How many handshakes do you think happen in Washington, D.C., every day?
Used in business deals, among friends and between politicians, a handshake is a nearly universal sign of greeting in the Western world.
Now imagine D.C. with no handshakes. It is an unnerving mental picture that seems awkwardly stiff and uninviting, but it is the daily reality in another capital city right now. In Freetown, Sierra Leone, the fear of Ebola has ended the use of handshakes entirely.
Ebola, a deadly virus transmitted through contact with infected bodily fluids, is ravaging western Africa. By the most recent reports, there have been roughly 3,000 cases and 1,500 deaths, although the World Health Organization thinks that actual numbers could be much higher.
Frighteningly, the uncontrolled nature of the epidemic has led to an exponential uptick in cases, and some experts predict that there could be 40,000 or more cases before we stop the spread of the disease. As J. Stephen Morrison from the Center for Strategic and International Studies has commented, even our confidence in calculating these types of numbers has eroded as this outbreak has mushroomed out of control.
Larry Gostin, the faculty director for the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center, has called this “one of the great humanitarian tragedies of our time” that was “in many ways highly preventable.” The outbreak occurred in countries that already had fragile healthcare systems and were operating with a bare-minimum number of health workers.
Now, over 100 of those health workers have died, which has further exacerbated the situation. Additionally, many people have become scared or skeptical of the health care system and are now avoiding hospitals. The skeptics have a point — while hospitals are still the best option for infected people to receive treatment, they aren’t the safe havens they should be.
Logistical shortcomings have meant that health workers do not have the proper personal protective equipment, like basic gloves and facemasks, to keep themselves safe, and adequate infrastructure does not exist to ensure basic sanitation. Worse than the hospital situation are the difficulties for people who are unable to access health care facilities and die at home. These individuals are often stigmatized and are more likely to spread the disease to those with whom they live.
In the words of Marty Cetron of the Centers for Disease Control and Prevention, this Ebola outbreak is one of what are becoming “predictably unpredictable outbreaks.” While we can invest large sums of money into treatments and vaccines for Ebola, there are also many “best value” interventions on which we should also focus our effort and money.
Hospitals must have the resources to be true care facilities. Investing in personal protective equipment, training doctors and nurses and improving community health education will not only help tremendously in this crisis, but will also fortify the healthcare landscape in general.
And unfortunately, while Ebola has received deserved widespread media attention, it is not the biggest killer in the region. HIV/AIDS, malaria, TB and diarrheal diseases also have a great, yet preventable, impact on these same countries. Investing in health systems and strengthening measures to combat Ebola will also help to combat these other diseases
It will be an international triumph when the Ebola virus is brought under control and when the outbreak has ended. But we can’t stop our efforts when the crisis is over. In order to be prepared for future predictably unpredictable outbreaks of this magnitude, basic health care in the region must be strengthened.
Ali Carter is a senior in the College. She is president of END7, a group that works to raise awareness about neglected diseases.