Wednesday, June 7, 2017

Logistical Challenges Are More Than Occasionally Paramount, In Epidemiology...

While the near-daily WHO situation reports -- out of the Democratic Repubic of the Congo, Bas-Uele Province -- are generally now very encouraging, with the rings of contact identified, contained and being follow-up monitored (and the total is now down to only 15 people). . . I wanted to take a moment to reflect on the challenges Doctors Without Borders, UNICEF and WHO face -- just to get "on-scene".

In a few (of the more-accessible) villages of northern Bas-Uele, a 180 mile "Jeeps-only" ride over a rutted cart path is needed, from the nearest airplane accessible city of size. But in Muma, and other even more remote villages -- an 80 mile motorbike only foot path, over broken bridges, and dense jungle is the only way in.

Imagine that, if you will: transporting epidemic diagnostic equipment, and public health supplies, to say nothing of cold-chain vaccines, all by donated motorbike -- for about 14 hours, in the sweltering, wet, thick bug-infested jungle heat. Then one arrives to only dirt floors, and stick huts, in a small jungle clearing. Everything needed for a clinic must be sewn from whole cloth. And anyone who's ever ridden a dirt bike in the Outback (or the Amazon, the Rockies or Andes), for even half a day, knows that it feels like internal organ damage (lacerations and contusions) are being inflicted, with each pock in the trail.

Yet these kind and brilliant people. . . persist. The planet should regard them just as highly and nobly -- as Nobel science and literature prize winners. Here's the bit, from WHO, overnight:

. . . .Some of the health zones where cases of Ebola have been either confirmed or suspected are many hours away from the coordination centre. Inaccessible by 4-wheeled vehicles, affected sites such as Muma, situated around 100 kilometres away, require long and hazardous journeys down narrow forest paths and across dilapidated bridges on motorbikes donated by UNICEF and UNFPA. . . .

To allow for an effective response, smaller multidisciplinary teams have now been established in these hard-to-reach locations.. . .

That bit above is, in many ways, the very best of what we humans offer one another, as a borderless planet. I'd like to see more of it -- lots more. Onward.


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