Ebola

It is time for a new topic! My previous posts have been heavily focused on homosexuals and human rights. In case you are just tuning in, the reason for this is because President Yoweri Museveni just signed the Anti-Homosexuality Bill on February 24^th, 2014. 

As a recap, the bill calls for the potential lifetime imprisonment of homosexuals living in Uganda. This is a “hot topic” right now, as the bill has only magnified and capitalized on preexisting prejudices against homosexuals. Homophobia and its related oppression and discrimination has remained a toxic and pervasive problem in Uganda. The Anti-Homosexuality law merely confirms these notions and fuels the fire of historical homophobia.

But today my new topic is EBOLA.

Current global health initiatives have been so heavily focused on other things, that it is so easy to dismiss something as incredibly important as Ebola. I kind of forgot it existed… Smallpox was eradicated in 1977. Wasn’t Ebola also sort of “eradicated” at some point?...No.

So I decided to do some digging, and discovered Ebola's history in Uganda. Ebola is a deadly health concern that warrants discussion.

For starters, let’s talk about what EBOLA is. Ebola is a deadly "virus disease". It is also commonly known as Ebola hemorrhage fever. Yes, it is as horrible as it sounds.

Ebola was first recognized in 1988 in Sudan. For you geography geniuses, Sudan is actually Uganda’s northern neighbor.

Since the outbreak, professionals have recognized 5 major kinds of Ebola. The 5^th kind of Ebola, Bundibugyo ebolavirus (BDBV) was actually recognized in Uganda. The Ugandan Ministry of Health recognized BDBV in 2007. The Center for Disease Control and the World Health Organization confirmed this outbreak of Ebola as a new species of the virus. Fortunately, the epidemic in Uganda ended in 2008 with its last recorded case. (however, Ebola is not eradicated. It outbreaks sporadically in African countries.)

Before discussing Ebola further, let’s talk about the symptoms of Ebola.

Here are the devastating symptoms of Ebola outlined by Wikipedia:

 

If you don’t follow that dense terminology, Ebola is pretty much a flu-like disease that causes fever, hemorrhaging and severe diarrhea. According to the World Health Organization, Ebola is “one of the most virulent viral diseases known to humankind”. Unfortunately, 25-90% of Ebola cases end in death. It is highly fatal, and symptoms appear very abruptly. This means you can suffer gastrointestinal bleeding, bleeding from your eyes/ears/nose, skin rash bleeding, genital swelling , etc all very quickly. These symptoms typically lead to a death marked by suffering. Thus, Ebola is gruesome and fatal.

In an interesting article, Linda Poon, a public health writer, talks about an Ebola outbreak in Uganda in 2000.  She start off with saying  “understanding local customs — and fears — can go a long way in getting communities to cooperate with international health care workers”. Okay…this makes sense. I immediately wanted to know why she said this…

Apparently, Ugandans were very scared to bring their sick loved ones to health care clinics during the outbreak. They were afraid of the international healthcare workers because sometimes they would never receive word that their family members had died. In fact, the bodies were disposed of without any notification. Bodies needed to be zipped up quickly into body bags and disposed of so that the virus didn’t spread. Could you imagine putting your grandpa in the hospital one day only to wonder what happened to him the next day? Sounds like a law-case in the US. Because of this, Ugandans were actually skeptical that Europeans were working in a body-parts business. Naturally, they felt angry and disrespected by these international healthcare workers.

This fear of the healthcare workers becomes a huge issue in terms of Ebola because it deters people from seeking the healthcare they need. According to Barry Hewlett, a medical anthropologist, 

“This fear could have been averted by allowing family members to see the body in the bag and allowing family members to escort the body to the burial ground."

He further concludes that efforts to contain the virus must be culturally appropriate and sensitive, in order to ensure that people are accessing the health services they need rather than running away from them. I couldn’t agree more!

As a result, 3 major changes are helping increase access to care:

1. Removal of large tarps surrounding isolation area so that family members can talk to sick relatives
2. Medical team members attending funerals as a sign of respect
3. Addition of anthropologists to Doctors Without Borders program in order to help doctors understand how a local population perceives disease. (e.g blaming Ebola on sorcery rather than contact with body fluids)

By cultivating a cultural understanding among health professionals, they can work within the context of the community they serve in order to cater health services in a respectful and effective manner.  Doctors must maintain sensitivity to cultural beliefs in order to deliver their services to an accepting community.