This week’s winner, Bookworm Room’s To fight Ebola, we need a Florence Nightingale – although the Marines are good too examines the Ebola crisis in West Africa and a common sense, effective solution to it. Here’s a slice:
Tonight, we attended a talk with Paul Farmer, Dan Kelly, Raj Panjabi, and a fourth fellow whose name I can’t remember. The topic was Ebola. All four speakers had front-line experience, having spent a great deal of time recently in Ghana, Sierra Leone, and Liberia. All of them are affiliated with non-profit organizations that have as their sole purpose bringing long-term and emergency healthcare solutions to third world countries. They are all admirable men and masters of their material.
That’s why it was disappointing that the evening was so horribly dull. Rather than the four of them presenting a coherent analysis covering both Africa and America, they engaged in a repetitive, jargon-filled talk that kept reiterating the key points. The key points were interesting, and probably could have been covered in about fifteen minutes. I wasn’t able to take notes, but here’s what I got:
1. Liberia and Sierra Leone have both suffered tremendously from civil wars that utterly destroyed their infrastructure and left them with virtually no health care. I believe it was Liberia that ended up with around 51 doctors for the entire nation. The American equivalent would have been 8 doctors for all of San Francisco.
2. When the latest Ebola outbreak began in a remote village with an infected two-year old child, there were no systems in place to stop the disease’s spread.
3. Because there are no doctors, no buildings, and no supplies in these forsaken African countries, a few things happen:
a. The mortality rate is 70% to 90%.
b. People view hospitals and medical clinics as death traps, which they are.
c. People therefore avoid hospitals and medical clinics, furthering the disease’s spread.
4. To the extent there are any systems on the ground in Ghana, Liberia, and Sierra Leone, they are the NGOs represented at the talk, plus WHO, the CDC, a British government agency, and a few disparate other groups. They are trying to coordinate, but are behind the curve. The local governments are helpless.
5. Money is starting to come in, but little of the money pledged actually makes it to the situation on the ground.
6. If the situation does not approve, we can expect 500,000 to 1.4 million dead in Africa by the end of January 2015.
7. If, however, the money rains down and the existing organizations are able to train health care workers, open clinics, and have medical supplies on hand to treat people, the number of dead may stop at around 70,000.
8. Bringing the current Ebola crisis to heel in Africa, even under the best of circumstances may take 18 to 24 months.
9. A military organization is best suited to imposing structure on these dysfunctional regions. (When I heard this, I thought to myself “So that’s why Obama sent in the Marines.”)
10. Taking a page out of the Borgia book for poisons that can be absorbed through the skin, Ebola can transmit through people’s skin. It’s not enough to keep your hands away from your nose and mouth. If someone’s infected blood, vomit, fecal matter, semen, spit, or sweat just touches you, you can become infected. Even picking up a stained sheet can pass the infection. Additionally, scientists do not know how long the virus will survive on a surface once it’s become dehydrated. The current guess is that Ebola, unlike other viruses, can survive for quite a while away from its original host.
11. The Ebola virus is from the same family as the Marburg virus, which found its way to Germany in the 1960s, killed a few people, and was then quickly contained. That’s good news for Westerners and their medicine.
12. If patients get Western medicine that treats the symptoms — drugs to reduce fever and to control vomiting and diarrhea, proper treatment if the body goes into shock, and blood transfusions — the mortality rate is “only” 25% — which is still high, but is significantly lower than the 70%-90% morality in Africa, where patients get little to no treatment. (See point 3 regarding the disease-spreading negative feedback loop of the high mortality rate.)
13. This is a genuine crisis. If anything, the media is erring by downplaying what’s been happening in Africa, and governments are most certainly responding too slowly to a problem that must be fixed in Africa, rather than just being stopped here (as if that were possible).
In sum, Ebola is a really bad disease, made horribly worse by the complete post-civil war dysfunction and poverty in these three West African nations. With enough money and man power, the disease can be brought to heel. The only problem is getting the money and manpower in place.
Hearing that the problem is one of men and manpower, I immediately thought (as everyone must) of Florence Nightingale. I’m sure all of you remember her story, but I’ll tell it again for my satisfaction. Florence was born in 1820 to a very wealthy, very well-connected, very upper class British family. She was expected to do the ordinary thing: become a “finished” young lady, get married, and have the next generation of wealthy, well-connected, upper class British children. Florence, however, wanted something different. She wanted to be a nurse.
To appreciate just how shocking Florence’s career goal was, imagine your own sweet, young daughter looking up at you and saying “Mother and Father, I want to become a prostitute, and work in the worst slums, with a lot of filthy, disease-ridden people. Oh, and I’m planning to numb myself against the horror of my chosen life with strong drink and opium.” By saying that, your daughter would have described precisely what many nurses were like back in the middle of the 19th century, or at least what upper class people thought they were like.
The hospital in Scutari, circa 1856
The hospital in Scutari, circa 1856
Understandably, Florence’s parents said “No!” and kept saying “No” despite Florence’s certain belief that God himself had called her to the job of nursing. By the time she was 24, Florence ignored her parents and began to study what she could about nursing. She also traveled widely around Europe and the Mediterranean. During her years of work, study, and travel, she met several important men whose wealth and connections would aid her in the coming years.
Much more at the link
In our non-Council category, the winner was Benjamin Weingarten, writing in The Blaze–Why America’s Foreign Policy Has Failed, From George W. Bush to Barack Obama, and the Antidote submitted by The Noisy Room. The title is pretty self explanatory.
Here are this week’s full results.Ask Marion, The Independent Sentinel and the Colossus of Rhodey were unable to vote this week. None were effected by the 2/3 vote penalty:
See you next week!
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