October 23, 2014

"You can't put out 99% of a forest fire. You have to put it all out."

Daniel Bausch, Ebola Doctor

For almost twenty years Dr. Daniel Bausch — director of the Emerging Infections Department at the U.S. Naval Medical Research facility in Peru — has been back and forth to West Africa, treating cases of hemorrhagic fever caused by Ebola and viruses like it (Lassa and Marburg among them). Bausch may know Ebola, up-close and personal, better than any American doctor working today.

This time, he says, it’s worse than ever before. In Sierra Leone and Guinea, medical teams he helped assemble have been hollowed out by the disease. Among the lost is Dr. Sheik Humarr Khan, the veteran chief physician at the Kenema Clinic, whom Bausch himself had hired for the job ten years earlier. Bausch believes he left Sierra Leone the same day this Spring that Dr. Khan began to show symptoms of Ebola; he died in July.

Bausch saw doctors and nurses getting sick, leading to a collapse of morale and a swamped ward. At one stretch Drs. Bausch and Khan were alone, shoulder-to-shoulder, tending to a ward full of sixty or so Ebola patients. I asked him about Dr. Khan, whose heroic fight and calm death sounds like something right out of a novel.  Like the humanist Dr. Rieux, to be precise, in Albert Camus’ novel, The Plague.  Dr. Bausch told me he was re-reading Camus’ masterpiece through the Ebola tribulations in West Africa this fall of 2014.

Bausch believed at one moment this spring that the spread of the disease had been contained, but he told us it’s proof that “you can’t put out 99 percent of a forest fire — you have to put it all out.”

Still he’s hopeful that we’re getting the message in the West: we need to try harder to bring the best of modern medicine to the world’s poorest corners. West Africa, he said, will need the Marshall-Plan treatment after its long war with Ebola finally comes to a close.

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  • Potter

    I am grateful for this conversation; a lot of good points were made after the DR. admirably refuses to get into non-productive blaming. This is an opportunity for further awakening about the need for first class health systems in remotes places, especially those vulnerable as Sub Saharan Africa. To accomplish that we need concerted efforts, organization and the knowledge we are gaining now. Dr. Bausch mentioned several times that a Marshall Plan is needed. On the news today the reports tell of political shifting around in reaction to fears, trying to get it right, making mistakes in the process.

    Thank you so much for taking the broader view with this excellent guest I admire. Of course thanks also and again for referring us back to Camus’ The Plague and your podcast.

    I don’t know if more information about Dr. Khan’s case was left on the cutting room floor, but I was curious about Dr. Bausch’s take on that.

  • Cambridge Forecast


    The recommended Marshall Plan for West Africa in this ROS discussion is hard to envision in a context of such nativist, isolationist, indeed irrationalist moods in America and the
    Congress. The politics of fear isn’t conducive to a Marshall Plan, at least not
    in the current conjuncture.

    A more practicable avenue in terms of the Ebola epidemic might involve the promotion of a free vaccine with the “national security”/”vital national security” standard smokescreen as
    ideological cover.

    On Thursday, November 6, 2014, TV’s “NBR” or “Nightly Business Report” (CNBC/PBS) the following current share price news was discussed for three Ebola vaccine companies. The transcript of that show says:

    “Nightly Business Report” Transcript: Thursday, November 6, 2014

    “News about a trio of drug companies that are all working on Ebola vaccines.
    Sarepta`s profit topped forecast but revenue was short of estimates. Tekmira
    posted a wider than expected loss, but announced it will produce Ebola
    treatments for the Department of Defense. And BioCryst posted a wider loss on
    increase research and development expenses.
    Shares of Sarepta shot up 7 percent. Tekmira rose 4 percent. But BioCryst down nearly 7 percent.”

    Tekmira (Canada) mentioned above is connected to the DOD and that’s where some large-scale
    initiative for Africa-wide Ebola vaccination could originate, with “national security” as rationale.

    This route looks to be the only feasible answer to Dr. Bausch’s viral “forest fire.”

    Richard Melson