Ebola - This plague ship mentally is not really helping

Ebola - This plague ship mentally is not really helping Self preservation appears to be hot wired into all species and we humans are no exception.

Those two words 'self preservation' raise some interesting questions about our fears, outlook and understanding of the world around us. For all our supposed achievements, as a species we are still one that is easily preoccupied, disturbed and made uneasy. The unknown not only frightens us, it gnaws away at our confidence and sows seeds of doubt. Each of us is made uneasy by that over which we believe we have little or no control. Our apparent self confidence as a species is easily dissipated and soon becomes self doubt. Desperate as we are to maintain our own equilibrium, and the status quo, we are fearful of that which may impinge on our lives and well being. Apparently it does not take much to throw us off kilter.

The recent Ebola virus outbreak in parts of Africa has managed to shake confidence and the response to the disease illuminates many of our deep seated fears and insecurities. The fact that the disease is currently affecting countries such as Guinea, Liberia and Sierra Leone confirms latent fears about what is still viewed as 'the Dark Continent'. Confirmation bias has kicked in with a vengeance along with it all the spoken and unspoken prejudices that have dogged the continent of Africa for so long. The outbreak narrative beloved of scriptwriters and film makers plays on our preoccupation and continues to foster an 'us and them' way of viewing the world. Reason and practical solutions have been replaced be an irrationality and superstition that is more akin to a Seventeenth Century outbreak of the Bubonic Plague than a medical emergency in the Twenty First Century. For all our supposed progress in some respects it would appear that we have evidently changed very little.

There are of course legitimate questions to ask about the poor leadership and management of healthcare systems and facilities. Anyone who has witnessed firsthand the woefully poor cleaning regime at the Connaught Hospital, in Freetown (the capital of Sierra Leone) will appreciate that there are deep seated attitudinal problems. Certain individuals and even professional bodies at times appear to have a tenuous grasp on the fundamentals and are often quite content to abdicate themselves of responsibility. In a number of countries strategic planning across the realm of health care and health education has been woefully inadequate for decades. Matters have not been helped by the fact that the political and business elite routinely neglect and ignore local facilities and opt for expensive treatment overseas. In addition under investment and inadequate or non-existent training has ensured that countries are ill equipped to deal with even some of the most rudimentary of health issues.

Regional suspicions and anxiety have already seen the implementation of limited cordon sanitaires. This policy has even seen the likes of British Airways decide to suspend flights to Sierra Leone and Liberia until at least the end of the year. Whilst there are some who will defend such so-called precautions, it is clear that the actions of BA and other airlines such as Air France further undermine confidence and raise questions about the airlines true commitment to the African continent as a whole. In comparison with other airlines BA has been extremely slow to expand its network across Africa and one wonders whether its half hearted approach is mirrored elsewhere. Furthermore, there are ethical questions about access to new drugs. When an American or a Britain falls ill they are soon spirited away to receive the latest treatments, whilst locals are left with few if any care options. Vigilance is

clearly important, as is the sensitisation of local peoples concerning the disease and means by which it is potentially contracted. In this age of globalisation no society can firewall itself off from potential dangers and we must guard against those intent on either exaggerating threats and or seeking to profit from them.

When it comes to disease and urbanisation there are still lessons to be drawn from the experience of nineteenth century London. Rapid urbanisation, jerry built, over crowded and damp and poorly ventilated dwellings and near non-existent sanitary systems provided ideal conditions for the likes of cholera and typhoid fever to prosper. It was not until the issue of public health was addressed by the likes of the social reformer Edwin Chadwick (1800-1890) and the civil engineer Joseph Bazalgette (1819-1891) that matters really began to improve.

Major urban centres require strategic planning, provision of green spaces, adequate provision for the collection, handling and processing of sewage and household and industrial waste, as well as an emphasis on providing access to affordable clean water and universal health education. Many rapidly expanding urban centres, especially in the developing world look set to repeat the fatal mistakes made by cities such as London in former times.

Whatever our anxieties or fears it is important that we remember that the Ebola virus is not a uniquely African problem; it is something that warrants a concerted and co-ordinated approach by the whole international community. Whilst no one should underestimate the challenges that will need to be faced in tackling this disease, one thing is for certain, the current plague ship mentality of some is certainly not helping matters.

For further information about Ebola visit: http://www.who.int/mediacentre/factsheets/fs103/en/ http://www.nhs.uk/conditions/ebola-virus/Pages/Ebola-virus.aspx http://www.wellcome.ac.uk/Funding/International/WTP057179.htm? gclid=CJ2EwvqEwMACFUXLtAodvCsAyw Mark T Jones

www.marktjones.com