases like influenza. Because of this, Ebola is actually relatively hard to transmit from human to human, and is less contagious than measles, whooping cough or polio.

According to the scare merchants at Fox News, however, "The deadly Ebola outbreak in West Africa poses a threat to America." Other choice headlines include, "Here are the 35 countries one flight away from Ebola-affected countries," and "Ebola outbreak: Deadly foreign diseases are 'potential major threat.'"

Residents of a quarantined community in Sierra Leone sit in a crowded treatment center
Residents of a quarantined community in Sierra Leone sit in a crowded treatment center (Cyprien Fabre)

The Center for Disease Control and the World Health Organization, however, both agree that there is almost no chance that an outbreak could occur in the U.S., or in any nation with sufficient medical infrastructure. In fact, in previous outbreaks, infected individuals have returned to their home countries, with no further transmission there.

Two American missionaries were flown back to the U.S. after contracting Ebola during this most recent outbreak. There was very little alarmism about these two Ebola-infected people on U.S. soil. However, some right-wingers are urging the U.S. to close all flights to and from West Africa to prevent the spread of Ebola.

This double standard reflects another component of this outbreak: racism. The renowned public health expert Donald Trump tweeted, "The bigger problem with Ebola is all of the people coming into the U.S. from West Africa who may be infected with the disease. STOP FLIGHTS!" Meanwhile, the right-wing reminded readers that 80,000 Nigerians travel to the U.S. every year in an article entitled, "Air travel from Nigeria most likely path for Ebola to reach U.S."

THERE ARE several theories about the natural host for Ebola, but the most widely accepted one is that the virus lives in fruit bats. In this scenario, an infected fruit bat would come in contact with a person (possible through another animal) and introduce the disease into a human population.

But the primary mechanism through which humans become infected is contact with other humans--the vast majority of humans infected acquire Ebola from contact with the bodily fluids of other infected humans. Furthermore, doctors believe that humans can only transmit the disease after they begin to show symptoms.

Media hysteria claiming people in the U.S. (or any other nation with similar infrastructure) are at risk from Ebola is simply that--hysteria.

And while some elements the Ebola virus' natural host and life cycle remain unclear, the media obsession with the possibility of that constant consumption of bush meat or various cultural practices in caring for the dead plays a role--among the many racist assertions in the U.S. media--is a distortion of the facts fueled by racism and the desire to profit from spiking readership and viewership.

The current Ebola outbreak in West Africa is the most deadly in history. Over 2,000 cases and 1,000 deaths have been associated with it. Declan Butler, senior reporter for the prestigious scientific journal Nature, puts this outbreak in context by saying, "Since Ebola first appeared in 1976, only 19 outbreaks have had more than 10 victims...Only seven other of the few dozen past outbreaks have involved more than 100 cases."

So what has made this outbreak different? Ebola has usually been contained in remote villages, far from cities. This outbreak has spread to the sprawling urban centers in several West African countries.

The combination of urban overcrowding and completely inadequate health facilities in such urban centers creates a perfect breeding ground for this and many other illnesses. Monrovia, Liberia (population 1.5 million), Freetown, Sierra Leone (1.2 million) and Conkary, Guinea (1.7 million) have all reported growing numbers of cases.

According to Bessman Toe, head of the Montserrado County slum-dweller association in Monrovia, in some areas, up to 70,000 residents have access to only four public toilets connected to a sewage system. The UN estimates that 42 percent of the population of Monrovia are "squatters," thus living in makeshift shacks tightly crowded together. In the Kroo Bay neighborhood of Freetown, rent is prohibitively high for the structures on dry land, so many are constructing shelters on the floating garbage over the ocean.

In Guinea, there are 0.1 doctors per 1,000 people. That number is 0.022 for Sierra Leone and 0.014 for Liberia. Basic health protections, like disposable gloves, are simply not available for those few doctors practicing in these countries. And while many doctors have been sickened in this outbreak due to these conditions, their numbers overestimate the size of the health care staff which is trying to stem the tide of the infection. Ebola may be a deadly disease, but it is clearly not the root cause of these deaths.

RACISM AND economic disparities can also seen in discussions about Ebola treatment and vaccines. The treatment known as zMapp has allowed for near-recovery in the patients who have received it in the U.S. But even following a formal request from the Nigerian government, the U.S. refused to supply the serum on August 7. The Obama administration cited concerns about the experimental nature of the drug.

The next day, it agreed to supply Liberia with doses for two doctors. Either the drug became less experimental overnight, or the sheer hypocrisy of the statement was too much to bear.

It is absolutely true that the zMapp serum is experimental. This therapy is produced in plants and is made of proteins called antibodies that bind the Ebola virus in the blood, keeping it from damaging the body. Prior to its use on the Americans, it had only been tested in monkeys. It is also true that a Spanish priest was administered the serum after returning to Spain, and the treatment did not save him.

However, the limited monkey studies that have been done indicated that the serum must be administered within 48 hours of infection to have full efficacy--and in the case of the Americans, that happened.

Two doses of the experimental treatment were secretly flown to Africa and administered to the Americans prior to their flight back to the U.S. This brings us to the central hypocrisy: Drugs are only "too experimental" for Africa if they are scarce. Already, zMapp developers say, "The available supply of ZMapp has been exhausted. We have complied with every request for ZMapp that had the necessary legal/regulatory authorization."

After the recent UN and World Health Organization approval of experimental treatments for Ebola, these countries have also been flooded with other new "treatments" for the disease.

One of the most high profile is Nano Silver. Although silver particles do have some anti-microbial properties and have been shown to bind some viruses, this treatment has never been tested in live animals, much less humans. These small silver particles, if ingested, would likely pass out of the patient without ever encountering the Ebola virus. If the treatment is injected, the side effects could be more fatal in the long term than the disease.

The Nigerian Health Minister confirmed that the country was to receive a large shipment of Nano Silver to combat Ebola. The manufacturer of this treatment also offers online sales of ear candles, hemp oil, chocolate and "mental clarity packs." Again, we see the pattern of African lives as disposable in the eyes of those seeking profit for their drugs.

People are not dying of Ebola because of "exotic cultural practices." Nor is Ebola impossible to treat and inevitably spread throughout a population.

While its symptoms are sensational and more fatal than some other diseases, the rapid, widespread nature of this Ebola outbreak can be tied directly to systemic inequality. The natural features of this disease (unclear and infrequent transmission into human populations, difficult to transmit when even basic infection prevention practices are in place) actually make it very unlikely to spread. It is the very unnatural features of overcrowded, under-resourced poor urban centers that allow the Ebola virus to thrive.

Poverty and racism are the most deadly aspects of this disease. Until we live in a world with access to healthy living conditions and quality health care for all, we will continue to see contagious unnatural disasters.

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