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It takes a village: Local solutions to global disease

Written by Nathan Grubaugh, 2015-2016 Sustainability Leadership Fellow and PhD Candidate in the Department of Microbiology, Immunology, & Pathology.

My first impression of Liberia was of paradise – tropical weather and lush green forests that merge with sandy beaches and a vast blue ocean. Walking the streets of Monrovia, this beautiful façade was lifted to reveal an ugly reality - 85% of the population lives in poverty. One in 100 women die during pregnancy, while 20% of children are malnourished and 7% do not make it to the age of five. I saw countless children in orphanages and buildings still riddled with bullet holes serving as stark reminders of the civil wars that ravished this nation in the 80’s and 90’s.

 

A year later, in 2013, I returned to Liberia. This time I travelled to Lofa County, near the intersection of Sierra Leone and Guinea. The scene was different there. The forests were dotted with dozens of small villages comprised of mud-brick houses. The villagers worked hard and made proud but meager livings by farming and taking whatever the forests offered. The faces of poverty were masked by the always present flocks of loveable and hopeful children. Unlike in Monrovia, I felt welcomed by the villagers. I felt safe. 

But again, this pleasant life had a sad truth. The medical chart on the wall at a local clinic revealed that this area is holoendemic for malaria, meaning that essentially every person is infected. In fact, a local man told me that he often gets malaria five times a year. Poor housing makes it easy for bloodthirsty mosquitoes to enter, and malnutrition weakens their immune systems. In addition, the intimate relationship the villagers share with the forest puts them in close contact with several animal pathogens. What is worse is that the civil wars destroyed 95% of the healthcare facilities and chased away most trained professionals. The only thing that appeared to be in abundance was disease.

It’s not surprising that Lofa County was an epicenter of one of the most horrifying disease outbreaks of the modern era: the 2014-2015 Ebola epidemic. An already deadly disease was exacerbated by a deep-rooted mistrust in the government, a widespread belief that the virus was a hoax, and the terribly inadequate infrastructure. The lack of paved roads, electricity, and equipped hospitals made it difficult to treat patients. As the outbreak intensified, so did the panic of nations around the world, as the realization that this was not just an African problem took hold.

Globalization – especially trade and travel – makes it possible for unwanted “hitchhikers” to quickly reach lands far away. Therefore, the fear of the Ebola virus epidemic becoming a pandemic was not unfounded. Pathogens such as HIV, West Nile virus, and chikungunya virus have already made the journey from similar African villages to big cities around the world. As we continue to neglect diseases of Africa, they will continue to show up in our back yard. The next to emerge is almost certainly afflicting some impoverished village right now.

With so much disease in Africa, how do we begin to control it? How do we prevent the next pandemic? The answer is both obvious and complex: break the cycle of poverty and infectious disease. Help lift the villagers out of poverty, and they can combat disease in their own communities; or alleviate the burden of disease, and they can live more prosperous lives. They are capable of solving their own long-term problems if the global community can just give them a boost now.

What are we doing to help? The Arthropod-borne and Infectious Disease Laboratories at Colorado State University are collaborating with the Liberian Institute of Biomedical Research to address disease in Lofa County. For one, the team is enhancing disease surveillance activities in an effort to know thy enemy. They are also using the Nobel Prize winning drug, ivermectin, to kill malaria-transmitting mosquitoes. These efforts, while very important, are not nearly enough. New and effective drugs and vaccines are urgently needed to fight neglected tropical diseases. Investment is needed to build new facilities and train healthcare professionals. Scientists and medical professionals are not the only ones who can help. Non-profit organizations such as Camp for Peace Liberia and FACE Africa are working towards educating, empowering, and providing clean water to Liberians in efforts to create self-sustained communities. More people need to get involved, if not for the villagers, than for oneself. Because what is good for the village is good for the world.

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