Geography Reference
In-Depth Information
Increasing challenges also come from the failures of the major antibiotic drugs
that counter many diseases, which could reverse many medical advances. There
are also increased risks from new communicable diseases in densely populated and
interconnected urban places, as shown by the case of HIV. But a more recent ex-
ample is seen by the rapid spread of Ebola in West Africa, with over 5,000 deaths
and at least 14,000 cases by the end of October 2014. 40 As Rene Dubois (
1959
)
observed in many topics, nature in the form of some microbe will always strike back
at human bodies in some unpredictable way, for new viruses constantly emerge and
existing ones mutate and become resistant to drugs. Ebola's rapid spread was due to
its ability to mutate rapidly and suppress human immune systems. But it was also
a consequence of several environmental and cultural factors: the inability to rec-
ognize its initial appearance, probably from cross-species infection from the virus-
carrying fruit bats; its spread in areas of high density, poor sanitation, high mobility
levels, and very limited health care systems in personnel and facilities; a lack of
trust in authorities after years of war; and where traditional healing and funerary
practices involved a lot of touching, which led to greater spread since bodies are
especially infectious by extruding the body fluids that spread the virus. The heroic
efforts of the charity M￩dicine sans Fronti￨res helped many people, but did not have
the resources to contain the outbreak, with an often 70% death rate among infected
people. Unfortunately it took over six months for the WHO and other countries to
start a massive effort to try and contain the disease by providing: supplies of soap,
alcohol swabs and disinfections to help reduce Ebola's spread; thousands of trained
doctors and nurses to attend the sick; enough protective clothing; building isolation
hospitals to treat patients; as well as tracing the contacts of infected people, which
was impeded by the absence of detailed local maps. This outbreak showed we can-
not be complacent about the threat of new diseases. There is pressing need to have
enough of the needed facilities available to be sent quickly to areas where new
diseases are detected and a necessity to boost research to find vaccines and drugs to
combat such new diseases and older ones like malaria that are still endemic.
Many of these problems go beyond the ability of cities alone to solve them, al-
though their density and connections make them more vulnerable, especially those
with poor sanitation. Cities rarely have the power or finance to improve health
care on their own, but they can initiate new programmes to improve their facilities.
Yet their very size means that their politicians and citizen groups should be able to
mount successful lobbying of national governments to take the more active, com-
prehensive and multifaceted measures to improve health in urban settlements.
References
Adams, J. (1910).
Twenty years at Hull House
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Adams, J. M. (2012). Healthy places and healthy regimens: British spas 1918-50. In V. Berridge &
M. Gorsky (Eds.),
Environment and health
(pp. 113-132). Basingstoke: Palgrave- Macmillan.
Adler, N. E., & Ostrove, J. M. (1999). Socioeconomic status and health: What we know and what
we don't.
Annals New York Academy Science, 896,
3-15.
