The Angel of Death

One of the most interesting things about the West African Ebola outbreak is that stopping the disease has very little to do with hospital treatment. In fact, according to the WHO, it makes almost no difference to survival whether a West African is taken to a hospital or not. Mortality rates outside a hospital are 70%. "For patients who had been treated in hospital, the mortality rates were a little lower, ranging from 67 percent in Liberia down to just over 61 percent in Sierra Leone, so hospital treatment made some difference, but perhaps not as much as might have been hoped."

What makes a difference is the culture of the people around you. A patient is better off in a village than in more "modern", more cosmopolitan West Africa. In a village the intact culture drastically facilitates health education, contact tracing and the enforcement of quarantine.

"There's a better organization in communities, there's a common language, there are village elders, village chiefs who help keep things in order, and it's much easier and more effective to stop an outbreak in rural areas. Kikwit, the major outbreak in DRC in 1995, was only five hours journey by road from the capital, yet by stopping the outbreak in a rural area it doesn't spread into the complex issues involved in the city, where there's a breakdown in traditional governance and where there are all kinds of challenges due to different languages and different cultures."

The Liberian Firestone Rubber plantation is a well documented example of the proposition that a functional community is a safer community. Ebola has been unable to significantly penetrate into the 80,000 person plantation despite its location smack dab in the middle of the Hot Zone. The Firestone people didn't have fancy equipment. Much of their safety gear was improvised from existing materials. But what they had was an adequacy of common sense and a sufficiency of competence.

"In addition to creating a makeshift Ebola Treatment Unit, Firestone Liberia’s emergency response has included active investigations, contact tracing, and intervention measures. The company has conducted a mass education program, which involved teachers from the company’s schools going door-to-door to explain the disease not only to its employees but also to at least 72,000 additional people residing within the general community and surrounding areas."

A Liberian woman named Fatu Kekula reportedly nursed 3 out of 4 of her stricken relatives back to health using only plastic trashbags to make up her protective equipment and a cell phone to consult her family doctor on treatment instructions.  She made the best use of what she had.

By contrast "government" response has been a shambles.  They have made the worst use of what they had. According to the Nation, so cynical has the population of Liberia become about its own government that it many people at first believed that Ebola was a "scam to attract Western aid". One can see why. Medical supplies have been sitting on the docks of epidemic-stricken Sierra Leone for months, according to the New York Times, pending the signature of the country's "emergency operations center", which is doubtless awaiting the intervention of Grover Cleveland or Salmon P. Chase.

The scenario recalls Exodus and the Blood. Recently Ebola survivor Dr. Ken Brantly of Samaritan's Purse was in the news again for donating blood to newly infected patients in order to transfer his anti-bodies to them.  As in the Bible story, the Brantly blood seems to keep the Angel of Death away.

The blood will be a sign for you on the houses where you are, and when I see the blood, I will pass over you. No destructive plague will touch you when I strike Egypt. ... When the Lord goes through the land to strike down the Egyptians, he will see the blood on the top and sides of the doorframe and will pass over that doorway, and he will not permit the destroyer to enter your houses and strike you down.

Of course it does so for entirely scientific reasons. The metaphorical "blood" in this case may represent not only Dr. Brantly's donations, but the knowledge, common sense and cultural cohesion that  are inherent in this act; they characterize the functionality of traditional Congolese villages and the Firestone Plantation. Where the lifeblood of competence is to be found upon the door lintel, the Angel of Death passes by.

That dark being has been very busy. Virology Down Under notes that despite the international hue and cry, "Ebola virus disease case numbers have been doubling approximately every month since June (as far back as I went)".  Given that observed trend,  nothing suggests that it won't be 20,000 new cases in November, 40,000 in December, 80,000 in January and so on.

The numbers might well be less, but there is no reason to think, other than from optimism or hope, that the trend will not continue unabated. Not unless we do something different. The problem is simply this. The resources are being funneled to the same corrupt African system that failed to report and then to stop, and then to contain the disease in the first place.  These corrupt institutions are not only failing to repel the Angel of Death, they are standing outside the doorway like a carny barker inviting him in.

What holds true for West Africa holds true for Central America. General John Kelly of Southern Command said in a Department of Defense news article dated October 8 that corruption will pave a royal road of refugees from Mexico to the southern US border.

The potential spread of Ebola into Central and Southern America is a real possibility, the commander of U.S. Southern Command told an audience at the National Defense University here yesterday.

“By the end of the year, there’s supposed to be 1.4 million people infected with Ebola and 62 percent of them dying, according to the [Centers for Disease Control and Prevention],” Marine Corps Gen. John F. Kelly said. “That’s horrific. And there is no way we can keep Ebola [contained] in West Africa.”

If it comes to the Western Hemisphere, many countries have little ability to deal with an outbreak of the disease, the general said. ...

This is a particularly possible scenario if the disease gets to Haiti or Central America, he said. If the disease gets to countries like Guatemala, Honduras or El Salvador, it will cause a panic and people will flee the region, the general said.

“If it breaks out, it’s literally, ‘Katie bar the door,’ and there will be mass migration into the United States,” Kelly said. “They will run away from Ebola, or if they suspect they are infected, they will try to get to the United States for treatment.”

What holds true for Central America holds true for Detroit or any other place in which corruption and its handmaiden, lies, have seized control. The cry in each case will be: "somebody fix it".  Somebody.  Maybe "somebody" who thinks: 'so what if they have Ebola as long as they vote for me?'  James Carafano in the National Interest writes that one reason the 1918 Spanish Flu epidemic got so bad was because Woodrow Wilson tried to cover it up.

Stateside, at a military camp outside of Gettysburg, a young post commander named Dwight David Eisenhower ignored Washington’s advice to ignore the disease. Instead, he developed health protocols that broke the back of the disease’s run through the ranks. Impressed with the success of his methods, the Army ordered Eisenhower to dispatch his staff to other camps to train them on how to rein in influenza.

Likewise, many American cities got the disease under control only by ignoring the federal government and adopting responsible public-health policies.

Corruption kills. Stupidity kills. We have forgotten this. But in ancient times they knew better. In those primitive days the onset of plague, famine and war were often regarded by the population as a sign that heaven was wroth at its rulers for their iniquity;   the bazaars were  rife with rumor that the governing house was infest with debauchery, extravagance and indolence.   And it was whispered about that the plague would not cease until the Royal House had amended its ways. The Chinese referred to the such blame assignments as "losing the Mandate of Heaven".

Modern pundits may call such beliefs 'superstitious nonsense', but as is usual in history, there is a grain of truth to the accounts. Plagues and famines are true consequences of corruption which can be understood for entirely secular and rational reasons. For no governing class may lie and steal and distort with impunity without the consequences coming home to roost. One day what goes around comes around.  And for much of the world, that day is now.

The key to stopping Ebola in West Africa is to work around corrupt and incompetent officialdom to the extent possible and to strip off all the blinkers of political correctness that burdened international relief organizations for decades. It will require corrupt, inefficient and indolent institutions to do what they have never done before: do their job. And before the end of this epidemic it may destroy these institutions as well.

Can they do it? Maybe.  If not then make sure you've got some trash bags and a cell phone handy.


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