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Failures in efforts to eradicate the Ebola Epidemic

While Ebola virus disease (a severe hemorrhagic fever caused by species of viruses that attach to a host cell, replicate to spread throughout a human body and take over the body’s immune response) was introduced into the human population through the secretions, blood, organs and other bodily fluids of different infected animals (monkeys, chimpanzees, gorillas bats and such), the Ebola epidemic spread due to inadequacies of treatment centers and unpreparedness in prevention methods (Vinh-Kim 2014). Pharmaceutical companies and various governments have poured in billions of dollars to produce treatment methods for Ebola and yet have been ineffective (Vinh-Kim 2014). Despite the fact that top donors donated $3.611 billion (USD), the US allocated $2.369 billion (USD) for Ebola pandemic preparedness, the Ebola disease still burst into an epidemic killing 11,315 people worldwide (The Economist 2016). The efforts to eradicate the epidemic did not fail because of insufficient funds for treatment, lack of research or preparedness in epidemic threat but rather because of inadequacies of the treatment centers, negligence in prevention methods, and asymmetrical information.

Despite the billions that were poured from several capital donors in the name of Global Health and pandemic preparedness, the Ebola still burst into an epidemic because of inadequacies of treatment centers. Many hospitals and treatment centers lacked basic infection control equipment. Further, there was negligence in the use of basic apparatus for instance; needle stick injury and glove rips were very common. This put all the front line workers in contact with Ebola patients in a vulnerable position and led to spread of the disease and resulted in the death of health care workers. Several statistics and facts from Centre for Disease Control and Prevention (CDC) describe of cases where negligence led to death of healthcare workers (CDC 2016). CDC details that one researcher died from Ebola virus in Russia due to laboratory contamination (CDC 2016). Similar case was recorded in Italy and England where contaminated needle led to spread of infection in the laboratory.  36.1% of total number of death by Ebola in Uganda was caused by leakage in blood samples in laboratory tests (CDC 2016). In 2000, there was another Ebola outbreak in Uganda that was induced by inadequate protective measures. CDC reports that 53% of the total deaths caused by Ebola were doctors and nurses in Gulu, Masindi and Mbarara districts of Uganda. The doctors and nurses got the Ebola virus infection by providing medical care to Ebola case-patients and attending funerals of case-patients who died. Another statistic from CDC details that a total of 881 health workers died from Ebola infection in Guinea and 513 health workers died in Sierra Leone. Liberia lost 8% of its doctors, nurses and midwives to Ebola; Sierra Leone and Guinea lost 7% and 1% of their healthcare workers respectively (CDC 2016). The severe effect on the healthcare workers in these three countries led to stark setbacks in the treatment centers for other critical diseases like of HIV, tuberculosis, and malaria. Because of this, additional 10,600 lives were lost. CDC narrates that there was approximately 50% reduction in the healthcare services in Sierra Leone, Liberia and Guinea. Vulnerable, understaffed, and underequipped health care facilities are one of the fault lines of the Ebola outbreak (CDC 2016).

Poor regulation in treatment centers further aggravates the issue of spreading of Ebola viruses. In countries where religious and ethnic customs hold a lot of value, behavioral learning process takes time. During the Ebola outbreak, it was observed that Ebola infected a large number of persons despite the fact that it is transmitted solely through bodily fluids (Kekulé 2015). During the earlier outbreaks, it was more common for people infected with Ebola to isolate themselves at home instead of getting admitted at the Ebola treatment Centers (ETC) (Kekulé 2015). The patients not only didn’t get treated but also made other house members vulnerable to the Ebola virus (Kekulé 2015). Because, the population did not know how to protect itself, isolation in basic living conditions contributed to intensive phase of Ebola epidemic in Western Africa.

Asymmetrical information and negligence in post-treatment care was a consequential factor that contributed to the spread of Ebola virus. Initially, it was believed that a person who has fully recovered is no longer contagious however; a man can still sexually pass on virus despite recovery.  The Ebola virus is present in the semen for up to 3 months after recovery and can be sexually transmitted (WHO 2016). However, in 2015, there were two cases of Liberian men who had sexually transmitted the Ebola virus many months after it was thought to be safe for a survivor to engage in sexual activity (MMWR 2015). In order to investigate this, researchers examined semen samples 93 male Ebola survivors in Sierra Leone. The results revealed that some men still produced semen samples that test positive for Ebola virus nine months after recovery. All men who were tested in the first three months after recovery tested positive for having Ebola virus in semen. Over half of the men who were tested between the first four – six months after recovery tested positive for Ebola virus. Less than one quarter of men who were tested between sever to nine months after recovery tested positive (MMWR 2015). This study filled the asymmetrical information gap that earlier existed as it supplemented important new information regarding the existence of Ebola virus in the semen and sexual transmission of the Ebola virus. According to the Morbidity and Mortality Weekly Report published by CDC, there have been 5 cases of death caused by sexual transmission of the Ebola virus (CDC 2016).

Ebola, despite being a topic that has been exhaustively discussed in world news and received a lot of attention from international stakeholders is a disease whose treatment and prevention methods have been ineffective. Pharmaceutical companies and various governments have poured in billions of dollars to produce treatment methods for Ebola and yet have failed to be successful due to inadequacies of treatment centers and unpreparedness in prevention methods and asymmetrical information as illustrated in the narrative above. Establishing that the preventive methods were weak, the treatment systems should have been able to control the outbreak; however, this was not that case. These is still no licensed Ebola vaccines or effective treatment that can solve this epidemic primarily because 23,000 cases do not line up when compared to diseases such as AIDS or cancer and secondly, drug companies aren’t interested in something that infects a handful of people each year in poor countries (Skwarecki 2014). That being said, preventing Ebola outbreaks is not only researchers’ duty; community engagement is key to successfully control future outbreaks. There should be a strong pressure on survivors to become goodwill ambassadors for prevention and treatment efforts. Naturally occurring outbreaks don’t occur suddenly; genetic research shows that Ebola virus had been present in the Western African rainforest for more than ten years before the outbreak. With better preparation and epidemic surveillance, Western Africa could have been warned about the Ebola virus. Lastly, better protective measures should be advocated. People should learn how to protective themselves by adopting simple practices such as avoiding contact with the sick and the dead, isolating themselves from the treatment centers, practice careful hygiene and abstain from sexual activity if a partner is a survivor until the partner is tested negative (CDC 2015).

Ms Miha Alam

Byrn Mawr College

USA

 

Bibliography:

"Cost of the Ebola Epidemic." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 08 Aug. 2016. Web. 08 Oct. 2016.

"Ebola in Africa: The End of a Tragedy?" The Economist. The Economist Newspaper, 14 Jan. 2016. Web. 08 Oct. 2016.

"Ebola Virus Disease | Causes & Risk Factors." Ebola Virus Disease | Causes & Risk Factors. N.p., n.d. Web. 08 Oct. 2016.

Nguyen, Vinh-Kim. "Ebola: How We Became Unprepared, and What Might Come Next." Hot Spots, Cultural Anthropology website, October 7, 2014. https://culanth.org/fieldsights/605-ebola-how-we-became-unprepared-and-what-might-come-next

Kekulé, Alexander S. "Learning from Ebola Virus: How to Prevent Future Epidemics." Viruses. MDPI, July 2015. Web. 08 Oct. 2016.

"Outbreaks Chronology: Ebola Virus Disease." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 14 Apr. 2016. Web. 08 Oct. 2016.

Nguyen, Vinh-Kim. "Ebola: How We Became Unprepared, and What Might Come Next." Hot Spots, Cultural Anthropology website, October 7, 2014. https://culanth.org/fieldsights/605-ebola-how-we-became-unprepared-and-what-might-come-next

"Prevention." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 22 July 2015. Web. 08 Oct. 2016.

Skwarecki, Beth. "Why There’s No Ebola Treatment or Vaccine Yet, in One Chart | Public Health." Public Health. N.p., 01 Aug. 2014. Web. 08 Oct. 2016.

 


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