31 Oct - 6 Nov 2014 #730

Ebola in Asia

There is no question that an Ebola outbreak in South Asia will be very difficult to handle considering the region’s poor health infrastructure.
Dhanvantari by Buddha Basnyat, MD

There is no question that an Ebola outbreak in South Asia will be very difficult to handle considering the region’s poor health infrastructure. In the past too, there have been cases of people (returning to Nepal with infectious diseases from Africa)[http://nepalitimes.com/news.php?id=5624] and succumbing to it due to misdiagnosis.

The life-threatening falciparum malaria is one such example. A returning soldier from his peace keeping duties in Africa may be incubating this dangerous form of malaria but a visit to a doctor may not result in right treatment. This is because as in the case of Ebola, the symptoms are similar to common flu.

The good news is that Ebola is nowhere as common as malaria. Furthermore, the governments have been alerted to the possibility of travellers from West Africa carrying the virus and have tried to take the necessary steps to prevent an outbreak.

Because of their experience with the SARS outbreak in 2003, Hong Kong is probably the most prepared region to deal with an Ebola outbreak in Asia. However, the big difference between SARS and Ebola is that Ebola is not spread through aerosol. In Hong Kong, after the SARS outbreak many intensive care units (ICU) were instituted with negative pressure rooms to keep the organisms away from circulating in the atmosphere. Anterooms in were also instituted in these ICUs for the safe donning and removal of personal protection equipment, a matter of vital importance in controlling an Ebola outbreak.

(China is another country that will be able deal)[http://news.xinhuanet.com/english/china/2013-04/08/c_132292650.htm] with an Ebola outbreak better than most Asian countries. Their history of dealing with outbreaks like SARS and other influenza pandemics have helped them in this regard. In addition, it helps that China’s health care spending per person is five times that of India.

There is another important factor that will come into play if we have to deal with an Ebola outbreak. That is our mindset. We are not a country that likes to follow directions even at the cost of endangering ourselves. We know overcrowding causes accidents, but we still continue to travel that way. With this kind of a psychological impasse, it will be hard to deal with a disease where following directions (for example in disposing of dead bodies) is key to its prevention. In this context it is sobering to read that even in the mid-16th century London during King Henry the eighth’s reign, when plague struck, common people followed directions and burnt all the beds and mattresses of patients who died of the disease.

Nepal is still faltering in its preventive measures against more common and preventable (and treatable) diseases like tuberculosis. We clearly need to revitalise our efforts to control and treat diseases.

Whether the Ebola virus will successfully propagate to this part of the world or not, and how effective these governmental steps will be, only time will tell. But in general the consensus amongst experts is that there is only a slim chance that the virus will come here.

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