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Disposable Africans?

Now that the election is over it may be possible to redirect our attention from Ebola as a political talking point to the arenas of science, compassion, and justice. It’s hardly a coincidence that the headlines in recent weeks were coming from governors running for reelection – Quinn in Illinois, Cuomo in New York, or LePage in Maine – or, like the blustery Chris Christie, planning a run for president in 2016. Quarantine scores points for frightened voters and sounds quite gubernatorial or presidential at a time when real leadership struggles to address the more nuanced realities of a complex situation requiring thoughtful and scientifically grounded epidemiological protocols. Gov. LePage came from behind to win in Maine, helped according to some commentators by his last minute rhetoric about Ebola. Fear often works.

But let’s look at a few simple facts. The World Health Organization estimates that almost 5,000 people have died in West Africa from Ebola, most in the impoverished countries of Liberia, Sierra Leone, and Guinea. By the year end, the death toll is expected to be in the tens of thousands. In the United States one person has died. One. The survival rate for the few persons infected and being treated in the U.S. is extremely high. The mortality rate for the flu is much more alarming. Here, Ebola patients are hospitalized in highly specialized intensive care units with round the clock nursing and constant medical monitoring. Intravenous fluids rapidly replace lost fluid, and delicate electrolyte balances are carefully maintained. Kidney dialysis is available for those experiencing organ failure. Experimental drugs are made available. Furthermore, infected Americans tend to be far healthier to begin with and, therefore, more able to endure the assaults of the virus.

In the most severely affected countries of West Africa medical infrastructure is woefully inadequate and in some cases at near collapse. Endemic poverty and the enduring effects of civil war hamper even the most heroic work of medical personnel, many of whom have themselves been infected and died. Patients who do make it to rudimentary hospital wards receive minimal intravenous therapy, have blood chemistry tested intermittently at best, and are often visited by medical personnel only once or twice a day. Many are malnourished and weak even before they have been infected making them highly vulnerable. None have received the experimental drugs Americans are offered.

In a study by the Centers for Disease Control it was found that if aggressive infection control in the most affected countries had begun within two months of the first reported cases, the total number of persons infected could have been limited to about 5,000. But that didn’t happen. Instead of bold, aggressive action in May, large scale international intervention didn’t begin until late August and early September, multiplying the number of cases likely by year’s end to at least 130,000.   Recent aggressive response in Nigeria shows the difference speedy action can make.

Meanwhile in the United States, aggressive tracking and monitoring of contacts by the first Ebola patient in Texas began within two days of symptoms, and even that quick response was declared unacceptably slow by the CDC. The undeniable reality that Ebola has revealed – once again – is that when it comes to health, race, poverty, and geography makes all the difference.

It is probably unrealistic to expect that we will hear a U.S. politician these days boldly naming the unjust realities that consign thousands of Africans to death from Ebola. Beholden to the drug companies, there will be few calls for the development of drugs to fight a disease that is unlikely to create a long term, lucrative market in the US or Europe. Once the induced panic wanes here, research efforts will likely ebb as well. We quickly spent $1 billion in our fight against ISIS. Calls for dramatic increase in funding for an Ebola support mission in West Africa will undoubtedly be highly contested by austerity hawks. While more is promised, the US has thus far spent less than a third of that amount on Ebola fighting measures in Africa.

Thus far the religious community’s response has largely consisted of expanded medical relief efforts, prayers, and the courageous defiance of political fear mongering by a Baptist pastor in Texas who immediately visited the family of the infected patient from Liberia. That’s all good. Very good. But where’s the religious leadership’s vocal and public outrage over the glaring injustices that render Africans essentially disposable? This is nothing new. Look at our tolerance for years of horrific civil war in Congo. But the Ebola crisis puts it in stark contrast once again. Here is an opportunity for religious and political leaders to say “enough!” Thus far that voice has been, for the most part, either silent or weak.

Quarantines at our borders and airports play well to a frightened electorate. They help protect our privileged access to the highest quality medical care and to the most advanced public health detective work. They also place obstacles in the way of those wanting to take their medical training and expertise to Africa to treat patients. In short, they reinforce the undeniable conclusion that for many of us, Africans are, indeed, disposable. That may be fine for politicians counting votes. We’ve come to expect little more. But for religious people across the theological spectrum it is just unacceptable.

John H. Thomas
November 6, 2014

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