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Fevers, Feuds, and Diamonds: Ebola and the…
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Fevers, Feuds, and Diamonds: Ebola and the Ravages of History (edição 2020)

por Paul Farmer (Autor)

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1293210,347 (4.05)11
"Public health expert Paul Farmer describes the historical origins of the 2014 Ebola epidemic"--
Membro:x_hoxha
Título:Fevers, Feuds, and Diamonds: Ebola and the Ravages of History
Autores:Paul Farmer (Autor)
Informação:Farrar, Straus and Giroux (2020), 688 pages
Coleções:Available
Avaliação:
Etiquetas:disease, empire, disaster, history, Africa, geography, non-fiction, 21st century

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Fevers, Feuds, and Diamonds: Ebola and the Ravages of History por Paul Farmer

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Wow, very in-depth look at the West African ebola epidemic of 2014. Very interesting and disturbing reading while the COVID-19 pandemic rages. The book was completed just as the COVID-19 pandemic was ramping up. ( )
  bness2 | Aug 20, 2021 |
Paul Farmer writes about the Ebola epidemic in Western Africa in 1014. His emphasis is on the fact that epidemics of contagious diseases do not occur in a vacuum, but instead are result of social, medical, and economic deficits that provide opportunities for a disease to rage out of control.

After an description of the clinical desert that existed in West Africa at the time of the outbreak, he describes the sequences of events, almost as if in real time. Then he turns to the history of the area, including the extractive colonialism by European countries and slave trading. Colonial rule meant that these areas were raided for people and natural resources, often heavily taxed and with forced labor, with little to no investment in infrastructure such as health care, education, or basic sanitation. Even while expat colonials living in the colony might enjoy these things within their own compounds. Upon gaining freedom, these countries were left destitute and vulnerable to any factions that hungered to rob them of any remaining natural resources.

The theme through the book is the lack of: staff, supplies, space, and systems to provide basic health care. And the hold over of a philosophy of containment of disease over one of providing medical care that arose in the colonial era. This goal of containment of ebola was the dominant approach during the 2014 epidemic, resulting in many needless deaths. Yet, western medical providers who were airlifted out of the region and provided with 21st century medical care survived their ordeal with the disease. The result is a deep distrust of medical authorities within the region.

Farmer also emphasizes the understanding of social medicine in the context of local cultures for the successful delivery of medical care, citing the work of social psychologists and anthropologists.

Finally, it becomes clear that these clinical deserts are likely to contribute to further epidemics and pandemics in the future, unless we as a society work to equalize the availability of staff, stuff, space, and systems to provide medical care through out the world.

The writing reminds me of Sebastian Junger and Frank Snowden, whose works are both cited in this book. There are segments where the author's anger clearly comes through...but it is a righteous anger formed from his life's work of dealing with difficult contagious diseases. ( )
1 vote tangledthread | Jul 16, 2021 |
I cannot give this book enough stars. 5 plus stars!!! The author puts the ebola outbreak in historical context. This is important as we need to learn from the history of the material conditions that made this outbreak possible. We can learn much about how to break the chain that leads to pandemics and epidemics and all problems by tracing the chain to what brought us to the point of pandemic. This is not just a history but how to look at history to learn how to go forward and make sure it never happens again. I cannot recommend this very relevant book for today. Dr. Farmer is a scientist, medical doctor and a writer who knows well how to y=use the tools called the written word. ( )
1 vote ricelaker | Jan 27, 2021 |
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Farmer embeds a memoir of his own experiences in Guinea, Liberia, and Sierra Leone during the height of the West African Ebola epidemic of 2014 in a much broader critique of colonialism and its lingering effects, which he views as primarily responsible for the lamentable state of public health in the region today. He reviews 500 years of history to make this case. Farmer always writes with great passion, but as a medical doctor by training with much experience in African countries, he is particularly authoritative about the issues Ebola posed for medical staff. His book argues that a “control-over-care” ideology permeates the region to the present day, as a legacy of the colonial emphasis on the containment of diseases rather than the treatment of the afflicted. During the Ebola outbreak in West Africa in 2014, this logic of control meant that the main strategy to address the epidemic was to isolate infected individuals and the communities where the virus had spread, rather than to try to care for the infected. Farmer argues that as a result, many Africans died needlessly, despite widely available treatments.
 
The global responses to Ebola and the coronavirus have cast light on the importance of what Farmer calls the “staff, stuff, space and systems” of public health. What good does it do for a well-meaning organization to build a new hospital in Sierra Leone if there are no doctors or nurses to staff it? What about the irony that those few medical professionals in West Africa lacked gloves to protect themselves, when the latex in those gloves is extracted from their soil by American companies that manufacture gloves overseas? How many died because health systems collapsed under the weight of Ebola and therefore could not treat more prevalent diseases like cholera and malaria?

Today, the countries that have handled the coronavirus with relative success are those that were prepared with the staff, stuff, space and systems. Germany and South Korea launched massive testing campaigns early and kept their outbreaks relatively small. Taiwan, Thailand and Singapore have had some of the lowest death rates in the world. America, by contrast, had a shortage of personal protective equipment early in the pandemic, a shortage that continues to plague some states and counties.
adicionada por kidzdoc | editarThe Washington Post, Reid Wilson (Nov 26, 2020)
 
The book centers on the Ebola outbreak of 2014 in three West African countries, Guinea, Liberia and Sierra Leone — nations that are medically impoverished. When people began in late 2013 to fall ill in Guinea with Ebola, the illness, transmitted through sweat, saliva, vomit, feces, and other bodily fluids, spread rapidly and soon crossed borders. Blame rained down on individuals, families and communities who were described by international agencies as willfully resisting sensible public health measures. Caretaking of very ill loved ones, and preparing the body for burial of loved ones who had died no matter the cause, were portrayed as exotic "traditional" behaviors; this in turn allowed sufferers to be blamed for resisting Western knowledge and for contributing to their own misery.

The truth, as Farmer makes crystal clear, often with an incandescent anger that shines through even his measured words, is much different. Yes, the disease — just like coronaviruses — is spread in part through caregiving. But the base fact is this: Ebola swept through these nations in a catastrophic way more because of a history of inequality than because of viral biology.
 
These opening scenes imply a predictable template for the book: a memoir of public health heroism, laced with gruesome descriptions of Ebola’s devastating impact on the human body, in the style of Richard Preston’s best-selling Ebola chronicle from the 1990s, “The Hot Zone.” But “Fevers, Feuds, and Diamonds” turns out to deviate from those conventions in a number of surprising ways. To begin with, the Ebola virus is less of a relentless killer than it is in Preston’s account. “With the exception of one Liberian-born U.S. citizen,” Farmer points out, “every American who fell ill from the strains circulating in West Africa survived. So did most Europeans.”

Farmer notes that even severe cases of Ebola rarely produce the horror-film symptoms featured so prominently in Preston’s “Hot Zone”: patients bleeding from their eyeballs, their organs liquefied in a matter of hours. Most cases instead involve fluid and electrolyte loss caused by vomiting and diarrhea, which can often be treated with basic supportive and critical care, like intravenous fluid replenishment or dialysis. Ebola was so lethal in upper West Africa not because the virus itself conveyed an inevitable death sentence, but because countries like Liberia and Sierra Leone lacked these health care essentials. “For all their rainfall,” Farmer writes, “their citizens are stranded in the medical desert.”
adicionada por kidzdoc | editarThe New York Times, Steven Johnson (Nov 17, 2020)
 
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There's a thread you follow. It goes among

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To Humarr and Martin, who didn't make it;

to Ibrahim and Yabom, who did;

to all the caregivers;

and to Ronda and Bill, who helped us join them.
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In October 2014, having signed up to help respond to an exposure to an explosive Ebola epidemic, I traveled to West Africa in the company of colleagues.
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