Phil Cotnoir
asked
Tim Butcher:
I'm sure I'm not the only one who would like to hear your thoughts on the terrible Ebola outbreak in Liberia, Sierra Leone, and Guinea. I read Chasing the Devil a while back and it seemed like you had quite a firm grasp on the history and particular cultures of those countries. Any thoughts?
Tim Butcher
The ebola crisis in West Africa is a huge concern. Poor Johnson Boie, the sterling guide who acted as gatekeeper for my understanding of rural Liberia when we walked across the country in 2009, texts me daily. I read avidly. He has retreated – on the advice of health experts – back to his home village up in Lofa County, where the outbreak began in Liberia, and is doing everything possible to keep his community safe.
At first my thoughts were of linkage. I came across ebola when I wrote my first book, Blood River, on my journey through the Congo. Ebola was identified there for the first time in 1976, taking its name from a small river called `Ebola’ that runs into the Congo River north of the riverine settlement of Bumba.
I had reported in 2000 on an ebola outbreak in northern Uganda and got to learn the basics of the disease: a filamental virus, harboured by bush animals most likely bats, once it jumps from the animal to human the virus invades cells, replicates like mad and after 21 days of incubation acts like a wrecking ball to blood vessels, smashing capillary walls and causing the patient to bleed out. Blood loss is so bad catastrophic the patient basically dies of dehydration.
But I also learnt two other things. If treated by healthworkers who stay healthy, the patient can survive if kept hydrated. Survival rates if – and it’s a big if – healthworkers stay healthy are much, much higher than the scare stories of the media suggest. I also learnt that all ebola outbreaks recorded have taken place either in the Congo basin or within overland transport links of the basin.
So my first big thought was: how did it jump 2,000 miles north and west to Guinea, where it first appeared before spreading to Sierra Leone and Liberia? Scientists are debating how this might have happened but there is no clear answer yet.
As the crisis grew bigger, my next thoughts were about another unique feature of this new outbreak: it has reached urban populations. This has never happened before and this makes it so much more important from a global perspective.
We know HIV only became globally pathogenic because it spread to a large urban area ( the Congo, again I am afraid to say – Kinshasa ) and now the same has happened to ebola. Will ebola go globally pathogenic?
My thoughts then turned to Douglas Adams and his refrain `Don’t Panic’. If we panic and give up on helping the West African communities currently blighted, then it is more likely to become a global problem. I recalibrated the refrain to `Don’t Panic Yet’. As long as common sense prevails and good health care arrives, this outbreak will be dealt with and it will not spill globally. But this means the world will have to get involved, because of my next thoughts.
There were about how the fantastic people of West Africa, people like Johnson, are so chronically let down by their hopeless, corrupt, ineffective governments. We know ebola is containable using methods that are not that expensive or demanding in expertise, what is known as `barrier nursing’ where healthworkers are protected.
I know Salone and Liberia have first class health practitioners more than capable of dealing with the outbreak. What they don’t have is the gear, resources and equipment. And here, the local governments are to blame. When I passed through Salone in 2009 on the Chasing the Devil trek, there was one working X ray machine in the government sector. There were lots of broken ones but only one working one. And that comes down to stolen budgets, corrupt management and incompetent administration.
Remember more than 200 people died in Freetown, capital of Salone, just a couple of years ago because of cholera, one of the most manageable diseases in the world. Clean water means no cholera and yet that is beyond the abilities of a government in an economy that grew 33 per cent two years ago (yes, 33 per cent real growth in one year, OECD figures).
Then my thoughts turned to Graham Greene. His 1935 journey passed through the exact hot zone for today’s outbreak. All the places named in reports today sounded familiar to me as I passed through them when following his route and it made me re-read his original diary which I have a copy of. The first name he gave the book that would become Journey Without Maps was different. It was `Journey in the Dark’.
It made me think of Joseph Conrad and the literary millstone he hocked Africa with when he chose the title `Heart of Darkness’ for the novel he wrote out of his own experience on the Congo in the 1890s. Was Conrad presciently hinting at a dark health crisis, then morphing and replicating in the African bush into what would become HIV? Was Greene hinting at another health crisis lurking in the jungle that he crossed?
My thoughts keep churning at every turn of this virus-led ebola health crisis.
At first my thoughts were of linkage. I came across ebola when I wrote my first book, Blood River, on my journey through the Congo. Ebola was identified there for the first time in 1976, taking its name from a small river called `Ebola’ that runs into the Congo River north of the riverine settlement of Bumba.
I had reported in 2000 on an ebola outbreak in northern Uganda and got to learn the basics of the disease: a filamental virus, harboured by bush animals most likely bats, once it jumps from the animal to human the virus invades cells, replicates like mad and after 21 days of incubation acts like a wrecking ball to blood vessels, smashing capillary walls and causing the patient to bleed out. Blood loss is so bad catastrophic the patient basically dies of dehydration.
But I also learnt two other things. If treated by healthworkers who stay healthy, the patient can survive if kept hydrated. Survival rates if – and it’s a big if – healthworkers stay healthy are much, much higher than the scare stories of the media suggest. I also learnt that all ebola outbreaks recorded have taken place either in the Congo basin or within overland transport links of the basin.
So my first big thought was: how did it jump 2,000 miles north and west to Guinea, where it first appeared before spreading to Sierra Leone and Liberia? Scientists are debating how this might have happened but there is no clear answer yet.
As the crisis grew bigger, my next thoughts were about another unique feature of this new outbreak: it has reached urban populations. This has never happened before and this makes it so much more important from a global perspective.
We know HIV only became globally pathogenic because it spread to a large urban area ( the Congo, again I am afraid to say – Kinshasa ) and now the same has happened to ebola. Will ebola go globally pathogenic?
My thoughts then turned to Douglas Adams and his refrain `Don’t Panic’. If we panic and give up on helping the West African communities currently blighted, then it is more likely to become a global problem. I recalibrated the refrain to `Don’t Panic Yet’. As long as common sense prevails and good health care arrives, this outbreak will be dealt with and it will not spill globally. But this means the world will have to get involved, because of my next thoughts.
There were about how the fantastic people of West Africa, people like Johnson, are so chronically let down by their hopeless, corrupt, ineffective governments. We know ebola is containable using methods that are not that expensive or demanding in expertise, what is known as `barrier nursing’ where healthworkers are protected.
I know Salone and Liberia have first class health practitioners more than capable of dealing with the outbreak. What they don’t have is the gear, resources and equipment. And here, the local governments are to blame. When I passed through Salone in 2009 on the Chasing the Devil trek, there was one working X ray machine in the government sector. There were lots of broken ones but only one working one. And that comes down to stolen budgets, corrupt management and incompetent administration.
Remember more than 200 people died in Freetown, capital of Salone, just a couple of years ago because of cholera, one of the most manageable diseases in the world. Clean water means no cholera and yet that is beyond the abilities of a government in an economy that grew 33 per cent two years ago (yes, 33 per cent real growth in one year, OECD figures).
Then my thoughts turned to Graham Greene. His 1935 journey passed through the exact hot zone for today’s outbreak. All the places named in reports today sounded familiar to me as I passed through them when following his route and it made me re-read his original diary which I have a copy of. The first name he gave the book that would become Journey Without Maps was different. It was `Journey in the Dark’.
It made me think of Joseph Conrad and the literary millstone he hocked Africa with when he chose the title `Heart of Darkness’ for the novel he wrote out of his own experience on the Congo in the 1890s. Was Conrad presciently hinting at a dark health crisis, then morphing and replicating in the African bush into what would become HIV? Was Greene hinting at another health crisis lurking in the jungle that he crossed?
My thoughts keep churning at every turn of this virus-led ebola health crisis.
More Answered Questions
Peter
asked
Tim Butcher:
Read both books ages ago, but thought they were worth a puff. I think we may have some links: I was assistant sports editor at the Telegraph from 1990-2013, worked at the Mail, People and Mirror (in its heyday), but I am a Zimbo having grown up in Rhodesia. Dad ended up as Mugabe's first chief justice (used to be a good thing) and uncle was rector at Peterhouse. Am having an outing to Kaap outing in November?
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Oct 04, 2014 08:43AM
Oct 11, 2014 07:20AM