25 May 2018

The Atlantic: Vaccines Alone Won’t Beat Ebola

In the Congo, if you’re sick, you’re usually surrounded. Medical services are thin, so family members shoulder the burden of nursing their loved ones back to health. At one hospital I visited (well before the current outbreak), a family had camped outside a treatment building, waiting for their relatives inside to recuperate. Their laundry was drying on a washing line. “In an outbreak, you want to separate sick and healthy people, but here, if people are sick, everyone’s there,” one survivor told me. “Here, for we who live in communities, it is solitude that kills us.”

That mindset continues after death. Families will clean and dress the bodies of their loved ones. They’ll caress, kiss, and embrace them. Spouses might even spend a night next to their deceased partners. Through these bonds of affection, Ebola, which spreads through bodily fluids, can easily jump from one host into an entire family. The worst thing about the virus is not its deeply exaggerated bloodiness, but its ability to corrupt the bonds of community. It is a pathogen well-suited to a world where sickness and death are met with touch and affection. [...]

By that she means: finding infected people and tracking their contacts; ensuring hygienic practices that keep infections from spreading; and engaging with communities. These are old-school measures. Public Health 101. But they’re also the bedrock of any outbreak response. They’re vital for diseases that have no available vaccines or treatments, like Lassa fever which is currently breaking out in Liberia, or Nipah which has risen again in India. And they’re still vital when vaccines are available. [...]

For a start, there’s a language barrier. The Congo has upward of 200 languages. In Bikoro, around 90 percent of people speak Lingala, the main local dialect; to reach the people who don’t, the ministry is also translating its messages into N’Tomba, which is spoken by 40 percent of the region.

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