Tag Archives: Africa

#Ebola in West Africa: Update

WHO has put out very few updates in the last several days. The most current update is August 28th, and it pertains to information from August 26th and before. Based on that update, the total number of cases (confirmed, suspected, etc.) is ow 3069 with 1552 deaths. The number of new cases per day may be increasing, may be decreasing; hard to say at this point. Here’s the new cases per day since the second week of July:

Screen Shot 2014-09-02 at 11.08.33 AM

Senegal now has one case, a person who traveled there from Guinea. He had contact with a lot of people including health workers and family before it was figured he may have Ebola. There is no word from the Congo since I last wrote about it, at least from WHO.

I’m sure Murphy’s Law will apply and WHO will issue new information soon after this post goes up, so expect an update very soon.

DR Congo #Ebola Outbreak

We can now be pretty sure that the Ebola outbreak in the DR Congo is not an extension of the West African outbreak. The index case seems to have gotten the disease from a mammal she butchered, and the numerous other cases seem to stem from contact with her primary as health care workers and family members. I don’t think we have enough information yet to assess this outbreak vis-a-vis the genetics of the Ebola itself.

From WHO:

On 26 August 2014, the Ministry of Health, Democratic Republic of the Congo (DRC) notified the World Health Organization (WHO) of an outbreak of Ebola virus disease (EVD) in Equateur Province.

The index case was a pregnant woman from Ikanamongo Village who butchered a bush animal that had been killed and given to her by her husband. She became ill with symptoms of EVD and reported to a private clinic in Isaka Village. On 11 August 2014, she died of a then-unidentified haemorrhagic fever. Local customs and rituals associated with death meant that several health-care workers were exposed and presented with similar symptoms in the following week.

Between 28 July and 18 August 2014, a total of 24 suspected cases of haemorrhagic fever, including 13 deaths, have been identified. Human-to-human transmission has been established and includes the health-care personnel who were exposed to the deceased pregnant woman during surgery (one doctor and two nurses) in addition to the hygienist and a ward boy, all of whom developed symptoms and died. Other deaths have been recorded among the relatives who attended the index case, individuals who were in contact with the clinic staff, and those who handled the bodies of the deceased during funerals. The other 11 cases are currently being treated in isolation centres.

#Ebola: Second, possibly third outbreak, West African outbreak growing

The number of people known or suspected to be infected with Ebola in the West African outbreak is increasing, and the rate at which it is increasing is increasing. About 40 new cases are being reported per day on average, but the number of new cases has been going up by a few a day.

However, it is still unclear that these numbers represent what is actually happening on the ground. There is little confidence that the WHO has a good idea of who is currently stricken with the disease, and efforts to contain those who are have had mixed results.

A second outbreak is now occurring in the DR Congo (formerly Zaire). This is a second separate outbreak. So, it is NOT correct to say that Ebola has spread into the Congo. It didn’t. It emerged there independently.

What are the chances of that happening? I have long maintained that the conditions for Ebola spreading into human populations include factors that make the overall chance of that happening, for a large region, go up enough for multiple simultaneous epidemics to be more likely than chance might suggest. Perhaps I’ll discuss my reasoning for that another time. In any event, the DR Congo outbreak, about which we know very little so far, appears to be a different strain of Ebola, so this is not the Wester African Ebola spreading to Central Africa.

There are reports of a third outbreak of an unknown disease that might be Ebola also in the DR Congo. But that could be a lot of things. Including Ebola… so we shall see.

Also, there is one new case in Nigeria, after a period of several days with no new cases.

#Ebola UPDATE-Rate Of New Cases Rises, Note to Laurie Garrett, is there a case in South Africa?

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h2>New for August 16th

I will try to keep new information and updates in the same post for a while until I have a chance to do a comprehensive re-overview of everything.

The 16 August update from WHO indicates a large uptick in the daily number of cases. Over the two days of the most recent reporting period an average of 76 cases per day have been identified as confirmed, probable, or suspect, with a total of 76 deaths over that period of time.

Good news is that the situation in Nigeria doesn’t seem to be developing. There were no new cases over the this reporting period, and one death. The last new cases in Nigeria were reported on August 6th for the period between August 2 and august 4. So over ten days without a new case in Nigeria probably means that the “outbreak” is burned out.

Meanwhile, there is another suspected/possible case in another country. This has happened a number of times, where a suspected Ebola case is identified. Hong Kong, the Philippines, the US, etc. have had these, and of all of the cases none have been shown to be Ebola except possibly one, and that is in Saudi Arabia did not work out either, the Saudi case was not Ebola. The new possible case is in South Africa.

The updated graph showing the increase in daily cases is inserted below as before.

And now, a personal note to Laurie Garrett. Laurie wrote this post, and I wanted to comment on it but the commenting system there did not work for me. (Perhaps one has to be subscriber.)

Laurie,

I love you work. It was your book, based on your Thesis at the Kennedy School, that got me interested in tropical diseases. Well, that and at the same time going to the tropics, running a makeshift health clinic there, and getting some of the diseases. I often point people to your earlier writing on influenza to find out about the true pre-Wakefield anti-vax movement, to see how the US handling of Swine Flu made it very difficult if not impossible to have a sensible national vaccine program that was not byzantium (which is what we have now)

But I think your article on not being scared enough about Ebola has some problems. I agree that this outbreak has not been taken seriously. I nave noted in my own writing that WHO and CDC, even, are coddling the public about some of this. I also noted, which I don’t think you did, that Ebola “in Africa” is Ebola in America already. One of my neighbors died of Ebola, and one of his relatives in Liberia did as well, and some of my other neighbors lost relatives, I’ve heard. This is because Liberians and other Africans live in communities with one foot in Africa and one foot here. Those who died of Ebola did so in West Africa, but they are still neighbors who live here part time or African-based relatives of neighbors who live here full or part time.

So yes, for many reasons, be concerned.

Here’s where I don’t agree with you.

First, while the cures and vaccines are truly not deployed as you point out, you are more negative than necessary. In fact you are hyperskeptical. A common phrase in hyperskepticism is “there is not a shred of evidence of…” Well, there is not a shred of evidence that my four year old is upstairs eating a peanut butter and jelly sandwich instead of the nice dinner I made my family, but that does not mean it is anywhere near impossible. In fact, he’s probably eating a peanut butter and jelly sandwich, though I can produce not a shred of evidence from here in my basement that he is. There is in fact good scientific reasons to think that the cures that have been brought to the brink of testing are likely to work, and Ebola is not like Malaria (not even close) or even viral cousins such as Influenza when it comes to vaccine prospects. The prospects are good, if only someone would work on them.

Next problem: No, Saudi has not Ebola. No, there have not been a number of actual, non-panic-based cases of Ebola outside of the affected area other than my neighbor and those he infected, in Nigeria.

Next:No, Nigeria does not actually seem to be having an outbreak. No new cases in ten days is good news. It may be over there.

We’ll see about South Africa.

But yes, I do agree with you on two other points. First, all of the health care molecules have moved to one corner of the proverbial room suffocating other health care efforts in the affected countries. This is a big deal. Second, yes, it really is possible despite major media and major organizations insisting it is highly unlikely for this outbreak to seed an outbreak pretty much anywhere in the world. Not that likely. But I won’t say that there is not a shred of evidence that it could happen (citing that every single case outside the zone for which confirmation was completed has not worked out). I’ll just say that we have no freakin’ clue how likely it is, but it is not zero and the consequences would be dire.

So, I don’t want to tone-troll your article. You went for breathless, and you got to breathless, and that’s probably a good choice, you have the credibility to pull it off and people need to hear much of what you said. But no, Ebola is not leaking out of the zone now, and yes, there is better hope I think for the existing (as in on the table, not deployed or even tested) cures and vaccines (and by the way, the “ethical considerations” are a red herring, that is true for all drug development, but seems only mentioned frequently with respect to Ebola).

End of rant. Again, love your work.

Cheers,

Greg

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h2>End of August 16th update

Probably.

Yesterday I made the optimistic statement that the number of new cases a day may be leveling off, as for two reporting periods in a row, representing five days, the new cases were about half of the previous reporting period, normalized to a per-day estimate.

Today’s report from WHO covers two days and indicates 128 more cases, so the number of new cases per day for the latest known period is actually higher than at any previous time during this outbreak. Pursuant to this I’ve replaced the pertinent graphic below. I was optimistic, but I also provided caveats. The caveats won.

Is the current Ebola Outbreak subsiding?

At some point, the Ebola Outbreak in West Africa has to slow down and stop. The disease is too hot to not burn itself out, and it has no human reservoir. Ebola accidentally broke into the human population earlier this year or late last year, probably once (see below), and despite the regular increase in daily reported cases over the last several weeks, the disease must at some point begin to level off.

The latest two updates from WHO indicate that the Ebola outbreak may be leveling off now, tough it is too early to be certain. The following graph shows the approximate number of new cases reported per day by WHO. This is calculated by taking the number of new cases in a report and dividing by the number of days covered by that report. A given estimate of daily new cases may be quite off for a number of reasons. First, even if there is a long term upward or downward trend, there is likely to be a lot of randomness in the data. Second, this is the number of cases reported in that time period, not the number of cases that manifest. It is likely that some cases manifest during the reporting period are not recorded yet, and cases manifest for the prior reporting period are included in the current reporting period. Over several reporting periods this would, obviously, even out, but a given number of days in a reporting period may be off by a day or so. So, these caveats mean that we should be very cautious in interpreting this graph.

NEWER GRAPH:
Ebola_2014_outbreak_cases_per_day_Aug_15Update

Note that what appears to have been a fairly steady increase in number of cases, with about the same number of ups as downs but with the ups adding to a higher sum, since late June, has been followed by two reporting periods with decreases in numbers of new cases. Note also, however, that in late May the number of new cases per day went up fairly quickly then dropped again before a new steady rise occurred. If we use a moving average of 3 data points, which would combine sets of 2-4 days each to obtain something close to a 10 day effective moving average, the upward trend is more evident than any recent downward trend:

Screen Shot 2014-08-12 at 2.44.43 PM

The next two WHO reports may clarify this trend.

Mortality Rate Is Decreasing

The mortality rate for this outbreak continues to decrease slightly, which is probably a result of increase effectiveness of the response to the outbreak, despite all the news stories about how things seem out of control.

EbolaOutbreak_2014_MortalityRate_Aug_11_update

The current mortality rate is dropping below 55% given confirmed, probable, and suspected cases and deaths. But the rate varies across different categories. The outbreak-long rate for all cases and all deaths is currently 55%, and looking only at confirmed cases and deaths, it is 56%. The mortality rate for all previous African Ebola outbreaks, taking total reported cases and total reported deaths, is 66%.

This is the largest outbreak ever, and then some

Currently there are over 1,800 confirmed, probable, or suspected cases reported in the West African outbreak, and 1176 confirmed cases. Using just the confirmed cases, to be conservative, the present outbreak is 277% larger than the next largest outbreak, which was in 2000 in the Gulu, Masindi, and Mbarara districts of Uganda, with 425 cases. The total number of confirmed cases for the present outbreak represents about 49% of all of the prior African Ebola outbreaks combined.

Patient Zero Identified?

Patient Zero, who we assume is the person to whom the disease jumped from its usual animal reservoir, directly or indirectly, may have been a toddler in Guinea. The two year old child died in December 2013, which is quite a bit before this outbreak came on everyone’s radar screen, and after which it was fairly low level for a while.

I’ve long maintained that a likely way for Ebola to get into other species is from ground dwelling mammals, such as chimps, gorillas, or forest antelopes and duikers, ingesting or mouthing the discarded wadges of fruit previously handled by Ebola-carrying fruit bats. From such non-human animals the Ebola would then enter human populations from people butchering bush meat. In this case though, I wonder if the toddler may have been a direct recipient, picking up and mouthing fruit-bat spit covered fragments of fruit found on the ground. A parent’s worse nightmare, apocalypse style, to be sure.

The Famous Untested Drug

There has been a bit of complaining about my use of the term “drug” or “cure” for ZMapp, a drug that was developed to fight Ebola but not used until just now. Some have said it is not a drug until it is tested and deployed, and until then, it is a possible cure and not a real cure.

This is wrong. A “possible cure” is when you take an existing compound or substance, apply it to a pathogen or an affected animal model, and get a hopeful result. This possible cure can then be further developed to make, most of the time, nothing because these things generally don’t work out. Or, to make a cure. Which can then be tested.

In the case of the treatment now given to three patients (two survived one died), the cure was developed for Ebola based on some pretty solid science and prior experience with similar type cures working for similar diseases, successfully, in the past. The cure was not in “hopeful” or “possible” phase, but rather in developed but untested phase. The WHO convened an emergency panel of experts, yesterday, which decided that the cure should be used in the field under certain circumstances. So now there is an untested but developed cure for Ebola being deployed in West Africa. The WHO discussion on this is here.

Ebola Outbreak Continues, Probably Worsens, Perhaps Spreads

The WHO came out with a new report today with the latest figures on Ebola. These numbers take us to the end of July. There are two bits of bad news.

First, the number of new cases is high, as high as any prior report (but keep in mind that these reports cover uneven time periods). There are 163 new cases and 61 new deaths, bringing the total number of confirmed cases and deaths to 1009 and 574, with the total number of confirmed, probable, and suspected to 1,603 cases and 887 deaths.

Second, Nigeria is now in the mix. There was previously only one case in Nigeria, a Liberian man who contracted Ebola in Liberia and died in Nigeria. But now there are three probable new cases in Nigeria and one probable Death (none confirmed). According to WHO, of the Nigerian cases, “…one is a health-care worker and one is a Nigerian who travelled to Guinea — and a suspected case in a nurse.” I’m not sure if four cases (if confirmed) is an outbreak yet. If all the cases have quirky explanations having to do with other countries, than this not be anything new. But this could also be the beginning of the spread of the disease into Nigeria.

Here’s a graphic of the cumulative number of caeses by country (not counting Nigeria) and the total so far. These are all cases (confirmed, probable, suspected). You will notice that Sierra Leone is contributing the largest number of cases, but Liberia is contributing the strongest uptick in what seems to be an increase in rate of new cases (more on that below).

Ebola2014_Aug4_update_cases_by_country

This graphic shows the number of cases over time and the number of deaths over time (totals). Note that the gap between the two is widening, suggesting a lowering of the mortality rate.

Ebola_2014_total_cases_and_deaths_Aug4_update

To try to get a better idea of mortality rate over time, here’s a graph of the an estimate mortality rate based on the total number of cases and the total number of deaths for each of the WHO reports (which come out every few days) over time. There is no sense in calculating a simple correlation coefficient or R-squared value for these data because each data point is based on the adjoining data point plus or minus (they are not independent) but one suspects a proper time series analysis would suggest a decrease.

Ebola_2014_mortality_rate_over_time_per_report_August_4_update

Keep in mind that as the number of cases or deaths shifts along the confirmed-probable-suspected axis, the morality rate can change quite a bit. One might expect that the least certain category would have the lowest mortality rate because one is more likely to incorrectly assign a patient to having the illness than one is to attribute a death to the disease. Here’s the behavior of mortality rate across the different categories of available data. Note that the rate for “new” is probably going to be biased downwards if the rate of new cases is going up (because the number of people who have not died yet, but will, is greater than if the rate is going down); that 37% figure, therefore, is nothing to get excited about. Also keep in mind that “Total” is a combination of the other three categories. Given the vagueness of some of the data, one could say that a good estimate of mortality is 55%, but a large number of cases have been added in the last several days, so it might be better to say that the mortality rate in this outbreak is at least 55%.

Ebola_2014_Mortalit_Rate_Across_Categories_Aug_4_update

It seems that the number of new cases is going up but this is hard to count. The WHO reports cover different time periods, and I’ll wager that even within that constraint the data are a bit funky given the on the ground situation. Over the large scale of time it is clear that the number of new cases is rising. This graph shows the number of new cases per month, but keep in mind that the dates of the various reports do not match the ends of the months cleanly so there is room for error her. These are all cases.

Ebola_2014_New_Cases_Per_Month_Aug_4_Update

Since the rate of infection can go up or down over a matter of days, or a least, more rapidly than would be reflected in a month by month accounting, here’s the same data by half-month:

Ebola_2014_New_Cases_Per_Half_Month_Aug_4Update

And, because that does not capture important detail here’s the data again by WHO report, keeping in mind that the length of time covered by each report varies.
Ebola_2014_Rate_New_Cases_Per_Report_Aug_4_update

Actual epidemiologists use much more sophisticated methods for analyzing this sort of data, but this should give you the idea that while the rate of new cases varies a lot from report to report, there is a general upward trend in the number of new cases.

This Ebola outbreak is not going away soon, it seems.

Other posts on Ebola:

<li><a href="http://scienceblogs.com/gregladen/2014/08/04/there-is-a-cure-for-ebola-we-have-it-we-just-dont-let-anyone-use-it/">There is a cure for Ebola, we have it, we just don’t let anyone use it.</a>

<li><a href="http://scienceblogs.com/gregladen/2014/08/04/ebola-outbreak-continues-probably-worsens-perhaps-spreads/">Ebola Outbreak Continues, Probably Worsens, Perhaps Spreads</a></li>
  • Ebola Perspective: Risks of spread to the US and elsewhere
  • <li><a href="http://scienceblogs.com/gregladen/2014/07/27/ebola-outbreak-in-west-africa-some-basic-information/">Ebola Outbreak in West Africa: Some basic information (Updated)</a></li>
    

    Ebola Perspective: Risks of spread to the US and elsewhere

    LATEST UPDATE HERE

    It is true that this particular outbreak of Ebola has taken health officials somewhat by surprise. It is impossible to know, but I suspect that if you had asked a few ebola experts, a year ago, if there could be an epidemic that would spread across three or four countries, infect a couple thousand people, and last with no sign of letting up for a few months (that is the current situation, more or less), most would say no, probably not, though it is within the range of possibilities. Does the fact (assuming it is true) that this particular Ebola outbreak is unprecedented and kinda over the top even for an over the top disease like Ebola mean that there is something different about this Ebola or this outbreak? That is a question that may be on your mind.

    Another concern is the possibility that since this outbreak involves populations with more mobility including via aircraft than previous outbreaks that the Hollywood Scary Fiction scenario could happen. Here’s how that goes. Someone infected with Ebola, but not symptomatic, gets on a long plane flight, maybe with a few legs and layovers. They start to get sick on the first flight, and after changing planes twice and being very sick for the last leg, they get off the plane and collapse, are taken to a local hospital very far form the Ebola epidemic where no one is expecting Ebola, spend a little quality time in the waiting room, and are finally put in an in-patient unit in a room with two or three other people. Hundreds of people have been near this person. The patient threw up in the bathroom of each of the airplanes he was on, and later someone filled the sink in the same bathroom and used the water in the basin to wash his or her face. He drooled on his pillow while sleeping in his seat, and somehow the person next to him ended up with that pillow and slept on it for an hour. He threw up on some nurses and some orderlies had to clean up his diarrhea in the hospital a few times. And so on. By the end of all of this, a half dozen people are infected with Ebola, including a personal trainer, a grade school teacher, and four nurses. That’s just the first scene in the movie, long before the character played by Morgan Freeman is on the scene, and when the character played by Morgan Freeman shows up, you know things are getting serious.

    A variant of that concern is this: Two aid workers helping with the Ebola epidemic, Americans, catch Ebola and are very ill. It is decided to fly them back to the United States for treatment. This brings Ebola into the US, where it could spread to other people because, well, because Ebola! But is this a realistic concern or just a Hollywood studio’s wet dream?

    At this point in the epidemic we are seeing the usual bifurcation of reaction among the general public, sciency bloggers, and the press. On one had there is growing panic, people either being very scared, for real, or people or press outlets shopping fear on the market because it sells. On the other hand there is the stern corrective statement that all your fears are invalid, Ebola isn’t going to get out of hand, isn’t going to get to the US, there is nothing to worry about.

    At the same time there is a parallel and equally bifurcated rhetoric about the bigger picture, about dealing with Ebola as a public health problem. On one hand you have people asking for a vaccine, or some sort of cure, to address this thus far orphaned disease, because they are worried about it. On the other hand you have people noting that Malaria kills millions a year, and most years, Ebola kills no one, and when there is an outbreak, it only kills dozens or hundreds, except this last time which is still only many hundreds dead and the very low three figures sickened.

    Every one of the above mentioned concerns is valid and invalid at the same time, and every one of the reactions to the current Ebola crisis is both correct and incorrect at the same time. Let me explain.

    What is the meaning of the bigness and badness of the Ebola 2014 outbreak?

    There may be new things to learn about Ebola from this outbreak, but that won’t be until after the dust has settled and scientists have had a chance to look more closely at the data, and the virus, and everything else. But there does not seem to be anything new or unusual about the disease, and I don’t think there is any major difference in how the outbreak is being handled. But there are two differences from earlier outbreaks, one of which is certainly relevant to the large size of this event, the other perhaps important but as yet unclear.

    <li>Most, really all, prior outbreaks occurred in areas where the affected population was relatively thinly scattered on the landscape and the movement of people in and out of the area was minimal and slow. This outbreak is happening where there are much larger concentrations of population and a lot of movement of people.  This has simply upped the chance of transmission in close quarters (higher density) and made for opportunities for spread to previously unaffected settlements.</li>
    
    
    <li>There has been resistance to health workers coming into some villages.  This story is spreading around as though it was a major thing, that large areas were becoming dangerous or difficult for health workers to enter or work in.  We need to be cautious in drawing conclusions from the news.  It is very easy for westerners to slip into blaming the natives for their own difficulties and contrasting native ignorance with Great White Smartness.  There may well be areas where this is happening or important but until there is some actual unbiased carefully collected and evaluated information on this, please don't draw conclusions.  If you hear about something that looks like a great story, there is a good chance that it is a great story.  Emphasis on "story." </li>
    

    This particular Ebola outbreak is really like all the others, but jumbo size.

    Could sick aid workers being brought to the US spread the disease here?

    No.

    You can stand in a room with a person infected with Ebola ten feet across the room from you, and stand there for hours, without a mask, and you will not, can not, get Ebola. It simply isn’t transferred that way. Clean up Ebola vomit, Ebola diarrhea, physically move Ebola victims from bed to bed, give them a sponge bath, tend wounds or other injuries, insert and remove IV’s, handle the bodies of recently deceased Ebola victims, and especially, give traditional treatment to those bodies which, as is done in many cultures, which may involve cleaning and even internal cleaning or handling of organs, etc. etc., and you’ve got a reasonable chance of getting Ebola. Even then, the number of health care workers who actually get Ebola is probably very small. Tragic and horrible when it happens, but a few out of thousands most directly exposed and at risk for months is a small number.

    The people who are being transported to the US are isolated, in negative pressure facilities, and are being handled with kid gloves. Well, latex gloves, actually. They can not infect anybody but their immediate caretakers, and those individuals are very well protected.

    There is a risk of a different sort, though. While these particular patients are being handled with great care, there are healthy helpers, medical workers or others, who have been working with Ebola patients and seem to have not contracted the disease, who are occasionally wandering off to their respective homes and, I’m pretty sure, not being quarantined. I am not sure if all the people involved in helping in West Africa are being tested or properly watched. They may be, but there is some evidence that this is not the case. I’d like to learn more about that, and I hope we don’t learn anything the hard way.

    One US based doctor has returned to the United States and decided to quarantine himself. Alan Jamison will keep himself separate from society for 21 days since his last potential exposure to Ebola.

    If he is doing this on his own, there is the implication that doctors or others who were working with Ebola victims are being allowed two wander off and commune with the rest of us with the prospect that they are infected and eventually could spread the disease. However, I’m not sure that this is true. I don’t know that Dr. Jamison was not tested, I don’t know how much exposure he had and I don’t know what the procedure is for managing this potential problem. This is one guy who may be making hay where there is no grass. Worst case scenario, though, is that a health worker gets sick, the beginnings of Ebola like symptoms emerge, and the health worker gets treated. Nobody who has been working with Ebola patient is going to get a head ache, feel like throwing up, and say to themselves, “Hmm. I wonder if I’ve got allergies or something?”

    We should be worried about people wandering off, leaving the sites of the outbreak, generally. That’s clearly how this has spread to begin with. This applies to health workers and regular people. It applies to journalists in the field. We should not assume, but we can reasonably hope, that people are doing the right thing. But even when they don’t, remember, this is not measles, which is highly contagious.

    (Also, in case you didn’t know, Ebola is of course already in the United States. See this.)

    Can the scary hollywood scenario happen?

    Yes, of course it can. There is nothing in that scenario, taken on its own, that can’t happen. Bodily fluids get around. People are confined on aircraft, share a bathroom, and occasionally eat each other’s cookies by mistake. I don’t think there is any scientifically valid way to suggest that people who are symptomatic with Ebola are anything but a nightmare on a regular airplane flight, hanging around in airports, sharing cabs, et. When I hear international health experts saying that the chance of Ebola transmission on an airplane is pretty much non existent, I want to ask them: Ok, so, you’ll be entering and leaving the sick rooms of Ebola patients, maybe taking your kids along because it’s Follow Your Parents to Work Day, and maybe even have your kid sit next to the patient in bed and read them a story, without any protective gear at all. Right? No, absurd.

    However, the crazy scenario I gave you above, with the vomit and the pillow and the bathroom, requires a lot of things to go wrong in sequence, which is pretty unlikely. Also, the worst case scenario is that a few people end up with Ebola. It would be very hard for that to spread in the US. We’re too good on our health care, even when it seems we are not. On the other hand, if an air route with a symptomatic Ebola patient is sending people to any of many other places, with high population density, little education or information about things like Ebola (or even a belief that it is not a disease you get from other people) and no monitoring, I’d worry that smaller outbreaks could show up in other countries or other cities, in West Africa, elsewhere in Africa, or beyond. You can say that chances are it won’t happen. But it did happen. Ebola is in multiple countries spreading from multiple sites in West Africa.

    I’m pretty sure the people who deal with Ebola, though, try to not take chances. Rhetoric to the contrary is to avoid panic. Avoiding panic is good, and in fact, panic is unnecessary. Ebola is not that contagious. But somewhere between being concerned and avoiding panic by making it sound like Ebola refuses to pass from person to person on air planes, there is clearly something lost in translation.

    Who cares about Ebola, it is not Malaria!

    To me this is one of the most insidious problems we have and it doesn’t just apply to Ebola vs. Malaria. Let me give you an example from an entirely different area.

    How much money have spent on the science of subatomic physics, say, just in the US. And, what are the benefits? More importantly, what were the benefits that were specified at the outset of various research projects, and which of those have been realized?

    The answer to that second question is probably zero, zero. No benefits were specified, and thus, any gained don’t count. You are probably thinking, “No, wait, what about the knowledge, and all that stuff!?? That was surely specified in the grant proposals!” No doubt, but simply advancing knowledge is not a benefit. How do I know that? Malaria! Those physicists may have advanced our knowledge, and as a side effect invented the DVD and stuff, but nobody cured Malaria. Therefore it doesn’t count.

    Sounds like an incredibly stupid argument, doesn’t it?

    Now, side step over to Ebola. Is creating, say, a vaccine to address Ebola worth it? No! Why? Because Malaria! Malaria is way bigger, kills more people, is a truly serious public health problem, Ebola is rare. So if you’ve got some research money don’t spend it on Ebola, spend it on Malaria.

    That would be the smart thing to do!

    This is also an incredibly stupid argument, for a few reasons. The only reason you can compare Ebola and Malaria is because they are both diseases. They aren’t even the same kind of disease, they don’t have the same geographical spread (though it is overlapping). But they are diseases, so when we consider spending resources on research in one, it is natural to compare to the others. But they are also two different things. If I had a million dollars in the bank of my Malaria Vaccine Research Institute and gathered all the scientists together and said, “OK, folks, until we’ve spent this one million dollars, I want you all working on Ebola instead of Malaria, K?” they would look at me funny for a while and then call my wife to take me home. Ebola is a virus, Malaria is a cellular organism. They are very different things. The expertise and lab equipment would not be in my Institute. I might as well tell my scientists to spend a million dollars working on the next generation of high definition TV. That would be cool! And, suggesting that we compare the costs and benefits of that project to working on Malaria or Ebola would be dumb.

    One of the benefits of working on a vaccine for ANY virus is advancing knowledge of vaccines for viral disease generally, and we have a lot of work to do on vaccines for viral diseases. Perhaps work on Ebola would have some great side benefits. Indeed, money spent on a vaccine for Ebola would very likely produce … wait for it … a vaccine! Money spent working on a vaccine for Malaria has thus far failed to produce squat.

    A vaccine for Ebola is probably relatively easy to develop. Ebola is not a human disease. It comes from an animal reservoir. Ebola, if hit with a vaccine in human populations, can’t evolve resistance to that vaccine (or other treatment). Humans have little or no history of immune response to Ebola, and a very long (in essence, multi million year long) history of immune response to Malaria and its cousins. Developing an Ebola vaccine would be like putting up a childproof gate in your house, where the 2 year old is Ebola and the childproof gate is the Vaccine. Developing a vaccine for Malaria is like trying to stop a squadron of Navy Seals from penetrating a drive-in theater at a date and time of their choosing.

    This is why literally billions of dollars has been spent … billions, seriously … on developing a Malaria vaccine and there isn’t one. I would venture to say that if we looked at the part of the money spent on Malaria research in general (including vaccines) that covered just couriers and postage over the years, we’d have enough to fund a full on Ebola vaccine development program. Maybe not. Maybe you’d have to add in a few percent of the money spent on conferences (which are very important, I’m not saying they are not) by Malaria scientists. There is probably more money being spent right now on retirement payments to retired scientists who spent most of their time working on Malaria than needed to build an Ebola Research Center that could get a vaccine out there in a few years. Seriously. Please don’t compare Malaria to Ebola and use that to suggest that we should ignore Ebola. The crumbs that fall off the pieces of Malaria cake at the Malaria birthday party would be enough to handle Ebola. (Bonfire of the Vanities Reference.)

    But still, why should we bother with Ebola?

    Why bother with any disease? Why not figure out which one disease causes the most mortality or morbidity, and disallow any research on anything else? Then, when that is solved, move on to the next one. There are several reasons to not do this. First, it might not be possible to solve the big bad disease quickly, or ever, so the entire research program would spin its wheels forever. Second, the second and third and way down to the tenth or twentieth diseases are all real disease people really get and that really cause suffering. While the argument that spending excessively on a rare disease is a poor choice, spending a modest amount on a very addressable problem that is also small is exactly what we should be doing. Third, you can and should think of some of this as pure research. Pure research is where scientists seek out the answers to questions in a special category of question: Questions that scientists ask. No other criteria need apply. Scientist tend to ask questions that are at the edge of knowledge, or perhaps that are hanging around this or that water hole of ignorance. Scientists ask the questions they ask because they have two characteristics: There is something unknown, and there is something about that unknown thing that is knowable. With research. Usually.

    Now go back to Ebola again. Doesn’t somebody want to know about Ebola? Of course they do. Ebola is one of a family of viruses, the Filovirus family, that includes some pretty benign viruses and a handful of nasty ones (Ebola isn’t the only one). In the past there was a lot of research interest in the filovirus family for use as a biological weapon. Imagine making an Ebola like virus that spread though the air! You could really kick ass, militaristically speaking, with such a weapons. But, fortunately, we as a species have recently decided to not view biological weapons as legitimate. Research on biological weapons continued, of course, long after they were outlawed because we assumed we needed to “understand them” (make them and test them on rats) in case the other guys were making them, so we could deal with them. But I’m pretty sure most of that research has gone by the wayside as well. I would not be surprised, and I’m not much of a conspiracy theorist so I don’t want to emphasize this too much, if a lot of the work to make an Ebola vaccine was in a file drawer somewhere.

    Also, there is the simple stark reality of Ebola. If you are a typical American you may not care about Ebola because it is in a different country and won’t get here and there are other problems. But say you are like my neighbor here in Coon Rapids, Minnesota, Decontee. Decontee is Liberian. She is part of a large Liberian community here in the Twin Cities. Many Liberians are American Citizens with strong ties to Liberia. There is constant travel back and forth. I asked a Liberian guy I know where he gets his sombe (a wonderful traditional West and Central African dish) and he said “From my grandmother.” “Does she grow it?” “Yes. In Liberia. I get it when I go there.” The point is, there is a lot of back and forth. To be an American who is Liberian is to be a member of a community of people who is currently, at this very moment, threatened with Ebola. People in your community, in your family, can get Ebola. Decontee’s husband and her sister in law both got Ebola and died of it last week. Ebola is a problem that affects communities that are Diaspora that include our very neighbors and friends. It should not be an orphan disease.

    So wait, there was way too much nuance and possibly contradiction here, what am I supposed to think?

    I don’t want to tell you what to think.

    But in this case I’ll make a suggestion.

    Do not be worried about the health workers being brought back to the US. Indeed, at this point, openly worrying about this can do little more than make you look a bit dumb and a bit insensitive.

    Yes, worry about the possibility of Ebola getting “out” to pretty much anywhere, elsewhere in Africa, to the US, etc., because it can. But don’t worry too much. The chances are low. Forget about this “Oh, Ebola is not transmitted between people on airplanes” magical thinking. Of course it is. But Ebola is always hard to transmit, even on airplanes. In other words, be realistic.

    Forget about this comparison between Ebola and Malaria. When the Malaria people turn up a vaccine after spending billions of dollars of research money we can make a comparison. At the moment, Ebola is probably a vaccine-ready disease, and Malaria is not. You are comparing apples and oranges. No, worse than that. They’re both fruit. You are trying to compare, in a cost benefit analysis, the efficacy of spending money on a new car vs. working out whether or not it is worth clipping coupons when you go to the grocery store. Why are you doing that?

    But, if you are a member of a community like the various African communities in the US, then you do indeed have more of a concern. Not so much that travelers will bring Ebola to your doorstep, though that is a tiny bit more likely for you than for some others, maybe. But because your community is being directly affected because your community lives in two worlds, and one of those worlds is being invaded by a monster.

    Ebola Outbreak in West Africa: Some basic information (Updated)

    LATEST UPDATE HERE

    UPDATE: The latest numbers do not indicate a weakening of the outbreak. (See list of new cases below. Several graphs have been updated as well)
    UPDATE: More detailed discussion of transmission of Ebola
    UPDATE: I note with sadness the death of my neighbor (though I did not know him) of Patrick Sawyer, of the Liberian Ministry of Finance, who died in Nigeria of Ebola contracted in Liberia. He was on his way home to Minnesota at the time.

    There is an Ebola Outbreak currently underway in several West African countries, mainly Sierra Leone, Liberia, and Guinea. This is the most extreme known Ebola outbreak to date. The first known outbreak of this virus was in 1976, and there have been several instances since then ranging from single cases (which by definition are not outbreaks) to 425 confirmed cases (with 224 deaths in that instance, in Uganda, 2000-2001). The current outbreak is significantly larger with about double that number or more.

    There is some confusion in the press (most notably in CNN) about the nature of Ebola and perhaps about some of the details of this outbreak. Here, I want to provide some basic data to help clear some of this up. CNN reported at one point that you can get Ebola only after a person is symptomatic, and (in the same story) at any time a person is infected even if they are not symptomatic. It is probably the case that as long as Ebola is in a person’s system, they can spread it. It is only spread through contact with bodily fluids, but that is not such a hard thing to do; mucus membranes can absorb the virus, as well as cuts or other injuries. It is probably sexually transmittable. It does not appear to be airborne, but bodily fluids that are in or on needles, hospital equipment, etc. can carry the disease to another person.

    Another issue with reporting is the difference between suspected cases, likely cases, and confirmed cases. Even within the health community these numbers are all over the place because they are always changing as cases go from suspected to either eliminated or confirmed. Wikipedia and CNN both recently stated that there have been 1,093 human cases with 660 deaths so far. However, this includes both confirmed and suspected cases. There is a good chance that the total number of cases is in fact close to this, but the data are of lower than ideal quality. If we want to look at mortality rates and changes over time in this outbreak, it is better to look at a smaller subset of the better confirmed data. That’s what I’ll do here. But, when looking at the numbers, keep in mind that although most of the data I show in graphics below show several hundred fewer cases than being widely reported, the actual number of people affected by the disease over the last four months or so is probably not only higher than the cleaned up data set but also, likely higher than the reported 1,093. Furthermore, the data I’m using here only go up to July 24th.

    One of the most egregious errors at CNN is the frequent statement that Ebola has a 90% death rate, but that the current outbreak has a much lower death rate. This is rubbish. Ebola simply does not have a 90% mortality rate, and stating that the current outbreak is much lower in mortality gives the impression that this particular form of Ebola, or this particular outbreak of the disease, is somehow not as bad as usual. In fact, this outbreak is worse than any previous outbreak for several reasons. For one, it is larger. Also, it seems to be not burning itself out like most previous outbreaks did. Ebola outbreaks in the past have tended to happen in relatively isolated areas, because the population that includes victims is in close proximity to the presumed reservoir of the disease (probably fruit bats) and interacts directly with the intermediate hosts (eg. primates or other mammals that picked up the disease from fruit bats*). But there is plenty of reservoir and intermediate reservoir in some areas near major population areas. Apparently, Ebola broke into the human population in one or more areas of high population density, and this density together with relatively high mobility is allowing the disease to persist.

    The following graphs are based on data I collected from the WHO reports. For March, I use only very likely cases, for April through July, I use only confirmed cases (not available for March). And, July does not include the last week for that month (a few more days have been added to this information bringing us to July 23rd, added on July 30th).

    The following charts show the total number of cumulative cases conservatively estimated, and total number of cumulative deaths. When the outbreak starts to weaken, we would see a leveling off, but that is not indicated here (UPDATED).

    UPDATED_EbolaCumulativeCases2014

    The last several reports from WHO (including confirmed, probable, and suspect cases) are as follows:

    July 21st through July 23rd: 108 NEW
    July 18th through July 20th: 45
    July 15th through July 17th: 67
    July 13th through July 14th: 18
    July 08th through July 12th: 85
    July 06th through July 08th: 44
    July 03rd through July 06th: 50

    The exact time spans for each of these reports may not be the same, but I believe the number of cases do not overlap; each listing is a separate set of new cases. Clearly, for the last several days of available information, there is variation in, but no let up in, the number of new cases.

    Looking at the number of new cases reported (and for the most part confirmed) and the number of deaths (the same data as used to make the cumulative graphic above, but by month) we have this (Updated):

    EbolaConfirmedCasesAndDeaths2014

    Keep in mind that the data for July are short by several days.

    Another area where MSM, and for that matter, Wikipedia, could do a better job is in reporting the mortality rate for the disease. Wikipedia states that “The disease has a high death rate: often between 50% and 90%.” This is misleading because the outbreaks with 90% mortality rates are not typical, and the statement seems to be based on a set of data that includes a lot of data points one would do better to ignore. I assume CNN is taking this information (from Wikipedia or elsewhere, which perhaps repeats the Wikipedia claim) and exaggerating slightly when they say that Ebola normally has a 90% mortality rate.

    The Ebola affecting people right now in Africa is one of a handful of similar viruses known over a larger geographical range. Some of the deaths found in the larger data set of all known outbreaks are from individuals who showed up in a hospital nowhere near where they got the disease, or laboratory workers. The best way to estimate mortality rates related to the present outbreak in West Africa is to take only field cases — actual outbreaks in normal populations — in Africa only, and to not count “outbreaks” that are not outbreaks because only one person is in the sample.

    The following chart compares mortality rates for all of the “outbreaks” listed in Wikipedia page regardless of size of sample, geography, or circumstances, with only those that are African Ebola in the field. The latter set also excludes the present outbreak.

    Ebola_Mortality_Rates

    Notice that the clean data are bimodal; some outbreaks have mortality rates between 0 and 90%, others between 40 and 60%, and not much in between. Also, there are several in the all-data set that have a mortality rate of zero. This bimodality is not necessarily a persistent statistical characteristic of the sample; I could make it go away by changing the histogram intervals. But it is a convenient place to break the sample into “more severe” and “less severe” outbreaks.

    The zero cases in the full data set are all odd cases. Seven are not in Africa and include in some cases lab workers or animal handlers, and most are not African (Zaire type) Ebola. One is a scientist who caught the disease from doing a necropsy on a chimp in the Ivory Coast, examining an outbreak among the non-human primates there. There is one case where the fatality rate is 100%, but this was only one person, and the case was discovered post hoc. We don’t know if anyone else there had the disease. A 90% mortality rate occurred in a remote part of the Congo, with 143 people affected including health care workers. It appears that several individuals contracted the disease butchering non-human primates. This occurred during suboptimal conditions during the Second Congo War. One case of 88% mortality occurred early on in the history of the disease (the second known outbreak) also under very poor conditions. Although the data are too sparse to draw firm conclusions, it seems that the more severe outbreaks in terms of mortality tend to have occurred under more difficult conditions.

    Ebola probably has a very high mortality rate when an infected person gets no medical treatment, and a mortality rate closer to 50% when a person quickly gets medical attention. There is no cure, but when a patient is given IV solutions in a hospital setting the chance of survival goes way up. This might suggest that smaller outbreaks that run their course before intervention would have a higher mortality rate, or that the mortality rate would be higher near the beginning of the event. Similarly, one might expect mortality rates to be higher in the early years of Ebola than later, as treatment methods developed.

    There is some, but not much, evidence for these effects.

    The following chart shows mortality over size of the outbreak, using only the cleaned up data set:

    Ebola_Mortality_Rate_Over_Size_Of_Outbreak

    There is not a relationship between size of outbreak and mortality rate.

    This chart shows the mortality rate over time, for the cleaned up data:

    Ebola_Mortality_Rate_Over_Time

    This seems to show that lower mortality has been achieved in recent outbreaks, though the statistical significance of this is non existent. But, the data set is small. The above chart also indicates the average morality rate across all of these events, which is 64% across 18 outbreaks. Not “usually 90%” as CNN states.

    The following chart shows the approximate mortality rate for the current outbreak by month.

    Ebola_Outbrak_2014_Mortality_Rate_By_Month

    This is calculated from confirmed or highly likely cases. This is not a true mortality rate because people who got the disease in one month may have died the next month. But it does give an approximate indication of change over time in rates. The rate at the beginning of the outbreak could be high, or this large percentage could be a function of how cases were counted. In any event, this is an indication of higher mortality rates calculated at the beginning of an outbreak, and there are likely two reasons for that high rate, either or both applying in a particular case.

    <li>Early in an outbreak a number of people are affected, but live, and don't make it into the data  base because they are not identified; they got sick, got better, and went on their way. Those who died were all or almost all counted. </li>
    
    
    <li>Early in an outbreak a number of infected people are not treated with the maximum available medical attention, so more of them die.</li>
    

    The current outbreak is settling in at about 60% mortality rate. There is no indication from WHO that the epidemic is slowing down.

    UPDATE: Is Ebola Only Transmitted By Symptomatic Individuals?

    According to the usual sources (WHO and CDC for example) the following is probably true. When someone gets Ebola, typically, after a while they get sick. This means they show symptoms. If they did not show symptoms they would not be “sick” even if the virus was in them and even if the virus is multiplying in them. Presumably people are infected with a sufficient number of viroids that they become a host for the disease, the virus starts to multiply above some level that makes the person sick, and we can say at that point that they “have Ebola.” This is when the infected person is able to transmit the disease to others through bodily fluids that might come into contact with wounds or mucous surfaces in the downstream patient.

    This is what the WHO and CDC literature on Ebola says, and this has lead bloggers and news outlets to state incorrectly that Ebola is only transmitted to others when the person shows symptoms. Unfortunately this is not true in one or possibly two ways.

    It appears that people who have had Ebola, live, and get “better” (i.e., their symptoms go away) can still carry Ebola for a period of time, and in this state, they can still transmit it. What has probably happened is their immune system has started to fight the virus enough that it is attenuated in its effects, but it isn’t’ entirely gone yet. Medical personnel like to send someone home only after the virus has cleared. Even so, men who are supposedly virus free by that standard, when sent home after surviving Ebola, are told to avoid sex for several weeks because there is still the possibility of sexual transmission of the virus. Meaning, of course, that the virus is still knocking around in some individuals at this point, and still transmittable. It is not clear how likely that is to happen.

    This is very important. Most people would interpret “only transmitted by people showing symptoms” (or words to that effect) when they read it in a news outlet as meaning – well, as meaning exactly what it says. But post-symptomatic patients may still transmit the disease.

    Is it possible that pre-symptomatic people can transmit the disease too? Personally I think it is possible even if it is generally unlikely. In a disease that kills over half of those who get it, “unlikely” is not comforting. A small percentage of people who never seemed to have had Ebola, or to have been exposed to it, seem to have antibodies that would probably only develop if exposed to Ebola. Some studies have shown immune reactions to Ebola in those known to have been exposed but also known to not have gotten sick. This is important but not shocking. There are a number of different situations where a normally icky disease that makes you really sick seems to have infected a certain percentage of people asymptomatically. Are these people carriers at some point, i.e., people who have the virus in them, can transmit it to others, but don’t get sick themselves? There is no evidence to suggest that this is the case with Ebola, but the total number of known human cases of Ebola is very small and the conditions for study of the disease in the field very poor, so the safest thing to conclude is that we simply don’t know, but it is also reasonable to say that asymptomatic carriers don’t seem to be a problem, or this would likely be noticed.

    The important point here is that there is not a perfect correspondence to being infected and having symptoms, and transmission post-treatment and survival is possible and of sufficient concern that WHO and CDC assume it, so it would be unwise to make too many assumptions about pre-symptomatic transmission.

    Imagine you are a health care person addressing an Ebola epidemic. An jet liner flies over a very long flight, say 10 hours long, on Monday. On Friday five people who were on the plane come down with Ebola and you have reason to believe that they were all infected before the flight. Would you determine that it was impossible for the nearly 300 people stuck on a tube with five pre-symptomatic Ebola carriers to become infected? No. You would watch those people and test them.

    An additional point to underscore; it has been touched on but not emphasized. The symptoms of Ebola include vomiting and bleeding from places one normally does not bleed. Put another way, the symptoms of Ebola include spreading around bodily fluids. This is often how diseases spread. The disease results in a bodily reaction that spreads the disease (look up “virulence”). So, no matter what, the most likely transmission by far is during the period of symptomatic reaction to the disease, or for some time after death while the virus is still viable. That does not mean that there is no transmission before or after, but it does mean that the most obvious transmission will be from symptomatic patients or recently diseased symptomatic patients.


    • Fruit bats will drop fragments, or stones, of fruit they feed on, sometimes in discrete piles. It is almost impossible to imagine a ground dwelling frugivore, such as a chimp or a duiker, not stopping to munch on this detritus. Since Ebola is spread through bodily fluid contact and can be spread via mucous membranes, and fruit bat spit counts as a bodily fluid, I’m personally of the opinion that this is how Ebola may often transfer from its natural reservoir, where it seems to exist without harm, to other animals. Of course, I figured this out after having discovered and handled several such piles of fruit bad wadge.

    Keeping The Carbon In The Ground Elsewhere: Developing Nations

    John Abraham has an interesting post up at the guardian called “Global warming action: good or bad for the poor?” It is a response to a post by a group of guys who tend to write annoying stuff about climate change (you can go to John’s post for that information). Here, I want to make a brief comment related to John’s excellent post.

    The crux of John Abraham’s post is this, in two parts: 1) Some have argued that mitigation against climate change is bad for “the poor” (read: people in developing countries) because they have a right to go through the same phases of technological and social development we (read: The West) have done, which would presumably include building numerous dirty coal plants so everyone can have a washer and dryer and blender and other stuff. This, John argues, is wrong at several levels. 2) As John demonstrates through is own activities, described in his post, it is possible to skip the 19th and 20th centuries in developing energy technologies and go right to the mid 21st century, installing carbon-free efficient inexpensive easily maintained and sensible technology.

    I worked for several years in South Africa, as you probably know. When I first started to work there, we had problems with communication because we were usually in remote areas where there was no phone. We did get cell phones, but there were two problems with them. First, there were two major TeleCom carriers, and we worked in areas that were serviced, if they were serviced at all, by one or the other but usually not both. So we’d get two sets of cell phones. Second, as just implied, there was no cell phone service in many areas. During one field season we worked in a remote area of the Northern Cape. We were working on a farm not far from Upington for a while. We could get brief and unreliable cell phone service if we climbed a hill and stood near a certain water tank and held the phone up really high in the air. Sometimes. Farther out in the bush, where we spent considerable time, we had no cell phone access at all. There were land lines here and there but this required traveling way out of our way to use an unreliable pay phone.

    During a later year, we prepared for our return to that remote area by getting the usual two cell phones, and also, carrying out all of the communications we could prior to leaving, letting people know we’d be mostly out of touch for a few weeks at a time. We packed up the Toyota Prado and the trailer with our gear and food, piled into the vehicle, and set out across the southern African subcontinent. A few days later we came to a key stop in our journey, the entranceway to what was then known as the Kalahari Gemsbok Reserve, on the border of Namibia and Botswana. I was chatting with the students who were on the field school about how our cell phones would be useless here, but there was a land line at the park headquarters that we could use now and then with the TeleCom cards we could purchase at the gift shop. As I was saying this, my field manager, Lynn, drove the car out of the river bed we had been following, and we ascended a hill overlooking the campsite at the entrance of the park. From there we could see dozens of camp sites, occupied by South African campers with their 4X4 vehicles, their amazingly tricked-out trailers deployed to form bedrooms and kitchens. The campers were standing around cooking their braai (that’s South African for BBQ) as it was nearing dinner time, late in the afternoon.

    Two sights took my breath away. Well, not really, but these two sights made me stop talking and change my story about making phone calls. First, there was the huge cell phone tower ascending from behind the camp site, the alp glow of the setting sun accentuating it’s technological glory. The other was this: About half the people standing around in the camp site, cooking their boerwors and t-bones, were chatting on their cell phones.

    Remember World War II? Yeah, I don’t either. But it happened. Part of World War II involved bombing the crap out of German Industry. Japanese Industry was also bombed but there was probably less of it to begin with. The point is, at the end of the war, German and Japanese industry was toast, and those two countries were under occupation. Then there was the Marshall Plan and all that. This involved rebuilding industry in those two countries. Then, later, each in their own way, Germany (well, West Germany) proceeded to kick our industrial asses by more or less starting from scratch, combining in-place ingenuity, effective corporate culture, and brand new factories to grab several major international markets. There were a couple of decades there, overlapping with the ones I grew up in, during which it was not uncommon to hear Americans griping about that. Those guys, they started the war, we defeated them, then we gave them all this stuff, and now my commie neighbor drives a Japanese car. Dammit and get off my lawn. That sort of stuff.

    I remember doing an archaeological survey in a newish exerb in the Boston area during one of those periods when Americans were especially mad at the Japanese for making great cars. In that particular neighborhood, some good ol’ boys (yes, they have the in the Greater Boston Area) had gone around the neighborhood and, using chalk, marked up the driveways of anyone who had a Japanese car. They drew nasty pictures and wrote obnoxious and racist words. So, part of Western Culture, mainly that sub-part that arises from the Allied Powers, or maybe just America (but I suspect the United Kingdom as well) developed an anti-Japanese, and to a lesser extent, anti-German thing based on post Marshall plan resentment.

    John Abraham is a nice guy and I am not. Perhaps. John saw the article he critiqued in his blog post as being misinformed and stupid. Fine. I suspect, in my not-as-nice-guy way, that there is something deeper. Let me review before I reveal.

    First, some climate change science denialists make the argument that mitigation against climate change by implementing new technologies will hurt poor people in third world countries.

    Then, an expert on climate change and energy, John Abraham, notes that this is wrong, because we can implement the newest technologies in places like Sub Saharan Africa and go right from a sort-of-pre-industrial state to a 21st century state.

    I note that not only is John right, but that it has happened before, in Japan, Germany, and with my example here South Africa, with various industries (cars, TeleCom, etc.)

    And then we have this idea that people in the West have been known to resent those who have sailed past us in technology achievement because they ended up in a situation where they needed to move from the stone age (into which they had been bombed) to absolutely modern, or even next-gen, times.

    If we give effective, inexpensive, workable, modern non-carbon energy technology to Africa and help it get deployed, then African nations will, in the near future, show up at international climate change summits with a new message that climate change science denialists and carbon-based energy magnates will not want to hear. They will say this. “Look, we’re doing pretty well without carbon based energy technologies. We’re advancing the standard of living without destroying the planet. Why haven’t you done that, The West?”

    And, when it comes to production, new ideas, technology, stuff you want to buy, the raw material of the global free market, the Africans are going to kick our asses.

    And that will be great. But some are afraid because of a thing they have. It’s called racism.

    Killing The Namibian Black Rhino for $350,000 UPDATED

    UPDATE (March 27 2015): US gives Texan rhino hunter an import permit

    A Texan who won an auction to shoot an endangered black rhino in Namibia has been given a US permit to import the trophy if he kills one.

    The US Fish and Wildlife Service said hunting an old rhino bull helps to increase the population.
    There was an outcry when Corey Knowlton won the auction last year, with animal rights activists decrying it. It’s not yet clear when the hunt will happen.

    Namibia is home to some 1,500 black rhino, a third of the world’s total.

    The US agency issuing the permit said that importing the carcass from Namibia would be allowed because it met criteria under the Endangered Species Act of benefiting conservation.

    Since first considering whether to issue the permit in November, the agency has received petitions with around 152,000 signatures demanding that it be denied.

    UPDATE: The identity of the hunter has been revealed over social media.

    Dallas (CNN) — Corey Knowlton is on edge sitting inside a Las Vegas hotel room, surrounded by a private security detail, explaining why he spent $350,000 for the chance to hunt a black rhinoceros in the southern African nation of Namibia.
    “If I sound emotional, it’s because I have people threatening my kids,” Knowlton told CNN. “It’s because I have people threatening to kill me right now [that] I’m having to talk to the FBI and have private security to keep my children from being skinned alive and shot at.”

    Knowlton was outed over social media as the winner of the Dallas Safari Club’s auction for a black rhino hunting permit from the Namibian government last weekend. It didn’t take long for the threats and vitriol to start pouring in.

    “You are a BARBARIAN. People like you need to be the innocent that are hunted,” posted one woman on Knowlton’s Facebook page.
    Some sounded even more sinister. “I find you and I will KILL you,” read another threat. “I have friends who live in the area and will have you in there sights also,” wrote another commenter.

    here is a black rhino in Namibia that will be shot by a sports hunter who won an auction for the privilege. The permit to kill the rhino was won in competitive bidding for the sum of $350,000. All proceeds will be donated to support the rhino conservation efforts in Namibia.

    There has been an expected outcry on the internet over this event. There are people who hunt big game some (but not all) of them have little problem with this, and then there is everybody else, and most people find the idea of killing a black rhino, which are endangered, abhorrent.

    I want to relate the story of another rhino, a white rhino, that was killed after a similar auction, elsewhere in Africa. I won’t give details of time, place, organizations involved, or individuals involved because I feel that the reaction to this sort of thing could spill over in inappropriate ways. The point of relating this story is to add some nuance to the situation.

    There is a rhino conservation project with which I’m intimately familiar. It was initiated years ago by a charismatic conservationist and expert on the rhino. The project has three major components. First, there is a large area fenced off from the surrounding landscape on which both white and black rhinos roam free. You might wonder if rhinos can roam free in a fenced off area, but the area is quite large, nearly 90,000 acres. This is about the size of the city of Montreal or Detroit. Many areas in Africa in which “wild game” live have fences around them, though there is a trend to take down the fences especially where the enclosed areas are on the small side.

    Second, there is a larger project that defines a biosphere, including the aforementioned reserve, of nearly 15,000 square kilometers. This is about the size of Connecticut. The biosphere includes numerous game parks, some that allow hunting, and a number of human-use areas, but with restrictions of what sorts of uses are allowed. The biosphere includes one of the more unique floral communities in the world with a high degree of endemism, and is the home of the usual range of African animals including rhinos and several antelope species, though I don’t think there are any elephants there at the moment. This is also home to an impressive avian and reptilian fauna.

    Third, there are a number of tourist destinations within the biosphere that bring income to the local communities and help run the conservation projects, including one at the aforementioned rhino conservation area. Some of the tourist destinations, as mentioned, accommodate hunting. In addition to the tourist areas there are also nature-oriented schools and childrens’ programs, though I’m not very familiar with them.

    The rhino reserve is big, but so are rhinos. Several years ago, a large and older white rhino took over the breeding rights of a large number of female rhinos in this reserve. White rhinos are not especially aggressive, but when it comes to mating competition they are fairly typical as male mammals go. This rhino was doing damage to other males on the reserve, and was actually starting to damage some of the females. I don’t think any rhinos had been killed but it seemed inevitable at the time.

    And, as it turns out, this particular rhino was sterile. This constituted a serious threat to the otherwise very successful rhino breeding program, which had been producing rhinos for introduction into area where they were previously hunted out.

    One might think that you could just pen up a rhino like this, keeping it separate from the other animals, perhaps making it an “ambassador rhino” for tourists to see up close. Unfortunately, that turns out to be more difficult than it sounds. Rhinos are large powerful animals and this one was especially large. Black rhinos are very aggressive. Once penned up it would spend considerable effort to escape, and would likely have a certain degree of success. A smaller adult male black rhino that was raised as an orphan, rescued after hunters killed its mother, was easily able to escape from a well built corral a few years ago, at this same reserve. It did considerable damage, focusing mainly on the cars in the nearby parking lot. A white rhino female, also an orphan, raised in the same facility was released at maturity, bred, and the last time I saw her was wandering the bush with her new baby and doing quite well.

    The point is this: If you raise large mammals, there often comes a time when one of them has to be put down owing to any of a number of different reasons. The bush in Africa, for the most part, is highly managed. Unmanaged areas tend to have very little in the way of larger wild animals because either they are poached out or the animals die off because populations grow too large and are then affected by drought or disease. If there were fewer people, less human settlement, and no fences, these die-offs would be offset by better conditions in other regions, and animals would later migrate from high-population areas into decimated areas once the latter were ecologically restored naturally.

    So, the difficult decision was made to put the large white male rhino down. A permit from the government was obtained. And then the people managing the reserve decided, legally and as per the permitting process, to allow a hunter to put the animal down, which would have the same final effect but produce several thousand dollars in funds for the conservation program. The fee in that case was, if I recall correctly, $10,000.

    I spent an evening listening to the story of how that went, told to me by the ranger who was tasked with getting the hunter and the rhino in the same place. It would have been his job to put the rhino down had the decision not been made to bring in the hunter, and he did not relish the idea either way. As he told me the story of how the hunt went, he paused a few times to cry. This, the killing of the rhino in any manner, was something he did not want to do, even though he agreed that it had to be done.

    It would be irresponsible for me to relate the details of what happened, but I’ll tell you in private if you buy me a beer. I can say a little about it. After several days of tracking the rhino, stopping several times for meals and other refreshment, the hunter was finally brought to a point where his quarry was visible and in range. He took a couple of shots but missed. The ranger was ready the whole time to dispatch the animal with a good shot in the event that the hunter merely wounded it. In the end, the ranger shot the rhino, and photographs were taken. If I recall correctly, there was no trophy; I’m pretty sure that would have been illegal.

    The $10,000 was employed usefully and made a difference.

    I’ve spent considerable time on rhino reserves in this area, and with the people who run them. I have never been to a rhino reserve in Namibia but I have met people who worked in that country on conservation, and I’ve worked in a reserve on the Namibian border. I can promise you that there is not a single person involved in rhino conservation in the region who wants to see any rhino put down for any reason, but sometimes, apparently, it has to happen.

    Some of the responses people have had to the Namibian black rhino killing seem to lack a sufficient understanding of the situation. This is perceived as a bad thing to do primarily for two reasons. First, it is wrong to kill an endangered animal. This is a bit naive because a given rhino is not endangered; all of them are. Being endangered is something that happens to a species, not an individual. A given animal may be of great value to the perpetuation of the species, while another may be a detriment to conservation efforts. The second common response is that the rhino should just be left alone. In the case of the white rhino mentioned above, that was not an option. The idea that leaving the rhinos alone is untenable given the current situation of human-animal conflict, ecology and climate, and habitat loss. The only places where there are rhinos at all in Africa are places where management is intensive. Sometimes intensive management means taking down an animal.

    Namibia puts down a small number of black rhinos every year, about three. These are usually hunted but the permits are not issued outside the country. This particular case is the first time that has happened, and the amount of money being raised is considerably more for that reason. The black rhino being hunted is a “geriatric male” who would normally be earmarked for being killed as part of the conservation program. Not all of the people involved in Namibian conservation think things should be done this way, but generally, those that do not agree are hard pressed to propose alternatives.

    It is certainly reasonable to question whether or not sports hunting should be allowed at all, or if specific highly publicized hunts like that of the Namibian black rhino should happen. Even if animals need to be hunted out of a given area for population management, this can be done as part of wild game harvesting, for the most part. Having said that, there is a counter-argument. You can’t really incorporate large older sterile and ornery rhinos in the meat trade very easily. And, of course, there is the money. I think one of the things that troubles people the most, and that troubles me and the ranger who told me the story of the white rhino, is the strong contrast between a big game hunting mentality and a conservation mentality. Even if it can be argued that a great deal of effective conservation occurs in the context of maintaining hunting as a sport, the point of view of big game hunters and conservationists is often dramatically different.

    My opinion on the matter is that the rhino should not be put down, but probably has to be even if I don’t like the idea. I’m happy to see $350,000 put into Namibian rhino conservation … that will go a long way … but I think there is a bigger problem here. $350,000 is nothing at the international level for conservation of rhinos. It simply should not be the case that creating this sort of spectacle is necessary to fund black rhino conservation at this level. It is not OK that $350,000 is small change for some lucky hunter, but a huge sum for conservation. That is the problem.

    Nelson Mandela Has Gone Home

    Imagine going back in time to visit Nelson Mandela in prison and telling him this: “You will live through this and be free, you’ll lead your country and set an unattainable example of leadership, you’ll retire as president and die at a very old age. The violence associated with the end of Apartheid will be so little it will be mostly forgotten. There will be truth. And reconciliation.” That would have been a remarkable, impossible prediction at the time, because he was clearly destine to die in prison, and there was little possibility of reconciliation and there was every chance of bloodshed. Then you could add something equally unlikely: “There is a young African American man at a protest rally in the United States right now, agitating against apartheid. Long after your release from prison and your presidency, he will become the President of the United States and he will, in eulogizing you on your death, mention that his first political act was to protest racial injustice in your land.”

    I can not say anything about Nelson Mandela that others with more knowledge and experience are saying now around the world. I’m hearing some remarkable voices saying some remarkable things. Go listen if you haven’t already. But I do remember a few things that I’d like to write down.

    I remember, when Mandela was in prison and Apartheid was still the rule of the land in South Africa, but not knowing much about it, the protests in Harvard Yard and the mock shantytown that stayed up for months to agitate for divestment. I wonder if young President Obama was ever in that shantytown or if he organized or attended any of those rallies. Presumably so.

    I remember watching transfixed, along with something like a billion other people, when Mandela made the final leg of his “long walk to freedom” on his release from prison. I remember being in Bloomington, Indiana, at a conference of the Society of Africanist Archaeologists, attended by numerous South Africans who had already sent in their absentee ballots, for the first election.

    I remember turning down opportunities to work in South Africa, honoring the boycott, but later of course I did work in the New South Africa (and yes, that’s what they call it there) and I spent considerable time in the country across numerous visits. Some of my best memories are in South Africa, and it is where I met Lynne, one of my best friends ever. I remember being there during one of the elections and seeing two of my Afrikaner colleagues in tears because Mandela was president. They were tears of joy, mind you. These men, as boys, had been shuttled to school and back in an armored bus as part of an armed convoy, in the Northern Province, now Limpopo, under threat of the ANC bush army, which at the time was in part led by Mandela himself before he was imprisoned. At another time they showed me the place where they waited for the armored bus, on the edge of a farm by a highway.

    I also remember visiting, not too far from there, an Apartheid fence. This was a five meter high double chain link fence topped with razor wire, designed as part of the first line of defense against invading armies that were expected in those days, armies from the front line states that would take over South Africa and throw out the Apartheid white minority government. The fence ran only a few hundred meters and stopped abruptly on both ends, which would have allowed the invading armies to simply walk around it. This was because the permission of the landowner was needed to put in the fence, and only one land owner overlooking that part of the Limpopo River was interested in having it. If you think that is strange, you just don’t know South Africa. It’s still strange, but at the same time, perfectly normal.

    Travelling back south the same week, I learned that the bus stop was on a long straight section of highway designated by the South African military as a landing strip. There were apparently many of these, which would be used to move the army to the border at the time of the impending invasion. We all remember the assumption that Apartheid would likely end in a bloodbath, internally or by invasion or both.

    But Mandela did not let any of that happen. The smartest thing the white minority did was to give the country, essentially, to Mandela. Truth and reconciliation ensued.

    I also remember, in detail, every single one of the racist stories I was told by numerous disenfranchised whites, whom I would run into now and then around the country while doing my work. I remember the details so well because even though every one of those stories was about someone the person telling it knew, and set in a specific time and space like it had really happened, there were really only a handful of different stories but every story was repeated again and again by different people in far flung regions. When I encountered South African white racism in the wild I found it to be a joke, not a very funny one, a parody of itself, a badly strung together set of urban myths, self aggrandizing and used up. But most of the minority citizens I knew and became friends with in South Africa are as sad today that Mandela has died as anyone else.

    As President Obama said today, there will never be another person like Nelson Mandela.

    When Are Nomads Not Really Nomads? (Efe Pygmy Ethnoarchaeology)

    “First, we’re going to collect our data,” Jack, the archaeologist, was telling me as we slogged down the narrow overgrown path. He seemed annoyed. “Then, we’ll leave. Until we leave, they won’t leave. They think it would be rude. After they leave, we’ll go back and map in the abandoned camp.”

    I had just arrived at the research camp in the Ituri Forest, then Zaire and now the Congo, after a rather long and harrowing journey that took me from Boston to New York to London to Lagos to Kinshasa to Kisingani to Isiro, all by plane, then over 250 kilometers of increasingly less road-like road, to the world’s most “remote” research site to be found among human settlements anywhere on the planet. Jack’s research involved looking at what happened to Efe Pygmy “camps” after they were abandoned. The Efe hunter-gatherers were known to move camp an average of once every two weeks or so. An archaeologist would want to know what happens to a camp once it is abandoned because many of the ancient sites we excavate are exactly that, abandoned settlements. Jack had been tracking Efe movement and camp abandonment patterns for one year, and the expectation was that I would continue his data collection for another year, as he and his wife returned to Montana to write up their results.

    A typical Efe forest camp.
    A typical Efe forest camp.
    The Efe, being very hospitable, were reluctant to leave a camp with visitors present, even if the visitors promised to leave with them, and certainly would never leave a camp if the visitors stayed behind. It just wasn’t done. Jack never told me how long it took for him and Helen to figure out that every time they visited a camp they were told would be abandoned that day, the Efe never actually moved, but eventually they came upon the method of arriving about the time of expected abandonment, collecting some preliminary data, and then leaving only to return hours, or perhaps a day, later.

    “Oh, excuse, me have you moved yet? No? OK, see you tomorrow.”

    When we arrived at the camp, which was located very near the Lese villages … the Lese are the farming people who with an overlapping culture and economy with the Efe … there were a lot of people there. This was a camp with several adult couples and a number of kids of all ages from baby up to nearly teenage. Since this was Jack and Helen’s last visit, they brought gifts to give to the people who had helped them out for the previous year. Project regulations and ethics required that any gifts be irrelevant to diet or economics, not usable as tools of poaching, not likely to change people’s status, and be likely to be used up or worn out quickly. So, everybody got plastic green sunglasses, the really cheap kind you buy by the dozen at a party store to use as favors.

    A typical Lese village.
    A typical Lese village.
    The data collection involved listing all the people who were present, using coded references so no one could ever trace a real individual to any of our reports or publications. Years ago there was a revolution here in the Ituri during which lists of plantation workers or other employees, people who might be sympathetic to the Belgian colonials, were used to find and sometimes kill sympathizers. In case something like that ever happened again, we did not want our records to be used to identify people who were friendly to outsiders who might be seen as oppressors. That we tried very hard to not be oppressors was hardly the point; violent revolutions often get such things wrong. We would also offer everyone in the camp the opportunity to display their tools and other durable items so that we could inventory and photograph them. This was done voluntarily, but in this particular culture there was no proscription against it as long as we were looking only at regular household items or hunting weapons. Any sacred ritual items would be kept hidden, most likely, and we would not ask about them.

    It was a party, a good time, lots of conversation, some weeping over the fact that the much beloved Jack and Helen would be moving back to the States, lots of fun with the green sunglasses, lots of data collected. Then, we left, and the next day we returned to map in the locations of the small dome shaped leaf-covered huts and other structures, fire hearths, stick chairs, drying racks, midden piles, trampled central-use areas, and so on and so forth. This is what the abandoned camp of a people known in the literature, and generally to outsiders, as “nomads” looked like. There was lots of stuff there, but all of it was made from materials available on the spot, transformed from wild growing plants to architecture and kitchen furniture, but eventually thrown out or left behind. Everything else was carried by the Efe, in one trip, to the next camp they would build from natural materials. Or almost everything.

    Saying goodbye to Jack and Helen.
    Saying goodbye to Jack and Helen.
    To understand the movement of the Efe across the landscape, one had to first understand the seasonal cycles of the villages and the forest. While the Efe were hunter gatherers, living off the land in the African rain forest, they also associated with the Lese Villagers, farmers who grew crops in swidden (slash and burn) gardens. Sometimes the Efe men helped the Lese to develop the gardens, especially new gardens, by cutting and burning trees, in exchange for some goods, often tobacco and marijuana (which were always consumed together). But much more regularly, the women worked in the gardens planting, tending, harvesting, and processing rice, peanuts, cassava, plantains, and other crops. These gardens had a seasonal cycle. Being almost on the equator, there were two growing seasons, a wet season for “dry” country rice and a less wet season for growing peanuts. The other crops were grown year round. So, there was a harvesting and planting season around June, and another harvesting and planting season around November.

    Collecting data from an abandoned camp.
    Collecting data from an abandoned camp.
    In return for their work in the fields, Efe could take food from the gardens. In the end, about half of the food the Efe ate consisted of agricultural produce procured in exchange for this work and the other half of their food came from the forest, mostly hunted meat but also gathered fruits and roots and other things.

    And the forest had it’s seasonal cycle as well. During the dry season, which lasted several weeks around November and December, certain animals were easier to hunt because the streams they hid in, or that would impair hunter’s movement through the forest, were very low. Staring in late June and running into August, the famous African Killer Honey Bees (the wild version of our own domesticated honey bee) produced copious honey in nests about 100 feet up in the forest canopy. The Efe men were very dedicated to harvesting this honey.

    If you think about that information for a bit you’ll notice possible conflict. For example, the Efe are drawn to the deep forest for Honey Season, but this overlaps with the mid-year harvest and planting. The November harvest and planting overlapped and conflicted with the dry season hunting. You might guess that men and women would have different opinions about where to reside during these periods of conflicts. The women would never stay overnight in a farm village during harvest; they moved each day by foot from the Efe camp to the gardens and back. But as it became more desirable to camp farther and farther into the forest, that commute became longer and longer. We say (usually tongue in cheek) that Western couples fight over certain things, like money or how to raise the kids or what channel to watch on TV. Efe couples argue over where to put the camp in relation to the horticultural villages vs. the deep forest.

    I ended up never continuing Jack and Helen’s data collection project. That I would spend a year doing Part II of another graduate student’s thesis was an idea cooked up by our shared advisor, but neither Jack nor I saw the benefit in doing that. He had enough data, I had other things to do. So, instead, I studied the larger scale structure of Efe nomadism, of their movements across the landscape and their use of forest resources.

    I discovered that each Efe group possessed (and that is a carefully chosen word) rights to a trail, usually one single trail but sometimes something a bit more complicated, that ran from the villages out into the forest. Along this trail, at intervals of almost exactly 1.5 kilometers, was a potential camp site. Of these camp sites, a handful were used again and again as the Efe moved through their seasonal cycle. Some of the other camps were used only occasionally. This was interesting, because it meant that even though the efe might move over 20 times a year, the part of their movement in the deep forest had them return to the same exact four or five camps again and again for years. They would also repeatedly use the same camps near the villages, but since village farmers often moved their swidden gardens, wiping out grown-over sections of the forest in one area and abandoning a garden elsewhere, the Efe “village camps” … the camps used during planting and harvest seasons … were often destroyed or otherwise became inconvenient.

    Efe hunter.  As a general rule, if you don't know at least approximately where something is in the forest before you go looking for it, you're not likely to find it.
    Efe hunter. As a general rule, if you don’t know at least approximately where something is in the forest before you go looking for it, you’re not likely to find it.
    I also discovered that the Efe named each of their camps. This should not be surprising. Humans everywhere use place names to navigate and situate themselves in space. As with place names generally, the names of camps often had a meaningful history. One camp was named “Near the rotten orange tree.” That was a camp located near a garden where there once stood a citrus tree, long gone. That was revealing because there were no villages anywhere near the old orang tree today, the original village having been left decades ago. The best camp name I encountered was “Place the women refuse to pass.” This meant that this was the location along that particular group’s trail that the women refused to move camp beyond during the seasons they commuted to work in the gardens. As it was, this camp was about two hours walk from the villages. No wonder they refused to live beyond that point while working in the farms!

    And now we come to the interesting anthropological lesson that emerges when we look at other cultures, in this case, the Efe and Lese. In books and articles about the Pygmies of the Central African rain forest, the Pygmies (including the Efe as well as other groups with different names) are often called “nomads.” Nomads, we all know, are people who move a lot. The term also invokes, for many, a certain amount of randomness, or at least, uncertainty in where one might be moving next. There is indeed uncertainty, of a sort, among the Efe as to when they are going to move and where to. But this is simply because one does not need to decide when or where until it is time to do so. There is a constant negotiation happening between members of a particular group as to when to move, and which camp to move to. If there is a big enough difference between different families in a camp, they can easily move to two different locations for a while, or one group can stay and others leave. But these differences never lead to the men going one place while the women go elsewhere, even though the biggest conflict is usually between men and women. The point is, their movement is not random, but well considered and systematic, yet in at the scale of days or weeks in advance, not very predictable at any level of detail.

    Yet, at the same time, the Efe are the opposite of nomadic. Consider their Lese village farmer neighbors. They live in permanent villages. But, over time, the Lese use up garden space and firewood in the vicinity of their village. Also, a mini-epidemic of disease in a given village will cause people to not want to live there any more. So, over the course of a person’s life, say a person who lives to 70 years old, one might move seven or eight times from one village to another just in service to the agricultural cycle.

    But wait, there’s more. Among the villagers, men and women, when they are married, move to one parent’s village or another for a while, then try to start their own village, and that sometimes does not work out, so they move again. So, around the age of marriage, a person may move three or four times in two or three years. A young man might spend two or three years working at a plantation far from their village, or spend some time in the army. A woman and her children might move to near a chief’s village if her husband is caught doing something wrong and forced into indentured service for a few months. Every now and then the government comes along and moves any village that is too far out in the forest closer to the road so it is easier to tax them. Then later, the government disappears (remember, this is a remote area) and everyone moves back. If grandma gets really sick part of the family might move far away to a mission hospital, because the family is required to supply food and labor to support grandma’s stay in what amounts to a hospice. And so on and so forth.

    Betweeen all of these factors, Lese farmers might move 20 times in their life.

    Let’s view “nomadism” among the Efe hunter gatherers and the Lese villagers from a slightly different perspective. Let’s ask the question: How many different places have you slept a total of 100 nights or more? That eliminates short forays, fishing trips, very short marriages, etc. Or, putting it a slightly different way, let’s look at the list of places one lives ranked by how many nights one has slept there in a lifetime. Nomads, given our usual conception of them, should have a very long list with a small number of nights at each place, while settled people should have a list with a short number of localities each associated with hundreds or thousands of nights, even if there is a tail of several places with a small number of nights each down hear the bottom of the list.

    If we look at the “nomadic” hunter gatherers of the Ituri Forest, the Efe, their list will have five or six places that account for 80% or more of their nights, if we adjust for the frequently destroyed camps in or near the gardens. The Lese farmers, on the other hand, will have over a dozen localities with a several hundred nights in each. By that reckoning, the Lese are more nomadic over a lifetime, even if the Efe are constantly moving.

    Minnesotans who go away for college and whose families have a cabin (maybe a series of cabins over time) up north and who spend part of their lives moving opportunistically from apartment to apartment in South Minneapolis are pretty nomadic too. I myself moved once before the age of 16, then about every six months for the next 15 years, chasing relationships, jobs, schools, and doing field work.

    Finally, let’s look at nomadism in one more way. If you move every several years, occasionally more often such as around the time of marriage, then at any given time the landscape you know is the landscape you live in, and the memories of details of the landscape of your childhood or other times gone by both fades and becomes obsolete. But if you move constantly, but over the same exact landscape all the time like the Efe do, then your knowledge of every bit of the landscape is detailed an intense and constantly updated and renewed. The Efe know every root that ever tripped them and every rocky pile that ever harbored a small forest animal procurable for dinner and every mature fruit tree and every patch of tasty forest yams in the place they live. The other part of my research, looking at Efe diet, came to this conclusion: There is a fair amount of food in the rain forest, but the only way to find any of it is to know in advance where it is located. Otherwise, the costs in time and energy to discover it excede its caloric value.

    The Efe are not nomadic. They are, rather, constant inspectors of their rather large home, centered on their traditionally used trail, consisting of a half dozen venues to sleep and live.


    More stuff about the Congo

    A while back I wrote a Novella, as a fundraising effort for the Secular Student Alliance, set in the eastern Congo. A cleaned up version of it is available here: Sungudogo

    You can read the harrowing real life story of a season of field research in the same region, in a series of blog posts, by clicking HERE (then click through to the next blog post, and the next, and the next, until you’ve read them all!).

    And, THIS LINK will get you to a selection of other stories set in the region.

    Jack’s research was written up here:

    Ethnoarchaeology Among the Efe Pygmies, Zaire: Spatial Organization of Campsites, by J. W. Fisher, Jr. and H. C. Strickland. American Journal of Physical Anthropology 78:473–484.

    More on river blindness and related diseases

    We were talking about River Blindness.

    Trigger Warning: The video below is not for general consumption. Having said that you may want to watch it. The first part depicts the reactions of a handful of celebrities watching a series of shots depicting seven different related tropical diseases, and I must say, having seen all of these diseases in person (and having treated some of them, and had mild versions of a couple myself) that these particular videos show the worst side of it. But still, a very large number of people (according to the source of the video, about a billion) have some form of these diseases, mainly in Africa but also in Central and South America and Asia. The celebrities are: Emily Blunt (“Salmon Fishing in the Yemen,” “Devil Wears Prada”); Eddie Redmayne (“Les Miserables,” “My Week with Marilyn”); Tom Felton (“Harry Potter” series); Yvonne Chaka Chaka (South African pop star); Tom Hollander (“Pirates of the Caribbean,” “Pride and Prejudice”); and Priyanka Chopra (leading Bollywood actress and international recording artist).

    The last part of the video is the same celebs giving a pitch for you to pitch in and donate some money and spread some awareness.

    The project that produced this video is called End7, a reference to ending all seven diseases. What they say is mostly true: You can treat these diseases very inexpensively. At present, the pharmaceuticals are well known and inexpensive. However, people with advanced stages of some of these parasitic infections can’t be treated easily if at all because the treatment may involve causing effects that result in very severe immune system responses. The idea is to treat children, more or less prophylactically, so they don’t develop the advanced versions.

    The disease are:

    <ul>
    
  • Elephantiasis
  • <li>Roundworm</li>
    
    <li>Hookworm</li>
    
    <li>Whipworm</li>
    
    <li>Trachoma</li>
    
    <li>River Blindness</li>
    
    <li>Snail Fever</li></ul>
    

    King Leopold’s Soliloquy

    I first became aware of, and read, King Leopold’s Soliloquy, which is not his soliloquy but a parody of what he might say according to Samuel Clemens, while doing fieldwork in the ex-Belgian Congo. That is where the real story that inspired the essay took place. I lived in an area that at one time had a few a plantations, but the plantations only existed briefly and are now long gone. The “road” through this area was passable only with a very tenacious four wheel drive vehicle (we had a Land Rover) and grew worse every year. But the road at one time was excellent.

    I knew a guy, an older Efe Pygmy man, with one leg. When I first arrived in the Ituri Forest I was shown by my colleague an abandoned camp that a group of Efe Pygmies has only recently been living in, and told “everyone in this group lived here but the old man and his wife … he’s a bit contentious and there was an argument.” Having read all the literature written in English about Pygmies, I was aware of the fact that these foraging people, who moved frequently — perhaps ten times a year or more — would often change the composition of their residence groups to reflect forming and breaking alliances among people who often, but not always, lived together. After hanging out in the camp long enough for my colleague to collect some data, we went back to the road via a different path and passed the old man, Kobou (pronounced “Ko-bo-oo”), and his wife in a small clearing in a freshly cut garden. “Strange,” I thought, “They live in a square hut. Everyone else lives in a dome-shaped hut. I guess some Efe live in square huts.”

    But no. Kobou is the only Efe I ever came across to always build square huts. Maybe somewhere else in the Central African Rain Forest, but not around these parts.

    Thin, old, bearded, fierce eyes contagious laugh and one leg. Kobou1 was the father of one of my main informants. Kobou would come by the research base camp whenever I was there, more or less daily. He’d sit in a chair and chill for a while, then we might chat about one thing or another. Then he’d say “I’ve come to get my plantains” or “I’ve come to get my mohogo” or “I’ve come to get my [fill in the blank with something to eat that we had growing in our fields]”. The base camp did have a rather large garden, and the main purpose of the garden was so that Kobou and a handful of other Efe could come by now and then and claim some of the food.

    “You’d better cut your plantains, then,” I’d say.

    Kobou and I hanging around in the Harvard Ituri Project base camp.
    Kobou and I hanging around in the Harvard Ituri Project base camp.
    More often than not he’d reply, “I did already,” pointing with his bearded chin to some big bunch of plantains at the edge of the clearing. Then he’d speak to a child or other handy person in KiLese (the local language) and that person would drag the food over to Kobou. Kobou would then pull out some vines he always seemed to have handy and create a tumpline strap or other carrying device incorporating the plantains or other food item, stand up on his one leg, grab one of his hand-fashioned canes, attach the food to himself, and grabbing the other cane head off to his camp. Unless his wife was with him, then Mrs. Kobou would carry the food.

    Kobou had lost his leg to a snake. He had been bitten by a full grown Gabon Viper. The Gabon Viper is one of the scariest of snakes. It’s head is huge, it’s body very stout, and it’s venom is the richest venom known in a snake, both neurotoxic and haemotoxic.

    When my friend was bitten by the snake, he was driven by someone from a nearby plantation to a hospital, to have is leg cut off, which was the only way to save his life. In the days I lived there, this drive required many many hours (or a day or two), and would beat the hell out of the truck. But in those days, they were able to drive him there in a few hours. At 120 kpm, it would have been a two or three hour drive.

    But the reason that the road was so good is because of the sort of policy satirized in King Leopold’s Soliloquy. In those days, a Belgian Colonial Administrator would drive a vehicle at 100 kilometers per hour down this road with a glass of water on his dashboard. Wherever water spilled form his full glass, he would stop, and his agents would beat and/or maim the nearest villagers. This encouraged the villagers to keep the dirt road in perfect condition by constant attention to any rivulets or potholes, using hand labor and simple tools.

    Eventually, the revolution came, in it’s own way, and the Belgians, guilty of a decades-long holocaust, got their due. They were burned to death in the buildings they hid in, they were shot, strangled, and drowned, and a few got away.

    At a later time, I stayed in one of King Leopold’s mansions. Well, not really. We kept some of our stuff in the mansion. The mansion had no roof, and was filled with birds and bats, and their guano. It was better to stay in a tent, outside, even though one would risk being trampled by a hippo or hassled by a hyena. This was Ishango, known locally as “The Most Beautiful Place on the Earth.” It is. But they should really tear down those old mansions (Two stood there side by side) and neaten the place up just a little. Leopold had mansions here and there across his Congo, though he never actually visited the place.

    I have ruled the Congo State not as a trustee of the Powers, an agent, a subordinate, a foreman, but as a sovereign — sovereign over a fruitful domain four times as large as the German Empire — sovereign absolute, irresponsible, above all law; trampling the Berlin-made Congo charter under foot; barring out all foreign traders but myself; restricting commerce to myself, through concessionaires who are my creatures and confederates; seizing and holding the State as my personal property, the whole of its vast revenues as my private “swag” — mine, solely mine — claiming and holding its millions of people as my private property, my serfs, my slaves; their labor mine, with or without wage; the food they raise not their property but mine; the rubber, the ivory and all the other riches of the land mine — mine solely — and gathered for me by the men, the women and the little children under compulsion of lash and bullet, fire, starvation, mutilation and the halter.

    Leopold did not say that. Clemens puts those words in his mouth as a political and social parody. But it is absolutely accurate; had Leopold said those word he would have been speaking the truth.


    1Here and elsewhere, when I write about people in the Congo, I use fake names. There are reasons.

    A Test For River Blindness

    River blindness, also called Onchocerciasis, is the result of the infection of several different eye tissues by the nematode Onchocerca volvulus. The bacterium Wolbachia pipientis lives symbiotically in the gut of the nematode, and escapes the small roundworm to cause an inflammatory response in human tissues, which results in damage to the tissue. These infections can occur in a number of different human tissues causing a variety of effects, but when the eye tissues are involved, the result can be river blindness. It is endemic and widespread in several areas of Africa, as well as more restricted areas in South America and the Middle East.

    ResearchBlogging.orgTreatment of the disease involves killing the bacterium, which in turn kills the host nematode, using various anti-biotics. However, as we have learned over recent decades, widespread use of antibiotics can be less than ideal because this can cause selection for resistant strains so that treatment can become generally ineffective across an affected population. Ideally, there would be a reliable test for river blindness infection that would allow more targeted use of treatments. Continue reading A Test For River Blindness