Why There’s No Ebola Vaccine

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Ebola virus

Once upon a time, Ebola was a virus that attacked only poor people in the ‘developing’ world. Rich people in ‘developed’ countries didn’t catch nasty diseases like Ebola. Their wealth immunised them. They had nice, clean hospitals and lots of doctors and nurses who practised high-tech medicine.

All the same, even in the rich First World, poor people often got a raw deal. Many of them simply couldn’t afford health insurance. They were Third-World citizens in the First World. So they died from chronic diseases like diabetes and high blood pressure. Not as traumatic and swift as death by Ebola. But still. Poverty significantly reduced their chance of surviving expensive illnesses.

Then there were those deadly epidemics that sometimes broke out in the First World: polio, measles, mumps, chickenpox, whooping cough and influenza. These diseases affected both the rich and the poor. But, naturally, it was quite a strain on the poor to cough up the money for medical care.

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Flu patients in the U.S. 1918

In 1918-1919, millions of people across the world died of influenza. The scale of the crisis was so vast that resources were immediately invested in research. The catastrophe forced scientists to develop a vaccine to combat the virus. Returns on the investment were guaranteed. There was a huge global market for the influenza vaccine. Disease was a very profitable business.

By contrast, when the Ebola virus emerged in the Democratic Republic of Congo (DRC) almost 40 years ago, it was seen as an ‘African’ problem. Named after the Ebola River, the virus was, at first, contained within small villages. And it soon disappeared. Or so it seemed.


POOR AND EXPENDABLE

I suppose it didn’t make good economic sense then to try to develop a vaccine for Ebola. The market was small and the people who needed it were poor and expendable. Now, the virus has reappeared and it isn’t staying put in West Africa.

Ebola has flown across the Middle Passage to North America; and it’s also in Europe. In the rich world! All it takes is one infected person to start an epidemic, as Malcolm Gladwell reminds us in The Tipping Point. The Ebola River is flowing swiftly. And drug companies are now hustling to develop a vaccine.

Professor Peter Piot, director of the London School of Hygiene and Tropical Medicine at the University of London, tells the story of how he and his colleagues discovered the Ebola virus. In 1976, while he was still training in Belgium to become a microbiologist, a blood sample came to the lab in Antwerp on a commercial flight from Kinshasa.

The sample was taken from a Belgian nun who had fallen ill in Yambuku in deep rural Zaire, as the DRC was then known. It came with a question: Was it yellow fever? It was not. Piot and his teammates injected mice with the blood and after several days they started to die off. Mice of the world are going to rise up against scientists one of these days.

The Ebola virus was eventually isolated. But there’s a terrible twist to the story. According to Piot, nuns in Yambuku who operated a mission hospital were using unsterilised needles to give vitamin injections to pregnant women. The nuns accidentally infected them with Ebola. It is stories such as this that make conspiracy theorists sound almost sane.

STIGMATISING AFRICA

One of the tragedies of the current Ebola epidemic is the way the entire continent of Africa is being stigmatised as the land of disease and death. Some of us conveniently forget that the origins of modern medicine are in ancient Egypt, not Greece. It is Imhotep, not Hippocrates, who ought to be acknowledged as the Father of Medicine.

Onesimus

Onesimus

And we don’t have to go all the way to ancient Egypt to find evidence of sophisticated knowledge of medicine in Africa over several centuries. On October 17, 2014, the Boston Globe published an article by Ted Widmer: ‘How an African slave helped Boston fight smallpox’.

In 1721, the deadly disease ravaged the city. It was Onesimus, an enslaved African, who enlightened his supposed ‘master’, Cotton Mather, about the science of inoculation against smallpox. This is how Onesimus described the process: “People take Juice of Small-Pox; and Cutty-skin, and Putt in a Drop.”

Mather interviewed other Africans who had been vaccinated and who had the scar on their arm to prove it. He became an advocate of inoculation and tried to persuade the goodly citizens of Boston to try the preventative measure. His house was firebombed.

As Widmer observes: “There was a racial tone to their response as well, as they rebelled against an idea that was not only foreign, but African (one critic, an eminent doctor, attacked Mather for his ‘Negroish’ thinking).” How dare a ‘Negro’ teach white people about disease control?

The big lesson of the present Ebola epidemic is that continental Africans must reclaim the legacy of Imhotep. They need to put in place sustainable systems of health care. They cannot continue to be chronically dependent on the West to ‘help’ them out of one crisis after another. They must take charge of themselves. As our own poet Jean ‘Binta’ Breeze puts it so eloquently, “Aid travels with a bomb.” Just think of those pregnant women injected with Ebola.

Imhotep-Louvre

A TRIBUTE FROM MY FRIEND

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Kemorine Miller

On National Heroes’ Day last year, my long-time friend, Kemorine Miller, gave me a card in celebration of my being awarded an honour.  In all of the excitement, I didn’t open it right away.  I was so mad with myself when I later read Kemorine’s words.  They would have been so good to share at the gathering at my home on Heroes’ Day.  So, a year later, I’m posting them here, in appreciation of Kemorine’s generosity.

“Carolyn mi chile, mi heart full.  Mi proud caan dun.  If mi nuh mine sharp, di hola mi swell up an bus.  Wat a ting wen from fi mi generation mi owna fren from high school tun lecturer, auta an big-big educata.

Mervyn Morris

Mervyn Morris

Edward Baugh

Edward Baugh

Gal, mi glad seh yuh did teck een all weh Mas Eddie an Mas Mervyn did a teach yuh up a Uwee so now yuh coulda tun profesa like dem an now yuh get honours like dem.  Wat a sinting mi live fi si!

Chile, wa mi really glad fa is dat a nuh mi one si all weh yuh a duh ina education.  Dis ya National Hona tideh is di crowning glory.  Mas George an Mama Modesta bright yeye pickney, mi prouda yuh.  Nuff, nuff respect.”

Kemorine mi dear, nuff, nuff thanks!

Malcolm Gladwell An Chik-V

Two spelling systems are used for the Jamaican language below. The first, which I call ‘chaka-chaka’, is based on English spelling. The second, ‘prapa-prapa’, is the specialist system designed by the Jamaican linguist Frederic Cassidy. It has been updated by the Jamaican Language Unit at the University of the West Indies, Mona. After the two Jamaican versions, there’s an English translation.

CHAKA-CHAKA SPELLING

poz4Mi nah put goat mout pon Malcolm Gladwell. Not at all. Mi hope mosquito never bite im an gi im chik-V wen im come ya fi talk last week up a UWI. Im come fi help raise money fi di Sir John Golding Rehabilitation Centre. Dat deh centre did set up inna 1954 fi look after di whole heap a people dem weh did ketch polio. Di sickness tek Jamaica inna di July an 759 smaddy did get lik down; an 94 a dem dead.

Polio a one next virus laka chik-V. But a no mosquito spread it. Yu ketch it straight from one next smaddy. Mi know nuff a wi think seh a di said same ting wid chik-V. A no so-so mosquito. But di big-time scientist dem seh a no so. We done know bout science an science. But mek mi lef it.

Polio mash up yu nerves an bend yu up same time. Di good ting bout polio, dem have injection weh can protect yu. No injection no deh fi chik-V. An wen it tek yu, it hold on pon yu. Long time. An if any odder sinting wrong wid yu, chik-V mek it worserer. Yu can dead sake-a chik-V. Mi tink more an 94 a wi a go dead by di time chik-V done wid wi.

PITCH OVER YA SO

Malcolm Gladwell write one book weh im call The Tipping Point. Inna fi wi language, pitch over ya so. See di rest a di title: How Little Things Can Make a Big Difference. A true. Look how one lickle mosquito mash up so much a wi! Mi seh wi ha fi tek bad tings mek joke. Like how di lickle yute, Wayne J, sing bout ‘One Panadol’.

The Tipping Point a di first book Gladwell write weh come out inna 2000. An it sell off! A fi him ‘tipping point’ dat. Di book pitch Gladwell over mek im a roll inna money. Nuff, nuff money. Mi glad fi him. Him a one a wi. Him mother born right ya so. An him father from England know good woman.

Hear how Gladwell explain himself: “The tipping point is that magic moment when an idea, trend, or social behaviour crosses a threshold, tips, and spreads like wildfire. Just as a single sick person can start an epidemic of the flu, so, too, can a small but precisely targeted push cause a fashion trend, the popularity of a new product, or a drop in the crime rate.”

Gladwell tek di science bout how sickness spread all bout an divel it up. Him show wi how sopn good can spread same way. Me tink seh right now, Jamaica ready fi pitch over. Chiv-V mek wi see seh wi ha fi clean up di country. An a no ongle dutty wata mi mean. By di way, di chik-V mosquito love clean wata.

Inna him lecture, Gladwell seh wi ha fi rispek one anodder an trust one anodder. Wi ha fi mek everybody inna Jamaica know seh di whole a wi a smaddy. An me seh if it tek chik-V fi force wi fi see seh wi can’t gwaan so careless bout evriting inna Jamaica, dat a fi wi ‘Tipping Point’ fi true.

PRAPA-PRAPA SPELIN

Michael Gladwell

Malcolm Gladwell

Mi naa put guot mout pan Malcolm Gladwell. Nat at aal. Mi uop maskita neva bait im an gi im chik-V wen im kom ya fi taak laas wiik op a UWI. Im kom fi elp ries moni fi di Sir John Golding Rehabilitation Centre. Dat de centre did set op ina 1954 fi luk aafta di uol iip a piipl dem we did kech puolyo. Di siknis tek Jamieka iina di Juulai an sevn ondred an fifti nain smadi did get lik dong; an nainti fuor a dem ded.

Puolyo a wan neks vairus laka chik-V. Bot a no maskita spred it. Yu kech it chriet fram wan neks smadi. Mi nuo nof a wi tingk se a di sed siem ting wid chik-V. A no suoso maskita. Bot di big-taim saiyantis dem se a no so. Wi don nuo bout saiyans an saiyans. Bot mek mi lef it.

Puolyo mash op yu norz an ben yu op siem taim. Di gud ting bout puolyo, dem av injekshan we kyan protek yu. No injekshan no de fi chik-V. An wen it tek yu, it uol aan pan yu. Lang taim. An if eni ada sinting rang wid yu, chik-V mek it wosara. Yu kyan ded siek a chik-V. Mi tingk muor an nainti fuor a wi a go ded bai di taim chik-V don wid wi.

PICH UOVA YA SO

The-Tipping-Point-Book-CoverMalcolm Gladwell rait wan buk we im kaal The Tipping Point. Ina fi wi langgwij, pich uova ya so. Si di res a di taikl: How Little Things Can Make a Big Difference. A chruu. Luk ou wan likl maskita mash op so moch a wi! Mi se wi ha fi tek bad tingz mek juok. Laik ou di likl yuut, Wayne J, sing bout ‘Wan Panadal’.

The Tipping Point a di fos buk Gladwell rait we kom out ina 2000. An it sel aaf! A fi im ‘tipping point’ dat. Di buk pich Gladwell uova mek im a ruol ina moni. Nof, nof moni. Mi glad fi im. Im a wan a wi. Im mdaa baan rait ya so. An im faada fram Ingglan nuo gud uman.

Ier ou Gladwell eksplien imself: “The tipping point is that magic moment when an idea, trend, or social behaviour crosses a threshold, tips, and spreads like wildfire. Just as a single sick person can start an epidemic of the flu, so too can a small but precisely targeted push cause a fashion trend, the popularity of a new product, or a drop in the crime rate.”

Gladwell tek di saiyans bout ou siknis spred aal bout an divel it op. Im shuo wi ou sopn gud kyan spred siem wie. Mii tingk se rait nou, Jamieka redi fi pich uova. Chiv-V mek wi si se wi ha fi kliin op di konchri. An a no ongl doti wata mi miin. Bai di wie, di chik-V maskita lov kliin wata.

Ina im lekcha, Gladwell se wi ha fi rispek wanada an chros wanada. Wi ha fi mek evribadi ina Jamieka nuo se di uola a wi a smadi. An mii se if it tek chik-V fi fuors wi fi si se wi kyaahn gwaahn so kielis bout evriting ina Jamieka, dat a fi wi ‘Tipping Point’ fi chruu.

ENGLISH TRANSLATION

imagesI’m not putting a jinx on Malcolm Gladwell. Not at all. I hope he wasn’t bitten by a mosquito and didn’t get chik-V when he came here to give a talk last week at UWI. He came to help raise money for the Sir John Golding Rehabilitation Centre. That centre was set up in 1954 to care for the large number of people who caught polio. The epidemic broke out in Jamaica in July and 759 people were infected; and 94 of them died.

Polio is another virus like chik-V. But it’s not spread by mosquitoes.  You catch it directly from another person. I know a lot of us think that’s exactly how chik-V is passed on. Not only by mosquitoes. But the eminent scientists disagree. We know the difference between science and science. But don’t let me go there.

Polio destroys your nerves and twists you up immediately.  The good thing about the disease is that there’s a vaccine for it. There’s none for chik-V. And when it infects you, it lingers for quite a while.  A ‘good’ while. And if have any chronic illnesses, chik-V makes them rather worse. You can die because of chik-V. I think that more than 94 of us are going to die by the time chik-V is finished with us.

THE TIPPING POINT

Malcolm Gladwell wrote a book called The Tipping Point. In our language, pitch over ya so. Here’s the sub-title: How Little Things Can Make a Big Difference. It’s true. Just think about how one little mosquito has crippled so many of us! We really do have to laugh at our troubles.   Like the boy, Wayne J, who sings about ‘One Panadol’.

The Tipping Point is Gladwell’s first book which was published in 2000. And it was a bestseller!  That was his ‘tipping point’.  The book catapulted him to fame and fortune.  A huge fortune! I’m very happy for him. He’s one of us.  His mother was born right here. And his father, who’s from England, chose his wife very well.

Hear’s how Gladwell explains the book’s title: “The tipping point is that magic moment when an idea, trend, or social behaviour crosses a threshold, tips, and spreads like wildfire. Just as a single sick person can start an epidemic of the flu, so, too, can a small but precisely targeted push cause a fashion trend, the popularity of a new product, or a drop in the crime rate.”

epidemicGladwell applied to social issues the principle of how epidemics spread. He argued that good things can spread in exactly the same way. I think Jamaica is at at turning point right now. The Chiv-V epidemic has forced us to acknowledge the fact that we must clean up the country. And it’s not only dirty water I’m talking about. By the way, the chik-V mosquito loves clean water.

In his lecture, Gladwell said that we have to respect and trust each other.  We have to make everybody in Jamaica know that that all of us count. And I say that if it takes chik-V to force us to see that we can’t continue to be so irresponsible about everything that matters in Jamaica, that truly is our ‘Tipping Point’.

Too Little, Too Late, Sister P!

article-2649672-1E7EF20800000578-911_634x419Almost a year ago, in December 2013, the World Health Organisation reported that chik-V was in the Caribbean. Mosquitoes on the island of St Martin-St Maarten had been infected with the virus and were spreading it to the human population.

Even before that, the Pan-American Health Organisation (PAHO) and the Centers for Disease Control and Prevention (CDC) jointly published in 2011 a vital document, Preparedness and Response for Chikungunya Virus Introduction in the Americas. It warned that “[t]he resulting large outbreaks would likely tax existing health-care systems and the public-health infrastructure, and could potentially cripple some of society’s functioning”.

That’s when the Government of Jamaica should have taken notice and started a public-education programme on the threat of the virus. Before it got here; not now. Why was our minister of health not paying attention then?

The PAHO-CDC document, which is available on the Internet, clearly states its objectives: “the prevention, detection, and timely response to outbreaks of CHIK through surveillance, case detection, investigation, and the launching of public-health actions”.

DIEHARD COMRADES

39871pnp72confn201009219rbThe document highlights the importance of Government sending out information that would “encourage informed decision making, positive behaviour change, and the maintenance of trust in public authorities”. This business of trust is crucial. But how many of us actually trust our public authorities? Even diehard Comrades who have been afflicted with chik-V cannot truthfully say they trust the word of the minister of health.

The Government should have been using both old and new media to spread accurate information on chik-V over the last three years. The PAHO-CDC guidelines acknowledge the fact that an outbreak of the disease can cause “confusion and controversy”. Chik-V has certainly made imaginative Jamaicans chat a lot of nonsense. Like saying it was the plane that crashed off the coast of Port Antonio on September 5 that brought the virus!

I suppose the minister of health will claim that the Government didn’t have the money to launch an expensive media campaign. The International Monetary Fund (IMF) has been forcing us to cut back on government spending. But in 2011, when those detailed warnings about managing chik-V were issued by PAHO-CDC, we should have told the IMF to ease off. A crippled workforce cannot possibly be productive.

MOSQUITO HOTELS

imagesAdmittedly, the problem of disease control is much bigger than the failure of Government to lead effectively. We can’t leave it all up to untrustworthy Government. Every single citizen must take some responsibility for protecting our neighbourhoods from the threat of disease. Yes, the Government must ensure that gullies are regularly cleaned. But we have to stop throwing rubbish into gullies.

Another environmental issue we have to deal with is abandoned lots that are all-inclusive hotels for mosquitoes, especially when it rains. So here’s my story on that score. There’s an empty lot behind my house and two more in front. On all of them, the grass is at least two metres high. I know only one of the proprietors of these mosquito hotels. I called him a couple of weeks ago about bushing the lot.

I’d heard that he’d recently sold the lot, so I really wanted to be put in touch with the new owner. I couldn’t believe it when he told me that the lot had been sold by a third party and he didn’t know the new owner. So I asked him to let me know who the third party was. He would have to call me back. I heard nothing from him.

STORY COME TO BUMP

Then last week, a woman stopped at my gate to ask if the lots were for sale. I told her I didn’t think any of them was on the market. But I suggested that she talk to the mosquito hotelier I knew. I called him. And story come to bump. His lot was sold, but if he got a better offer, he would consider it!

sin-picture2This is a nice Christian gentleman who must know that it is sinful, if not downright criminal, to be offering for sale property that is supposedly already sold. It seems as if the nice gentleman is pretending he doesn’t own the lot so he won’t have to be responsible for bushing it. Anyhow, he did assure me that he had contacted the owner and it would be bushed by the end of the month. I guess he talked to himself – the first sign of madness.

This is what is so wrong with Jamaica. We are just too selfish. The owner of an open lot doesn’t usually live anywhere near it. So it’s not his or her problem if the lot is an unsightly breeding ground for mosquitoes. Too bad for the people who just have to put up with it; or clean it up at their own expense.

At a press conference called last Thursday, Prime Minister Portia Simpson Miller appealed to our better nature. She asked us to help the Government cope with our public-health crisis. She should have done that three years ago. Chik-V batter-bruise wi now. It’s much too late to kiss and make up.

Prime Minister and Minister of Health at press conference on public health crisis

Prime Minister Portia Simpson Miller and Minister of Health Fenton Ferguson at press conference on public-health crisis

Protecting Tourism At What Price?

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Dr. Fenton Ferguson

As late as last Monday, Dr Fenton Ferguson was still claiming that there were only 35 ‘confirmed’ cases of chik-V in all of Jamaica. If the goodly dentist has a public-health inspector to spare, I can prove that a full 25 per cent of these cases are concentrated in just two roads in my neighbourhood!

I have chik-V. My neighbours to my right and left and up the road are also afflicted. That’s four of us. And down the adjacent road, there are at least another five cases. So that makes nine out of 35. And that’s just the ones I know about. Of course, the big trick is ‘confirmed’. We are not ‘confirmed’ cases. We have the symptoms, but that doesn’t matter.

As far as the Ministry of Health is concerned, if you haven’t done a blood test, you and your doctor are just guessing. It could be chik-V, dengue or some mysterious combination thereof. You just can’t be sure. That’s why Dr Ferguson could have kept on pretending for so long that there are only 35 ‘confirmed’ cases of chik-V in all 14 parishes! It’s just a word game.

NOT A GOOD SIGN

brandmarkLast Tuesday, I decided I’d had enough of the guessing and spelling. So I told my doctor I needed to do the test. I wanted to be ‘confirmed’, or not, as the case may be. She sent me to Caribbean Genetics (Carigen) located in the brand new building that houses the Faculty of Medical Sciences at the University of the West Indies.

Carigen is on the fourth floor and the main elevators were not working. Already? Why aren’t the elevators being maintained, I wondered. But I was there for a blood test. I was not a professional building inspector. I decided to mind my own business. All the same, I felt uneasy. This was not a good sign.

As a victim of unconfirmed chik-V, I was not prepared to take the stairs all the way up to the fourth floor. Fortunately, the service elevator in the back was working. When I got to Carigen and presented the form for the blood test, I was informed by the receptionist that the test could not be done. There were no reagents in stock. And she did not know when they would be coming in.

She said they could still take the blood sample and the test would be done when the reagents were available. I declined the offer. I had no confidence in tests done on ‘stale’ blood. Of course, this must have been the ‘unconfirmed’ chik-V talking. My response was completely unscientific. In other circumstances, I would have readily taken the receptionist’s word for it: refrigerated blood could remain perfectly fresh for quite a while.

But, in my state of frustration, I was quite prepared to diss science in favour of instinct. And, in any case, my response was no more irrational than Minister Ferguson’s insistence for so long that there were only 35 ‘confirmed’ cases of chik-V in Jamaica. As if that was the whole truth of the matter.

SCARING TOURISTS

jamaica_tourist_boardI’m not surprised that the minister of health finally confessed last week that he’s been concerned about the impact of chik-V on the tourist industry. That now seems to be the primary explanation for why the number of ‘confirmed’ cases of the disease is so low. Of course, the unavailability of reagents for testing is another factor.

I completely understand Dr Ferguson’s anxiety about scaring off visitors with chik-V. After all, tourism is our bread and butter. But I think he’s underestimating the bravery of potential tourists. One of my neighbours with chik-V told me last week that she was expecting relatives from the UK to come on holiday. She warned them about the virus and suggested that they postpone their trip.

They called their hotel and were reassured that there was no problem. And they’re here, having a very good time. For them, the sting of unpredictable English weather is a confirmed fact. Much more certain than the risk of being bitten by a bad-mind mosquito!

I think the minister of tourism and entertainment should launch an innovative chik-V campaign. On departure, each visitor should be given a farewell gift: a badge of bravery that reads, ‘I survived chik-V in Jamaica’. It could become quite a fashion statement. A whole new meaning of ‘chic’!

lying-410x273Seriously, though, the minister of health needs to be far less concerned about tourists and much more worried about the people of Jamaica. The Government has a much bigger problem than chik-V. And, by the way, the Opposition is an essential part of government. Most Jamaicans simply don’t trust the word of politicians.

The health ministry’s concealment of the truth about the spread of chik-V is just another example of why most of us don’t take politicians seriously. Dem too lie! Half a truth is a complete lie. As one of my wicked friends said, if is one person she waan fi get chik-V is Dr Fenton Ferguson. Then him will know fa sure. There are definitely more than 35 confirmed cases of the disease in Jamaica. If is only one more!