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Ebola, cuts in CDC and NIH budgets, no surgeon general---but lack of outcry when the only people killed were in Africa.

   Several items in the news yesterday seemed to interplay.
   First, of course, was the media-driven frenzy over Ebola hemorrhagic fever.
   Second is the mention of Congress’s failure to even vote on President Obama’s nominee for Surgeon General of the United States.
   Third is the mention of cuts Congress has made to the budgets for the Centers for Disease Control and the National Institute of Health.
   Fourth, and only sort of a footnote, was the National Rifle Association.
   What I did not hear mentioned was race.
   Ebola first was identified in 1976 after an outbreak in Southern Sudan. Hoenen, T., 12 Expert Opinion on Biological Therapy, issue 7, 859-72 (2012). The disease has been a central dynamic of plot in several novels. The symptoms of the disease are gruesome, as are the symptoms of any hemorrhagic fever. The root of the word “hemorrhagic” is “hemorrhage,” defined as “a discharge of blood, as from a ruptured blood vessel.” From 1976 to 2013, the World Health Organization has found that 1,716 cases were confirmed, in sub-Sahara Africa.
   One aspect that drew my interest was set forth in several statements from medical authorities when the latest outbreak, that has killed more people than all the identified cases that pre-date it, is that, with proper basic medical care, the mortality rate—the percentage of people who, once infected with the virus, die—is far lower than the 70 to 90 percent that has been predominant in central Africa.  On PBS last week, a half-hour program was set in Sierra Leone where Les Docteurs Sans Frontieres—Doctors without Borders—are treating patients at temporary hospitals set up in tents. One of the doctors related the effects of dehydration—caused by vomiting and diarrhea, common symptoms of Ebola—and the importance of rehydration and replacement of electrolytes for persons diagnosed with the disease.
   Ebola and other hemorrhagic fevers, have broken out in sub-Saharan Africa over the past few decades. People in this country were not whipped up into a frenzy over those diseases or the numbers of people who died. One could ask—what would the reaction of the United States have been if the latest outbreak of Ebola had been in Denmark? There would not have been an outbreak because the disease is spread, in large part, by ignorance and poverty. In the PBS show, rumor spread amongst people of Sierra Leone that there was no disease, but that doctors simply took their loved ones so that the doctors could steal the loved ones’ blood. People are frightened and want to keep hidden loved ones who begin to exhibit symptoms because so few taken to the hospital tents return. People armed with automatic weapons tried to approach the hospitals. So we had doctors treating patients under difficult conditions now being threatened with armed attacks.
   As to the Surgeon General—who is an admiral, by the way—of the United States, that position largely is for dissemination of information to the American public. The credentials of President Obama’s nominee, Dr. Vivek H. Murthy, have not been questioned. What has been questioned is his membership in an organization, Doctors for America, that has taken the position gun violence should be considered a public health epidemic on a par with heart disease. The organization has pushed for gun control legislation. Fox News, on-line, 2/26/14. Spokes people for the National Rifle Association have stated the NRA will “score” those Senators who vote to advance the nominee will be scored. The NRA has a scoring system for political candidates, and American politicians do not want to be averse the NRA. There were over thirty thousand (30,000) deaths from firearms in the United States in 2010. Two-thirds of those deaths were suicides. The numbers would indicate gun violence is an “epidemic,” although the definition of “epidemic”—“affecting at the same time a large number of persons in a locality, and spreading from person to person”—seems to infer a sudden onset of a “new pathogen. Gun violence thuis would be a chronic problem. However one characterizes it, over thirty thousand people die each year from gun violence, and physicians treat them. To prevent a person from occupying the office of Surgeon General because he (or she, if the person were a female) because of the person’s membership in an organization that promotes gun control deprives this country of a voice for times such as these: when someone needs to be the spokes person for the United States to calm people about what is not an epidemic.
   Third, the tea baggers—they provided that name to themselves, remember—have pushed for cuts in government budgets. Those cuts have included budgets for the National Institute of Health and the Centers for Disease Control. The blame goes to members of both parties in Congress. While there is an open checkbook for any military contractor that wants to build a new weapon or another aircraft carrier, research for such things as medicines to combat epidemics have flat-lines over the last 30 years or so. CDC and NIH have taken hits. The mindset for such cuts can be traced to Ronald Reagan’s 1981 inaugural address in which he declared government is not the solution to our problem, but the cause. (Except, of course, as one column recently noted, when it comes to military contracts or intervention in other countries’ affairs.)
   The Dallas hospital where an Ebola patient was treated has two nurses, who treated that patient, who apparently have contracted Ebola. Right wing people decry the lack of leadership from President Obama for what has ensued. Realize, however, that the hospital had no protocols for handling patients with Ebola. One nurse, who took a flight from Dallas to Cleveland and back, could have been told not to fly. However, that was not part of the training. There were no protocols. Anyway, such things require money to implement. Hospitals concerned with profit will not spend the time and capital on protocols. There was no budget for it from the Government.   
   I already addressed the matter of the NRA, an organization that has far more clout with dollars than with membership.
   What has not been mentioned, by any source to which I have listened or from which I have read, is race. For 38 years black people in Africa have been killed by outbreaks of Ebola. American publishers have made money from the disease. Hollywood has taken its cut. Until there was a real possibility the disease would hit the United States, no one seemed interested. Now we are told the public is in a frenzy. Some people in the media certainly would like that.
   We can thank decades of American and European foreign policy in Africa for much of the problem of Ebola. We overthrew governments that threatened to nationalize a country’s natural resources in favor of corrupt individuals and groups of individuals who would safeguard the flow of materials for our benefit at the expense of the peoples of those countries. Now countries like Sierra Leone, Liberia, and Nigeria lack leaqdership that would have put resources into education and medical care. Money went into the hands of the few, but, then, that’s how things are here. If corruption is one means by which an epidemic spreads, people of Indianapolis probably should have concerns about Ebola, as well as TIFs and cricket fields.
   If the people killed by Ebola, when it first broke out in 1976, had been white, do you think there would have been a different reaction here? Do you think the United States would have sought to marshal an effort to help? We know the United States intervened when genocide was committed in what once was Yugoslavia. We did not seek to intervene in Rwanda when between 500,000, and 1,,000,000 people were killed.
   There is no Ebola epidemic in the United States. If we want to deal effectively with such public health risks, scrap a nuclear aircraft carrier, and save money from the budget to devote to CDC and NIH—or education, so we have more people in the healing arts or, on a fundamental level, better educated so that fear does not grip them when they turn on the TV, their laptop, or their cell phone.
   

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