1.4 Million Cases

It’s a tiny percentage of the world’ population, focused on a tiny part of the earth’s land surface, in one of the tiniest economies on the globe on the poorest and most troubled populated continent on the map. Moreover, it involves Black Africans, a racial minority in the Western world, where the West looks upon Black Africa as a place of vile revolutions, genocide, raping and pillaging, corruption, wars without end, starvation, malevolent dictators, zealots, drought and ceaseless misery. Boko Haram is a continental stone’s throw away. We’re used to suffering, death and destruction in that part of the world. The misery is “there” and impacts “them,” a swipe of racism tinging those words.

But West Africa may just be our test of morality, far more than our contest with the evil forces of the Islamic Republic that represent a huge embarrassment to American policy-makers over the past decade plus, who seem to have fought a failed war in Iraq and are ending a failing war in Afghanistan. In West Africa, we’re not covering up our mistakes. The misery there cannot be “our fault” in any way; it’s nature’s wrath, the deadly Ebola virus, that has killed thousands (half in Liberia). It has elevated the United Nations to an unprecedented high priority focus on an epidemic, one that could indeed spread and mutate across the earth.

But it doesn’t make too many headlines anymore, and this horrific and seeming incurable disease sometimes slips off the headline page (paper or online) into the back pages dedicated to backwater stories about backwater peoples. A Centers for Disease Control report released on September 22^nd says that the number of those infected with this killer disease is expanding very rapidly: “The report released [September 22^nd] is a tool the agency has developed to help with efforts to slow transmission of the epidemic and estimate the potential number of future cases. Researchers say the total number of cases is vastly underreported by a factor of 2.5 in Sierra Leone and Liberia, two of the three hardest-hit countries. Using this correction factor, researchers estimate that approximately 21,000 total cases will have occurred in Liberia and Sierra Leone by Sept. 30. Reported cases in those two countries are doubling approximately every 20 days, researchers said.

“‘Extrapolating trends to January 20, 2015, without additional interventions or changes in community behavior,’ such as much-improved safe burial practices, the researchers estimate that the number of Ebola cases in Liberia and Sierra Leone could be between approximately 550,000 to 1.4 million.” Washington Post, September 22^nd. The report also suggests that these numbers might be conservative and that many have been turned away from hospitals because there is no more room.

Matters may be somewhat more dire than originally forecast, although those who receive proper medical care have shown significantly higher survival rates: “Projections published in The New England Journal of Medicine predict that by early November there will have been nearly 20,000 cases…. The analysis of confirmed cases also suggests death rates are higher than previously reported at about 70% of all cases, rather than 50%.

“Dr Christopher Dye, Director of Strategy for [the World Health Organization], said unless control measures improved quickly ‘these [West African] countries will soon be reporting thousands of cases and deaths each week, projections that are similar to those of the Centers for Disease Control and Prevention (CDC)’… The CDC said that there could be up to 21,000 reported and unreported cases in Liberia and Sierra Leone alone by the end of this month.” BBC.com, September 23^rd.

Make no mistake, the United States has responded beyond the medical volunteers and missionaries, some of whom have perished in the process. The effort, however, represents little more than a drop in the bucket. The notion is for the U.S. military to set up some treatment facilities, including a small mobile hospital (25 beds) in Liberia that will treat medical workers who have been infected: “The United States recently launched a $750 million effort to establish treatment facilities in Liberia, and the United Nations Security Council voted unanimously last week to create an emergency medical mission to respond to the outbreak. In addition, the WHO is launching an effort to move infected people out of their homes and into small centers that would provide at least rudimentary levels of care, in hopes of increasing survival rates and slowing the transmission of the disease.” Washington Post.

But even as the area needs over a thousand beds to treat this epidemic, the U.S. is not willing to risk putting the number of U.S. personnel on the ground required to build and maintain the required additional capacity.

What exactly does the CDC say needs to be done stop crush this epidemic? “[CDC Director Tom Frieden] said ‘We anticipate that [focusing on the heavily infected areas, adopting new sanitation rules and isolating patients] will slow the spread of the epidemic,’ [adding that the] estimates in the report are based on data from August and ‘reflect a moment in time before recent significant increases in efforts to improve treatment and isolation.’ [He noted that] the tool developed by the CDC to make these projections provides the ability to help Ebola response planners make more informed decisions on the emergency response to help bring the outbreak under control – and what can happen if these resources are not brought to bear quickly.

“‘It is still possible to reverse the epidemic, and we believe this can be done if a sufficient number of all patients are effectively isolated, either in Ebola Treatment Units or in other settings, such as community-based or home care,’ he said. ‘Once a sufficient number of Ebola patients are isolated, cases will decline very rapidly – almost as rapidly as they rose.’” Washington Post. But suspicion that outside world, particularly some of the voluntary health professionals that have risked their lives to reach into infected areas, actually brought the disease with them has added a layer of risk to an already deadly situation.

Sadly, existing medical capacities in the most-impacted nations are abysmal:

“Liberia with a 4.2m population: 51 doctors; 978 nurses and midwives; 269 pharmacists.

“Sierra Leone with a 6m population: 136 doctors; 1,017 nurses and midwives; 114 pharmacists.” BBC.com, September 24^th. To make matters worse, this medical crisis actually threatens these nations’ very political survival: “"The worst-hit countries now face widespread chaos and, potentially, collapse,’ the International Crisis Group (ICG) said.” BBC.copm.

Is our increasing our response a moral imperative or a necessary selfish act to keep the disease from drifting into a wider infectious path? Given the movement of people across international boundaries, are we facing a bigger risk or is this simply a case of “them” over “there”?

 I’m Peter Dekom, and in a troubled world, humanity and inhumanity seem to struggle on a daily basis.