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Ebola: No time for 'compassion fatigue'

Fri 3 Oct 2014 In: Comment View at NDHA

I've heard some LGBT individuals inside and outside New Zealand seriously debating whether or not we should join other Commonwealth countries in providing medical and humanitarian support for West African nations hit by the Ebola virus. We should, despite the fact that Nigeria and Gambia are victimising LGBTI West Africans. What is the Ebola virus? It was first detected in 1976, at the Ebola River, a tributary of the Congo River within what is today the Democratic Republic of Congo. In August 1976, a teacher (46) arrived at the Yumbuku Mission House with what had prematurely been misdiagnosed as malaria. The man then experienced severe gastrointestinal bleeding and died three days after admission. Unfortunately, the new disease turned out to be highly infectious and lethal and the Democratic Republic of Congo is afflicted by civil war and widespread breakdown of medical and social service infrastructure. By October 1976, 318 people had contracted the virus and of those, 280 had died. Sadly, eleven of those were Congolese medical practitioners at the Yumbuku Mission House. Ebola is a filovirus which grows rapidly in human immune cell networks and then kills it. Since its initial discovery in the Democratic Republic of Congo (Zaire) (1976), it has also appeared in Sudan (1976), Reston (1989), Tai Forest (1994), Bundiburgo (2007) and now Sierra Leone, Liberia and Nigeria (2014). The Zaire/Congo strain is highly virulent and lethal in ninety percent of all recorded cases, the Sudan strain is lethal in half of all recorded cases, while the Reston and Tai Forest variants do not inflect humans. The current West African outbreak may be the less virulent Sudan strain, as only fifty percent fatalities have been recorded thus far, or it may be a third human-specific variant of the virus. Early symptoms consist of fever, acheing limbs and a sore throat. Then, blood clots start to develop within the major organs and spread across the human body. Some victims will recover but many will not. In its latter stages, the patient may haemorrhage to death. At present, there is no known antidote, although saline drips and plasma may help some to fight off the Sudanese Ebola variant. Ebola is believed to orginate in apes, fruit bats and pigs. Of these, fruit bats appear to carry the reservior within their bloodstream and may be the likeliest. Fortunately, the transmission of the virus can be controlled through measures such as strenuous use of handwashing. Nor can it be transmitted through airborne cough and sneeze residue. It is more infectious than HIV/AIDS, however. At present, Ebola outbreaks appear to be limited to the African continent. Infected blood, saliva, sweat and vomit are the chief human routes of inflection. Family members and medical personnel appear to be the next most significant categories of those infected. The incubation period varies from three days to two. The current outbreak seems to be the deadliest yet, but is currently centred in West Africa- mostly in Liberia, Sierra Leone, Guinea and Nigeria. Of these three nations, Liberia is under national lockdown and border quarantine. In terms of immediate risk to New Zealand, there would need to be breakdown of biosecurity and public health safeguards if an infected person left Lagos in Nigeria without detection and then travelled to Western Europe. This has not yet happened, nor is it likely to do so. And, to be sure, there are deadlier diseases than Ebola out there as well. Hugh Pennington described five in a recent Prospect article. E.Coli O104: H4 broke out in Germany in May 2011, infected 4000 and killed 50. This virus is food-bourne, causes haemolytic uremic syndrome, which destroys blood cells and causes diarrhoea and vomiting, but can be fought and averted through improved food handling hygiene. West Nile Virus is related to dengue fever and yellow fever. It can cause damage to the spine and central nervous system and is more severe amongst the elderly. Chikungunya is transmitted through mosquitoes and there have been outbreaks in Africa, Asia and the Indian and Pacific Oceans islands. Its symptoms are headaches, muscle pain, joint swelling and rashes. It has also appeared in the Carribean in 2014. Unlike the others cited above, it is not fatal, but can cause debilitating musculoskeletal pain in its aftermath. We are quite aware of the fourth one that Pennington mentions- syphilis. This STI is spreading markedly in the United Kingdom. It can treated with early intervention. Gay men, transwomen and transmen can easily avoid syphilis through rigorously pursuing safe sex. And then, of course, there's the flu, or influenza. Fortunately, seasonal outbreaks have proven not to be as virulent as the 1918-9 Spanish flu epidemic which ended up killing an estimated 100 million people across the world (three to five percent of the then global population), including all of my own Indian granddad's family back in the home country. Unfortunately, when it comes to Ebola however, there have been some unhelpful expressions of 'compassion fatigue' from some western LGBT individuals. Of all people, given the experience of gay men with our own HIV/AIDS epidemic, we should be the last ones who are engaging in this sort of inhuman stigmatisation of people living and dying from another life-threatening epidemic. Liberia and Sierra Leone don't have severe records of internal homophobic repression although clearly, Nigeria does. However, Nigeria has a complex, pluralist society, however admittedly corrupt, repressive and blighted by the virus it is. Innocent children, pregnant women, elderly rural inhabitants and others not directly associated with Goodluck Jonathan's corrupt regime don't deserve to be denied potentially life-saving medical treatment as if they were. To insure that it gets there and bypasses sclerotic, corrupt or dysfunctional government foreign aid, it may have to be provided through non-governmental organisations. Recommended: Barry and Bonnie Hewlett: Ebola, Culture and Politics: The Anthropology of an Emerging Disease: Belmont: Thomson: 2008. David Quannin: Spillover: Animal Infections and the Next Human Pandemic: New York: W.W. Norton: Tara Smith: The Ebola and Marburg Viruses: New York: Chelsea House: 2011. Hugh Pennington: "Five diseases that are worse than Ebola:" Prospect: September 2014: Philip Hunter: "What would happen if the Ebola virus reached Britain?" Prospect: July 2014: Craig Young - 3rd October 2014    

Credit: Craig Young

First published: Friday, 3rd October 2014 - 8:44am

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