Illustration by Eric Rannestad.
In the beginning of medical training, one of the essential principles learned is “do no harm.” Most people who have been writing about ebola in the United States aren’t medical professionals, so they might not feel a responsibility to uphold this rule. Coverage of the few ebola cases in the United States has read like some sort of zombie horror novel where all hell breaks loose the moment ebola spreads from West Africa to the United States and all of a sudden isn’t just a faraway statistic anymore. Ebola is scary, but fear of ebola shouldn’t lead to fear of other cultures or people.
Two summers ago, I contracted a tropical hemorrhagic fever. It was dengue, not ebola, but the two viruses have similar symptoms including high fever, vomiting, muscle pain, and internal and external bleeding. They both burden the developing world almost exclusively. Despite the fact that there are over 100 million cases of dengue annually, and that the death toll from the current ebola outbreak is quickly approaching 5,000, efforts to improve conditions that foster proliferation of disease haven’t received enough support. Additionally, neither virus has any FDA-approved vaccines or drugs.
We live in a world where pharmaceutical manufacturers, insurance companies and a dysfunctional medical-industrial complex turn illness and disease into something immensely profitable. However, since diseases like ebola and dengue primarily affect poor people who live far away, they are neglected, and research that could save millions of lives goes unfunded. In this system human suffering only matters when the people suffering can afford expensive treatments, and everyone else is just a number. People aren’t statistics. When the numbers say that 5,000 people have died of ebola, it means that 5,000 individuals, with talents and dreams and loved ones, died a bloody, unglamorous death.
When social factors play a role in determining quality of health, disease isn’t just a biological concern. Ebola is a race issue, due to how some new policies are equating fear of ebola with fear of Africans, a feminist issue, since almost 75% of ebola cases are in women, and a socioeconomic issue, as the Texas hospital sent the first US ebola victim home from the emergency room because he was uninsured.
My ultimate goal in life is to work for Doctors Without Borders. In following the work they’ve done to combat the ebola outbreak in Liberia, Sierra Leone and Guinea, it’s become clear to me that they’re not just combatting a disease. Liberia has a sad history of colonialism and civil war, which has left bad infrastructure and a rightful distrust of Americans. In order to do their work and take care of patients, Doctors Without Borders must find a way to overcome these systemic problems, handle cultural differences with sensitivity and prove to the people of Liberia that they’re not there to exploit or exterminate.
One way they’ve tried to show this was in the decision that they would not use experimental non-FDA approved vaccinations or drugs to treat ebola patients. Guided by medical ethics and the principal of “do no harm” the organization holds a position that distances itself from neocolonialism. These unapproved drugs could potentially save lives, but patients might not be able to give informed consent to participate in a clinical trial and the drugs could have unintended side effects. By not turning West Africa into a giant shady drug trial, Doctors Without Borders is legitimizing their intent to provide impartial care. Their price for integrity is measured in lives lost. However, the consequences of straying from the principals of bioethics would foster malpractice, distrust and dehumanization, ultimately costing even more lives.
