Ebola Cases and Deaths Under-Reported. Why?

It's not so complicated. Normally, no one cares whether West Africans live or die. Or what makes them sick, or what kills them. There are very, very few doctors and public hospitals, and generally, nowhere to go to get diagnosed. There are no established systems in place for reporting any deaths - and normally, nowhere to record cause of death.

….Deaths are always reported in developed nations - it's the law - "cause of death" must be determined, and funerals must be arranged through licensed facilities. Then there's the insurance to collect, estate taxes to pay, utility bills to shut off…. But people in undeveloped nations are on their own. Most West African nations do not even have laws saying deaths must be reported. There are no funeral parlors, no insurance, no taxes, not even any utilities to shut off.

So not all Ebola cases and deaths are reported. Maybe 25% are on the WHO master list. Maybe less. Why? Because no one is there to diagnose sick West Africans, whatever their ailment. NO deaths are reported, normally. ….Obviously, this situation makes "disease surveillance" next to impossible. Not ideal in our interconnected global economy.

HOWEVER, Nigeria, much praised for controlling Ebola, is taking steps to ensure Ebola deaths are reported and recorded.

Ebola: 340 Cases Under Surveillance in Rivers State (Nigeria)

The Rivers Commissioner for Health, Sampson Parker, on Wednesday said there were 340 Ebola Virus disease (EVD) cases under surveillance in the state.

….He called on the people to always report cases of deaths and stop the habit of burying dead bodies in a hurry.

The commissioner urged people of the area to alert local government disease surveillance officers as soon as there were cases of deaths.

“As a matter of fact, every death must be reported to local government health officials before anybody can touch it,’’ Parker said.

[tsk]


NOTE: "Disease surveillance" is why one of the USA's four general goals is to build up Africa's public health care system. So next time, maybe the world will see what's coming before it's out of control.

"It's perhaps no coincidence that this is out of control in countries that have vulnerabilities, that have not built up their health systems," Yamey said. "They do not have adequate hospitals, clinics, staffing, supply chains of medicines and diagnostic tests. And the global health community has known this for a long time. We need to do better."

…."This outbreak just emphasizes the tenuous nature of many African health systems," said Dr. Warner Greene, director of the Gladstone Institute of Virology and Immunology in San Francisco who has worked extensively in Uganda and other parts of Africa. "This is a tragic but strong example of why we need to be investing in the health of Africa and the health care capacity of Africa in a far more persuasive way."

It doesn’t help that thousands of people die in west Africa from other causes that if untested could possibly look like Ebola. With the medical system in these countries totally overwhelmed, who knows what people are dying from? I'm sure this is why an accurate count in impossible.

2011 deaths in Liberia

5,561 Deaths from influenza/Pneumonia
1,696 Deaths from tuberculosis
3,718 Deaths from malaria

www.worldlifeexpectancy.com...

a reply to: soficrow




So let me get this straight because Africa in general can not get it act together we here in the US should pay the bill to make it better........NO.


It is not Africa that is the failure it is the people that live in Africa. And no amount of helping is going to change this simple cemented fact. Look at Aids and all the money and support put in place and it failed because the people are failures. Also look at all the famine aid given out over the past 40 years this has also failed.



Places like Liberia are messed up beyond belief just look at what happened during the war and ask yourself can people like this really change the way they live. We should only help places like Nigeria because they actually give a crap. Places like Liberia can sort themselves out.

a reply to: soficrow

Not to mention the stigma of having Ebola in your family or social circle. I believe many people there would hide a fatality that looked like Ebola, if only to avoid being shunned themselves.

a reply to: TheBlackTiger

And not to mention that African nations will cover up their outbreaks and epidemics to avoid being shunned and bankrupted by the equally ignorant international community.

a reply to: SubTruth

SubTruth

....This is a much bigger deal than most people give it credit. It will continue to spread and 3000 troops will not stop it. This could very well be a run for the hills event if it keeps going like this.

a reply to: Richn777

Have you ever learned history? Not only can almost all of Africa's modern problems be attributed to western imperialism but Liberia is very interesting specifically because it's the result of an American/British colonization program created by people who thought freed slaves would do better back in Africa (sounds like racists today telling blacks and other minorities to go back to Africa of they don't like it here).

We should have been supporting them massively as a show of how western models of nations are superior. Imagine if today we had a little pocket of America in Africa. If you could point to Liberia and say that America not only helped slaves find success but created true modernity in Africa. Instead we offered no help during the military coup in the 80s which decimated their country for 20 years and now we do the same thing with Ebola (only offering help now out of selfish fear and perhaps some agenda considering we went straight from "eh whatever" to "SEND IN THE MILITARY" in a heartbeat.

My favorite example of us screwing them in racist ways is how in 2013 a private consultant was hired to make the nations college entrance exam. They collected fees for the test and LITERALLY zero people passed out of 25000. University officials cited lack of English skills and lack of enthusiasm.

www.theguardian.com...

If literally no one passes a test, the test is rigged. Bonus points for implying it's the student's fault.

a reply to: soficrow
S&F
Customs and burial rituals are bound to affect a small percentage of unknown deaths. The imagination could run wild. For instance, how many bodies have been buried in secrecy, late at night? And so on and so forth. Some infected people run.

a reply to: drwill

True, but that's not the main problem. I suspect a lot of people simply don't know just how different our societies really are. Even here though, some people will hold up a burial for a week while others bury their dead quickly, for religious reasons. Still, everything's reported here - but undeveloped nations do not have the infrastructure for even the basics, never mind disease surveillance.

a reply to: tavi45

I don’t understand your point. Yeah Liberia has problems and they have had problems way before this Ebola outbreak. Sending help in part is selfish, I agree. No one wants Ebola to jump continents or mutate into something worse. If we can stop this in Africa then we are all safer. On top of that, no one wants to see Liberia, Sierra Leone or Guinea completely decimated. This virus has that ability.

a reply to: soficrow

wow have you read this one?

this one is being reported:
Ebola crisis: Eight Ebola workers, journalists found dead after attack in Guinea; WHO says outbreak is accelerating

Eight people who were part of a team sent to educate villagers in Guinea about Ebola have been found dead after they were attacked by angry locals.

Guinean government spokesman Damantang Albert Camara said the discovery was made in a remote area in the southeast of the country.

"The eight bodies were found in the village latrine," he said. "Three of them had their throats slit."

originally posted by: Thurisaz
a reply to: soficrow

wow have you read this one?

this one is being reported:
Ebola crisis: Eight Ebola workers, journalists found dead after attack in Guinea; WHO says outbreak is accelerating

Eight people who were part of a team sent to educate villagers in Guinea about Ebola have been found dead after they were attacked by angry locals.

Guinean government spokesman Damantang Albert Camara said the discovery was made in a remote area in the southeast of the country.

"The eight bodies were found in the village latrine," he said. "Three of them had their throats slit."

That was pretty horrible! Hard enough to take the chance of helping and catching Ebola - now you have to worry about getting killed for trying to help. Hey, now the military will have a purpose - they get to provide armed escort service in the future!