Last week we cheered as two American aid workers badly sickened in Liberia with Ebola virus disease were discharged from Emory University Hospital in Atlanta. They were cured of this terrible infectious disease, but cures are hard to come by for the people infected in the West African nations of Liberia, Guinea, Nigeria, and now, Sierra Leone.
In the three weeks since the last Ebola update on The PediaBlog, the number of cases and deaths have nearly doubled. The World Health Organization (WHO) reports as of August 22:
Confirmed, probable, suspected cases of Ebola: 2,615
Deaths from Ebola: 1,427
Fatality rate: 55%
Karen Weintraub says WHO fears the numbers might be understating the severity of the crisis:
In a news release Friday, the WHO conceded that it has likely been undercounting cases of Ebola because families are in denial or afraid to admit their loved ones might have the dreaded disease.
“In parts of Liberia, a phenomenon is occurring that has never before been seen in an Ebola outbreak. As soon as a new treatment facility is opened, it is immediately filled with patients, many of whom were not previously identified,” according to the statement. “This phenomenon strongly suggests the existence of an invisible caseload of patients who are not being detected by the surveillance system.”
Stephen T. Fomba grew up barefoot in Sierra Leone:
I didn’t mind growing up this way, for I didn’t mind work and did not know what I did not have. But I hated having to make these walks barefoot because we could not afford shoes. The injuries were too much. I sustained burns from the hot ground and rocks; wounds from sharp stones, thorns, and even broken bottles; infections from unknown bacteria; and various ailments—red skins, open sores that took very long to heal, fevers. Even when hurt or ill, I had to keep walking, often as many as 20 miles a day, usually under a hot sun.
We rarely think about the perils of walking barefoot. But according to one widely cited estimate, some 300 million children on earth don’t have shoes. Many illnesses and infections come from the ground, caused by stepping on sharp objects or touching saliva, blood, or bodily fluids. And it’s not merely those who can’t afford shoes who have to go barefoot; many millions of people around the world own poor quality shoes, but have to be careful not to overuse them to avoid early wear and tear. Shoes are for special occasions.
Fomba worries that those in West Africa increase their risk of contracting Ebola by walking barefoot:
Are barefoot walkers, I wondered, coming in contact with Ebola-positive body fluids on the grounds they tread upon? People are always spitting out saliva. If an Ebola-positive person walks around barefoot, steps on a sharp object, and bleeds, he or she would easily spread the virus. And if an Ebola-negative barefoot walker steps on an Ebola-positive saliva or blood, that barefoot walker would unknowingly become infected. I’m not sure how much barefoot walking is contributing to the spread of the virus right now, but a virologist confirmed my hypothesis.
Controlling the Ebola outbreak is a complex, global effort. But at the local level, we could start with something very basic, but very important. Providing shoes to barefoot walkers would make them safer and healthier. It also might save us.