DPSEEA-based Analysis Of Vector-borne Diseases And Ebola Outbreak In Africa: An Essay.

The DPSEEA Framework for Analyzing Environmental Health Indicators

Question:

Discuss about the Environmental and Global Health Issues for Vector-Borne Diseases.

Vector-borne diseases can be described as the infection that is spread or transmitted by an infected certain species that carry the virus within their body. The vector can be a bat, fly, tick and mosquito. Weather plays a major role in influencing the population of the vectors, abundance, distribution, habitat suitability. Temporal pattern and the intensity of the vector activity all over the year. Not just the climatic factors but also the land use pattern, density of host and habitat destruction plays a major role in the spread of diseases. In this study, Ebola disease is used as vector-borne disease and Africa is selected as the geographical location where the impact of the Ebola is noticed (Altizer et al., 2013). The study also deals with the usage of the DPSEEA framework for the analysis of the disease; how Ebola is managed by the health and the other agencies and the suggestions that address the gaps in the current policy and the management of the environmental health issue. 

The World Health Organization developed a framework called the DPSEEA framework, and this framework is the basis of the development of the environmental health indicators. Initially, the DPSIR was recognized and then it was done by recognising environmental state through the exposures to major health effects. The DPSSEA framework stands for the driving forces, pressure, state, exposure, health effects and the actions. The framework takes into account the various environmental and the health issues and problems that are associated with the driving forces like the technological change, economic development, population growth and the policies underlying the above mentioned (Gentry-Shields & Bartram, 2014).

Driving force- a study was conducted jointly by the National academy of sciences and the London school of hygiene and tropical medicine found that the 61 percent of the cases were caused by the 3 percent of the people that are infected. The study also concluded that the although the infected people are buried in a proper way, however, the unsafe funeral procedures followed are one of the major reason for the spread of the transmission of Ebola. The study even highlights that there are biological and the social factors that have led to the spread of the disease. The research also pointed that the children aged 15 years and the adults aged 45 years are more like to spread the disease in comparison to the other people. There is a possibility that there is a combination of the factors that led to the spread of the disease. Also, there is another way by which the disease spread unknowingly. The people that were taking care of the infected people who were already suffering from the disease led to the spread of the disease (Baize et al., 2014).

Driving Force: Factors Contributing to Ebola Outbreak

Pressure- the countries that became affected are one of the poorest countries in the world. Guinea is the only place in the world that the Bats travel to. Guinea ranks 178 out of the 187 in human development index which is framed by United Nations. Half of the Guinea population live under the poverty line and the country is slowly trying to get out of the civil war. When the disease out broke, there was a widespread lack of the proper coordination system and were poorly equipped. The country was unable to monitor the movement of the people across the different regions. Guinea even lacked a robust healthcare system and they were unable to respond with the basic health resources. Due to poverty, the people further went to the forest to meet their day to day needs. The Ebola virus which was already circulating in Guinea but in a suppressed way, however, the disease received a further chance to spread when the animals carrying the Ebola virus came in contact with people (Alexander et al., 2015).

State changes- Due to the increased poverty among the people of Guinea, forced them to move to the forest to full fill the daily needs of food. Within the forest ecosystem, the animals were already carrying the Ebola virus, and the movement of the humans further into the forest led to the establishment of contact with the humans.  The pressure on the environment increased due to the excessive human interference into the forest ecosystem due to the extraction of minerals from mines and to bring firewood to make charcoal.  The extreme dry season also triggered the outbreak of Ebola (Feldmann, 2014).

Exposure- The increased activity into the forest is the prime reason for the increased exposure of the people to the animals that are already exposed to the Ebola virus. The humans that went to the forest for sustaining the livelihood primarily came in contact with the animals that were affected by the virus and this further increased the spread of the virus within the humans (Muyembe-Tamfum et al., 2012).

Effects- Initially the people of Guinea were infected with the Ebola virus mildly. The increased activity of the humans into the forest has led to the virulent strains of Ebola to come in contact with the human subjects.

Assessment- the people that are affected by the Ebola experience pain in muscles, joints, chest and abdomen. A person may also experience vomiting blood, nausea and diarrhoea.

Pressure: The Social and Economic Conditions of Guinea

The DPSEEA framework failed to take in to account the economic, political and the social influences because the framework is unable to highlight the social conditions of the people of Guinea and the political scenario of the country that were it was experiencing during this moment of Ebola outbreak. The country was just out from a civil war and this aspect was included within the framework. The framework only also fails to explicitly deal with the social issues that were prevalent during the Ebola outbreak and the spread of the Ebola dynamics was only restricted to the environmental aspects. The vector-borne disease is only looked through the lens of how the humans and the environment contributed to the spread of the disease. The biological elements are only considered in the framework (World Health Organization, & UNICEF, 2012).

Presently, there is no medication available that are approved by the food and the drug administration for the cure of the patients that have already been exposed to the virus but is yet to become ill. Thus, the patients are treated maintaining the standard operating procedure, through the replenishment of the nutrition, pain control, ventilation support, electrolytes and fluid are provided to the patients in order to manage them and prevent the complications and the symptoms of the Ebola disease. The survivors of the disease are able to produce the infectious virions for an extended period and the patient needs to be isolated throughout the occurrence of illness (Chertow et al., 2014). The healthcare professionals that are attending the infected persons must wear the personal protective equipment (PPE) which includes wearing the gloves and the surgical masks. Also at this time the infected mother's breast is also not allowed to be fed to her child. The symptomatic management of the disease is also vital for relieving the patients of the pain, fever, diarrhoea, nausea, vomiting. Morphine is used as the opioid analgesics and paracetamol is used as the first line agent for the treatment of the pain and fever. Non-steroidal anti-inflammatory drugs are not recommended during the pain treatment due to the increased risk of bleeding. The pharmacological drug therapy is used for the safe treatment of the Ebola virus disease. a potent drug called the favipiravir (T-705) is found to be effective against the RNA virus (Sivanandy et al., 2016).

Since the outbreak of Ebola, Centres for the Disease Control and Prevention (CDC) undertook one of the major parts in response to the Ebola diseases. In the human history, more than three thousand staffs have been actively involved in the system. More than twelve hundred staffs were deployed in West Africa to work for 50,000 work days. The efforts that were involved in the management of the of the disease are communication, healthcare infection control, contact investigation, epidemiology, strengthening the laboratory, mobilizing the partners, and the border screening in the United States, Senegal, Mali, Nigeria, West Africa. The efforts were undertaken at the national and the international level along with the different partner organizations. CDC was able to international, national, public health for the prevention of the worst events. The epidemic Ebola virus disease also led to the strengthening of the international and the national events for the purpose of the system detection and the respond to the prevention of the spread of the disease in the future (Frieden & Damon, 2015). 

State Changes: Impact of Human Activity on the Ecosystem

The community health worker played a major role in the spread of the Ebola disease and its outbreaks by educating and engaging the communities. There were reports that the rapid containment of the Ebola disease was possible only in those regions where there were a strong bond and understanding between the community worker and the community people. The community health worker when provided with the proper health training, support, supervision can lead to better health outcomes. The community health workers also made a significant contribution for the rapid containment of the spread of the Ebola virus disease is through the engagement, outreach and education. The knowledge of acting quickly is one of the major reason that can lead to the reducing the risk of the disease. The community health workers also contributed to the building and strengthening of the health systems that are affected by the virus and other countries (Perry et al., 2016).

Critical infrastructure- firstly, the response to Ebola led to the coordination of the multiple partners into a single system. The ministry of health in Liberia established a national IMS in the year 2014, this was also supported by the CDC, WHO and other major partners. The daily activities were managed by the emergency operations centres which improved the coordination system at the national and the local level. The outbreak response in Sierra Leone was done through the district and the national Ebola response centres that are supported by the military and the civilians. New infrastructures were created which led to the build-up of the emergency response teams and the increased coordination capacities. In Guinea, the national Coordination cell was formed along with the support provided by the public health agency of Canada, CDC and WHO (Marston et al., 2017).

Changes in the legislature at the state and federal level due to the Ebola outbreak-During the complex events that were occurring in Africa. The African president revealed the ground reality. Not a single African country devoted and dedicated its office to technology and science. The advisors at the president’s house lack the administrative, financial and the legislative capacities (Juma, 2018).

The suggestion for the management of the health issues related to the Ebola virus are as follows:

• Science presidential advisory can be established that will make the African engineers and the scientists contribute effectively to the development and improvement of the humans. This can be done through the development of channels like the Network of African Science Academies.
• Proper legislatures were evenly lacking throughout the African nations. Thus, the government must emphasize on the framing of the legislation that will be in accordance with the prevailing situation in African countries.
• The external nations have done their part by sending the doctors and the health workers that can also help and train the regional health workers regarding the proper handling of the dead carcass.
• Bats and the other primates are the prime vectors of the disease and thus, this knowledge can be effectively provided to the common people so they can stay aware of the present condition.

Conclusion

From the above study, it can be concluded that the vector-borne disease like Ebola generally depends on the human activity and the activity of the animal species. Humans that are coming in contact with the animal species is the prime reason for the spread of the disease in the first instance. The increase in the human interference into the forest ecology and the lack of the knowledge of the disease has led to the increase in the spread of the Ebola disease.

Exposure: Increased Contact with Animals Carrying Ebola Virus

Reference

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