Ebola Hapa

Yesterday, the DRC and WHO announced that Ebola is here. But not here here, and not Ebola Ebola. There are a lot of buts involved in explaining this… which I know you probably don’t want to hear. It must be frustrating to hear me sounding cavalier about this topic — though it’s not at all how I intend to sound, because believe me, I have quite a healthy respect for my own mortality and can often sense impending doom (even when utterly unnecessary). If Seb and I felt at risk, we would be out of here.

“But by the time you change your mind it might be too late!” you’re probably thinking. To that I say, I hear you. I don’t have a good answer for you, either, other than saying that risks and dangers surround all of us all the time, no matter where we are. In many respects both of us feel safer over here than we did at home, in fact. But I won’t go into that now.

So here are those buts:

  1. The Ebola virus that’s happening here is not the same as the one in West Africa. In a way that’s a good thing, as it means the virus didn’t just jump over that huge distance between West Africa and us, spreading more fear that it can spontaneously appear anywhere in the world (or even anywhere on this giant continent). On the other hand, it’s perversely sad that two of these viruses have hit in the same year.
  2. This is the seventh time Ebola has hit the DRC. Four of those outbreaks have occurred since we started doing business here in 2005. The last one occurred in 2012, while we were living here. No one was too worried about us then! It largely flew under the radar, as this one surely would too if it weren’t for all the media attention surrounding the current outbreak in West Africa. That media attention is warranted, but it’s important to understand how the two differ. This is the first time Ebola has hit West Africa, which is much more populated and interconnected with the rest of the world, versus here in the more underdeveloped Central Africa. The infection rate and death toll has been drastically higher than in previous outbreaks, due to the region being more densely populated and not used to recognizing the signs and symptoms nor providing early care. And as we all know from the news and our Facebook feeds, it’s far more widespread, affecting multiple countries in the region, which is also unprecedented.
  3. So Ebola hits Central Africa now as it has six times before without this same kind of media coverage because no one cares?? Well, not exactly. But it usually doesn’t get very much attention because it’s always been limited to small, remote villages. Unlike the current outbreak in West Africa, it’s always in fact been limited to a single town. And the one announced yesterday is too.
  4. The Ebola virus that’s happening here is in a single village in the north of the country. Thirteen people have died including five healthcare workers who were simultaneously dealing with malaria and cholera, and there are eleven more suspected cases. So far this is consistent with all prior outbreaks in this country, which have been very deadly percentage-wise but not very widespread. This is one time we can give thanks for the LACK of roads and trains and planes and all general forms of transport within much of Central Africa and especially surrounding the typical Ebola-stricken village in our country. The “impenetrable forest” between us and them isn’t just a page from a fantasy jungle book.
  5. Speaking of the distance between us and that village in the north of this same country, it is on the same scale as Rome is from Copenhagen. Except to get there one would need to pass through the equatorial jungle and cross multiple rivers by dugout canoe or nonexistent ferry.
  6. The current thinking is that the virus lives in fruit bats. Every Ebola outbreak has them in common. Fruit bats are a delicacy in West Africa and probably elsewhere, and they’re currently migrating across the stricken region in DRC. These regions also eat a lot of bush meat, like monkeys and antelopes that eat partially-digested fruit dropped by the bats. Most Ebola outbreaks can be traced to a single person who handled these animals or ate them undercooked. Once that person falls sick, it’s easy to spread to others around them because people have a habit of living very closely together in many of these remote villages. They share latrines and bodily fluids rather regularly. Funeral rites are another problem; a dead body with Ebola is still contagious, and people get quite close to their dead in some of these regions, keeping the body around for a long time. This all sounds extremely gross and probably politically incorrect, but I say it to put a bit of context around how we’re not likely to catch it as we share none of these behaviors.

Obviously I am neither medical expert nor fortune-teller, but it seems that as long as this episode remains consistent with all previous episodes in Central Africa, there is no need for alarm. Even the normally-quite-conservative US Embassy in Kinshasa says so. I also think that the best thing we can do when others are panicking is to not do that. Panic comes from fear which comes from misinformation which comes from hearing others panic and leads to tragedies like the mob who believed Ebola to be a hoax and attacked a quarantine center in Liberia, causing sick patients to flee into the community and accelerating the spread of the disease.

Assuming the panic doesn’t spread and they let me in, I’m headed to France in just two weeks. This was planned months ago, but if things get worse I might just stay there. Then I’ll be worried sick for Seb, who’s not coming to France with me! And, oh — there’s that familiar sense of impending doom I often get. But this one must have to do with all those pickpockets and con artists in Paris, or maybe that third Intensive French class I enrolled in! Wish me luck!!

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14 comments

  1. Thanks for your well informed analysis of the virus and how panic can get people into trouble. We all deal with misinformation in one form or another. I will try not to worry about you guys there in Africa so much. Love you so much! Dad

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  2. Hey Jen, great post and you are right on about the potential threat (or lack there of). My first public health job in DRC (Zaire, at the time) was to track Ebola and Monkeypox in the Sankuru area of Kasai Oriental. This was in 1980, just a few years after the first outbreak which was also in that area. My mobile team of a doctor and several nurses trained all the health center personnel in the region to be able to ID a case of these diseases and notify us of any suspect cases. We would then go to the site, quarantine if necessary and take blood samples to send back to WHO in Geneva for verification. In a full year of actively and intensively searching for cases in the very area that had had an outbreak, we never found one actual case. Nor did the teams that followed me in the years after I left. It is, indeed, extremely rare and burns itself out very quickly because, 1. it is so deadly and, 2. requires direct transmission of bodily fluids. Sadly, this is why most of the mortality ends up being health workers who care for the very rare cases. They are the only ones really in danger. Amuse-toi bien en France, ne t’enquete pas pour Sebastien! xxx

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    1. Lauren, so great to hear from you! I LOVE your story here. I have a powerful image of you whacking your way through the jungle with a machete, approaching these tiny villages… how amazing! How scary too, you are very brave. We miss you being here 😦

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  3. Have a wonderful time in France Jen!! I was just talking about our trip there together a few weeks ago. It sounds like I will be in Ireland around the same time – if you get tired of the French – come spend some time w/ the Irish!

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    1. Fun coincidence, I was just talking about our trip there too! Have fun in Ireland. If I get stuck in France for longer than planned maybe I’ll get to make a visit!

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  4. Jen — I have had several people from your company that ask about the Ebola. My response has been that if it suddenly becomes dangerous in DRC, FMI will probably take measures to protect employees, whatever those measures need to be. Do you support this thought. — Cyndi
    PS — Love your messages!!!

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    1. Yes, absolutely. I do think like Lauren said above the one here will burn out rather quickly. We’ll see. If not, yes I think they’ll do something, even if it’s more to manage perceptions than any real risk. Just tell your clients to skip the bat and monkey meat (or eat it really, really well done!) 😉

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  5. and of course if you must stay in Europe after your francais intensif, we have a mazot (little house0 in our garden that you are welcome to use. x

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