|The Ethics of Epidemics|
- Published on Tuesday, 28 October 2014 12:06
Periodically in human history we experience terrifying epidemics - the Black Death of the fourteenth century killed around 75 million people (1.5m/4m or 30% of the population in the UK alone), the flu epidemic of 1918 killed more than all those who perished on the battlefields of the first world war. Such epidemics kill indiscriminately: the young are often the most vulnerable and surviving soldiers, rejoicing in their hopes of liberty, succumbed in their thousands. How do we feel about the situation in Sierra Leone?
3,806 people (officially) have died so far and the United Nations has given just 60 days for the Sierra Leone Government to contain the epidemic before declaring it out of control. Volunteers are paid £60 a week to put on white protective clothing and goggles - the virus invades through the eyes and nose - and go about the task of moving people into holding centres where they are contained, rather than treated. The dead lie about for hours, even days, often defended by their loved ones who are appalled by the thought of disposal in mass graves without a proper burial service. The old tradition of touching the dead breeds infection: people become infected after 7 days incubation and then are dead by day twelve. As the immune system closes down in death, so the virus assumes an even deadlier form.
This weekend they buried Fatmata Turay, a baby of four months age, who had caught the virus from her dead mother. For 23 hours her body had been unclaimed by the volunteers. A Times journalist recounts the scene as Fatmata, guarded by her drunken grandmother, is zipped inside a double body bag and the premises sprayed with chlorine.
"I watched Fatmata dropped into regulation 8 foot deep grave among hundreds of others..the man carrying her tried to lessen her fall bending awkwardly down over a yawning grave, but there was little dignity in the moment..not a single mourner was present, and no prayer accompanied the dead orphan's drop" (Anthony Lloyd, Times October 28th).
Few countries have matched the support of Britain's £80m for Africa, £10m of which has gone to Sierra Leone. A hospital ship is on its way with 250 military personnel to support those already in the permanent military base there. 800 NHS staff have volunteered to serve there. Margarita Toumasou, who responded to a separate volunteer appeal by Avaaz, the online campaign, commented: "There are risks every day with our job with HIV, with hepatitis. They need people to deliver the therapeutic care. They are not getting the numbers they need and we are trained to cope with risk." But is even this too little, too late? We will know by Christmas.
The Ebola outbreak began in May. Only as the first cases are reported in the UK, or in the United States, do we begin to respond. It is as if yet again the problems posed to the world by Africa - disease, poverty, corruption, famine, tyranny - are brushed under the carpet until it affects you and me directly. At the same time, volunteers from Britain continue to work in the stricken countries, in close contact with the dying and the dead, taking huge risks on our behalf.
Of the ethical challenges of our time, few are greater than the inequality that affects Africans. Poverty drives people into poorly sanitised conditions. 345 million still cannot draw clean water in Africa, and Water Aid, the charity, estimates 10% of those will die from water borne disease. Ebola is caught from infected bushmeat, and only the poorest people eat monkeys and fruit bats. Treatment centres are inadequate and local superstitions and beliefs about the dead ensure that many cases go unreported. Volunteers risk not just death from the disease, but violence from villagers desperate to keep them away. Dr Benjamin Black of Medecins sans Frontiers reveals how local beliefs exacerbate the problem: "There is a section of population here who simply don't believe Ebola is real, they think it is witchcraft".
To the heroism of the volunteer (like Will Pooley, the UK victim of ebola who is returning to Liberia) we must add the reflection on our own secular and insular worldview. Whilst Afghanistan and Iraq continue to be top of our agendas - because it supposedly affects the 'national interest' whatever that means - a much deadlier threat goes unchecked which has the power to wreak human suffering on a vast scale.
"I must go back to Sierra Leone to continue my work in helping those people affected by Ebola", commented Will Pooley after his recovery.
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