The Right Coast

June 29, 2005
Africa's Health Barrier
By Maimon Schwarzschild

Speaking of health, this RightCoaster will be visiting Ethiopia in a few weeks: and that means a lot of preventive medicine in the meantime. The recommended vaccines and immunisations include yellow fever, hepatitis, meningitis, polio, and malaria. The travel clinic said don't even bother bringing a sterile syringe: "Would you carry it with you at all times?" asked the Doctor sceptically. "If you get into the kind of accident that requires a transfusion, you're probably done for anyway". On that cheery note, we decided no sterile syringe, and never mind the HIV rate.

As for Dengue fever, there is no immunisation. "Try not to get bitten by mosquitoes", said Dr Cheery, with that sceptical look again.

Robert Kaplan -- a "travel writer" only in the high, serious, Victorian sense -- wrote a provocative piece in 1994 called "The Coming Anarchy". It definitely bears re-reading. One of his points was that disease is isolating Africa from investment, from tourism, from hopeful contact with the rest of the world:
As many internal African borders begin to crumble, a more impenetrable boundary is being erected that threatens to isolate the continent as a whole: the wall of disease. Merely to visit West Africa in some degree of safety, I spent about $500 for a hepatitis B vaccination series and other disease prophylaxis. Africa may today be more dangerous in this regard than it was in 1862, before antibiotics, when the explorer Sir Richard Francis Burton described the health situation on the continent as "deadly, a Golgotha, a Jehannum." [I]n Africa the HIV virus and tuberculosis are now "fast-forwarding each other." Of the approximately 4,000 newly diagnosed tuberculosis patients in Abidjan, 45 percent were also found to be HIV-positive. As birth rates soar and slums proliferate [in Africa], some experts worry that viral mutations and hybridizations might, just conceivably, result in a form of the AIDS virus that is easier to catch than the present strain.

[But] it is malaria that is most responsible for the disease wall that threatens to separate Africa and other parts of the Third World from more-developed regions of the planet in the twenty-first century. Carried by mosquitoes, malaria, unlike AIDS, is easy to catch. Most people in sub-Saharan Africa have recurring bouts of the disease throughout their entire lives, and it is mutating into increasingly deadly forms.
Conditions are somewhat less dire in Ethiopia than in West Africa, although Ethiopia is desperately poor. In countries -- or "countries" -- like Liberia and Sierra Leone things have only gotten much worse since Kaplan wrote.

I hope to have a healthy time in Ethiopia. And to keep in mind my completely undeserved good luck in having been born on the fortunate side of the world's "wall of disease".