After Ebola, Cholera?

Not far from the epicenter of the Ebola outbreak in West Africa, a growing number of cases of cholera have spread. If these two contagious diseases overlap, it could be a catastrophe.

Hazmat-suited workers fighting Ebola in Unification Town, Liberia on Aug. 30
Hazmat-suited workers fighting Ebola in Unification Town, Liberia on Aug. 30
Renaud Piarroux*

MARSEILLE — Guinea, Sierra Leone and Liberia, the three West African countries hardest hit by the Ebola outbreak, are considered vulnerable to another contagious disease, cholera, especially during the rainy season, which lasts through November.

The last serious cholera epidemic, in 2012, seems to have been spread by the travels of fishermen along the coasts of these countries. It affected 30,000 and killed 400 in Guinea and Sierra Leone.

In fact, cholera is not always present on these countries. Since 2012, the situation stabilized and no epidemic has been registered so far this year.

But what would happen if cholera were to return in an area already affected by the Ebola virus? Cholera can be transmitted by body fluids. It can also infect the immediate surroundings of a patient and, at a greater distance, contaminate water sources, making it possible to simultaneously infect a large number of people.

In 2010, the contamination of one river in Haiti was the origin of a huge epidemic that infected more than 700,000 people, killing 8,500.

Victims of the 2010 cholera epidemic in Haiti — Photo: Marcello Casal Jr/ABr

In case of an epidemic, the first thing to manage is the flood of patients. Diarrheas and vomiting lead to dehydration, which in its more severe forms can end in the patient’s death. Each Cholera Treatment Center with a few dozens beds requires several hundred nursing staff and various personnel working directly with the patients.

Where would we be able to find these workers in countries from which, for fear of Ebola, health personnel have fled? And how could we protect them from a potential contamination from an Ebola patient with diarrhea? Should they also be working dressed as spacemen?

The fight against cholera requires that meetings be organized in neighborhoods and villages to tell the populations how they can protect themselves. But how can these campaigns be set up in a context of general fear and devastating rumors, with teams working to raise awareness being beaten up by villagers convinced that they were responsible for the Ebola epidemic?

Unquestionably, the sum of the two diseases would be a catastrophe in itself, and one would think that major efforts should be underway to prevent it from happening.
Surprisingly, that is not the case. Indeed, a few hundred kilometers east of the area affected by Ebola, a cholera epidemic has begun to spread. The epicenter is located in Ghana, where the threshold of 2,000 cases per week has been reached. From Ghana to Liberia, there’s only Ivory Coast to cross. It’s very little, especially when we think about the porous borders and the importance of human travels in this part of Africa.

We have no idea how to put an end to the Ebola epidemic, and how many lives it will claim. We should at least try to prevent another disaster by intervening urgently to bring the expansion of cholera in neighboring countries under control.

*Renaud Piarroux is a professor and tropical medicine specialist in Marseille.

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What It Means When The Jews Of Germany No Longer Feel Safe

A neo-Nazi has been buried in the former grave of a Jewish musicologist Max Friedlaender – not an oversight, but a deliberate provocation. This is just one more example of antisemitism on the rise in Germany, and society's inability to respond.

At a protest against antisemitism in Berlin

Eva Marie Kogel


BERLIN — If you want to check the state of your society, there's a simple test: as the U.S. High Commissioner for Germany, John Jay McCloy, said in 1949, the touchstone for a democracy is the well-being of Jews. This litmus test is still relevant today. And it seems Germany would not pass.

Incidents are piling up. Most recently, groups of neo-Nazis from across the country traveled to a church near Berlin for the funeral of a well-known far-right figure. He was buried in the former grave of Jewish musicologist Max Friedlaender, a gravesite chosen deliberately by the right-wing extremists.

The incident at the cemetery

They intentionally chose a Jewish grave as an act of provocation, trying to gain maximum publicity for this act of desecration. And the cemetery authorities at the graveyard in Stahnsdorf fell for it. The church issued an immediate apology, calling it a "terrible mistake" and saying they "must immediately see whether and what we can undo."

There are so many incidents that get little to no media attention.

It's unfathomable that this burial was allowed to take place at all, but now the cemetery authorities need to make a decision quickly about how to put things right. Otherwise, the grave may well become a pilgrimage site for Holocaust deniers and antisemites.

The incident has garnered attention in the international press and it will live long in the memory. Like the case of singer-songwriter Gil Ofarim, who recently claimed he was subjected to antisemitic abuse at a hotel in Leipzig. Details of the crime are still being investigated. But there are so many other incidents that get little to no media attention.

Photo of the grave of Jewish musicologist Max Friedlaender

The grave of Jewish musicologist Max Friedlaender

Jens Kalaene/dpa/ZUMA

Crimes against Jews are rising

Across all parts of society, antisemitism is on the rise. Until a few years ago, Jewish life was seen as an accepted part of German society. Since the attack on the synagogue in Halle in 2019, the picture has changed: it was a bitter reminder that right-wing terror against Jewish people has a long, unbroken history in Germany.

Stories have abounded about the coronavirus crisis being a Jewish conspiracy; meanwhile, Muslim antisemitism is becoming louder and more forceful. The anti-Israel boycott movement BDS rears its head in every debate on antisemitism, just as left-wing or post-colonial thinking are part of every discussion.

Jewish life needs to be allowed to step out of the shadows.

Since 2015, the number of antisemitic crimes recorded has risen by about a third, to 2,350. But victims only report around 20% of cases. Some choose not to because they've had bad experiences with the police, others because they're afraid of the perpetrators, and still others because they just want to put it behind them. Victims clearly hold out little hope of useful reaction from the state – so crimes go unreported.

And the reality of Jewish life in Germany is a dark one. Sociologists say that Jewish children are living out their "identity under siege." What impact does it have on them when they can only go to nursery under police protection? Or when they hear Holocaust jokes at school?

Germany needs to take its antisemitism seriously

This shows that the country of commemorative services and "stumbling blocks" placed in sidewalks as a memorial to victims of the Nazis has lost its moral compass. To make it point true north again, antisemitism needs to be documented from the perspective of those affected, making it visible to the non-Jewish population. And Jewish life needs to be allowed to step out of the shadows.

That is the first thing. The second is that we need to talk about specifically German forms of antisemitism. For example, the fact that in no other EU country are Jewish people so often confronted about the Israeli government's policies (according to a survey, 41% of German Jews have experienced this, while the EU average is 28%). Projecting the old antisemitism onto the state of Israel offers people a more comfortable target for their arguments.

Our society needs to have more conversations about antisemitism. The test of German democracy, as McCloy called it, starts with taking these concerns seriously and talking about them. We need to have these conversations because it affects all of us. It's about saving our democracy. Before it's too late.

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