martes, 16 de diciembre de 2014

´Ebola ¿principio y final? ´ An essential book for understanding this pandemic and social phenomenon

Everyone interested in cooperation and global health is to be congratulated with the publication of ´Ébola ¿principio y final? ´. It is the first book published in Spain about this pandemic and social phenomenon. His author is a physician and writer Alberto Infante, a senior and veteran civil servant of the WHO and the Ministry of Spanish Health, he has a great capacity for synthesis that analyses and complaints about the failures which have been committed by international agencies ´denying´ the magnitude of this tragedy in Western Africa and delaying the necessary assistance; as well as the errors made by Central and local administrations when managing this disease in Spain. Red Deporte has had the pleasure of talking about ebola with Alberto Infante, an interview that follows.

What prompted you to write a book about ebola?

I wrote it at the request of my spirited editor who probably was “infected” by the interest contracted by the 2 cases of the religious Spanish and the nursing assistant infected. I thought about a rigorous and serious text that would ask the right questions and will place the problem of this outbreak in a fair manner. A text that criticizes both unwarranted alarmism in the developed world like the oblivion of the tragedy in the most affected countries. And always from a humanist perspective, as well as from an international public health point of view.  

The media has talk much about ebola in the last few months. Has it distorted reality, or negated many things that we should know? What does the book contribute with in this sense?

In my opinion, the serious media in general has been serious about the subject. But unfortunately, there are many who are not, and those…..Let us not fool ourselves: among us there is a lot of ignorance about ebola (even among medical practitioners). Ignorance allied with fear produces absurd behaviour like saying that a person is not contagious…at the same time that he/she is transferred to an isolation unit by personnel protected with Level 4 suits. But we are not the only ones. At Deli´s airport a person has been quarantined from Liberia, a person without symptoms and who tested negative in three blood tests, but with trace of virus proteins… in his semen.  My book attempts to provide reliable information and, if possible, some sanity.

We have seen how ebola has arrived to Spain or The United States. In theory we could expect for the virus to spread for more countries in Africa. Why is the reason it hasn´t expanded even further in the African continent? 

Yes, it has expanded. At the beginning, there were cases in Senegal and Nigeria that were swiftly and well remedied.  Not long before it was an independent outbreak in Congo that is over. There have been also a few cases in Mali. We cannot exclude the possibility of more cases appearing in neighbourhood countries. But the virus, although is very lethal, fortunately enough is not too contagious. It is necessary an intimate contact with blood or fluids of a sick person and that contact to be in an invasive way. The virus is not transmitted by air and intact skin protects you. In addition, by the time symptoms appear these are very disabling, patients cannot move on their own feet. That is why, regardless of the measures taken, the frontiers of these countries are porous and the under-reporting of sick and deceased is still too high. 

What is the impact of ebola in the most affected countries, both psychologically and economically, or on the population daily basis?

On a psychological and social level the impact is being enormous: schools and hospitals closed,  markets that hardly open, people who stop working in the affected areas, dozens of abandoned children, afraid of the healthy ones to become infected, fear of the contacts to be isolated, fear of the sick for going to the treatment centres, fear of the care takers and the ones who buried bodies…..This situation is changing little by little in some areas (for example in Monrovia) but not in others, especially in rural areas. On the economical level, suffice it to say, that these countries (in 2013 there were among the ten poorest countries in the world) grew at 4 and 8% before the outbreak; however, according to a World Bank estimate, in 2014 they will grow very little or in some cases will decrease. In many areas they are not sowing and the risk of a famine breaking in the next few months is very real.

To conclude ¿how was the experience of writing this book “in the heat of the moment” and in full eye of the storm? Have you met much resistance and hurdles on the way by people and institutions? Or on the contrary, have you found support and testimonials which have made the writing of "Ébola" a gratifying experience? 

I wrote the book in little more than ten days and my editor launched it in another ten. It has been a race against the clock, which was facilitated because I was working at the WHO  facilities between April and June, and I directly witnessed the inaction during those months; and also because working at the National Health School we lived (and discussed) the Spanish cases very closely.  In September and October there was no meeting or talk in which I was not asked about ebola.  Moreover, together with Dr. Juan Martínez Hernández, we had to explain it first to the pupils of Diploma de Salud Internacional and afterwards to a massive staff meeting at the Instituto de Salud Carlos Tercero.    Much of the book I owe it to those discussions with colleagues and friends, but logically, the responsibility of what is written is only mine. Lastly, some courses started for training personnel of the National Health System (that are still on-going).  I believe if these had started before the first repatriation, things would have gone much better. I have no found any impediment for writing it and both the experience of writing as well as attending afterwards numerous meetings about the subject has been rather gratifying. Although, given the decrease interest about this subject in the developed world (we only remember Santa Bárbara when it thunders) I am afraid my spirited editor will think it about twice before asking me again.

The book ´Ébola ¿principio y final? ´ is available online and in shops like Casa del Libro, El Corte Inglés or through the publisher ´Nostrum´ on the following telephone number: 915 732 186


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