Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 14, 1995 TAG: 9505150098
SECTION: NATIONAL/INTERNATIONAL PAGE: A-14 EDITION: METRO
SOURCE: Associated Press
DATELINE: BRAZZAVILLE, CONGO LENGTH: Medium
African nations can't live without modernization. But for now, they can't always live with it, either.
The stripping of rain forests for logging and agriculture; the creation of road, rail, air and water links; the sprouting of cities; the easy availability of powerful medicines - all are signs of Africa's development.
They also have exposed it to new dangers.
Viruses once confined to impenetrable forests are now found near crowded cities. Infectious agents - including those that cause malaria - are battling back against ever-stronger medicines sold over the counter in African towns.
The exploitation of natural resources has led to the constant movement of people in search of jobs. With that movement comes the spread of disease.
Health experts say these are the harsh side effects of development that must be accepted if epidemics are to be handled effectively.
``The history of human beings is the history of disease. That is the reality,'' said Dr. Andre Lubanov, an epidemiologist at the World Health Organization's African headquarters in Brazzaville.
The latest outbreak of the deadly Ebola virus in Zaire should not lead to finger-pointing at the incursion of modern ways, Lubanov and others say. It should serve as an urgent reminder that despite its advances, Africa remains abysmally backward in two crucial areas: health care and communication.
``We cannot stop everything, but we can get rid of certain things, we can prevent others, and there are things we can control,'' said Igor Rozov, a spokesman for WHO, the United Nations' health agency.
``But if we are to start with anything at all in the way of trying to handle the situation in Africa, we have to set up a very developed surveillance system. This is a must.''
By surveillance, Rozov means immediate reporting of rare illnesses to health officials and quick testing of samples in sophisticated laboratories - things that simply aren't possible in most of Africa.
The profit-driven leaders who mined gold and diamonds, ripped open forests, created massive bureaucracies and armies and built massive capitals to house them rarely have pumped money into health and communication for their people.
When the leaders need health care, they fly to Europe. When they need to make a call, they reach for the cellular phone.
The people in mineral-rich Zaire are among the poorest on Earth. Two-thirds are without clean drinking water, 86 percent without indoor plumbing.
Zaire's government spends about $1 per citizen per year for health care.
From the crumbling capital, Kinshasa, you can see the Congolese capital of Brazzaville and take a 20-minute ferry ride across the Congo River to get there. But you can't call to Brazzaville using Zaire's phone system.
It's not much better in Brazzaville, where 172 doctors work at the 9,500-bed state-run university hospital. Virtually all the specialists have left for well-paying jobs in Europe, lamented hospital administrator Bernard Ovoulaka.
``If you need a specialist, you are evacuated to France or South Africa. If you cannot afford it - well, sometimes you die,'' he said.
As in previous Ebola outbreaks, most people affected this time have been health workers who did not have the basic equipment such as masks and gloves to shield themselves from victims, who spurt blood from the eyes, nose and other orifices. The disease spreads like AIDS, through bodily fluids.
If the hospital in Kikwit, where the epidemic apparently started, is like those in most African cities, syringes are used several times because there's no money to buy new ones.
The city has a population of more than half a million, but there are no phone links with the outside world.
Despite such obstacles, Lubanov says control and even eradication of some diseases in Africa is possible if modern methods are combined with traditional ways - even if that means banging on drums to alert villagers of an epidemic.
``Why not?'' he said. ``All communications means can be involved. We cannot provide every village with a radio system.''
There have been successes, most notably in the effort to eliminate polio. About half the continent's children are immunized against polio, compared with 5 percent 15 years ago. WHO's goal is to eradicate the disease in Africa by 2000, at a cost of about $800 million.
If Rozov's warning of new viruses in the future is accurate, international donors will have to cough up far more for African health care to stop other illnesses from raging out of control.
Either that, or African governments will have to have a serious change of heart in the way they spend their money.
``The more we know, the more sophisticated is our technology to find viruses, the more viruses we will identify,'' Rozov said. ``The question is whether those viruses will be fatal, and how we can deal with them.''
by CNB