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Ebola: Poor Black African Epidemic…

October 14, 2014
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One of the “Great Twins”…The Congo River, the other being the Amazon. Note where the Ebola River flows into the Mongala, which flows into the Congo…

One of the “Great Twins”…The Congo River, the other being the Amazon. Note where the Ebola River flows into the Mongala, which flows into the Congo…

(cross-posted at Foreign Policy In Focus, Z-Net)

1.

Of the many strands, that woven together, make up one of the world’s greatest rivers, the Congo, there is one which enters the river’s main waters as the great river arches to its most northern latitude. Starting from the southeast regions of what is today the Democratic Republic of the Congo, it first stretches almost due north, its main artery referred to as the Lualaba. A ways beyond Kisangani and Bumba, the main branch, fed by hundreds of tributaries, lurches almost due west, making a gentle west-north-west arch until, past the rapids just after Kinshasa, it tumbles dramatically to the ocean past Goma.

Near the northern most point of the Congo’s flow, a tributary merges in from the north just west of Lisala, the Mongala, a river that flows essentially longitudinally from north to south. Near the head waters of the Mongala, the Ebola, “a tributary of the tributary,” itself a 155 mile river, flows into the Mongala from the northeast adding to its volume and energy. At the point where the Mongala enters the Congo mainstream, the great river is flowing almost due west from the continent’s interior.

The Ebola River gave its name to viral disease which has now reach epidemic proportions in West Africa having, by official statistics already taken the lives of 5000 people. As statistical analysis in Sub-Sahara Africa is far from precise, it is possible that the actual number of victims is quite higher and that frankly, there is no accurate estimate of how widespread the disease has managed to extend its range. According to Pierre Piot, the Flemish (Dutch speaking Belgian) researcher who, in 1976 first identified the disease as a unique new pathogen, quite different from Marburg’s Virus with which it was first confused. 

In an October 4, 2014 interview in The Guardian of London, (a translation of an article which first appeared in the German magazine Der Spiegel) Piot goes on to explain that the Ebola Virus actually did not originate along the Ebola River but among the Yambuku somewhat south of the Ebola River. Piot was working in a Belgian research lab at the time. When first handling the Ebola Virus he noted in The Guardian interview that “Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids!” 

When first handling the Ebola Virus he noted in The Guardian interview that “Of course it was clear to us that we were dealing with one of the deadliest infectious diseases the world had ever seen – and we had no idea that it was transmitted via bodily fluids!” 

While there have been several outbreaks of Ebola in Central Africa, they were, until recently, only local and easily contained. While exact trajectory of the virus has not entirely been worked out, the main agent are certain species of African bats, who spread the condition to other animals, especially mammals, among them non-human primates. In the 1980s an anthropologist, dissecting an Ebola infected dead disease chimpanzee, contracted the condition, indicating that it had once again mutated to jump to humans, much like the Asian Swine Flu.

For all that Ebola outbreaks were localized to a region between northeast Congo (Orientale Province) and what is now South Sudan. there have been several Ebola outbreaks in this region, including ones in 1977, 1998, 2007 that killed hundreds at least. But this most recent outbreak is different. It moved from Central Africa to the West African Coast, a distance of several thousand miles. It has been more virulent, suggesting that the virus has, as viruses do, mutated into new more deadly forms.

2.

As a number of informed commentators have noted, while the Ebola virus has started to spread globally, its impact will be felt in a much more pronounced manner in the world’s poorer regions, most especially Africa. With literally millions of people of Indian origin living especially along Africa’s eastern shores, there is also growing concern over the virus’ potential spread to the subcontinent. India has a long history of commercial relations with East Africa going back not just centuries, but millennia. These close ties continue up until today. While it has already spread to Europe and North America where isolated cases have emerged, it is far more likely that in the core countries of the global economy, that Ebola’s impact will likely be contained and limited in scope.

The fact of the matter is, as a recent World Health Organization article points out, that Ebola is an unequal opportunity killer. “The outbreak spotlights the dangers of the world’s growing social and economic inequalities. The rich get the best care. The poor are left to die.” The same article goes on to sketch how Ebola’s impact is magnified by social factors. Liberia’s case is typical, a country of 4,500,000 people with a grand total of 45 doctors for the whole country which translates to one doctor for every 100,000 people. Fear-mongering triggered by rumors and panic spread “even faster than the virus” amplifying social disruption and economic losses beyond the zone of contagion. As our world today is interconnected by many threads of commerce and family networks, it has become more difficult, if not virtually impossible anymore to contain such a virus to a limited region putting the whole world at risk. There are some suggestions – including from a most recent Pentagon analysis of the impact of global warming, that among other things, global warming will increase the likelihood of more viral epidemics, infectious diseases, as new strains emerge, stimulated by the warmer global temperatures.

…Ebola is an unequal opportunity killer. “The outbreak spotlights the dangers of the world’s growing social and economic inequalities. The rich get the best care. The poor are left to die.”

Furthermore, a half century or more after the wave of African independence freed the continent from most colonial rule, the healthcare delivery systems in many (if not most) African countries are in shambles, or completely nonexistent. Add to this base of neglect forty years of IMF structural adjustment policies which have repeatedly and systematically pressed poor African (and other) nations to cut government services and subsidies to medical drugs and education. Many African countries – certainly the Congo among them – spend far more on military equipment than they do on healthcare by a factor of 10 or even 20 to 1. And where war strikes as it has in the Congo over the past twenty years, what little health care might be available, evaporates to naught leaving such regions medically fragile and susceptible to the kind of health ravages which the Ebola virus can rain down on human populations. Faced with a crisis like Ebola, African healthcare systems can not cope; in fact they simply collapse. Due to a combination of these factors, medical resistance to disease collapses as well. there is a simple but accurate maxim here: deadly pathogens exploit weak healthcare systems. As the WHO article continues,

It is,…important to understand one point: these [human] deaths are not “collateral damage”. They are all part of the central problem: no fundamental public health infrastructures were in place, and this is what allowed the virus to spiral out of control.

There is one final ingredient to this toxic mix. Despite the fact that the Ebola virus was identified as a pathogen extremely dangerous to humans some forty years ago, there are virtually no cures, no vaccines. It is hard not to conclude that the reason for this lack of interest is that until now the disease has been confined only to poor African countries reducing the research and development incentive to zilch. Where the prospect of profit disappears, research dollars fizzle. It is the case that the World Health Organization has swung into action, finally with the full cooperation of the world’s core countries, and it is possible, or so they say, that vaccine antidote might be available by the end of the year. But then a number of epidemiologists interviewed on the mainstream media have admitted that, had the funding and political will been available, such a vaccine could have been available ten years ago.

——

Links:

Leigh Phillips. The Political Economy of Ebola.  Jacobin, August 13, 2014

Leigh Phillips: Socialize Big Pharma. Jacobin. June 29, 2013.

Ebola: From Whence The Ebola Virus?

4 Comments leave one →
  1. October 14, 2014 6:09 pm

    Mike McNeal weighs in on the Obama Administration’s efforts to fight Ebola in Africa…He posted this on Facebook…I thought these remarks were very well taken. He cites a number of websites in making his points. They are worth reading.

    On the fantasy that the U.S. can meaningfully contribute to a resolution to the ebola outbreak in west Africa via its ‘Operation United Assistance’ ( and consider the disposition conferred by scientism and the scientistic mentality it legitimates, as one [significant] source of people’s unwillingness to accept that there is little we in the West can do that will be efficacious in dealing with the ebola outbreak):
    1. Our assistance is only slated to go to Liberia, which is just one of /three/ nations effected by the outbreak; the virus will continue to spread unchecked in Sierra Leone and Guinea, in whose rural areas the outbreak began and where experts suspect a plurality of cases are currently hidden from view
    2. The CDC estimates that the vast majority (approximately 82%) of ebola patients are being treated at home, very probably infecting their caretakers and spreading the illness (See: http://www.nytimes.com/2014/09/25/world/africa/liberia-ebola-victims-treatment-center-cdc.html?hp&action=click&pgtype=Homepage&version=LargeMediaHeadlineSum&module=photo-spot-region&region=top-news&WT.nav=top-news&_r=0);
    3. The construction of 17 U.S. treatment centers, with an envisaged 100 beds each (or 1700 beds in sum total!), will not notably change the situation on the ground, particularly if the outbreak escalates (is escalating) according to the widely cited projections (today it is reported that estimated infections now exceed 6200 people, see: http://www.washingtonpost.com/world/africa/sierra-leone-to-cordon-off-3-areas-to-stop-ebola/2014/09/25/13dad80e-4492-11e4-8042-aaff1640082e_story.html)
    4. The “400,000 Ebola home health and treatment kits” the U.S. operation plans to distribute to Liberians are likely to prove ineffective, not least because they will provide a false sense of security to home care-givers (see: http://www.npr.org/blogs/goatsandsoda/2014/09/19/349908367/inside-an-ebola-kit-a-little-chlorine-and-a-lot-of-hope)
    5. There is no evidence to support the conjecture that the proposed (ongoing) military-led U.S. intervention will be effective given the practical limitations in infrastructure and indigenous cultural practices and prejudices in Liberia (including the consumption of “bush meat” and traditional funeral practices that include touching, kissing and bathing the corpse, all of which spread the virus)
    6. While the aetiology of the disease strongly suggests that quarantine is the only way to subdue the outbreak given treatment options and other limitations in the region (though there is also no evidence that quarantines are working), U.S. treatment centers will entice families to bring infected loved ones to them, potentially exposing more people to the risk of infection (see: http://www.npr.org/2014/09/25/351373651/ebola-crisis-elevates-sierra-leones-state-of-emergency)
    7. Even if the treatment centers (with their 1700 beds) can be set up and made operational in short time, they will be quickly overrun, raising the problem of U.S. officials turning patients away (who are American officials to choose?), just as the people of Sierra Leone and Guinea are likely already wondering; let me add: the operation of each of the 17 facilities the U.S. is making noises about constructing will require staffs of 400 people, and (here’s the best part) the mission envisages /volunteers/ filling those 6,800 positions! The U.S. is only promising to staff a 25 bed facility for Westerners infected with the virus!
    (See the article posted immediately beneath this thread)
    8. In light of the raised public expectations generated by the arrival of American assistance, the existence of inadequate supplies, treatment facilities, and trained caregivers are likely to inflame frustrations, further social discord and chaos, and increase demands for assistance (a vicious circle — though the scenes of conflict we can expect to ensue will certainly gratify the journalists reporting on the situation)
    9. It has actually been proposed that those who have survived / overcome the infection be primary among those selected to train to care for ebola patients, as scientists /think/ that they /may/ be immune to re-infection. What are the odds they will be willing to take such a risk? See: http://www.slate.com/articles/health_and_science/medical_examiner/2014/09/ebola_emergency_response_are_survivors_immune_and_what_drugs_and_vaccines.html
    The article below details the basic tactics and aims of ‘Operation United Assistance’ and its estimated costs.

    Obama announces ‘Operation United Assistance’ to confront Ebola | New Pinnacle
    By Joe Teh When disaster strikes Africa, it’s common for the world to look up to former colonial powers to take the lead in offering assistance. For…

  2. John Kane permalink
    October 15, 2014 8:24 am

    Thanks, you are one of too few making the nonetheless obvious suggestion that ebola’s spread is directly related to both poverty and capitalist control of world health.

    • October 15, 2014 9:48 am

      Hello John..

      I agree with you that the relationship between ebola’s spread, poverty and the “capitalist control of wealth” is “quite obvious”. A couple of nights ago, when I first started to seriously wonder about all this, i was struck by the fact that those nations which to date have been most adversely affected by the ebola virus (Liberia, Sierre Leone, Congo) are 1. Sub-Saharan Africa 2. all have been devastated by war in recent decades 3. all have been subject to IMF Structural Adjustment programs which have cut what little funding existed for healthcare administration. Then I saw the piece by the World Health Organization making all the same points and decided to write about it.

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