
 
 Government health workers are seen during the administration of blood tests for the Ebola virus in Kenema, Sierra Leone, June 25, 2014. (Umaru Fofana/Reuters) 
 
 “I don’t believe in Ebola,” Craig Manning’s local driver told him as he chauffeured the viral emergency specialist through Freetown, Sierra Leone, where infection rates are rising. The man came from a rural part of the country where people were already dying from the virus. He was adamant, like many others in his community, that “there is no such thing as Ebola.” 
 
 He is wrong. The epidemic, the deadliest on record, continues to batter Sierra Leone, Guinea and Liberia, with 85 new cases and 68 new deaths reported in only four days earlier this month, according to the World Health Organization (WHO). Sierra Leone bore the brunt of new infections and deaths, with 49 new cases and 52 deaths reported. The total number of cases stands at 982, with 613 deaths as of July 17. 
 
 Yet, as the Ebola virus continues to spread in West Africa, so do the rumors. Some say you can contract Ebola from a motorcycle helmet. Others say you can cure the deadly virus by drinking Nescafé mixed with cocoa and sugar — or with two large onions. 
 
 It’s Manning’s job to take onions out of the equation. 
 
 A health communications strategist with the Viral Special Pathogens Branch of the Centers for Disease Control and Prevention, Manning was sent to Guinea at the first outbreak of the Ebola crisis in March. When one of his colleagues, Pierre Roland, an expert on Ebola, gave a presentation at the U.S. Embassy in Conkary about mitigating risks of transmission, Manning recorded him. He then had the edited 30 second snippets translated into 10 local languages and broadcast over local radio stations and TV. 
 
 When the virus spread to Sierra Leone, Manning followed it, teaming up with BBC Media Action to bring together radio station managers from across the country to help spread the word. 
 
 Manning said aggressive intervention is necessary to prevent more people from becoming infected, but ensuring local populations understand Ebola first is essential. For instance, in areas where the virus has spread, relatives wash bodies by hand before funerals, putting families at risk of new infections. 
 
 “People do not easily accept the idea that teams will take their deceased loved one, put them in a bag and bury them somewhere different,” said Manning. “The challenge is to strike a balance.” 
 
 
 
 Health workers carry the body of an Ebola virus victim in Kenema, Sierra Leone, on June 25, 2014. (Umaru Fofana/Reuters) 
 
 This balance demands communication, according to WHO spokesperson Daniel Epstein. 
 
 “There are a set of beliefs and myths that impede our messages about treatment – it is a huge challenge,” he said. 
 
 Doctors Without Borders has been unable to gain access to some affected areas due to hostility from the people there. Local communities fear outsiders are bringing the virus with them or want to exterminate the infected, since so few who get treatment return alive. 
 
 WHO is helping coordinate information sessions on Ebola to train local leaders how the virus is transmitted and how people can stop it. 
 
 “It is necessary for any group engaging in Ebola control to provide health education prior to initiating any other intervention,” said Rashid Ansumana, a researcher at Mercy Hospital Research Lab in the city of Bo, Sierra Leone, where 15 physicians treat a population of more than 150,000. Ansumana comes from the city of Kailahun, an epicenter of the outbreak, and said a large number of new infections are going undetected. His family lives in constant fear. 
 
 “One false rumor that is circulating is that health officials might inject suspected Ebola patients with lethal substances,” he said. He suggested HIV prevention protocols, which people are familiar with, can be used to explain how Ebola can be transmitted through blood or other body fluids. 
 
 In 2012, Mercy Hospital used the crowdsourcing platform Ushahidi to monitor an outbreak of the highly infectious Chikungunya virus, technology he believes could be employed to combat Ebola. 
 
 Crowdsourcing data during emergencies has become an important new way to quickly source information about people at risk and to locate the epicenters of the crisis, used to great effect during the earthquake in Haiti to aid a targeted, effective response. 
 
 “In West Africa, someone who has Ebola might not seek testing or treatment due to the monetary costs or the fear of getting a positive result for the virus, the impact and potential stigma that has for their family,” said Kathryn H. Jacobsen, associate professor for epidemiology at the Department of Global and Community Health at George Mason University. For diseases such as malaria, she said, people in this region will often go to a local pharmacy where medication is available without a prescription, rarely going to hospital. 
 
 “To have people reporting in cases through text messaging would be a very helpful system,” she said. 
 
 
 
 Healthcare workers prepare isolation and treatment areas in Gueckedou, Guinea, in March 2014. (Kjell Gunnar Beraas/MSF via AP) 
 
 WHO has been operating emergency Ebola hotlines in the affected countries that get 200 to 300 calls a day. The organization is exploring text messaging, since 40 percent of affected populations use mobile phones. 
 
 Doctors Without Borders have brought anthropologists on board in an attempt to better understand the traditions and cultures of the people they are treating. 
 
 While expert advice is important, the key to getting the message through to communities in more isolated areas is building a network of local spokespersons and engaging religious and cultural leaders. 
 
 There have been small victories. Manning said his driver had come to trust him. 
 
 One day, his driver tugged on his sleeve at a gas station. Out of the blue, he said: “I want you to speak to these people about Ebola.” ||||| The present Ebola outbreak in Guinea, Liberia and Sierra Leone is the deadliest on record. On June 23, the World Health Organization reported 635 Ebola cases, including 399 deaths. By July 12, the figures were up to 964 cases, including 603 deaths. Doctors Without Borders and the World Health Organization are providing substantial medical personnel and resources on the ground in order to help contain the outbreak. 
 
 The United States, according to the CDC, has sent a seven-person team to help in Guinea, and provided protective clothing and equipment for healthcare workers in all three countries. In the grand scheme of things, that is a minimal amount of aid -- echoed by the minimal coverage the outbreak has garnered in U.S. media. (Far more attention was afforded GOP Congressman Phil Gingrey’s outlandish and factually implausible comments about refugee children crossing the border bringing Ebola into the United States from Central America.) 
 
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 There is more than one way to interpret America's disinterest. One is racism -- the sense that the people dying of Ebola are so different from “us” that we really can’t identify with them. Another is compassion fatigue. Isn’t there always some horrible disease afflicting Africa and Africans? 
 
 Indeed, many of the English-language articles that have been written about the Ebola outbreak focus on “ignorant” and “superstitious” Africans who give more credence to witchcraft than to modern medicine. 
 
 For example: 
 
 The key to halting Ebola is isolating the sick, but fear and panic have sent some patients into hiding, complicating efforts to stop its spread. … Preachers are calling for divine intervention, and panicked residents in remote areas have on multiple occasions attacked the very health workers sent to help them. In one town in Sierra Leone, residents partially burned down a treatment centre over fears that the drugs given to victims were actually causing the disease. 
 
 This analysis, picked up by several news outlets, simultaneously reveals the kind of xenophobic Western mindset that victims of the Ebola outbreak distrust, and hints at why Western readers do not seem all that interested in learning about or from the outbreak. 
 
 The suspicions with which many people in Guinea, Liberia and Sierra Leona regard Western interventions make sense. Healthcare workers are particularly hard-hit by Ebola, and workers and other patients who hadn't been infected can return home not knowing they now carry the disease, transmitting the virus to their families and communities. International relief organizations in these countries set up emergency treatment that will be taken down when the immediate threat is over. But family sticks around forever. Refraining from leaving sick relatives in hospitals (that typically utilize isolation as the sole means of containing the Ebola virus) can be a pragmatic and sensible choice to rely on the kinship and community networks that have kept people alive in the past. 
 
 From my perch as a medical sociologist, the claim that mobs attacking treatment centers are panicking reveals “troubling truths" regarding the Western track record of medical experiments and geopolitical ambitions in Africa. Distrust of Western medicine may have less to do with superstition than with history: forced sterilizations in Peru; the intentional infection of Guatemalans with gonorrhea and syphilis; marketing campaigns urging mothers in countries lacking safe water supplies to replace breastfeeding with infant formula so that women could work in western-owned factories; the sale in Africa of pharmaceuticals that passed their expiration date for sale in the West; the harvesting of organs in India for transplants to wealthy foreigners. 
 
 In sub-Saharan Africa, outbreaks of new diseases such as Ebola (first identified in 1976) echo the spread of industrialization, urbanization, unprecedented militarization (funded by western countries), deforestation and the destruction of eco-systems that have forced communities to expand their search for food into territories that traditionally were not used for that purpose. In reports in the English-language press, however, there is little consideration of the political and economic structural forces that gave rise to the emergence and spread of Ebola. Rather, as Jared Jones writes, “African ‘Otherness’ overpowers the possibility of a non-cultural causality in the dominant discourse, and other factors are left unexamined as potentially causal or exacerbating.” Attention to sorcery rather than the inequalities of globalization obscures the fact that the biggest leaps in life expectancy in the U.S. and Europe came about because of massive government-funded public health measures -- sewage systems and clean water supplies – not because we gave up our religious beliefs. 
 
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 The articles I read in the English-language press decry the absence of functioning healthcare infrastructures in the African nations hit by the Ebola virus. But I am not convinced that the United States would do much better. There are a great many things that western medical institutions and personnel do extraordinarily well. We have sophisticated surgical technology and an advanced pharmacopeia of medicines to treat hundreds of diseases. But the bulk of our medical resources go towards curing rather than prevention. What we do dedicate to prevention tends to be limited to proximate factors such as germs and personal behaviors such as smoking that make individuals sick. We also divert resources into campaigns for procedures such as mammograms which detect but do not prevent disease. We pay less attention to poverty, inequality, environmental degradation and, yes, globalization, as root causes of sickness. 
 
 Perhaps it is not surprising that the United States has contributed so minimally to managing the Ebola outbreak. Effective public health endeavors need organized and sustainable systems for preventing the spread of disease. And, as I have argued before, the United States does not have a healthcare system. “System” denotes an overarching set of principles, practices, procedures and organizational structures, whereas our U.S. healthcare landscape is a decentralized and incoherent hodgepodge of financing and delivery mechanisms lacking rational methods for setting priorities. 
 
 Services and regulations, as well as thresholds for Medicaid eligibility, vary enormously from state to state. Municipal, county and state health departments rarely have mechanisms to keep track of patients who move to another jurisdiction. Hospitals around the country and even within one city or state use incompatible medical records. (Even the federal government's Veterans Affairs and Department of Defense records are mutually inaccessible.) We have for-profit and not-for-profit hospitals. (And it’s often difficult to tell which is which.) Though many of us believe that emergency rooms serve as a safety net, federal law only requires emergency rooms to assess and stabilize patients (and they are allowed to charge a whole lot to do so), not to cure them. Walk-in clinics are proliferating in Wal-Mart and CVS branches. Hundreds of for-profit and not-for-profit insurance companies compete for “good” (that is, well-paying and relatively healthy) patients and customers. Behavioral and oral healthcare are almost never integrated with the rest of healthcare. And the Affordable Care Act — touting that “consumers” can “choose” the insurance plans that “best fit their needs” — is not designed to turn this chaos into any sort of longterm sustainable system. 
 
 We need to learn about public health emergencies around the world not only because they might become our emergencies, but also because those emergencies could be better contained and managed if we were to invest our expertise, our attention and our resources into community, national and international health preservation. For a fraction of the money that Western countries have poured into military campaigns in Africa, it would have been possible to support local governments in building functioning public health infrastructures. But let’s also not forget that despite spending more on healthcare per person than any other country in the world, here in the U.S. we are dead last among developed countries in health and life-expectancy, according to a recent study of 11 nations by the Commonwealth Fund. Ignoring the reality that the health of each of us is inexorably intertwined with the health of others is a collective disaster-in-the-making. ||||| Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings. 
 
 / Updated 
 
 The deadly Ebola virus that’s killed more than 600 people so far in West Africa may have been smoldering there for years and has almost certainly sickened people who thought they had something else, researchers say. 
 
 A new study of blood samples from people being treated for a serious, viral-like illness in years past in Guinea, Sierra Leone and Liberia suggests some of them could have been infected with Ebola. Now researchers are digging deeper to see if the virus has always been lurking there, just undetected. 
 
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 It’s not a perfect test — the blood samples were several years old and had to be heat-treated so the researchers would be safe — but it’s a lead worth following up, said Randal Schoepp of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) team that did the research. 
 
 “It had been circulating there for a long time,” Schoepp told NBC News. “It just hadn’t gotten out of control or the right conditions weren’t there.” 
 
 “It had been circulating there for a long time." 
 
 Other researchers said the tests used are not 100 percent reliable, and more testing will be needed to see if they reflect what’s really happening. But it would be unlikely for a virus such as Ebola to appear completely out of the blue in a region. Experts suspect bats and perhaps other animals, too, carry the virus. 
 
 “It makes us realize that you don’t have to see an outbreak (to know a virus is circulating in an area),” Schoepp said. “In Africa, it is easy for a disease to smolder because there is so much disease.” 
 
 Ebola has killed at least 613 people in Guinea, Sierra Leone and West Africa in an outbreak that started in spring, according to the World Health Organization. It’s been diagnosed in 982, making for a mortality rate of more than 60 percent. 
 
 The WHO and Medecins Sans Frontieres (Doctors Without Borders) both say the outbreak is out of control. It killed 25 out of 28 nurses in a single hospital in Sierra Leone and patients are disappearing into the forest rather than seek treatment. 
 
 Ebola had never been seen in West Africa before, although there are plenty of other nasty infections, from malaria to dengue and, especially, Lassa fever. Lassa fever is caused by a virus unrelated to the one that causes Ebola but causes similar symptoms, include high fever, vomiting and internal and external bleeding. 
 
 Lassa is a far bigger problem than Ebola — it infects between 100,000 and 300,000 people a year in West Africa, killing 5,000, according to the U.S. Centers for Disease Control and Prevention. 
 
 So when someone shows up with a fever in West Africa, Lassa is a prime suspect. 
 
 Several U.S.-based organizations have been studying Lassa in Sierra Leone in the decade since a civil war there ended. But not everyone has Lassa or malaria — the majority of infections are never diagnosed. 
 
 “Generally only 30 percent to 40 percent of samples tested are positive for Lassa virus,” Schoepp’s team wrote in the journal Emerging Infectious Diseases. 
 
 Schoepp’s team looked at blood samples taken from 253 people cleared of both Lassa and malaria between 2006 and 2008. “Most samples were from acutely ill patients from eastern Sierra Leone; some were submitted from Liberia and a few from Guinea,” they wrote.
– The Ebola outbreak that's claimed at least 500 lives in West Africa may have been lurking a while before going on its killing spree, NBC News reports. Researchers figured this by studying blood samples from old cases of viral illnesses in Liberia, Sierra Leone, and Guinea, and finding possible signs of Ebola. The results aren't 100%—the samples were old, after all—but evidence suggests that an Ebola outbreak could be spotted ahead of time. "It makes us realize that you don’t have to see an outbreak" to know it's there, said Randal Schoepp, a US Army researcher. "In Africa, it is easy for a disease to smolder because there is so much disease." This is Ebola's first outbreak in West Africa, but other dangerous diseases like dengue, malaria, and particularly Lassa fever are common there. Lassa fever also comes with Ebola-like symptoms such as internal and external bleeding, vomiting, and high fever. Analyzing 253 blood samples from 2006 to 2008, Schoepp's crew found that almost 9% of samples cleared of other ailments tested positive for Ebola antibodies. Another challenge is educating West Africans about Ebola, for odd rumors are spreading there—like the notion that Nescafe can cure it when mixed with sugar and coca, the Washington Post reports. But Susan Sered writes at Salon that the biggest challenge may be educating Americans, who could easily afford to "support local governments in building functioning public health infrastructures." (Read about Guinea's rather odd means of curbing Ebola.)