Ebola geography – Part 2

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PART 2

What are the factors that cause Ebola to spread? How is geography related to this? Let us look at this at two scales: within Africa, and outside Africa.

Within Africa

“Ebola … spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids” according to the World Health Organization (WHO).

Densely populated living spaces, shared toilets, inability to isolate patients, lack of hygiene, and especially clean drinking water – all these make it easy for the Ebola virus to spread from person to person. What causes such conditions? It is mainly poverty. You will see how poverty in Africa is affecting the affluent countries of Europe and North America when you see the movement of the virus.

The poverty is also seen in other ways. Most people in the Ebola-affected areas – even in urban areas – lack easy access to medical facilities. The density of hospitals (number of hospitals per capita) is very low. Those few hospitals that do exist have very poor facilities to treat patients. Further geography problems make accessibility of these hospitals a problem – physical barriers (e.g.: poor roads, transportation facilities) and cultural barriers (e.g.: inadequate awareness about identifying the disease early enough to be able to save lives).  The number of medical professionals per capita is also very low – this makes the situation worse.

Additionally, traditional ritual practices in many of the affected areas include washing the bodies of dead. If these are bodies of those who have died of Ebola, living persons and the spaces in which they live also get contaminated. This makes it easy for the virus to spread to other people.

Once patients are diagnosed, they need to be isolated quickly and very efficiently. This is also difficult for the same reasons above. Therefore, lockdown (preventing movement of people so that patients and healthy people do not come into contact) is very difficult to enforce. Human mobility cannot be shut down that easily and without force.

However, there has been a certain degree of success in Nigeria. The United Nations (UN) has declared Nigeria safe from Ebola. However, one cannot presume that this will continue to be so. Therefore, Nigeria is also on alert.

Outside Africa

Africa as a whole, and the Ebola-affected areas in particular, face a very difficult situation. Therefore, many aid workers from other countries come in to help – mainly doctors and nurses.  Why do they go to Africa? What is their motivation? One reason is that they wish to help affected people. Another reason is that by helping in Africa, they can contain the disease – i.e., prevent it from spreading too far from the currently affected areas. So, such aid work is both altruistic (for the good of others) and practical.

And who sends these aid workers? Usually various government and non-government organizations – e.g.: church groups, Doctors Without Borders, UN, etc.

Many of these aid workers who return to their home countries, may have contracted Ebola but not have developed symptoms of Ebola. Ebola usually takes 21 days to start showing symptoms. During this time, the infected person is actually quite contagious and may not know it.

When they travel, they come into contact with lots of people (e.g.: in the planes, trains, buses, etc.). The infection may spread to those people also. For this reason, every identified Ebola patient who has returned to his/her home in USA, Canada, or Europe has been quarantined (isolated) and their movements are traced. Due to growing fears of Ebola’s spread, many countries have enforced testing procedures at their international airports and people traveling from or through Ebola-affected areas of Africa are screened and kept under watch for 21 days. If they show any symptoms, immediate quarantine and treatment follow. These steps have saved quite a few lives in the western countries.

Some aid workers who were infected got early treatment and are declared healthy now and they plan to return to Africa.

Map of countries affected

Travel among the affected non-African countries is also a source of spread. Maps have helped understand some of the processes involved. However, whole countries are facing the stigma (shame) of being Ebola countries. This has serious impacts on the economies of those countries, but also one people’s feelings. So, in order to put things in perspective, some users of Twitter have been publicizing a map of Africa showing the actual size of Africa (that it is a vast continent and not a country) and the areas where Ebola is prevalent (a few countries in a small part of the continent’s west).

Response

Organizations and countries have been calling the attention of the world, especially of the wealthier countries, to do a lot more to help overcome Ebola. The UN, WHO, International Monetary Fund, World Bank, and others have become involved in this effort.

Even small and relatively poorer countries have responded with considerable concern. Of these, Cuba (find it on the map) has mobilized the largest team of highly trained healthcare workers from a single country – 461 doctors and nurses to provide care in Sierra Leone, Guinea and Liberia, according to one report.

Coverage and how to follow the story

Internationally, the media have been reporting on the evolving story. Some experts are also saying that the media are making things sound worse than they really are. Nevertheless, there is considerable alarm about this pandemic.

Things you can do:

1. Here is a list of online resources that you can read to learn more about Ebola (the link opens in a new window/tab). These resources have many interesting and informative maps, illustrations, etc. Here is a list of resources that you can use to explore the topic in greater detail.
2. Examine how various other things connect in the spread of Ebola. Here are a few examples below. You may be able to think of many more.
   1. Poverty / wealth.
   2. Living arrangements.
   3. Environments in which people live.
   4. Transportation networks.
   5. Cultural and physical barriers to Ebola’s spread.
   6. You, as a geographer, have been asked by the Prime Minister of India to help apply your geography knowledge and skills to help make preparations to keep Ebola out of India. You are free to choose your team and coordinate it. Devise an action plan, giving proper arguments, to stop Ebola from entering India. And if it does enter, ways of keeping it from spreading further inside the country (this is called containing the disease).

If you do come up with a detailed plan, as a team, we at TIIGS would love to hear from you. The best entries will be recognized and awarded certificates. Contact us using the comments box below.

(A version of this article appeared in the Deccan Herald Student Edition, 13 November 2014)