Thanks to friend and colleague Joan Acosta for sending the link to this Reuters report: Why it’s the relatively wealthy who spread Ebola. Excerpt:
The media is focused on the horrors of Ebola, a disease with no known cure that is jumping across borders in West Africa, leaving more than 900 dead in its wake. Fears of the disease’s spread even traveled to the United States, where two Ebola patients are being treated at Emory University hospital in Atlanta, Georgia.
The virus first appeared in West Africa in March, but suddenly gained momentum in the past few weeks, making it the worst outbreak ever. The vast majority of cases and deaths have been in Sierra Leone, Guinea and Liberia, but Nigeria now confirms the presence of the disease.
The virus is spread through bodily fluids and has a relatively long incubation period of up to 21 days. At this point, roughly 40 percent to 90 percent who become infected eventually die.
Though the majority of victims are poor, the wealthier people who have contracted Ebola — those able to travel by plane or car during the long incubation period — may be the mechanism of Ebola’s march through so many West African countries.
Widespread poverty, inequality and unequal development have challenged efforts to stem the disease in these countries. Healthcare workers tell of resistance from the people most in danger of contacting Ebola. Some villagers are reportedly running away from medical teams.
This is perhaps understandable. Doctors and nurses are among the recently infected and dead, including the leading Ebola authority in Sierra Leone. So people, mindful that there is no cure, may be unwilling to risk exposure from healthcare workers.
In addition, Ebola has taken hold in countries where citizens have little confidence that the medical authorities have the infrastructure and resources to make things better.
Consider Liberia, with a population of roughly 4 million people. The country experienced a terrible civil war from the 1980s to 2003. Its public infrastructure was severely limited before the war and government services have only recently become available.
During the civil war, refugees from the country’s rural regions flooded the capital, Monrovia. Roughly 750,000 people now live in the capital, many in unsanitary conditions. Overall, 71 percent of the people have no access to modern sewer systems. Not surprisingly, Monrovia is one of the main centers of the Ebola outbreak.
What’s worse, there is no medical infrastructure to support the kinds of isolation and public health work required to manage an Ebola outbreak. In 2010, Liberia had 0.8 hospital beds per 1,000 people, and in 2008, it had 0.01 physicians for every 1,000 people.
By comparison, the United States, in 2009, had three hospital beds for every 1,000 people, and 2.42 physicians for every 1,000 people.
Under these conditions, Liberians have good reason right to feel skeptical about their doctors’ ability to manage the contagion.