Ebola virus disease

Ebola virus disease (EVD) is a rare and deadly disease in people and nonhuman primates. It was formerly known as Ebola haemorrhagic fever. The disease name was given Ebola because the first outbreak has occurred in Democratic Republic of Congo in 1976, in a community near to Ebola River. It is a severe, often fatal illness in humans. The viruses that causing EVD is located mainly in sub-Saharan Africa. The virus causing Ebola disease is a member of the family filoviridae and is transmitted to people from wild animals and spreads in the human population through human-to-human transmission. Filoviridae includes three genera: those were Cuevavirus, Marburgvirus, and Ebolavirus. Within the genus Ebolavirus, already five species have been identified: Zaire, Bundibugyo, Sudan, Reston and Taï Forest. Among the five species, Bundibugyo ebolavirus, Zaire ebolavirus, and Sudan ebolavirus have been associated with large outbreaks in Africa. In 2014-2016, the virus causing West African outbreak belongs to the Zaire ebolavirus species.
The fruits bats of the Pteropodidae family are acting as a natural host for Ebola virus. Mainly the Ebola Virus enter into human body through the close contact with the bloody discharges, organs or other natural liquids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Also the Ebola virus spreads through human-to-human transmission by means of direct contact through broken skin or mucous layers and with surfaces materials (e.g. bedding, dressing) those were contaminated by virus containing bloody discharges and liquids. Ebola infection isn’t generally transmitted by food materials. Albeit in some parts of the world, Ebola infection may spread through handling and consumption of bush meat (hunted wild animals which are used for food). Also the Ebola virus persist long time in the immune-privileged sites of peoples those were recovered from Ebola virus disease like inside of the eye, testicles, also in the central nervous system. If a woman is affect at the time of her pregnancy, the virus also persists in the placenta, amniotic fluid and fetus. In women also the virus may persist in breast milk if the women have been infected while breastfeeding.
There are 26 recorded outbreaks in the history. In 1976, the first outbreak of Ebola virus disease was reported in Democratic Republic of Congo in a community near to Ebola River, which is the reason of its name1. That was a devastating outbreak that was killed 218 cases out of 318 cases with a case fatality rate 88%1,2. It was one of the most deadly outbreaks in history due to its case fatality rate. Since 1976, another 25 outbreaks of Ebola virus has occurred in ten countries of Africa, including Democratic Republic of Congo, Uganda. Congo, Sudan, Gabon, Sierra Leone, Cote d’Ivoire, South Africa, , Guinea and Liberia; one of America, United States of America and one of Europe, Spain3. In 2014, the biggest Ebola outbreaks occurred, which reported 17,942 confirmed, probable and suspected cases including 6,388 deaths with case fatality rate of 36% 3. In August 2018, a recent outbreak was announced in Democratic Republic of the Congo (DRC). In North Kivu and Ituri provinces of the Democratic Republic of Congo have been reported 142 cases including 97 deaths in 18 September 2018. This outbreak was happened just after a previous outbreak in the Equateur Province but it has been confirmed that this most recent outbreak is not related with the one in the Equateur Province4. It is also caused by Zaire ebolavirus species. The highest number of outbreaks (10) has occurred in the Democratic Republic of Congo3.
The focus of this paper is however mainly on the, cultural changes associated with Ebola virus disease and their economic instability due to Ebola outbreak in West African peoples. Throughout various times in history, Ebola virus disease influenced cultural deviations in the West African countries. In West Africa the Ebola virus epidemic has had a large impact on their culture. In most of the cases the impact is a somewhat negative one as it has disrupted many Africans’ cultures, traditional norms and practices. In 2014, the largest outbreaks has occurred in West Africa, which forced West Africans to face several difficulties and stand backed from their traditional norms and practices. Generally in this time their traditions have been extremely disrupted for the reason of Ebola virus infection. For example, Africans have had the tendency to stay near their debilitated relatives to nurture them during illness for centuries5. Unfortunately for the African people, many have been urged to stay away from their infected family members as potential contact could be deadly. Also in their culture it is a big part to touch the deceased at funerals and for the sister of the deceased’s father to clean, bathe and dress the carcass in a most loved outfit. When there is not any sister of this dead person then a female elder person in their community take the responsibility to perform this spiritual task. In addition to the fact that, not only to wash this deceased body but also to kiss the person who have passed.
In particular, funerals are thought to be major social occasions for families and friends to assemble around to praise the deceased6. The funeral performances, which include crying and dancing, is done out of consideration and regard for the deceased person. Funerals in Africa generally last for a several days, depending upon the status of the individual who died. At the end of the day, the more essential the individual who died was while they were alive, the more drawn out the mourning will last. More importantly, for the ritual hand washing after the end of the ceremony they used a common bowl for everyone and including last kiss to the dead person which is to be bestowed6. All the more essentially, there is a typical bowl utilized for custom hand-washing towards the finish of the function, including a last kiss or contact on the face, which is to be gave on the dead7. This is usually referred to as a “love touch” that cements unity between the living and ancestral spirits7. The Wesley Medical Center has reported that preventing African families from performing such customs is disrespect as it insults the deceased, putting the rest of the family in danger. In particular, it is trusted that the dead individual’s soul, also known as “tibo,” will make hurt and bring illness to the family because of an inappropriate burial. In that case if the expired person is a prominent people like the traditional healers then it is very common for the West African people to lay over the corpse with the hope that some of the spiritual gifts from this prominent person will be transferred to them7.
A combined effort was taken by WHO and the affected governments to reduce the Ebola outbreaks by this ritual burial process by setting guidelines which mainly defining how the dead bodies of Ebola disease are to be handled and subsequently buried8. While the guidelines were organized in accordance with current scientific knowledge of the disease, clearly very little attention was given to the cultural implications of a portion of the prescribed measures to the affected communities.
It may sounds simple for individuals in other cultures to feel that people in West Africa ought to understand that the highly infectious nature of the infection and its high mortality rates require some extraordinary measures to contain; However, additionally vital to understand that some of these funeral practices span from generation to generations and have been practiced in these communities for quite a long time. In addition, in an effort to rapidly dispose dead bodies and try to decrease the spread of the disease, some ‘Dead Body Management Teams’, frequently carried out burials before to notifying relatives of the deceased9.
As mention earlier, due to the sacred obligations given to the deceased and the cultural value placed on funeral traditions, most of the time this created doubt and dissatisfaction amongst affected communities. Resultantly, trying to abstain from having their relatives cremated or buried without their consent, a portion of the general population did not report their deceased relatives and secretly proceeded with traditional burial practices and, in the process, humbled efforts to prevent the spreading of Ebola. Also, there were a few reports in Liberia of corpse collectors allegedly accepting bribes to certified dead bodies falsely validating that the victim did not die of Ebola, allowing the funeral practices to proceed10. In recognition of the disagreeability of cremation, the Liberian government recently cancelled the cremation decree and ordered for the establishment of special burial plots for the deceased persons of Ebola11. Albeit WHO guidelines accentuated the need for understanding and respecting cultural practices and religious beliefs of West African peoples, but the major challenge is for health officers to convince involved communities to desist from inherent cultural practices.
West African peoples are mainly rely on traditional medical practices but after the Ebola outbreaks this will be little bit transfered into western medicins. About 70-80% poeple of some West African countries fully depend on tranditional medicine12. Traditional medicine have some positive role in helath care syatem like some ethno-medical beliefs and practices but also have some important negative impact on health care system, most importantly in patogen transmission. The traditional medicine procedures act as a media for some infectious disease pathogen. After the Ebola outbreak in West Africa it was clearly revealed that several traditional and spiritual healers falsely claimed that they have the ability to cure Ebola13. In one case the traditional and spiritual healers used warm salt baths and salt drinks as a preventive measure from contracting the highly infectious disease13. In Uganda, a traditional healers making incisions into people’s bodies and rubbing herbal medicine in his treatment purpose. Mainly the human-to-human transfer of Ebola occurs from direct contact with body fluids of the infected, it is not surprising that several people including traditional healers themselves reportedly got infected through these practices. By falsely asserting capacity to treat and cure patients from Ebola, traditional healers are regularly called to take care of seriously sick patients. Without proper protective resources they treat sick Ebola patients and most of the traditional healers often end up contracting the disease themselves and passing it to their other patients.
In some instance the changing face of Africa also provide some fuel for the dramatic increasing rate of Ebola. Today’s West Africa and their culture are far different from the time when the first outbreak was happened. By the time passing the population of these regions has tripled and forests have cut down. Due to this changing face the recent outbreak affect more peoples compare with the past. Previously, most Ebola outbreaks occurred in remote, scantily populated parts of Central Africa. It was easy for health officials controlled the outbreaks by quarantining the peoples those were affected in a certain area compare with recent. People could not go anywhere that the reason the outbreak did not spread. In the current outbreak people were infected with Ebola ended up on public buses, trains and airplanes. In the modern world it is very difficult to prevent infectious disease spreading than it was in 20 years ago
Ebola outbreaks have a great economic impact on West African countries. After the outbreaks their economy dramatically fall down due to the reason of many foreign buyers went back to their own country. A huge number of foreign workers back to their home countries due to the fear of Ebola. Most countries of this region have a weak health care infrastructure which influences the expatriate workers. For example, In Ghana, there is no reported case of Ebola but due to the reason of weak health care infrastructures some global companies have evacuated non-essential personnel. Some of the big investor country like as china also drops down their investment in West African countries compared with the last few years when china have invested heavily in Africa. The trade, tourism and the agriculture sector have heavily affected in the whole region. One of the big attractions for foreign countries to invest West Africa is the size of the market but after the Ebola outbreaks huge numbers of peoples were died has effectively reduced the attractions. West African tourism sector almost collapse due to this outbreaks. Their travel companies, hotels and airlines faced a dramatic loss in their revenues. Most of the visitors cancel their bookings and they lost their interest to visit West Africa which creates the tourism sector vulnerable conditions. Some West African regions, two- third of the population live below the poverty line and they are mostly dependent on this tourism sector. After the vulnerable conditions of this sector they were in big troubles. Agriculture has another sector in West Africa which contributes a big portion to their economy but at the time of Ebola outbreaks this sectors greatly hampered. For Global cocoa supply, West Africa almost contributes 70% supply with Ghana and Ivory Coast representing for 60%. Their cocoa supply was dramatically hampered by Ebola outbreaks, which creates a negative impact to their economy.
It is true the Ebola outbreaks greatly hampered the West African cultures and their Religious beliefs. Most of the cases the impact is negative for West African peoples but also the negative impact will help the West African peoples to protect from several infectious disease those were transmitted by this funerals process.
Ebola Virus is not only a threat for West Africans, but also an emerging issue to sub-regional, local and worldwide security. In this perspective it requires global attention. An Economic Community in West Africa the Mano River Union (MRU) has initiates a regional strategy to preventing Ebola in this region. Such Strategy will be more efficient than simply focusing on national preventive activities. West African governments should increase investments in health care to accelerate recovery efforts. Fortifying health care systems and identifying the structural vulnerabilities that allowed Ebola to create such crisis.