The Good Samaritan: Religion and Epidemics

The parable of the Good Samaritan, the story of a man coming to the aid of a beaten and bleeding traveller ignored by other passersby, is a mainstay in the teachings of Christianity. The Good Samaritan embodies a common theme in the world’s faith traditions, the idea that we should look beyond social distinctions and self-interest to help those in need. It is a plea to lead by example, to live by the Golden Rule. At its best, organized religion achieves this kind of grace, and sets an inspirational example.

Do unto others

The relationship between religion and epidemic disease is, to put it mildly, complicated, and at times even contradictory. In the name of religion, some have denounced the sick, arguing that the spreading illness (i.e. HIV/AIDS) is a curse from God, and have impeded public health efforts. Religious cultural practices, particularly funerary rites involving contact with the remains, have inadvertently helped spread disease, such as Ebola4. But on the other hand, religious groups have also done exactly the opposite: tirelessly work to dispel the belief that epidemics are divine plagues, promote preventative practices like condom use, and tackle the challenges of illness on the ground. The work of faith-based organizations (FBOs) has been essential for the care and support of people living with some of the most intractable and frightening epidemics of the modern era, including HIV and Ebola1.

Throughout the current Ebola epidemic in West Africa, FBOs have played an important role in stemming the tide of the outbreak. Many have established medical missions, clinics staffed by foreign medical professionals, usually on a short-term basis2, in the affected region. This work demands compassion and courage, because the risks are high. The first two American cases, Dr. Kent Brantly and Nancy Writebol, contracted the disease while treating patients in Liberia at a mission run by the FBO, Samaritan’s Purse. Both survived and Brantly has publicly pointed to his faith as his inspiration, professionally and personally. After recovering, he has continued to selflessly combat the disease, setting a startling example of individual belief and bravery. Brantly had donated his plasma (infusion with the plasma of an Ebola survivor is a potential treatment for Ebola) to three patients, another medical missionary, Rick Sacra, and two infected Texan nurses, Nina Pham and Amber Vinson5.

good samaritan
The good fight.

As you would have them do unto you

As mentioned in my recent post on meningitis, by creating large, diverse groups of people, pilgrimages can present a major public health risk, and many are enormous. Each year, more than 5 million Catholics visit the Sanctuary of Our Lady of Lourdes in France. The Hajj, the Islamic holy pilgrimage to Mecca, annually draws millions of Muslims from across the globe. Perhaps the most impressive in sheer numbers is the Kumbh Mela, which occurs every three years, when Hindus travel to the holy Ganges River. During the course of celebrations in 2007, 70 million pilgrims visited Allahabad, a single city on the river’s banks, and in 2001, the movement of people was so great it could be seen from space. These incredible aggregations of people have indeed led to disease outbreaks; in fact, it was a frequent feature of the Hajj into the 20th century3.

And yet. Religious mass gatherings (a mass gathering is a large number of people attending an event at a specific site for a finite time) have overcome these very real dangers to become important examples of public health preparedness and planning in the 21st century. In particular, the Saudi Arabian government has gone to staggering lengths to address the difficulties of hosting the Hajj. Within the immediate vicinity of the holy sites, there are 141 primary health-care centers and 24 hospitals, with a total capacity of nearly 5,000 beds, including 547 beds dedicated to critical care. There are more than 15,000 doctors and nurses on staff. One hundred and thirty-six of these healthcare centers have the latest emergency management medical systems, and are staffed by over 17,000 specialized personnel. Incredibly, health services are provided at no charge3.

These herculean efforts have provided important information about institutional prevention and preparedness for mass gatherings, religious or secular (i.e. the Royal Wedding, which drew a crowd of more than 1 million people in London). The involvement of so many countries (more than 180 countries are often represented at the Hajj) has also promoted international cooperation in prevention work, and encouraged global health diplomacy3.

Epidemic disease does not always bring out the best in humanity, including religious groups. Fear can be an ugly thing. But when religious organizations are able to look past difference and disagreement and see the need of the suffering, it is an awesome demonstration of their ideals. Their work is a powerful reminder that to be good, you must do good.

References

  1. Green, EC. (2001). The impact of religious organizations in promoting HIV/AIDS prevention. The World Bank. Web. 31 December 2014.
  1. Martiniuk, ALC, M Manouchehrian, JA Negin, & AB Zwi. (2012). Brain gains: a literature review of medical missions to low and middle-income countries. BMC Health Services Research, 12:134.
  1. Memish, ZA, GM Stephens, R Steffen, QA Ahmed. (2012). Emergence of medicine for mass gatherings: lessons learned from the Hajj. Lancet Infectious Disease, 12:56-65.
  1. Osterholm, MT. “Why it’s harder to contain this Ebola epidemic”. Chicago Tribune. 4 August 2014. Chicagotribune.com. Web. 3 August 2014.
  1. Ungar, L. Ebola survivors speak of suffering, service, faith. USA Today. 8 November 2014. Web. 5 January 2015. http://www.usatoday.com/story/news/nation/2014/11/07/kent-brantly-to-speak-about-medicine-faith/18600745/

Image source: Creative Commons, http://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_West_Africa

Ebola Epidemic: An Opinionated Update

According to the CDC, as of October 12, 2014, there have been 8,973 Ebola cases (4,983 confirmed by laboratory tests) in the three West African countries where the disease has become epidemic: Sierra Leone, Liberia, and Guinea. Of the nearly 9,000 cases, 4,484 have resulted in death, making the fatality rate a little under 50%. There have been 4 cases outside of West Africa, all travel-related (meaning the patient had either contracted Ebola in a country where the disease is epidemic, or cared for someone who had), only one of which has resulted in death1.

The lone American fatality, Thomas Eric Duncan, died in Dallas, Texas on October 8, 2014. Since his death, two of his nurses, Amber Vinson and Nina Pham, have fallen sick. It is now clear that there were some serious missteps during Mr. Duncan’s treatment; nurses were not properly trained, appropriate protocols were not in place, and, as a consequence, up to 100 other people may have been exposed to the virus2.

In the wake of Vinson and Pham’s diagnoses, there has been an outpouring of American fears about Ebola, overrunning other national concerns and, at times, our national compassion. There has been a repeated call to close the American border to travelers from countries where Ebola is epidemic. This approach is shortsighted; it sacrifices American goodwill for a false sense of security. Closing the borders is unlikely to keep Ebola from spreading, as transmission in an airplane is extremely unlikely to begin with (people well enough to travel are not contagious, even if infected), but it is guaranteed to make aid work in the affected region even more difficult4.

Liberia has 1 doctor for every 100,000 citizens, and is dependent on foreign health care workers to fight the raging epidemic. Cutting off American assistance will only allow the disease to further devastate the country and increase the chances that it will spread to other parts of the globe. The single best means to combat the epidemic is to control the outbreak in West Africa, and that requires open borders4. While fear is justified, we cannot allow the haze of hysteria to cloud our judgment; the general anxiety has grown so intense, that it has been compared to the panic of the early AIDS epidemic, and given its own name, Fearbola3.

Unfortunately, the national dialogue about Ebola seems polarized: one group emphasizes the unlikelihood of Ebola’s spread, while at times patronizing and scolding those who are afraid, and the other focuses on the disease’s dangers and advocates ever greater control measures, including isolationism, potentially to the exclusion of the best weapon in our arsenal: our compassion. The selflessness and courage of the health care workers fighting this disease should be rewarded with as much support as we can muster, from a prepared and proactive government and a public that follows their brave example. We must strive for a middle ground where we acknowledge our fears, and yet address this crisis not with terror, but with humanity.

Is Ebola scary? Yes, without a doubt. Death is frightening. It is frightening to consider what Ebola could do if it caused an outbreak in America, frightening to think what we would do if that happened. We are not as prepared as we should be, and clearly there is room for improvement, but we can’t afford to protect ourselves by ignoring the plight of others.

We can do better. But we can also be better.

References

  1. 2014 Ebola Outbreak in West Africa- Case Counts. Centers for Disease Control and Prevention. 15 October 2014. Web. 16 October 2014.
  2. CDC admits to mistakes in Ebola protocol. CBS News. 16 October 2014. Web. 16 October 2014.
  3. Petrow, S. In Ebola fear, a familiar whiff of paranoia. The Washington Post. October 15, 2014.
  4. Phillip, A. Why hasn’t the US closed its airports to travelers from Ebola-ravaged countries? The Washington Post. 4 October 2014. Web. 16 October 2014. http://www.washingtonpost.com/news/to-your-health/wp/2014/10/01/why-hasnt-the-u-s-closed-its-airports-to-travelers-from-ebola-ravaged-countries/