Editor’s note: Aimee Ferraro, PhD, MPH is an epidemiologist and faculty member in Walden University’s School of Health Sciences. After completing a CDC/CSTE Applied Epidemiology Fellowship with the Pennsylvania Department of Health, Dr. Ferraro has been conducting epidemiological research on infectious diseases in Lima, Peru.
The West African Ebola epidemic of 2014 has been hard to ignore. The outbreak began in Guinea in December 2013 and spread to Liberia and Sierra Leone. Eighteen months later, according to the World Health Organization (WHO), more than 27,000 people in 10 countries have been infected with the virus and more than 11,000 of them have died. These are unprecedented numbers that surmount any previous outbreak of Ebola virus, and they likely underestimate the true scale of the epidemic.
Ebola is a frightening disease. It is a virus that leaps from an animal host to humans and then transmits through bodily fluids. (The animal reservoir has yet to be confirmed, but bats are considered the most likely species.) Ebola triggers internal and external bleeding, killing about half of the people afflicted with it. Moreover, the Ebola virus is shed during clinical illness and after death, so the risk of infection remains long after the victim has passed away. This explains why Ebola often infects medical practitioners who care for infected patients as well as mourners who prepare the dead for burial.
How did this happen? Paul Farmer, a physician who led a team in Liberia through Partners in Health, argues “the fact is that weak health systems, not unprecedented virulence or a previously unknown mode of transmission, are to blame for Ebola’s rapid spread.” Other experts have noted that lack of a proven Ebola virus-specific treatment and the months of delay in responding to the outbreak contributed to the failure to control the epidemic. The United States government pledged aid and assistance in September 2014, only after the first case of Ebola was identified in a man who had been infected in Liberia and traveled to Texas.
There is some good news to this story. A concerted effort by international health and development organizations resulted in an influx of much-needed supplies and medical professionals to prevent further transmission and provide treatment to those who were already infected. On May 9, 2015, the WHO declared Liberia free of Ebola virus transmission. Unfortunately, new cases began to emerge seven weeks later and the outbreak continues in two neighboring countries, Guinea and Sierra Leone, and some models estimate that the epidemic will continue through 2016.
Even when West Africa emerges from the worst outbreak in history, there will still be years of economic and social problems to overcome. The United Nations Development Programme reported that “stigma, risk aversion, and shutting down of borders have caused considerable amounts of damage, affecting economies and communities in a large number of countries across [West Africa].” Tourism, agriculture, and mining have all been disrupted. Stories of social stigma against survivors of Ebola are starting to emerge, painting a bleak picture of hostility, unemployment, and exclusion resulting from fear of transmitting the virus even after being declared free of the disease. These issues highlight the importance of considering needs beyond Ebola prevention and treatment in West Africa. A comprehensive response is required to fully address the repercussions of the Ebola epidemic.
The West African Ebola epidemic signals the need for social change. It highlights the health disparity between developed and developing countries. It reminds us that disease is a result of myriad factors beyond the individual, including family dynamic, community engagement, political forces, economic and social status, healthcare infrastructure, and geographic location. West Africa clearly shows us that the real problem is systemic—Ebola is just the symptom.
How can you help? Any time fear and stigma are involved, awareness is the first place to start. Share your resources—social, intellectual, and economic—to help reduce the income disparity between developed and developing nations. Be an agent of social change—write to your government representatives to tell them the importance of funding public health activities on a national and international level. Spread the word through social media that the Ebola crisis is not over so we should not turn away. Support organizations like Doctors Without Borders and the Red Cross so that trained professionals can continue to fight the Ebola epidemic in Western Africa. Remember Walden’s mission and be a ripple in the pond. If each of us makes an effort to rid the world of problems like the Ebola epidemic, our ripples will result in a big wave of social change.
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