Can the Ebola epidemic promote the development of medicine?

Having been born and raised in the United States, I have become accustomed to the reputation of the U.S. as being ahead of the curve in terms of advances in numerous fields including medicine, and the research that we produce in these fields strongly backs up this claim. I have been reminded of this over the past few days while following coverage of the Ebola outbreak in West Africa.

American health care providers in the region who caught the disease likely had their lives saved due to how prepared the U.S. was in terms of certain procedures that were put in place in order to treat them and prevent spread of the virus to the rest of the American public once they arrived in the States. It is the advanced understanding of infection control, the ability to develop new drugs, and the new discovery of how certain infections spread that put us at an advantage. It is this advantage that I encountered while training as a physician here, and it is an advantage that, with the appropriate resources, allows me the ability to treat a wide variety of patients, even if the disease may be rare. This exceptionalism in terms of the medical care we can provide in the U.S. brings about a sense of personal pride, and I felt that pride as I was hearing about the recovery of these providers due to the outstanding staff at the hospitals that received them.

But there is a conflicting emotion that also is in me as a person of Nigerian descent; it is a feeling of sadness as I see how the country of my ancestors is dealing with the epidemic. Even though the cases of Ebola in Nigeria are not as much as in other West African countries, it still struggles with lack of resources in the hospitals to adequate treat this type of epidemic. Lack of resources lead to inadequate care, and ultimately a higher death rate. Unfortunately, we are seeing it at full force as we see the governments in those countries struggle with how to contain the Ebola epidemic. Thankfully, the World Health Organization is trying to determine ways to deliver potential therapies to these countries, but time will be an issue. It takes time to make some of the vaccines that they are hoping to administer, and unfortunately time is not a luxury that some of these patients have. It underscores the importance of proximity to resources that are being developed.

Even in the U.S., proximity to particular medical resources can be a factor in terms of delivering adequate care for particular conditions in certain communities. Some places have more advanced capabilities than others, and depending on the distance, medical care may be delayed to certain communities unless adequate means to transfer patients to capable facilities are in place. Thankfully, this is not much of an issue in developed countries since reliable means of transport are readily available, and there are plenty of capable facilities in many parts of these countries.

Unfortunately, in the developing world, these luxuries may not be readily available. Transportation may be an issue, and even if transportation may be reliable, the centers that can deliver adequate care may be few and far between, leading to significant delays in care that could make the difference in whether a person survives a particular condition. Having spoken to friends who have rotated in clinics in the developing world, there are stories of patients who have died for lack of medications or other resources that are readily accessible in the U.S. and other developed countries. I can only imagine that this is a contributing factor in the rapid spread of the Ebola virus in West Africa, and it is tough to watch when I can easily take these medical resources for granted while I practice in the U.S.

My hope is that as more attention is brought to this epidemic, we become more aware of the disparities that exist between the developed and developing world in terms of medical care. The resources that exist in the U.S. should be more available in other countries, if anything to prevent the spread of potentially lethal infections like the one we are seeing in West Africa. With the numerous technological and scientific advancements made over the past few decades, more opportunities for sharing of ideas and resources are possible to help developing countries catch up in terms of ensuring better medical care for their citizens. We should not become accustomed to seeing many people die of disease due to lack of resources or scientific advancement, and accept that as the norm. My hope is that the same pride that I feel for the advances made in American health care over the years will be present as I hear stories of the advancement of health care in Nigeria, other countries in West Africa, and beyond.

Chiduzie Madubata is an internal medicine physician.

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  • Tim Mosher

    Having been involved in third-world medical missions, I have seen the disparities. I can imagine it is even more stark for someone who has lived in both scenarios. Our impulse is to wish we could instantly transplant the medicine we have to these places. But the reality is that the indigenous culture will always have to step up to the task to make sure improvements are sustainable. We did not get to our level of medicine in America without great sacrifice over many decades, buy many people who never received the benefits of which they were trying to achieve.

    I have been encouraged in this respect with my interaction with Haitian doctors and nurses. As we have provided facilities, medicine, and tools, they have done the hard work of staffing, learning, and growing their capabilities. Many of them have sacrificed better careers, getting married, or moving to the country to bring improvement in their health system. These are the things that will ultimately improve things. But it will take decades, just like here.

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