4 ms·

The description of the conditions in Liberia, Guinea, and Sierra Leone and the over-whelming odds that the doctors there are facing was heartbreaking to read.

The description of the conditions in Liberia, Guinea, and Sierra Leone and the over-whelming odds that the doctors there are facing was heartbreaking to read. The Ebola outbreak in West Africa is as much a function of poverty as it is of the Ebola Virus. One of these all of us can fight.

throwaway5752 12y ago
I am profoundly moved by the heroism Dr Khan and his nurses showed and the example they've set for future generations of medical professionals. I hope it's publicized when Dr. Khan's family finishes setting up the foundation in his name http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61428-8/fulltext http://www.thelancet.com/journals/lancet/article/PIIS0140-67...
- monsterix 12y ago
  I wonder who were the people that took the decision to not give ZMapp to Dr. Khan. What were their reasons to take the drug away for what seems like treating white patients first while we can come back to Khan later (sorry but there is no better way to put this). A full enquiry and reportage on that side of story will be helpful I think.
  - Steuard 12y ago
    One issue that I've seen raised before is that there's a bit of a Catch-22 in public perception in Africa. As you point out, withholding the experimental drug has nasty overtones of "saving the cure for the white folks". But there's also a real risk that if they gave the first experimental treatment to Dr. Khan, the narrative would be "using the black folks as guinea pigs". Both of these concerns are based on actual history, so they're not easily dismissed in the region. I don't know how you balance that. If the treatment is new enough, you really might not know whether it would help or hurt the patient's odds of survival.
    - deleted 12y ago
      [deleted]
    - monsterix 12y ago
      Hm. I agree that it'd be hard for anyone to decide on a thing that affects public perception in Africa. And in that pressure, I believe, probably the worst decision was taken in the case of Dr. Khan. If they had tried the third vial (extra bottle) of drug on Dr. Khan, and so close he was to the medicines!, and had he survived (given that others did) the public perception would have certainly changed. Don't you think? SIDENOTE to downvoters: Very interesting behavior of what I believe is a small set of users on HN. I know Steuard, above, had not down-voted my parent comment on the top until about an hour ago. And then came a sudden barrage of negative votes from a few users. It'd be really interesting to find out the correlation between the users who down-voted and the color of their skin. I am pretty sure about the outcome. Also I have a strong feeling (could be unfounded though) that the committee that withdrew the drug from Dr. Khan in Africa had racial bias too. And that they took the most selfish option available at the time - without caring much about a precious human life or public perception both. Most of the pointers indicate that the names of those individuals should come out in public, and their reasoning be brought out too. We had a similar situation earlier where the potentially nasty hid behind a committee / organizational name - remember? - when Aaron Swartz happened and the people in the bureaucracy had to be called out.
      - throwaway5752 12y ago
        It is absurd and conspiratorial to think that someone would volunteer or work with MSF at great personal cost and risk and then do something so terrible because of racism. Had you tried to research it, you might have found some of your answer articles like http://www.cbc.ca/news/health/dying-sierra-leone-dr-sheik-umar-khan-never-told-ebola-drug-was-available-1.2738163 http://www.cbc.ca/news/health/dying-sierra-leone-dr-sheik-um... that talk about some of the details behind the decision. You make a really vile accusation with very poor reasoning against people doing very good, noble work (and calling for them to be named publicly). I didn't downvote you, but I don't have any sympathy.
  - maxerickson 12y ago
    They were doctors at MSF: http://www.nytimes.com/2014/08/13/world/africa/ebola.html?_r=0 http://www.nytimes.com/2014/08/13/world/africa/ebola.html?_r...
  - azernik 12y ago
    There was quite a bit of reportage (both in this article and in the wider news media). For reference: "If something went wrong with the drug, there was no intensive-care unit in Kailahun. The population of Sierra Leone would be furious if the West was seen to have killed Khan, an African scientist and a national hero, with an experimental drug. But if he wasn’t given the ZMapp, and he died, people might say that the West had withheld a miracle drug from him. “I was making sure my tone of voice stayed neutral,” Kobinger recalled. The debate and the calls went on for three days."
    - deleted 12y ago
      [deleted]
    - monsterix 12y ago
      So why not share the names and reasoning the doctors had which perceptibly led to withholding (rather taking it away) from Dr. Khan? Public perception makes it hard I can understand, but not giving the drug simply to manage public perception is incredibly selfish and stupid no matter how you choose to see or read all the reportage. > Debates and the call went on for three days? Lol, sure. Does that even make any sense? Groupthink as a proxy for effort? Seen that before!
mblevin 12y ago
As someone who has spent extensive time in West and Central Africa, poverty is as much a second order (or third or fourth) effect as the Ebola outbreak, and much harder to fight. System fragility (whether it's relative to disease, famine, or other natural disasters), is a function of poor leadership more than anything. What is scary is that there is plenty of evidence that government to government aid does more harm than good, and Western attempts at fixing the problems only make things worse.[1] [1]See any of Bill Easterly's writing - http://williameasterly.org/ http://williameasterly.org/
- authatheist 12y ago
  By "poor leadership" did you mean "warlord rulers taking the vast majority of the aid money thrown in their general direction"?
  - mblevin 12y ago
    "Warlord" implies a military bent. Many of the worst culprits are bureaucrats - spending most of their time wearing $10,000 suits while being wined and dined by Western leaders and skimming millions into the accounts of their inner circle. Power is not always held by physical force.
deelowe 12y ago
How? Throwing money at the problem doesn't yield results (as is typically the case). The issues in Africa seem to be fundamental; they are issues of culture, resources, and structure.

throwaway5752 12y ago

I am profoundly moved by the heroism Dr Khan and his nurses showed and the example they've set for future generations of medical professionals. I hope it's publicized when Dr. Khan's family finishes setting up the foundation in his name http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61428-8/fulltext http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

monsterix 12y ago
I wonder who were the people that took the decision to not give ZMapp to Dr. Khan. What were their reasons to take the drug away for what seems like treating white patients first while we can come back to Khan later (sorry but there is no better way to put this). A full enquiry and reportage on that side of story will be helpful I think.
- Steuard 12y ago
  One issue that I've seen raised before is that there's a bit of a Catch-22 in public perception in Africa. As you point out, withholding the experimental drug has nasty overtones of "saving the cure for the white folks". But there's also a real risk that if they gave the first experimental treatment to Dr. Khan, the narrative would be "using the black folks as guinea pigs". Both of these concerns are based on actual history, so they're not easily dismissed in the region. I don't know how you balance that. If the treatment is new enough, you really might not know whether it would help or hurt the patient's odds of survival.
  - deleted 12y ago
    [deleted]
  - monsterix 12y ago
    Hm. I agree that it'd be hard for anyone to decide on a thing that affects public perception in Africa. And in that pressure, I believe, probably the worst decision was taken in the case of Dr. Khan. If they had tried the third vial (extra bottle) of drug on Dr. Khan, and so close he was to the medicines!, and had he survived (given that others did) the public perception would have certainly changed. Don't you think? SIDENOTE to downvoters: Very interesting behavior of what I believe is a small set of users on HN. I know Steuard, above, had not down-voted my parent comment on the top until about an hour ago. And then came a sudden barrage of negative votes from a few users. It'd be really interesting to find out the correlation between the users who down-voted and the color of their skin. I am pretty sure about the outcome. Also I have a strong feeling (could be unfounded though) that the committee that withdrew the drug from Dr. Khan in Africa had racial bias too. And that they took the most selfish option available at the time - without caring much about a precious human life or public perception both. Most of the pointers indicate that the names of those individuals should come out in public, and their reasoning be brought out too. We had a similar situation earlier where the potentially nasty hid behind a committee / organizational name - remember? - when Aaron Swartz happened and the people in the bureaucracy had to be called out.
    - throwaway5752 12y ago
      It is absurd and conspiratorial to think that someone would volunteer or work with MSF at great personal cost and risk and then do something so terrible because of racism. Had you tried to research it, you might have found some of your answer articles like http://www.cbc.ca/news/health/dying-sierra-leone-dr-sheik-umar-khan-never-told-ebola-drug-was-available-1.2738163 http://www.cbc.ca/news/health/dying-sierra-leone-dr-sheik-um... that talk about some of the details behind the decision. You make a really vile accusation with very poor reasoning against people doing very good, noble work (and calling for them to be named publicly). I didn't downvote you, but I don't have any sympathy.
- maxerickson 12y ago
  They were doctors at MSF: http://www.nytimes.com/2014/08/13/world/africa/ebola.html?_r=0 http://www.nytimes.com/2014/08/13/world/africa/ebola.html?_r...
- azernik 12y ago
  There was quite a bit of reportage (both in this article and in the wider news media). For reference: "If something went wrong with the drug, there was no intensive-care unit in Kailahun. The population of Sierra Leone would be furious if the West was seen to have killed Khan, an African scientist and a national hero, with an experimental drug. But if he wasn’t given the ZMapp, and he died, people might say that the West had withheld a miracle drug from him. “I was making sure my tone of voice stayed neutral,” Kobinger recalled. The debate and the calls went on for three days."
  - deleted 12y ago
    [deleted]
  - monsterix 12y ago
    So why not share the names and reasoning the doctors had which perceptibly led to withholding (rather taking it away) from Dr. Khan? Public perception makes it hard I can understand, but not giving the drug simply to manage public perception is incredibly selfish and stupid no matter how you choose to see or read all the reportage. > Debates and the call went on for three days? Lol, sure. Does that even make any sense? Groupthink as a proxy for effort? Seen that before!

mblevin 12y ago

As someone who has spent extensive time in West and Central Africa, poverty is as much a second order (or third or fourth) effect as the Ebola outbreak, and much harder to fight. System fragility (whether it's relative to disease, famine, or other natural disasters), is a function of poor leadership more than anything. What is scary is that there is plenty of evidence that government to government aid does more harm than good, and Western attempts at fixing the problems only make things worse.[1] [1]See any of Bill Easterly's writing - http://williameasterly.org/ http://williameasterly.org/

authatheist 12y ago
By "poor leadership" did you mean "warlord rulers taking the vast majority of the aid money thrown in their general direction"?
- mblevin 12y ago
  "Warlord" implies a military bent. Many of the worst culprits are bureaucrats - spending most of their time wearing $10,000 suits while being wined and dined by Western leaders and skimming millions into the accounts of their inner circle. Power is not always held by physical force.

deelowe 12y ago

How? Throwing money at the problem doesn't yield results (as is typically the case). The issues in Africa seem to be fundamental; they are issues of culture, resources, and structure.