Ebola’s reputation is fearsome. Its horrifying symptoms, quick human-to-human transmission, and exotic locale seem ready-made for a thriller movie. Indeed, in the midst of the largest Ebola virus outbreak ever, a real-time script is emerging.
The story goes something like this: tribal habits, including archaic burial customs and a penchant for bush meat, have led to the emergence and spread of Ebola virus disease. The solution to the terrifying epidemic is to put patients in treatment centers, which are set up and staffed by foreign doctors. Despite the heroic efforts of a few outnumbered foreign aid workers, however, the epidemic has continued its spread, because too few international organizations responded to the challenge. Further, governments needed to get more directly involved, including by sending in armies, whose vast personnel and logistic capacity can help solve the problem. Also needed to prevent future such epidemics is more investment in health systems, essentially a combination of infrastructure and capacity building, such as training in disease surveillance.
This narrative serves an important function. It helps explain why the epidemic happened, who can be trusted to fight it, and who should be blamed for the things that have gone wrong.
There’s just one problem: the story is at best incomplete and at worst outright wrong. It excludes the most important truths about the Ebola virus epidemic—the very facts that could help the world stop this outbreak and prevent future ones.
Let’s start with bush meat and burial customs. These practices might explain the emergence and very early spread of the disease, but they don’t explain why Guinean villagers deliberately withheld initial Ebola virus cases from an outbreak team led by the U.S. Centers for Disease Control and Prevention (CDC), Doctors Without Borders, and their own government. Nor do they shed light on why health workers sent to inform communities about the epidemic in remote regions were ignored, threatened, or, in one tragic case, killed. Or why residents of pillaged and looted an Ebola holding center. Yet those are the most important facts to understand, because they explain how a localized epidemic that was typical of past Ebola virus outbreaks became an unprecedented plague that has engulfed three countries.
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