Posts Tagged Epidemiology
Some diseases are scarier than others. The world is a great big place and it’s filled with people who have different beliefs about the cause of illness and the proper way to approach healing and curing. We should make sure we’re starting on the same page.
Disease is an objectively measurable pathological condition of the body – think of tooth decay, measles, or a broken bone. By contrast, illness is a feeling of not being normal and healthy. This may be the result of disease but it may also be due to a feeling of psychological or spiritual imbalance. By definition, perceptions of illness are highly culture-related while disease usually is not.
What causes illness?
How illness is explained often varies radically from culture to culture. Likewise, the methods considered acceptable for curing illness in one culture may be rejected by another. These differences can be broadly generalized in terms of two explanatory traditions: naturalistic and personalistic.
The Western worldview relies mostly on a naturalistic explanation of illness – that it is due to impersonal, mechanistic causes in nature that can be potentially understood and cured by the application of the scientific method of discovery. This perspective has crept into other parts of the planet and taken up residence alongside personalistic explanations. The greatest difference is that illness in personalistic systems is seen as being due to acts or wishes of other people or super-natural beings and forces. Curers usually must use supernatural means to understand what is wrong with their patients and to return them to health.
This is often where religion and medicine get tangled up.
It is easy for people who accept a naturalistic explanation for illness to reject the concept of the intrusion of foreign objects into the body by supernatural means. However, this explanation is similar to the “germ theory” that is readily accepted by many people. Both explanations require the belief in something that cannot be seen without special equipment or methods – in both cases, there is a reliance on special practitioners. It is common for people around the world to assume their medical system can cure people while other systems cannot. This universal ethnocentric view leads some doctors and nurses trained in modern scientific medical practices to reject the knowledge and methodology of folk curers, especially if they involve a personalistic explanation for illness. And the reverse is also true.
However, all medical systems have both successes and failures in curing the sick. Any medical system may work because of three different factors:
- First, the medical procedures actually help the patient recover.
- Second, patients often get well all on their own without treatment.
- Third, the placebo effect counts – patients believe in the treatment.
Why should you care?
Perhaps you’ve watched the news this year and heard about the ebola outbreak in West Africa?
You should pay attention.
Epidemic diseases are often highly contagious but not always present in a community. They appear, rise rapidly in the number of cases and then decline or disappear. Measles, influenza, and the plague are examples of epidemic diseases. Sound familiar? Some appear seasonally as a result of changing human interaction patterns and shifts in the environment. At the beginning of an epidemic, a contagious disease spreads at an increasing rate. As more and more people contract it, the chances of coming into contact with an infected person spirals up rapidly. Towards the end of an epidemic, there are fewer and fewer unaffected people. Once most people have become sick (and either died or recovered) there are insufficient numbers of available new hosts to sustain the epidemic and it gradually disappears.
We hope this happens swiftly in the current ebola situation in Guinea, Liberia, Sierra Leone, and Nigeria because the hotzone is still ramping up. The outbreak which began in March of this year continues to increase in range and scope. Response has been inadequate and slow, hampered by a lack of skilled personnel, cultural differences in attitudes toward treatment, and no cure to combat the disease. The lack of effective early containment measures resulted in the spread of the virus to heavily populated metropolitan regions. This concern weighs heavily on efforts to curtail more border-hopping.
Ebola is voracious. The virus carries a 50-90% mortality rate. Think about that. Out of every 100 infected people between 50-90 of those individuals will die. In this instance, the mortality rate is lower than usual, near the 50% mark – the singular bright note in a dark canvas. Visit the CDC FAQ for a look at the potential impact West Africa faces. The World Health Organization (WHO) has devised a plan to halt the spread but it stretches over a 6-9 month window. A lot of lives are going to be lost in the coming months.
Endemic diseases are always present in a community, usually at a low and more-or-less constant frequency. Malaria, arthritis, and high blood pressure are examples. Many endemic diseases and most epidemic ones are population density dependent – the higher the human density in an area, the more rapidly they spread. If the circumstances are optimal for the spread of contagion and if few people have an immunity to a disease, there can be a pandemic. This is an epidemic that becomes unusually widespread and even global in its reach. Such a situation occurred in 1918 when a new strain of the influenza virus infected 20% of the world and killed as many as 50 million people.
The manner is which any community responds to an outbreak affects the survival rate. When traditional treatments and methods fail, alternatives are sought. Any alternative. Desperate people seek out any whisper of a promise their loved one might survive. We’re witnessing the collapse of both naturalistic and personalistic systems of treatment in West Africa amid this crisis.
So what can you do?
When you hear about ebola in the news, listen. Donate money. Donate resources. Do what you can to help save lives. Make a commitment to assist. We can’t all go to West Africa but we can help send the supplies they need. People are desperate. People are dying. We can support the folks who risk their lives every day to save others. Can you help?
The CDC is appealing to the medical community in the United States for assistance with the West Africa Ebola Outbreak. If you are a qualified medical professional and want to volunteer to work in West Africa, click here to contact reputable organizations who are active in the Ebola response through the Center for International Disaster Information (CIDI).