The ‘Us’ and ‘Them’ of Epidemics

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The deadliest Ebola outbreak in recorded history took another grim turn on Tuesday with reports that Sierra Leone’s lead doctor has contracted the disease himself. Since March, Ebola virus fever, which has historically seen a case mortality rate of near 90%, has claimed more than 600 lives across three West African countries and shows little sign of abating.

Ebola has flared up violently, but infrequently, in Africa over the past two decades and its gruesome reputation precedes it. Once incubated, the virus causes bouts of vomiting, diarrhea, and severe internal hemorrhaging. A few of the victims recover; most do not. The bodies of the deceased remain contagious for days, which often leads to secondary infections as loved ones perform funeral rites. There is still no vaccine or antiviral therapy in sight.

*In an unfortunate bit of timing, two viral-themed thrillers (The Strain and Dawn of the Planet of the Apes) debuted the same week that the outbreak became the deadliest ever.

Ebola’s highly lethal nature is the stuff of nightmares, perhaps especially for a Western civilization currently awash in pandemic-tinged pop culture.* But as David Quammen wrote back in April, Ebola remains “a grim and local misery, visited upon a small group of unfortunate West Africans…It’s not about our fears and dreads. It’s about them.” No human has ever died from Ebola in the Western hemisphere. The reason for this is primarily epidemiological: Ebola cannot spread through the air (like, gulp, MERS can). Instead, transmission requires direct contact with bodily fluids. So while it’s certainly possible that Ebola could someday hop on a plane (to Paris, probably), previous cases suggest that it is somewhat less likely to reach pandemic level. Barring a massive, multi-national quarantine failure of bewildering proportions, the world at large is likely safe from Ebola for now.

But does this last fact color a Westerner’s view of an Ebola outbreak? Secure in the knowledge that the disease isn’t coming to the U.S. border anytime soon (despite what one misinformed Congressman might tell you), one might be tempted to gaze upon the disease as though it were under glass, a monstrosity that nevertheless poses little threat. Because of the virus’s highly localized nature, it is possible for an outsider to empathize with its victims while simultaneously viewing the disease as something exotic and remote. Ebola doesn’t happens to ‘us,’ we might surmise—it’s something that happens to ‘them.’

Much has been made in the media coverage of the fact that Ebola primarily spreads via the practice of eating bushmeat (wild animal corpses scavenged as meals in poor villages). There have also been reports of superstitious villagers resisting medical treatment and hiding victims from aid workers, leading some commentators to insinuate that the disease has only been able to spread because of ignorant primitivism on the part of the locals. This ‘blame the victim’ attitude not only plays into some of the worst stereotypes about rural African life, but adds to the alienation factor even further. It’s easy to tune out an epidemic when you’ve convinced yourself that you can’t identify with it.

Now, there’s no doubt that poor hygiene, holistic/mystical beliefs, and engrained suspicions of doctors are very real barriers to quelling medical emergencies such as this one, regardless of the traditions they originate from. Westerners are not immune to these blind spots (Seth Mnookin wrote the book, quite literally, on the pernicious anti-vaccination movement). In fact, studies have shown that citizens in Western countries perennially underestimate the risk of diseases that pose much more of a clear and present danger than Ebola does. For example, do you remember H1N1, a.k.a. “swine flu,” from 2009? At the time, it was considered serious enough to trigger pandemic warnings, but papers after the fact from Italy, Australia, Germany, and the U.S. found that larger-than-expected percentages of those distinct populations—faced with a choice between the vague fear of an infectious disease and a vague-but-deeply-held suspicion of a vaccines—shunned the widely-available vaccination.

The point? Humans don’t always act in the most rational fashion when it comes to large-scale public health crises, regardless of culture.

The parallel I’m attempting to draw isn’t perfect; vaccines exist for most forms of influenza, which gives health officials the advantage of immunizing segments the population over time and building a firewall prior to outbreaks. Nothing of the sort exists for Ebola, where effective containment is the only option.  This has exacerbated efforts to contain the disease in West Africa.  But we should resist the temptation to cordon off recent events there as somehow distinct from what an epidemic closer to home might look like someday. They only underscore further the need for disease education and prevention in order to keep a swifter, stronger virus from gaining a foothold.  We should be taking a hard look at how and why Ebola has been able to make further inroads this time than it ever has before.

Let’s send West Africa whatever resources we can—and avoid the mistake of thinking that what’s happening to ‘them’ couldn’t ever happen, in some new and different fashion, to ‘us.’

Trent Knoss is the digital editor at Backpacker Magazine and lives in Boulder, Colorado.  

4 Responses to “The ‘Us’ and ‘Them’ of Epidemics”

  1. matildathemoonraker

    Wow. While I agree, whole heartedly, m
    with your sentiment, I would be impressed if we could just educate people enough about how a vaccine works, how doctors and labs verify they are working and a chalky get people to get vaccinated…

  2. matildathemoonraker

    And, over all, world wide, I think more people are still dying of things that we can stop, that are 100 percent deadly if contracted and 100 percent preventable. Tetanus for example.

  3. Dwayne

    I blog often and I genuinely appreciate your information. This article has truly peaked my interest.
    I will take a note of your site and keep checking for new details about once a week.
    I opted in for your RSS feed as well.


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