Inferno is Steven Hatch's every personal experience of the ebola outbreak in West Africa. The initial cases of the virus were in Guinea but soon, Liberia was the centre of the horror. Dr. Hatch had worked as an infectious disease specialist in Monrovia, Liberia's capital. He went home but six months later when the ebola epidemic was in full bloom and the world was reacting with paranoia and fear, he came back to work in a treatment centre in Bong county. The conditions were primitive and the training people received didn't prepare them for working in searing heat while wearing PPE or personal protective gear. Tyvek suits, taped where they met the shoes, three layers of latex gloves, hoods and goggles. The outfits were awkward to move in, the goggles fogged up making vision difficult and the sweat pooled in the headgear and the entire PPE. For their own protection, medical personnel had to wear the suits whenever they dealt with patients. There was no way to know whether someone with a fever was developing ebola, suffering a malaria attack or presenting with some other tropical fever.
There were two main areas in the ebola centre, one for those sick and awaiting diagnosis and one for those whose blood tests confirmed ebola. Ebola confirmation wasn't a for-sure death sentence but many people died because there was no drug to treat it, dehydration was a major problem since rather than bleeding out (as books like The Hot Zone described), people suffered horrendous nausea and diarrhea. They would get weaker and weaker and finally die. Age or status didn't matter. Healthy adults, children, old people and babies, all were possible hosts for the virus.
Survivors had to deal with unenviable problems. Some no longer had any family, some were afraid to go back to their villages because they might be killed for carrying the virus, and other people were afraid they might still be contagious. The entire country was thrown into chaos. For Hatch, the ebola epidemic and its consequences were his personal hell, hence the book's title.
At the end of the book, Dr. Hatch appeals to people to get their children vaccinated against measles. After he returned from Bong County, there was a mini-outbreak of the disease in visitors to Disneyland. He points out that compared to measles, ebola is relatively difficult to spread. An infected person will likely only infect two others because the virus is passed by touch (contact.) Measles is airborne and although not as virulent as ebola, it can disable and kill. Someone with measles can pass the virus to 18 others.
This book exposes the nasty political atmosphere that developes and the 'dog and pony' show that the media turns the outbreak into. When Dr, Steven Duncan returns to the US after working with ebola patients and dies from the disease himself, panic ensues. It turns out SARS is much more a virus to fear.
Inferno reveals some of the problems both domestic and international that dealing with a dangerous disease outbreak causes. There is much more than the immediate danger and the urgent need to treat those affected.
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