Who's At The Door, Ebola or Al-Qaeda?

Links: A. French Troops Battle Terrorists In Northern Mali
           B. France Retaking Its Former Empire

You have to feel for the poor people of Mali.  The country is landlocked and would probably be a complete desert if it weren't for the Niger River.  Mali shares a border with Cote d'Ivoire

which, until recently, allowed Mali access to the second busiest port in West Africa (Dakar being first).  Unfortunately, in 2002 Cote d'Ivoire's turn came up on the African civil war Merry-Go-Round, which split the country between north and south and lasted until 2011.  The conflict has ended and Cote d'Ivoire has recovered in record time. The roads between Mali and Cote d'Ivoire are again full of trucks carrying goods between Bamako, Mali and the port of Abidjan; although, sadly the condition of the roads leaves a lot to be desired.  For roughly a decade Mali was solely dependent upon its road and rail (gulp!) links to the west: namely, Dakar, Senegal.  In 2012, Mali suffered through the Tuareg Rebellion.  The nomadic Tuareg people of northern Mali (Tuaregs are also present in southern Algeria and northern Niger), revolted in reaction to feeling marginalized by the government in Bamako and the mining activity, which they claimed damaged pastoral grazing lands.  It didn't take long for the world's favorite parasite, Al-Qaeda (in this incarnation, Al-Qaeda in the Maghreb - AQIM), to join the rebellion alongside the Tuaregs.  Not surprisingly, AQIM quickly pushed the well-meaning Tuareg aside and began to threaten other interests (read: French) further south (which included the occupation of Tombouctou).  The French Army arrived in January 2013 and one month later the issue was resolved.  The French military has always come to a fight ready to win both quickly and completely.  I remember when the United States military carried the same reputation. 

Ibrahim Boubacar Keita,
President of Mali

The Tuareg Rebellion cost Malian President Amadou Toure his job; the transitional military government kept its word and respectably clean elections were held in August 2013.  Ibrahim Boubacar Keita was sworn in on September 4, and he has done a superb job to date.  The Ebola outbreak in Guinea and Liberia brought the attention of the world to west Africa.  Mali has a long border with both Guinea and Liberia, and given the state of Mali's infrastructure (and low international expectations), great concern was expressed that Mali would also suffer an outbreak.  President Keita put national sensitivities aside and asked the United States and Europe to send medical experts.  The International Red Cross (IRC) was already in place, and all necessary authority and support was given by the Malian Ministry of Health to facilitate the education and preparation of both cities and rural communities.  Medecins Sans Frontieres (Doctors Without Borders) arrived, as did the Center for Disease Control from Atlanta and the World Health Organization (WHO).  Mali already had capable, modern hospitals in Bamako and Sikasso, and the Center for Tuberculosis and AIDS Research (SEFERO).  Screening facilities and Isolation Units were set up at all border crossings and Ports of Entry.  Heeding the request made by President Obama, Mali has kept open its border posts with Liberia and Guinea (despite intense pressure put on President Keita from internal groups).  To date, Mali has registered only one positive case of Ebola, and that was the tragic instance of a now-deceased two-year old child from Guinea who was transported across the border by her grandmother after the death of her mother.  No doubt additional confirmed cases will occur, but all in all, Mali has set an example for other nations (not only third world) to follow when bordering a contagious viral outbreak.

Again, exhibiting a willingness to take advantage of every opportunity, AQIM has made its presence known again.  I've heard it said that after the nuclear apocalypse, the only things left alive will be cock roaches and Cher.  Well, lets add AQIM to the list.  These nasty, parasitic desert rats dug some deep tunnels to escape French and Malian justice, and now the resources of the government are tied up not only in combating the threat of Ebola, but also in trying to build a durable, functioning transportation network to support a growing economy.  Earlier in the year, the Chinese had come around, promising all sorts of goodies.  In fact, China and Mali had negotiated Chinese financial sponsorship of an $11 Billion new railway system to replace the existing rail to Dakar (built in 1884; last real servicing completed in 1924) and to build an entire new railway from Bamako to the port city of Conakry, Guinea.  Sadly, in the last few weeks the Chinese have started to hedge on their commitment, issuing a statement that discussions took place but no obligations were agreed upon.  Bullshit.  The Chinese economy has started to show signs of trouble, which would make reconsideration of expensive foreign projects only routine.  Eleven billion dollars is nothing to the Bank of China, but it could actually change the lives of 15 Million Malians.  What is my interest in this situation?  I love west Africa.  I'm half-French and I truly enjoy the Francophile community.  And everyone, who is willing to do their part, deserves an opportunity.

U.S. Troops Head To Africa To Fight Ebola

Links:  A. 3,000 U.S. Troops To Deploy To West Africa
            B. U.S. Troops To Africa For Ebola Mission
            C. U.S. Military Quarantined After Ebola Trip

I have been finding reasons to avoid writing this post because I'm not very clear on my own

emotions regarding this mission.  In September, when the Ebola virus was tearing a hole through Liberia and Guinea, President Obama anticipated the need for U.S. assistance and ordered the military to respond (I'm assuming that the military and not the President's staff, developed the deployment agenda).  A plan was created which would eventually call for three thousand troops from the 101st Airborne Division to deploy to locations in West Africa (see Links A and B).  The first group of U.S. military personnel, Army Major General Darryl A. Williams and his staff of ten, just completed a tour of Liberia.  During the tour Major General Williams and his crew observed the screening procedures and medical assistance measures in place in all areas of the country.  Its safe to say that they reached some level of exposure to the virus.  As is explained in link C, they will be isolated and monitored for twenty-one days, which is understandable.

As the first link points out, the military will be tasked with building a 25-bed portable hospital in Liberia.  It is expected that 17 treatment centers will eventually be built in the area.  Along with building facilities to treat patients with Ebola, the U.S. military will train up to 500 health-care workers a week to combat the disease.  My friends in the region tell me that currently "you can't throw a stone without hitting a white person".  I assume that many of the white people in question are Americans, as my cousin in Bamako tells me that the Center for Disease Control (CDC) has commandeered the nicest hotel in town.  My close friend, who owns a luxury car business in Abidjan, Cote d'Ivoire, is very impressed with the medical facilities that seem to be popping up all over the country.  Medecins Sans Frontieres (Doctors Without Borders) is there, and the World Health Organization is too.  The International Red Cross (IRC), which has permanent offices in all the capital cities of the region, has been active from the beginning, and are probably responsible for keeping the number of Ebola cases as low as they are.  In the Spring, with the first confirmed cases, the IRC began sending volunteers out into the rural areas of Guinea, Liberia, Mali, Sierra Leone, and Cote d'Ivoire, to stress the need for sanitation and education.  Most importantly, the IRC took note of the local health facilities and what was needed to set-up screening centers and isolation units.  I am impressed with the response to date of the United States and European health communities.  So far the procedures put in place appear to be working.

I have heard it said that the true reason behind President Obama ordering troops to deploy to Africa is to assist in evacuations and crowd control.  I assume "crowd control" would include "riot control".  Orderly crowds being moved by authorities have a tendency to get out of hand in Africa (my comment is not racist; it is the product of my years of living in Africa).  Actually, orderly crowds can become quite "disorderly" anywhere, not just in Africa.  I believe the initial projections by the experts in Atlanta (CDC) forecast that the outbreak would have spread to Mali and Cote d'Ivoire by now.  Given the impossibility of adequately controlling border crossings (sound familiar?), the CDC probably assumed that infected persons who had not yet begun to show symptoms would be traveling as usual.  Keep in mind that many folks see the borders in African as more of a suggestion than anything else.  The valuable gold and diamond mines in

Diamond Mine in Sierra Lione

Mali, and other countries, traditionally employ workers from bordering states.  I believe that the CDC was correct in assuming that the situation would be much more serious than it is, hence the in-depth planning for mandatory evacuations and (if needed) crowd control.  This is in addition to the fact that some people will not voluntarily leave their homes, and in the instance of a deadly virus like Ebola, they cannot be left behind. The issue is not just the health of the resident; anyone who stays in the contamination zone becomes a potential carrier, who may find a way to rejoin healthy people and start the contagion all over.  At this point I haven't bought into the argument that the troops are really here to control people.  I'm not that cynical.  But then see me again next week.   

The Ebola Virus Disease At Its Source

Link: CDC Information On The Ebola Breakout

You know the old expression, "When it rains, it pours"?  I was unable to locate the origin of the expression, but I'm sure its one of the most popular in the English language.  Throw a dart at a map of Africa, and more than likely you will hit a country that is suffering from some event that justifies the use of "when it rains, it pours".  Liberia and Guinea are two nations located on the Gold Coast

(southwest coast) of Africa.  The name Gold Coast refers to the belief that in colonial times the region was rich in Gold deposits.  Other countries on the Gold Coast include Sierra Leone, Cote d'Ivoire, Ghana, Nigeria, Togo, Benin, and Cameroon.  At present, the eyes of the world are focused on this part of Africa because of an outbreak of the Ebola virus in Guinea and Liberia.  Both Guinea and Liberia are attempting to rebuild and recover after decades of civil strife.  At one time or another during the same period, Sierra Leone and Cote d'Ivoire were also engaged in civil wars.  Recently, though, a wave of tremendous hope and optimism had been taking hold in west Africa.  Change was the order of the day, highlighted by serious efforts at reconciliation and fraud-free elections.  Aid was pouring in, and Chinese companies seemed to be everywhere, building dams and roads into the jungle.  Serious discussions were taking place which would hopefully result in the elimination of African debt, and there was talk of education, healing, national soccer teams in the World Cup, and creating a tomorrow that is better than today.

And then Ebola shows up to put a wrench into the works.  The Ebola virus is very contagious and has a mortality rate of 90 percent and higher. This particular outbreak first appeared in a small village in Guinea and has now spread to Liberia and Sierra Leone, choosing a target population that is ill-equipped to fight back. The people in this region are the poorest in the world.  The average daily caloric intake as compared to western nations is miniscule (and, for the western nations, shameful).  The body that is healthy is best able to avoid catching the virus, and the body that is healthy is best able to recover from infection.  Simply put, the people of Guinea and Liberia do not eat enough to stand a chance against this virus.  The governments of Liberia and Guinea, in concert with numerous international health organizations, have done a very respectable job limiting the outbreak to particular provinces.  Given the lack of resources available, this fact is impressive.  The best news for all is that for the most part the international community has reacted swiftly and without fear.  To the physicians, nurses, and other health workers who have traveled to Guinea and Liberia, the struggle is not only to limit and smother the outbreak, but to save the lives of those already affected.  During previous outbreaks, persons who had contracted the virus were frequently left to die.  A determination of infection was a death notice, because no one wanted to treat someone who was carrying such a highly contagious and deadly virus.  I'm relieved to say that my contacts in both countries report that persons who have tested positive are treated with respect and humanity, and every effort is being made to help their bodies fight the virus.

Currently, vaccines are being tested in Mali and Cote d'Ivoire.  There has been serious concern (and a bit of panic) that the virus would spread from Guinea and Liberia into Mali and Cote d'Ivoire; as of 12 October 2014, no cases of Ebola have been confirmed in either country.  The World Health Organization (The United Nations) has been highly visible in Bamako, Mali and in Abidjan, Cote d'Ivoire, as has Medecins Sans Frontieres (Doctors Without Borders).  The United States Center for Disease Control (CDC) has also made its presence felt.  Finally, the international community is reacting to a health crisis as it should; with resources, manpower and sacrifice.  Earlier today (at Mass, no less), a friend asked me why the international community does not respond to famine and genocide with the same vigor and generosity.  The answer is quite simple.  Famine and genocide are not contagious.  Two million persons at risk from starvation in Eritrea and Ethiopia cannot result in even one case of hunger in the United States.  Warlords slaughtering innocent villagers in Somalia and Sudan does not lead to someone getting shot or stabbed in Copenhagen or Osaka.  In the United States, this current Ebola strain has resulted in the death of one Liberian national in Dallas and the positive infection of a health worker.  The degree of separation gets smaller and smaller, and people realize this.  So smothering this recent outbreak of Ebola at the source makes perfect sense.  The wealthier nations are happy to spend the money, and if locals are cured as well, then all the better.

I'm confident that this particular outbreak of the Ebola virus has reached its peak of infection.  Vaccines have arrived, and people are learning what they must do to avoid contamination. Although 4033 persons have died from this episode, I believe more and more infected persons will recover, as medicine and health care starts to take effect.  West Africa is a hot spot for all sorts of nasty diseases, and I'm optimistic that the current governments in this part of the world will make health education a priority.  The numerous companies involved with mining in Guinea, Cote d'Ivoire and Mali should not suffer too much from the slow down, and hopefully cocoa production will not be affected.  I realize I am being very optimistic, but doesn't it sound more pleasant than the non-stop media cacophony about one person with the flu in Baton Rouge and another person sneezing in Des Moines?  In 1994, Richard Preston wrote a fictional novel called "The Hot Zone", about a hemorrhagic fever outbreak in the United States.  For the longest time, it was all people could talk about.  I'm glad to say that Preston's book remained fictional.  But it did serve as a warning to our various health and disease-related organizations that we had better have a game plan.  I think this Ebola outbreak in West Africa has demonstrated that we do have a plan, both domestically and internationally.  Because we have fifty states and hundreds of international ports-of-entry, mistakes will happen.  But overall, I'm impressed with our response.