Education, Engagement and Ebola

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(Photo Courtesy of CDC/Dr. Lyle Conrad)

(Photo Courtesy of CDC/Dr. Lyle Conrad)
(Photo Courtesy of CDC/Dr. Lyle Conrad)

 
In season three of “Breaking Bad,” Jesse Pinkman’s character tells Walter White that Ebola is “a disease on the Discovery Channel.” Stephen Alder, chief of the Division of Public Health at the U’s School of Medicine, might say it’s a little more complex than that.
Alder has spent his career at the university studying public health and, with that, preventive measures to stop infectious diseases — such as Ebola — before they spread. The majority of his work has been in Ghana, a currently Ebola-free country in West Africa about 500 miles away from the three countries that form the outbreak’s epicenter: Liberia, Sierra Leone and Guinea.
He began working in Ghana with public health graduate students from the U in the summer of 2004, continuing a program that began around 1999. When he started teaching it, four students accompanied him; now, more than 50 students take the trip each year, examining issues of teen pregnancy, hypertension and infant deaths in the region with help from local colleges and teaching hospitals.
The trips continued through last summer and, depending on the health conditions in Ghana in 2015, may be forced to stop temporarily due to the threat of Ebola.
“There’s a long time between now and next summer in the lifetime of an outbreak,” Alder said. “We want to make this part of what’s great about coming to the U, but if it means that we have to compromise safety, that, of course, is something that we’re not willing to do.”
But the recent infections in the area have also changed Alder’s focus. While he stopped leading student groups in the region in 2010, with the U’s Scott Benson filling his place, Alder has not stopped traveling to Ghana. Although he hasn’t saved his plane tickets to remind him, he has flown to the country more than 50 times total. In his latest trip at the end of October, he spoke with local leaders and institutions about Ebola and early detection measures for public health.
“If we can prevent a case of Ebola, it’s so much better than if we try to treat a case, because the outcomes are just not that great,” Alder said. “We don’t know how to deal with this disease well.”
According to the Centers for Disease Control, Ebola has killed almost 5,000 people since March 2014, with more than 8,000 reported cases in West Africa and subsequent hospitalizations in the United States and Europe. The outbreak is now termed an epidemic, according to the CDC.
Once a person is infected, there is a 21-day incubation period in which Ebola can lay dormant. Until a patient shows symptoms, they are not contagious. The disease is spread by direct contact with bodily fluids, such as blood, spit or sweat.
Alder’s purpose is to teach community members in Ghana how the disease is transmitted, to detect the symptoms — high fever, vomiting, stomach pains and diarrhea — and to urge them to do the “compassionate thing” if a loved one is ill by taking them to a health care facility, rather than nursing them and risking further infection. He ultimately hopes to stop the spread of the disease though education and engagement, but it’s something he laments as well.
“Sometimes our best opportunity to be useful is when there are very unfortunate things happening,” Alder said. “And this is certainly an unfortunate event.”
Because Ghana is on the crux between being a developed country and an undeveloped one, he said. Its people are susceptible to both chronic ailments, such as obesity and diabetes, and infectious diseases, such as malaria and Ebola. Alder compares the situation to pop culture works, such as “Contagion” and “World War Z,” even if the movies are “sort of the zombie apocalypse.”
Garrett Flint, however, a recent U graduate in economics, feels the comparison is more like Lupe Fiasco’s song “Streets On Fire.”
“It just kind of reminds me about the hype about Ebola,” he said. “Some people aren’t worried; some people think it’s apocalyptical. There’s a lot of confusion going on around Ebola.”
Flint has been living in Botswana, a country in southern Africa, since May 2014, first through a Hinckley Institute of Politics summer internship, and later by landing a job with Stepping Stones, a non-governmental organization that works with youths. With frequent power outages and regions with more cows than people, Flint said Ebola is nobody’s top concern in the country.
There are flyers pasted to nearby buildings in the area and typical quarantines set up at the entrances into the country, but Flint is much more worried about the toll of HIV/AIDS, what he calls a “far more serious topic,” with nearly a quarter of the people infected there.
“I hope [Ebola] doesn’t ever come here to Botswana,” he said. “This country is still reeling after the devastation that HIV/AIDS had and still continues to have on the country.”
Alder said the difference with the AIDS pandemic is that the people affected can still live a “relatively normal” life, while Ebola has a quicker mortality rate. He said the 2014 outbreak of Ebola has been “quite unprecedented” in scope compared to previous waves of the disease, first beginning in 1976 in what was formerly known as Zaire.
Also staying in South Africa this past summer, Alexis Jessop, another Hinckley intern, worked closer to the original and historic roots of the disease, but further from the current outbreak. While South Africa is currently free of the infection, Jessop had a close encounter when in Johannesburg. She traveled to the city to meet Linda Dunn, former director of the U’s Bennion Center, and her husband Mike. While there, she met some missionaries from the Church of Jesus Christ of Latter-day Saints who were formerly serving in Liberia and Sierra Leone, two of the three infected countries.
“They told me they weren’t able to shake any hands and had to stay away from most people,” she said.
Jessop feels Ebola spreading to both South Africa and the U.S. isn’t implausible. And Alder has similar predictions. He said an outbreak of the disease is “possible anywhere,” but is reassured that the U.S. health care system could handle and control any infections in a short period of time, as similar cases have already proved to him in New York and Texas.
Meanwhile, the U is taking precautions by requiring all faculty and students who have traveled to the infected areas in West Africa to be cleared by the Health Science Work Wellness Center before resuming any university activities, with further restrictions on university-sponsored travel to the region. A mass email sent school-wide notes, “Travel to these countries at the current time poses substantial health and security risks.”
Researchers at the U are also looking into a possible Ebola drug target, isolating a region of the virus that may help in drafting a cure or vaccine.
“We’re fortunate to have such a world-class institution,” Alder said. “We’re doing some really, really terrific things. So, not surprisingly, we would be contributing to the science that may help us figure this out.”
He said work such as this, contributes to an “incredibly important” global mentality at the U of helping other nations. And, despite five seasons of “Breaking Bad,” Alder hopes Ebola won’t last another season in West Africa.
“I sure hope for the people of West Africa, our friends that are over there, that this turns around,” he said. “Just for the sake of humanity, I hope it turns around.”
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@CourtneyLTanner