Dr. James Appel has been asked by Adventist Health International to join her in the overwhelming job of providing care for non-Ebola cases that have been neglected due to other hospital closures by Ebola quarantine.
Dr. Appel is a very experienced mission doctor and has written extensively about providing Seventh-day Adventist health care in the Muslim country of Chad since 2004. His blogs about their daily experience caring for patients during the Ebola Crisis are available at www.ahiglobal.org.
After one month in Liberia, working with Dr. Seton and her dedicated Liberian nurses and doctors, Dr. Appel daily triages Ebola patients. The problems of preventing spread of this deadly disease in an impoverished community are a daily reality to this small team of Seventh-day Adventist health care workers.
As a massive and expensive foreign aid campaign slowly begins to respond to this crisis, Dr. Appel offers a very insightful analysis of what is wrong and what could be right from the donors and governments belatedly rushing in to “help.”
These deeply insightful comments were written by Dr. Appel from Monrovia, Liberia Monday, September 15, 2014. Adventist Today feel his opinions deserve to be considered by all donor organizations, and his article is reproduced here with Dr. Appel’s permission:
I don’t mean to be critical—
I don’t mean to be critical. I can’t really know what’s going on. I’m just a simple family doctor working in a hospital. I’m not really even taking care of Ebola patients. How could I know why Liberia is losing the fight against Ebola? I haven’t sat on any NGO (non-governmental organization) committees or listened to the WHO (World Health Organization) discussions or to what the CDC (Centers for Disease Control) has to say. I’m just ignorant. But I’m going to give my opinion anyway.
Losing a fight
Liberia is losing the fight against Ebola because they are depending on NGOs and an influx of Western money instead of traditional ways of dealing with epidemics. The first few Ebola epidemics were in remote villages where the villages touched by Ebola were self-quarantined according to ancient traditions of dealing with plagues.
No one went in and out, and the surrounding communities brought them food. The caregivers washed themselves and their clothes rapidly and frequently after each contact with the patient, just using simple soap and water. Very few ever got sick, and the disease was controlled in a few months.
Here in Liberia, everyone is excited about the millions of US dollars being poured in to “fight Ebola,” and everyone wants a piece of the pie. A certain NGO out in rural Liberia quarantined a village, claiming they’d tested and found three cases.
They applied for and received US$ 250,000 to fight Ebola in this village. They brought in a few sacks of rice and some chlorine. The villagers mobbed the trucks and carried off the plunder. And, miracle of miracles, not a single person died in the village.
Great effort at treating and controlling Ebola? Or pretending there’s Ebola in order to pocket some easy cash? I’ve never heard of a 0% fatality rate for Ebola, but you make the call.
Dozens of Land Cruisers
NGO’s spending hundreds of thousands of dollars to level earth with heavy equipment over a month in order to build tent cities capable of isolating and treating Ebola, but then not even giving them IV fluids or food, so that the Ebola patients sneak out of the tents and cross the street looking for food.
Dozens if not hundreds of US$70,000 Land Cruisers are taking foreigners around town to hotels, bars, clubs, and fancy guest houses so they can feel comfortable while they fight Ebola, and yet they can’t even collect the dead bodies that could expose so many more!
We’ve had bodies left for up to three days. Others have stayed in the open for up to five days before being collected. Patients are often turned away from the Ebola centers, and some have even refused to take anyone who doesn’t come in an ambulance. How many of the poor in West Point slum can afford an ambulance, even if there were enough available to take them?
According to James Pfeiffer, who is a professor of global health and anthropology at the University of Washington:
The aid and development industry helps cause Africa’s Ebola outbreak….We’re talking about reality…….about one of the root causes of the massive outbreak of Ebola now ravaging West Africa. It is the aid and development community – the same folks now responding to the rescue.
As the cartoon character Pogo put it: “We have met the enemy and he is us.”Pfeiffer says,
The popular narrative of the Ebola outbreak often points to weak governance, poverty and poor health systems as one of the primary reasons why this infectious disease has exploded in Liberia, Sierra Leone and Guinea. That’s absolutely true…
But what is usually not mentioned in the narrative, Pfeiffer adds, is how Western agencies devoted to reducing global poverty like the International Monetary Fund and the World Bank imposed policies on these countries (sometimes referred to as structural adjustment) that for decades has discouraged many African nations from investing in public infrastructure – such as basic health care systems.
What is also neglected is that the Western humanitarian community, the NGOs (non-governmental organizations), that are now trying to help – in many cases, courageously – fight this devastation also helped contribute to the weakening of in-country health care services……
Low-Tech Solutions from Dr. James Appel
Dr. James Appel proposes the following solutions. I got the idea from a seasoned MSF doctor named Cameron. (MSF is Médecins Sans Frontières, or Doctors Without Borders.)
There are two reasons people call the Ebola hotline: they have a dead body they suspect of Ebola, or they have a live patient they suspect of Ebola.
If there’s a dead body, the hotline should alert some local drivers with old beat-up pickup trucks, and the first one to the site gets the body. Of course, they will be given full protective gear.
If they bring the body in within 3 hours of the call they get US$50; if they bring it in within 6 hours of the call they get US$40; if within 12 hours, US$30; if within 24 hours, US$20; if after 24 hours, US$10. If after 48 hours, US$5. This will motivate people to quickly get the bodies and bring them in to be tested and buried appropriately, with minimal chance for contact and spread.
If it’s a live patient suspected of Ebola, a taxi can be called and for a few dollars take a nurse or lab tech out to the site in full protective gear. They will draw blood for Ebola testing, take the address and contact info, give the family a box filled with gowns, gloves, masks, rubber boots, bottles of chlorine, antibiotics, anti-malarials, oral rehydration salts and anti-vomiting medications.
They will contact the community leaders, who will ensure that the family is not only quarantined in their compound, but also provided with food and water.
All this could be done for a fraction of the current funds being used, and would be more effective, because the patients would all get the individual care that only a family member can give, including adequate food. It would also be more effective because you’d be using local methods and using the money to invest in the local economy instead of paying the high costs of plane tickets, salaries, living expenses, transportation costs, etc., of foreign aid workers.
I’m not saying that there shouldn’t be foreigners involved. I’m just saying that the foreigners should be working alongside the Liberians, helping them to find a solution to the Ebola problem, not trying to impose Western ideas that obviously aren’t working.
Foreigners should not be bringing in a lot of money that is spent on things that will just make the Liberians envious and want to share in the spoils of aid money.
Sorry for speaking my mind so frankly, but sometimes I just can’t seem to hold it all in, whether people like it or not.
On his blog, Jon Rappoport, lists the real factors which have been debilitating and killing people in that area for a very long time. These factors have nothing to do with a virus called “Ebola.”But the op is transformative. It shifts the focus. It paints a different picture. It makes a substitution:
Instead of severe malnutrition, protein-calorie deficit, starvation, contaminated water, horrific wars, grinding poverty, hopelessness, stolen farm land, industrial pollution, the invasion of outside investors and corporations who take over the natural riches of the area, toxic vaccine campaigns, toxic drugs (including vast overuse of antibiotics, which destroys the ability to absorb nutrients)—instead of these chronic conditions, we have a repackaged and re-formed and recreated reality: the virus. Ebola.
The Fatal Tendency of Mankind: Stupid Greed and False Philanthropy- Frederick Bastiat.
Albert Einstein said that, “Insanity is doing the same thing over and over again and expecting different results. For instance:
- The Bill and Melinda Gates Foundation, one of the largest charities in the world, has said that it will pledge $50 million to help fight the Ebola virus crisis in West Africa, which has killed over 2,200 people.
- The U.N. has estimated that close to $600 million will be needed in supplies to counter the epidemic. The U.S. government has already helped substantially, sending $110 million to West Africa, while The U.S. Agency for International Development pledged it will make another $75 million in funds available.
- BBC News reported that the British government has also stepped in and committed $40 million to fight Ebola, while the European Union has pledged funding worth $180 million to help West African governments strengthen their health services.
President Barack Obama announced a few days back that he will send U.S. troops to West Africa to help fight the disease, describing the situation as a “serious national security concern.”
We’re going to have to get U.S. military assets just to set up, for example, isolation units and equipment there to provide security for public health workers surging from around the world…..If we don’t make that effort now, and this spreads not just through Africa but other parts of the world, there’s the prospect then that the virus mutates. It becomes more easily transmittable. And then it could be a serious danger to the United States.
One wonders whether one of the U.S. military’s objectives is to fight “health wars” or set up hospitals. Lord Have mercy on Africa!
The character of Africa’s health and economic system cannot be changed with aid, military means or martial law. It’s impossible. Why? Aid and other donations in most African countries benefit only a small, privileged class.
Worse still, this international welfare in the form of aid destroys the incentive to be creative as Africans to solve our own problems. French political libertarian and economist Frederick Bastiat (1801–1850) described it as a law perversion by the influence of two entirely different causes: stupid greed and false philanthropy, which is the “fatal tendency of mankind.”He wrote:
Self-preservation and self-development are common aspirations among all people. And if everyone enjoyed the unrestricted use of his faculties and the free disposition of the fruits of his labor, social progress would be ceaseless, uninterrupted and unfailing.
But there is another tendency that is common among people when they can, they wish to live and prosper at the expense of others. This is no rash accusation, nor does it come from a gloomy and uncharitable spirit.
The annals of history bear witness to the truth of it: the incessant wars, mass migrations, religious persecutions, universal slavery, dishonesty in commerce, and monopolies.
This fatal desire has its origin in the very nature of man—in that primitive, universal, and insuppressible instinct that impels him to satisfy his desires with the least possible pain. When we look at God’s plan, we see that man can live and satisfy his wants only by ceaseless labor. That is the application of God-given faculties to the natural resources, in the midst of which He placed us.
This process is the origin of property. However in man’s quest to avoid pain, he has simply resorted to plundering his fellow man. Now, since man is naturally inclined to avoid pain and since labor is pain in itself, it follows that men will resort to plunder whenever plunder is easier than work. History shows this quite clearly and under these conditions neither religion nor reality can stop it.
Bastiat then asked the question:
When, then, does plunder stop? It stops when it becomes more painful and dangerous than honest labor. However, we entrust men to make laws with the sanction of the majority, and as result, we have allowed the law to be our instrument of plunder.
It is indeed impossible to imagine at the very heart of a society that the law has become an instrument of injustice. And if this fact brings terrible consequences to the United States, what about in most of Africa where the perversion of law is a principle or a system? Something to think about!