- - Monday, August 11, 2014

When the Ebola epidemic of West Africa burns itself out, as it one day will, the heroes and heroines of the struggle will be remembered as the men and women who risked their own lives to save the lives of others. Sixty of the 550 health care workers have paid for their devotion to the sick with their lives, recalling the Scripture (John 15:13) that “greater love hath no man than this, that a man lay down his life for his friends.” Hundreds of others are weary unto death.

Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, says these exhausted heroes “have issued plea after plea in recent days to the international community, saying, ‘We are exhausted. We are terrified. We want to leave. Can somebody else please come in and take over?’”

These health care workers, many of whom are volunteers and most of whom are from the nations afflicted with the epidemic, work in communities where there is no gratitude, only suspicion and hostility. The people in the remote villages of Guinea, Sierra Leone and Liberia, whence come most of the sick, typically loathe and despise the workers, who are outsiders, after all. These outsiders must deal with wild and bizarre rumors, says Ms. Garrett, “that they are deliberately infecting people, cutting off people’s arms and selling them on some alleged market and even claims that there are foreign health care workers who are foreign cannibals.”

The three nations most affected are weak states emerging from horrific and protracted civil wars and suffering a great gulf between the government and the governed. With considerable justification, the people are suspicious of the government. In many ways, these are not nations so much as tribes with flags.

Modern medical science is confident that it knows how the Ebola virus is transmitted, through contact with bodily fluids. Fluid from every body opening — eyes, nose, mouth, anus and genitals — contains the virus. Someone caring for the sick at home who tenderly wipes the brow of the sick and then touches his mouth, eyes or nose, is then at great risk of contracting the virus.

It’s exceedingly difficult to spread the word, even if villagers are willing to hear it. Most are not. In which of the continent’s 350 languages and dialects should the word be spread? How to explain a virus in a familiar bodily fluid when the “germ theory” is unknown? Superstition thrives in the backcountry villages and in wretched city slums that the sickness is the work of “evil spirits.”

Though there is no cure for Ebola, early palliative care helps, and a lot. Even clean water relieves dehydration, one of the killer symptoms of Ebola. The mortality rate, which has been “as high as 90 percent” in some villages, can be reduced dramatically with early good care to dramatically less than 90 percent. In Europe and North America, a mortality rate for Ebola might be reduced to 10 percent, still a killer disease to be dealt with aggressively, but it is not necessarily a death sentence.

These are dilemmas and obstacles the heroic health care workers in West Africa confront 24 hours every day in an epidemic the international health authorities say is “out of control.” The rest of the world owes them enormous gratitude — and the help that President Obama promises is on the way.

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