Ebola rears its terrible head again


When the largest-ever outbreak of the deadly Ebola disease struck West Africa in 2013, there was worldwide panic. The medical response mirrored the earlier irruption of Avian Flu except that tackling Ebola involved far more intensive treatment of victims, by medical personal who all too often risked and sometimes lost their own lives in caring for them.

And there was another important factor that almost certainly influenced the global reaction to Avian Flu. In the end, influenza is a common condition occurring regularly every winter. Though Avian Flu was alarming, treatments became available. It was an inconvenience rather than a threat to life. Few people now remember that in the three years from 1918, more people died from the so-called Spanish Flu pandemic than during the entire First World War.

Ebola was, however, an unknown disease, first identified in 1976 in two simultaneous outbreaks, in the Democratic Republic of Congo (DRC) near the Ebola River, after which it was named and in South Sudan. Thereafter, came more than a score of outbreaks with some 2,000 victims which placed it on the radar of the World Health Organization (WHO) but was largely overlooked in the West.

But when in 2013 the disease reared its awful head in the West African state of Guinea and quickly spread to Liberia and Sierra Leone, the WHO declared an international public health emergency and the rest of the world sat up and took notice. This outbreak raged for three years and killed more than 11,000 of the 29,000 people who contracted it. Westerners, including nurses who had been helping treat victims themselves became infected. Flown home, they recovered in intensive care and the condition was unable to spread because of strict quarantine procedures. However, underfunded and poorly resourced health systems in these three West African states struggled to cope.

The problems became particularly serious when people fled outbreaks of the disease, very often taking Ebola with them to new sites. Superstition, a belief in shamanistic cures and fear of the authorities also meant families failed to report victims with the tragic consequence that the relatives died and also infected others gathered anxiously around them.

Now Ebola has, in a manner of speaking, come home to the DRC. The WHO is reporting what it says is now the second-largest outbreak of the disease, 300 kilometers from Goma, a city with more than a million inhabitants. The fear is that the disease will not only reach there but could also be carried to neighboring Rwanda, South Sudan and Uganda. So far there have been around 2,000 reported victims, of whom over half have died. It is not yet clear if this is a reflection of the lack of adequate care or if this is a more virulent Ebola strain.

Earlier this year medical personnel were withdrawn because of wanton violence by lawless gangs of militias which are in almost permanent rebellion against the DRC government. Thankfully, it has now been possible for most of the brave doctors and nurses to return to their patients. The immense courage of these individuals, threatened by Ebola as well as militias, cannot be overstated. If they manage to contain the outbreak, the whole world will owe them a huge debt of gratitude.