Health Kenya

EBOLA – Why the WHO is scared

The latest outbreak of Ebola virus disease has spread further, infecting and killing more people than ever before. Past epidemics have been restricted to single countries but this time, the Ebola virus has spread from Guinea, to Sierra Leone and Liberia since March 2014.

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So worried are the World Health Organization (WHO) that they organised a high-level meeting of all Ministers of Health and directors of disease prevention from 11 countries in West, Central and East African region. The meeting was held on 2-3rd July in Accra, Ghana. The WHO hopes that by ensuring everyone was reading from the same script, they would be able to contain the outbreak.

The WHO have reason to panic.

As of 3rd July 2014, over 750 people have been infected with the Ebola virus and 445 were already dead. That is the most worrying thing about Ebola – out of every 3 people infected, 2 will die of the disease. In Guinea, there were 413 cases and 303 deaths – meaning 70% of those infected died.

But where is this virus from and how do humans get it?

The Ebola virus has found a home in the fruit bat. The virus lives in this flying fellow causing it no harm. Other animals like monkeys, Chimps, porcupines etc have been found to be infected. However outbreaks of disease in some of these animals have been observed so it is assumed, that like humans, these other animals are just unlucky to come into contact with the virus as it is shed by the fruit bat.

 

 

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I will paint a picture of how the disease gets to humans based on a story of Pendo and her love, Baraka.

Pendo wakes up on a cold morning in her mud-thatched hut near a forest in the Guinea. She notices that the firewood is running out, so she turns to her man.

‘You – Wake up! Get us a log or there will be no food tonight!

Pendo is in a bad mood. Baraka got back late from watching a Premier League match at the small shop in the village. The shop owner has the only battery operated TV in the village. Baraka returned home totally drunk and blamed it on the fact that his team had lost the game. Pendo wondered aloud whether any of those Europeans he spend all Sunday afternoon watching, would get drunk if Guinea lost any match, anywhere. Baraka’s obsession with the Premier League irritated her.

Baraka’s hangover was killing him but the sight of his now angry wife amuses him and he tickles her. She pushes him away but she is giggling. By mid-day he takes his panga and is whistling his way into the forest.

As he chops the branch of a tree, some frightened fruit bats scamper out of the thicket. Baraka is caught off-guard and the panga lands on his hand. Some bat shit lands on the panga cut and he rubs it off, cursing. He continues with his job but as he drags the log out of the forest, he notices that the cut was rather deep. He thinks to himself, that it will earn him some points with his wife and he may get a bit more than supper tonight. He is a happy man as he walks home with his log.

Un-beknown to him – that fruit bat was carrying the Ebola virus and it’s shit was full of the virus. Through the cut, the virus had made its way into Baraka’s system.

When he gets home and shows Pendo the cut, she washes it and ‘kisses it better’. The night is as good as he had hoped it would be. Baraka wakes up a happy man and barely thinks about the cut.

A week later, Baraka wakes up feeling very tired. As he takes of the scab from his healing wound, he wonders what the problem is.

The following day, he is feeling so bad that he can’t get out of bed. His wife of 6 months has never seen him sick and panicked, she calls a neighbour.

The neighbour looks at Baraka and realises he can’t walk to the bus stop, so he runs to the shop (where they all watch football) to ask if the shop-owner can come and drive his neighbour to hospital. Shop-owner has a pick-up – so Baraka, his wife, Pendo and the neighbour get onto the back. By the time they get to the hospital, Baraka has vomited all over the back of the pick-up.

Baraka is admitted straight away. The doctor decides that he needs a malaria test. A technician comes and pricks his finger to take blood for a malaria slide. But as he pokes the finger, Baraka jerks and the technician pokes himself with the same needle. The technician is cross – now he has to take another blood sample to re-assure himself that he will not catch HIV from Baraka. A nurse gives Baraka his first dose of Co-artem even though the malaria results are not ready yet, as he looks so bad.

Pendo sits beside Baraka in hospital, she does not want to leave him for a moment. She is trying her best not to cry as she cleans his vomit and wipes his brow as his temperature rises.

The neighbour has driven back with the shop-owner. They clean up the car. Some of the matter splashes into the neighbours eyes and he rubs it away annoyed.

In two days – Pendo is beside herself with grief. Baraka has died. She informs his family, they come to hospital to pick the body. Baraka’s mother mourns over him, kissing his forehead, rocking his face in her arms. They take the body to his village which is three hours drive. Baraka’s close relatives wash his body. The villagers come and touch his head and speak to him as he lays in the bed of his mother’s house. Every day his body is wiped. Everyday people are coming into the home, touching him and weeping over him.

By the time Baraka is buried, over 30 people have been in contact with his saliva, sweat, blood and vomit. Starting with his wife, mother, the neighbour, the shopkeeper, the technician and nurses at the hospital, Baraka’s relatives.

In a few weeks, 15 of them get seriously sick and are admitted to hospital. Only 3 of the 15 admitted leave the hospital alive. The rumours start to fly. A man, his wife, mother and 2 brothers are dead – the family has a curse.

When other relatives are admitted, their families storms the hospital – they believe that they need to see the witchdoctor in town not take their people to hospital to die.

In the meantime, the WHO has now send teams of people on the ground, they are trying to control the epidemic but more people are dying.

The church people in the city have called for a 21 day fast – the disease is a curse from the heavens. They are a sinful country that is why they are dying. God has send the disease to punish them and all the country needs in order to be healed is to pray and fast.

The remaining Baraka relatives are livid with the church people. They know they are not sinful but then other rumours come to their aid. People start to say that the medical people, with all those white people in astronaut suits at the hospital, are the ones who brought the disease.

‘Since when did a whole family of people die like that, what disease is this? It’s those people who have brought it’

More relatives storm the hospital, patients are pulled out.

The government starts to make noise – saying it is a crime to take sick people from the hospital. But this is all happening in an opposition region – rumours come fast and furious. The government is working with the white people in their white suits – they want to reduce the population in opposition strongholds so that they can stay in power, then they can win more elections.

The relatives continue to hide their sick as they look for witchdoctors.

The government realises that a heavy hand will not work and will probably drive people further away, so they set up a helpline so that anyone in needs can call them and get the truth.

The WHO calls a big meeting – involving 11 countries

………………………………..to be continued……………………………………………..

This may all sound like fiction – but you would not believe how close it is to what is happening in West Africa right now. Ebola- named after a river in Congo where it first reared its head in 1976, is back in full force. It’s the biggest, ‘baddest’ Ebola virus disease outbreak in history.

What’s making it worse are cultural beliefs that are leading people to withdraw people from hospitals.

http://www.nation.co.ke/news/africa/Ebola-Outbreak-Health-Sierra-Leone-Hospitals/-/1066/2365386/-/rgar5/-/index.html

Ebola is spread from contact with secretions from infected people: dead or alive. So any of those secretions coming into contact with your broken skin of mucous membranes means you MAY get infected. Mucous membranes line the alimentary canal, breathing apparatus, reproductive apparatus and the inside of your eye. So any of the pink looking insides of you are the mucous membranes and the virus can get in through these or cuts or wounds. Of course, contact does not mean infection and deaths – there is always the number who don’t get enough virus into the system and those who don’t die despite infection.

So what to do?

Don’t travel to the troubled area – and if it does come our way – stay away from the sick and bury the dead immediately – no carrying bodies across the country for ‘proper’ burial. Communication from the government needs to be one which people trust in. If people doubt what the leaders are saying, then rumours start and disease control will suffer.