Ebola cases reappear in Liberia, Guinea

Regional and international health officials emphasize that the Ebola virus disease crisis is not over, as three new cases have appeared in Liberia. This country was one of the hardest hit West African states by EVD from 2014 to 2015. Then more than 11,000 people in the region died from the most virulent forms of viral hemorrhagic fevers.

Liberia, Guinea and Sierra Leone were the most severely impacted states in the EVD outbreak, which became known internationally in early 2014. All three countries have experienced internal conflict and unrest over the last three decades.

Nathan Gboetoe’s father took him to the John F. Kennedy Medical Center in Monrovia, Liberia’s capital, on Nov. 18. Bleeding from the mouth, but without a fever, the 15-year-old was taken to the trauma ward and tested for EVD two days later. The results were positive. However, the delay in diagnosis and medical treatment led to Gboetoe’s death on Nov. 20.

The child’s death shattered the notion that Liberia had eradicated the dreaded disease.
The question arises: How could such a situation occur in light of the experiences of 2014-15 when the largest EVD outbreak profoundly impacted Liberia? The country has strong historic ties to the United States.

Clair MacDougall stated in an article on the Foreign Policy website: “Gbotoe should have been fully checked by a triage at the entrance at the hospital where health workers screen for patients who may have Ebola and need to be isolated. The doctors and nurses who handled his case didn’t wear the correct equipment for treating possible Ebola cases that protects against the highly infectious virus.” (Nov. 26)

Nonetheless, Dr. Francis Kateh denied protocol was violated. Kateh is the chief medical officer and acting director of the Incidence Management System that monitors Ebola cases. The same article quotes him, “No one would walk around with [personal protective equipment] in this climate.”

Kateh reported that the nine health care workers who interacted with Gbotoe have been quarantined and that the 150 people, both patients and medical personnel, who were in contact with him were identified.

Guinea’s last-known case

In neighboring Guinea, the health care resources are more limited than in Liberia.
Guinea, a former French colony, defied French imperialism in 1958 and gained its independence. The first EVD cases were identified there in late 2013.

On Nov. 28, Nubia, a 1-month-old baby girl, Guinea’s last reported EVD case, left the hospital. The baby is perhaps the first infant to survive after being born to an infected mother. Her recovery represents the hope that Ebola has been eradicated in the country. The medical staff was delighted, after dealing with one of the most challenging periods in the country’s modern history.

Laurence Sailly, director of the emergency team of Doctors without Borders (Medecins Sans Frontieres/MSF) in Guinea, told Reuters on Nov. 28, “This is a very happy day for us.” Nubia “is a symbol of what we are capable of doing at this stage of the epidemic.”

Sailly says that Nubia overcame the disease due to experimental drugs and intensive treatment provided by 20 health care workers. She received the Ebola drug ZMapp and GS-5734, an experimental anti-viral medication being developed by a U.S. biopharmaceutical firm. During the treatment, Nubia was connected to a monitoring system that allowed physicians and nurses to track the infant’s breathing and heart rate and make sure procedures were used to prevent further infections.

It will take another six weeks without any new cases for Guinea to be considered “Ebola-free.”

Worst outbreak in 39 years

The 2014-15 epidemic was the largest outbreak of EVD since it was first observed in 1976 in the Democratic Republic of Congo. Liberia’s recent case underscores the importance of robust surveillance measures to ensure rapid detection of any reintroduction or re-emergence of the disease in unaffected areas. Guinea, Liberia and Sierra Leone have installed surveillance systems to enable medical workers and members of the public to report EVD cases and deaths,

Several other West African states have not been impacted by the EVD outbreak, or else they swiftly eradicated a small number of cases in those countries. In Nigeria, Senegal and Mali, a small outbreak was immediately contained, resulting in few deaths.

The World Health Organization was severely criticized in 2014 for not taking decisive action during the first weeks and months of the outbreak. The U.N.-affiliated agency has said that Liberia, Guinea and Sierra Leone were not capable of handling continuing cases on their own.

“The response to Ebola — the national leadership, community engagement, so many people working so hard for such a long period of time with such dedication — if that can be translated into efforts beyond Ebola, then actually all the countries have a bright future ahead of them,” Peter Graaff, the U.N. Regional Inter-Agency Coordinator on Ebola, told the U.N. News Center. (Nov. 27)

This may be true in the short term, but Africa cannot continue to rely on outside institutions and governments to adequately monitor, prevent and treat EVD and other infectious ailments. Internal structures must be developed and enhanced to bring about healthy and productive lives for the majority of the continent’s residents.

Cuba: beacon of solidarity

To reach this objective, stronger emphasis must be placed on developing national and regional health care systems, along with advanced educational and communication networks to eradicate the underlying causes of the outbreaks. Socialist Cuba’s role in providing assistance during the peak EVD outbreak exemplifies how underdeveloped postcolonial states can reverse the legacy of imperialist exploitation and alienation.

After the 1959 revolution, Cuba broke with capitalist ownership of production and moved toward self-sufficiency. As a result of its rapid development as a socialist state, Cuba has become a beacon of international solidarity — particularly toward the African continent.

Cuba’s assistance to Africa continues a decades-long process of reconnection with its ancestral and cultural roots — and moves toward fulfilling its goals of working for a world where human beings’ value supersedes the drive for profits and political domination. Cuba’s contribution to the international response to the largest EVD outbreak ever seen was even recognized by U.S. corporate media.

African Union member-states have praised the Cuban government’s response to the EVD outbreak of 2014-15. AU Commission Chair Dr. Nkosazana Dlamini-Zuma visited Cuba recently to express gratitude and discuss ongoing collaborative projects between the continent and the revolutionary Caribbean island nation.