Ebola outbreak in West Africa

Ebola outbreak in West Africa

The Ebola outbreak in West African nations is one of history’s most pressing health problems. The first incidence happened in 1976 when humans first contracted the diseases in West Africa. The disease, believed to originate from bats and other non-primate animals, became one of the deadly viruses in the 2014-2016 outbreaks. People from the country faced health issues from lack of accessibility to health facilities due to affordability and inadequacy of the resources and staff to respond to the outbreak. Although the main interventions from a global response were targeted at the West African countries, including Guinea, Sierra Leone, and Liberia, the disease later spread to other countries, including the U.S. From a medical anthropology perspective, understanding the cultural and other environmental issues that contributed to the rapid transmission is critical to understanding the health disparities and the need to address such issues to control epidemic outbreaks in future better. In this case, this disease report entails understanding the background of Ebola, its outbreak in Guinea and impacts in 2014-2016, personal narratives from the situation, and critical medical health perspectives that made the West African region more susceptible to high Ebola prevalence.

Background

Ebola is one of the deadly viral diseases that occurred on the African continent. It affects people and non-alien primates, including monkeys, chimps, and gorillas (CDC, 2021). In 1976, Ebola was first identified. It was thought that non-human monkeys or bats were the most likely sources of the animal-borne Ebola disease (CDC, 2021). But the Ebola virus also affected people, gorillas, monkeys, duikers, and other creatures. The virus was transmitted through the infected animals carrying the disease (CDC, 2021). Various signs and symptoms tend to appear when Ebola has infected a person. The symptoms appear 2 to 21 days after the person has been in close contact with the virus. Some signs and symptoms are fever, aches, and pains such as headache, weakness, sore throat, and loss of appetite (CDC, 2021).

In 2014-2016, the Ebola outbreak in Western Africa started in a rural setting of Southern Guinea, and within weeks, it spread to the urban areas as well as across the borders, and after some period, the Ebola outbreak became a global epidemic (CDC, 2021). The most likely way for the Ebola virus to infect humans was through direct contact with animal bodily secretions, tissues, and blood. (CDC, 2021). Health care workers are at higher risk of getting infected by the Ebola virus, as they might not take proper measures when in close contact with patients while treating them (WHO, 2011). The Ebola virus affects children, pregnant women, and older adults. Almost 3600 children lost both parents, they started becoming wage earners, and most of the children were stunted (Elston et al., 2016). The pregnant women who suffered from acute Ebola and recovered still had chances of carrying the virus in the breastmilk, pregnancy-related fluids, or tissues which may be a risk of being transmitted to the baby (WHO, 2011). Older people with the Ebola virus live shorter and have a higher mortality rate risk (Zhang et al., 2015).

There were also different types of factors that contributed to the Ebola Viral Disease. Firstly, one of the biotic factors which contributed to the Ebola disease was through ingestion of the fruit that the infected fruit bat’s saliva has contaminated or feces; here is whereby the bats might lead to infecting other species such as duiker, non-human primates, or even humans (Alexander et al., 2015). Also, close contact with the infected animals’ blood, secretions, organs, and other bodily fluids may spread the disease (WHO, 2011). Furthermore, one of the abiotic factors that contributed to the Ebola outbreak was climate change, whereby the Ebola outbreak tends to occur more during the dry season because the hydrological changes may tend to influence forest fruit production (Alexander et al., 2015). For instance, during the dry season, the production of fruits tends to be more, whereby there are more chances for the infected bats to spread the disease by leaving their saliva or feces on the fruit (Alexander et al., 2015). It was also found that Ebola Virus survives more in dry areas (CDC, 2021). Finally, looking at the cultural factors which contribute to the Ebola outbreak, religious practices such as burial practices which involved washing and touching the deceased individual, may lead to the spread of the disease; moreover, funerals were known as one of the features which led to the transmission of the Ebola disease (Alexander et al., 2015).

Local perspective

The medical system in Western Africa during the Ebola outbreak tends to be poor. Some of the health system functions which were known to be essential were not functioning properly; there was an inadequate number of qualified health workers (Kieny et al., 2014). Furthermore, Western Africa’s inadequate health infrastructure, logistic support, health records, surveillance, administration, and medicine supply (Kieny et al., 2014). For instance, some of the rural settings of Western Africa, such as Sierra Leone, Guinea, and Liberia, were unprepared for the Ebola outbreak; their health systems were underfunded, under-resourced, ands overburdened (Elston et al., 2016). As a result, when the outbreak spread to the urban areas, there were insufficient treatment beds and inadequate supplies of medicines, and the patients who were symptomatic of the Ebola virus were turned away (Elston et al., 2016). For instance, some patients use traditional medicines and herbal remedies due to the poor medical system. As a result, many instances went untreated, and the populace’s unmet health requirements increased (Elston et al., 2016).

In Western African areas like Sierra Leone and Liberia, clinician doctors and nurses used to treat patients who were symptomatic of the Ebola Virus. Still, it was found that nurses, clinicians, and doctors were the ones who were at the most risk of getting infected by the Ebola Virus. Therefore they left their work and refused to work because of getting infected by the Ebola disease, which led to the closure of hospitals (Elston et al., 2016). The health care workers (clinicians, doctors, and nurses) were at the most risk of getting infected because they worked closely with the patients when treating them without following proper control measures (WHO, 2011). Due to all these health care constraints, the patients suspected of the Ebola virus were taken care of at home by their family members. The family members were being addressed on how to look after the people who were infected by the Ebola virus, such as by washing hands frequently, isolating the patient separately from other people, and not touching the patient as well as the items which have been in contact with the patient and assigning one single caregiver (Schmidt et al., 2020).

Some examples of local causation of the Ebola Outbreak in Western Africa were bat exposure and cultural practices. Bat exposure is when other animals ingest the fruit contaminated by a bat infected from the Ebvirusease (Alexander et al., 2015). Moving towards the cultural practices, in some areas of Western Africa, such as Guinea, it was found that cultural practices such as burial practices were linked to Ebola because they involve touching and washing the person with Ebola disease. As a result, these cultural customs contributed to the Ebola virus transmission (Alexander et al., 2015). For instance, it was also found that being in close contact with an infected person or animal’s blood, organs, secretions, etc., without taking proper control measures may also pose a high risk for an individual to get Ebola (WHO, 2011).

The local treatment towards the Ebola Outbreak was that the patients were offered supportive care, providing them with fluids and body salts either orally or through infusion into their veins (CDC, 2021). Additionally, to improve the survival of the patients, patients were given medicines to treat particular symptoms such as headache, muscle pain, fever, upper abdominal pain, or burning sensation (Zhang et al., 2015). According to the CDC, two U.S. Food and Drug Administration treatments helped treat the Ebola virus. The first was a combination of three monoclonal antibodies, and the other was a single monoclonal antibody (CDC, 2021). Although these two treatments were effective because they both had monoclonal antibodies, they tend to act as natural antibodies that stop germs like viruses from replicating after infecting a person (CDC, 2021).

Narrative/Interpretive Perspective

The first narrative is about Preston Gorman, a male aged 38 at the time of the narration. Gorman was born and brought up in Cedar Hill, Texas, in an evangelical family (Bernstein, 2019). He trained as a paramedic and firefighter before returning to school to study and become a physician assistant. However, when the Ebola epidemic in West Africa began, Gorman abandoned his work and joined the Boston non-profit Partners in Health Organization to assist those infected with the disease in Maforki, Sierra Leone, just 16 days later (Bernstein, 2019). This narrative is told from the journalist’s view of the statement recorded from Gorman after opening up about the condition and how he suffered trauma due to PTSD for an extended period leading to a loss of family, the girlfriend he was to marry, and friends.

This type of illness narrative is a chaotic story told from a sufferer’s narrative perspective (Singer et al., 2020). The rationale behind the chaos story is that although Gorman recovered from the illness of Ebola and went back home to Texas, he still discusses how PTSD contributed to his state of uncertainty, hopelessness, and confusion in his life, which he has started to rebuild (Singer et al., 2020). Gorman had the calling to help out and even quit his job to volunteer in an outbreak pandemic that was so dangerous. However, he contracted the disease, and his health deteriorated fast. At first, he recounts how he was left alone despite being sick to care for himself, such as getting out of the ambulance and barely walking to the treatment center while in Sierra Leone. His isolation and deteriorating health made him hopeless, and he even tried to stop treatment. He was later airlifted to one of the most advanced facilities in the US NIH, with a team of dedicated physicians to help him recover. Despite almost giving up and being forced to be sedated, he recovered and was released to go home in the company of his mother. However, his condition of depression before the volunteer and illness experiences also accompanied by the trauma he had gone through made him ill with PTSD, which led to him cutting off his family, friends, and even the girlfriend he was to marry. Although he is getting better, a lot of intervention has been implemented to help him. There are some characters introduced in the narrative, especially the mother and family that tried to be there for him, the team of doctors who rejoiced in his recovery as he was at the point of dying, and the organization in Sierra Leone that Gorman claims it did not have so much impact in helping him recover as they downplayed the impact of the trauma he went through. Therefore, the central idea is how he suffered the Ebola disease, an account of how his condition deteriorated, and how the trauma he went through continues to haunt him as he tries to recover. In the narrative, there is no usage of metaphors because of a vivid description of Gorman’s suffering and situation of despair.

The second narrative is about a medical doctor Kent Brantly, a male aged 33 years. Kent is an American from Texas and married to Amber, and together they have children (Fox, 2014). In this interview, Kent narrates alongside his wife the ordeal of his Ebola disease in Liberia (Fox, 2014). The type of the illness narrative is restitution (Singer et al., 2020). This is because Kent became sick and was admitted to the hospital and was near the point of death. At the time of his illnesses, the wife and children had traveled back to Texas while he became admitted and later transferred to a hospital in the U.S. Kent received medication and treatment helped him. Throughout the narration, Kent mentions that though he feared he would stop breathing and die based on the interventions and treatment, he remained hopeful because of his family and physicians’ support. Therefore, this narrative is told from the perspective of hope and a person that was very sick and getting better despite facing death and uncertainty of the Ebola outbreak. The linear story starts with Kent’s serious illness condition and ends with him being healthy, although he indicates he is still recovering his strength (Singer et al., 2020). In the narrative, the main characters introduced include the physicians who helped him. For instance, the nurse who was the primary caregiver is introduced, and the two interact in a way that shows the desperate situation of the doctor is about to die because of breathing difficulties. Therefore, the nurse is introduced at the point Kent almost gave up and the beginning of restitution. The wife is also introduced as a person who witnessed suffering perspective Kent and how the family had to cope with the situation. The narrative has no metaphors used because it is an emotional delivery of the sufferer’s experience, hope in God, and love of the family.

The two narratives have similarities in that both patients volunteered to work in West Africa during the Ebola Outbreak. They also come from the same region in Texas and are American citizens. However, the two worked in different countries and had different experiences. While Gorman worked in Sierra Leone and had additional mental problems of depression history and PTSD, Kent had none of the diseases except the time of Ebola. Kent was in Liberia and received the ZMapp drug, which was not approved for human trial as an experiment. Gorman did not receive the drug despite enrolling for it because he was in the control group. From a medical anthropology point of view, their experience highlights various perspectives of illness narratives from the victims and how they experienced the condition negatively. While Kent did not break down and had hope because of the family support, Gorman cut off his family friends and girlfriend after recovery and returned to Texas, where his family was awaiting him to celebrate him. Knowing these experiences helps to see how the condition affects people differently and the impact of culture on the patient outcomes in dealing with illnesses such as Ebola.

Critical Medical (Health) Anthropology Perspective

Understanding a disease also requires understanding the disparities and inequalities in the physical and social environments that contribute to better management of a health condition or enhance its spread and difficulty in containment. In the critical medical/health anthropology perspective (CMA), the model entails that political ecology and political economy contribute to the social determinants of health and inequalities among communities (Singer et al., 2020). Therefore, issues such as cultural differences, poverty, government regulations, capitalism, and how goods and services are distributed in the society, the environment, and the biocultural factors all contribute to understanding the diseases in society through a holistic perspective (Singer et al., 2020). At an individual level, some social inequalities contributing to disease development may include education, income levels, and cultural values (Singer et al., 2020).

In this particular case, the outbreak of Ebola in West Africa depicts the nature of the social inequalities and health disparities in contrast to other countries. The condition mainly spread through bats that spread to non-primate animals and human beings in West Africa (Alexander et al., 2015). Despite many people outside the U.S. being diagnosed with the disease because of human interactions and immigration, the disease most affected the west African countries, which had the majority of the cases, while most of the foreign countries, especially in developed regions, contracted the diseases but was able to manage it in a way that reduced the spread and longevity compared to west Africa (Alexander et al., 2015). The differences in how the cases were managed and the accessibility of healthcare show the health disparities between the rural and urban centers in West Africa and between African and European countries and the United States. Three main factors contributed to the social inequalities and health disparities from a political/economic perspective of the CMA: poverty, lack of sufficient health facilities and resources, and lack of cultural competence and educational awareness.

Firstly, poverty is the main issue in most African countries (Singer et al., 2020). During the Ebola outbreak, most people in West Africa lived in poverty (Alexander et al., 2015). Those affected, especially in the rural areas, could not afford to access good healthcare and tried to use local approaches to treat the disease. Poverty increased the danger of disease exposure for most residents of congested areas compared to wealthier individuals who could afford better healthcare access, especially to private hospitals and outside the nation (Elston et al., 2016). From a country perspective, most African countries did not have sufficient funds or resources to deal with the conditions, leading to straining most of their resources compared to most developed countries such as the U.S. (Elston et al., 2016). In this case, the poverty issue contributed significantly to the high number of cases and mortality in crowded places and West Africa especially compared to developed places and the wealthy in the society as part of the health disparities.

Secondly, the West African governments did not have sufficient health resources and facilities or the scientific resources to combat the disease (Elston et al., 2016). This majorly reflects the political ecology and economic differences between countries in developed and underdeveloped regions. In this case, most West African countries concentrated on providing few treatment health facilities and had few specialized physicians working in urban centers (Alexander et al., 2015). Most experienced health professionals try to find work in foreign countries where the returns for their services are higher than home countries (Alexander et al., 2015). Therefore, during the outbreak, most of the hospitals in the urban centers became congested, and many people were turned away and left to die, preventing access to healthcare. Besides, the hospitals in rural areas were few, contributing to limited healthcare access. Some of the foreign nationals, especially those volunteering as caregivers and physicians during the Ebola outbreak, had to be flown back to their respective countries to receive specialized medications leading to improvement of their health, although some succumbed to the Ebola disease (Alexander et al., 2015). Most of the research institutions that were able to come up with the ZMapp drug were from the United States, which shows the disparities in the investments in the health infrastructures and the capacity of the people to contain such an outbreak or find a vaccine (Alexander et al., 2015). These disparities contributed significantly to the spread of the disease, mostly in West Africa, and high mortality rates compared to other regions despite the help from volunteers worldwide.

Lastly, from an environmental perspective, the lack of cultural competence and educational awareness contributed to the health disparities during the Ebola outbreak that mostly affected the West African countries. The environment consists of both the physical and cultural and how human interactions within these environments contribute to the etiology of the disease (Singer et al., 2020). In the case of Ebola, one of the significant cultural factors contributing to the spread of the disease was the ritual of burying the dead (Alexander et al., 2015). Considering Ebola was being transmitted through close contact and touch of body fluids with an infected person, the washing and dressing of the dead without proper protective gear, especially if the dead person was infected, led to a massive spread of the disease (Alexander et al., 2015). This shows how such a culture contributed to the health disparities compared to areas where such culture was not followed (Singer et al., 2020). This shows the lack of awareness programs for the public, educating the public on how the disease is spread and the need for self-prevention. Lack of education also contributed to the way humans interacted with the ecology and natural environments leading to the spread of the disease from bats or the foods collected, such as fruits that had the infection from bats as a result of either feces or eating part of the fruits and infecting it (Alexander et al., 2015). Suppose the educational awareness about the ecological and social/cultural environments were determined through the biocultural lens. In that case, it could have helped many West Africans take preventive measures against contracting the disease.

Moving Forward

From the review of the disease report, the Ebola outbreak remains one of the potential global disasters. Although the cases of the Ebola outbreak have reduced, there is still hope to address the health disparities in developing countries and awareness on how to best deal with outbreaks. Most developed countries have advanced healthcare facilities and invested heavily in the medical research and development of drugs and vaccines (Kieny et al., 2014). However, the global collaboration is increasing with such developed regions and medical research companies trying to come up with long-term solutions such as vaccinations and disseminating knowledge on the disease so that individuals understand how best to practice healthy behaviors to sustain life. In this specific scenario, this collaboration through developing drugs for Ebola and continued vaccinations has enabled the control of the drug, with only a few cases reoccurring in the West African countries (Kieny et al., 2014).

Secondly, most developing countries, such as the West African countries, where the prevalence of Ebola is high, have increased investments in healthcare and tried to address the disparities in health. The aim is to ensure that most institutions can handle the situation in case of a major outbreak, especially if the outbreak is not high. However, because the number of health professionals and facilities with the capability to manage the cases of Ebola that come up with few fatalities has increased, there is still more to do to address the health disparities. Increasing government funding for addressing the societal factors contributing to the Ebola outbreak in West African nations is one example of how to do this. From the medical anthropology perspective, understanding some of the issues that contribute to the spread of the disease and its high prevalence, especially in poor regions, and some cultural practices is critical to developing better interventions (Kieny et al., 2014). In this case, most people have to learn how cultural practices such as washing and contacting relatives’ dead bodies can result in a high risk of Ebola contractions. While such practices are critical, people need to be educated on wearing protective gear and substantially reduce the risk of transmission.

From an action-oriented perspective, there is a need to address other issues, including the increased balance in investing in hospital capacity and accessibility to quality care. This will help address the disparities due to wealthy people getting preference and high-quality care (Singer et al., 2020). In addition to establishing health facilities, there is a need to educate more health professionals and employ them through the government to ensure equal distribution of the people (Kieny et al., 2014). This includes also making the compensation competitive to avoid scenarios where despite having trained health professionals in the country, they tend to seek employment elsewhere because of high compensations. Such government interventions are critical for improving general health outcomes in the West African countries and better preparedness in dealing with Ebola cases that may arise or other outbreaks. Lastly, addressing poverty in the country by increasing government investments in various projects and partnerships could create more employment opportunities and increase the ability of most people to afford health in the country.

Increasing collaboration in addressing health issues is critical from a global capitalist perspective. Despite some outbreaks from a particularly remote regions, some of the diseases could have a global impact (Singer et al., 2020). Ebola is just one example of how a disease that mostly affects West African countries ended up spreading to developed countries. Countries are increasingly getting globalized through the reading, immigration, and general movements of goods and services. Therefore, other countries, especially during an outbreak, could not only place the risk on the area where such a disease originates but also on other countries. From their narratives, the two U.S. citizens volunteered to work as health workers in the Ebola outbreak regions in West Africa to help overcome the acute shortage of healthcare workers and doctors in the region to address the problem (Singer et al., 2020). However, they ended up contracting the disease and spreading it to some healthcare workers back in the United States. The increased collaboration in addressing health issues through partnerships that can enhance better preparedness and sharing of information and knowledge is critical, therefore. This advocacy can help address most of the disparities and social determinants of inequity in the distribution of health resources that can help address the Ebola outbreak or any other condition nationally and internationally.

Conclusion

In conclusion, 1976 marks the beginning of the West African Ebola outbreak. In 2014-2016, one of the recent major outbreaks was first reported in Guinea. The disease is transmitted from bats to humans and non-primate animals through infected saliva and fruits, then spreads across the region and other continents. Most vulnerable populations included the health workers who were in contact with the infected patients and later spread them to their countries, such as the case of the personal narratives of the two doctors. Rituals such as washing and dressing the body of the dead increased many people contracting the disease in west Africa during the outbreak period. Other health disparities, such as lack of education and awareness, including the impact of such cultural practices, increased the risk of infection. This led to a high population infected by Ebola that overwhelmed the staff and available resources such as hospital beds and enough medicines. The rural parts suffered the most compared to urban places due to inadequate health facilities. This depicted the disparities between rural and urban as well as African and Developed countries such as the U.S. and the U.K. regarding health resources and progress. Moving forward, there is a need for healthcare advocacy to address the disparities and some of the social determinants of the healthcare systems in most West African countries. This includes addressing poverty, equitable distribution of resources in rural and urban places, and increasing educational awareness on cultural practices that can exacerbate the transmission of diseases during an outbreak. From a global capitalism aspect, all countries must stay committed to addressing health challenges such as the Ebola outbreak through contributing resources and sharing knowledge as the outbreak, despite originating in Africa, could impact other countries too.

References

Alexander, Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., Drake, J. M., Lofgren, E., Dato, V. M., Eisenberg, M. C., & Eubank, S. (2015). What factors might have led to the emergence of Ebola in West Africa? PLoS Neglected Tropical Diseases, 9(6), e0003652–e0003652. https://doi.org/10.1371/journal.pntd.0003652

Bernstein, L. (2019). An Ebola patient treated in the U.S. chose to remain anonymous. Now he’s telling his story. The Washington Post. Retrieved 28 June 2022, from https://www.washingtonpost.com/health/an-ebola-patient-treated-in-the-us-chose-to-remain-anonymous-now-hes-telling-his-story/2019/12/27/c8b6de6a-04a1-11ea-8292-c46ee8cb3dce_story.html.

Centers for Disease Control and Prevention. (2021, May 27). History of ebola virus disease. Centers for Disease Control and Prevention. Retrieved June 5, 2022, from https://www.cdc.gov/vhf/ebola/history/summaries.html

Elston, Cartwright, C., Ndumbi, P., & Wright, J. (2016). The health impact of the 2014–15 Ebola outbreak. Public Health (London), 143, 60–70. https://doi.org/10.1016/j.puhe.2016.10.020

Fox, M. (2014). Exclusive: Ebola Survivor Dr. Kent Brantly Reveals Near-Death Ordeal. NBC News. Retrieved 28 June 2022, from https://www.nbcnews.com/storyline/ebola-virus-outbreak/exclusive-ebola-survivor-dr-kent-brantly-reveals-near-death-ordeal-n194111.

Kieny, Evans, D. B., Schmets, G., & Kadandale, S. (2014). Health-system resilience: reflections on the Ebola crisis in western Africa. Bulletin of the World Health Organization, 92(12), 850–850. https://doi.org/10.2471/BLT.14.149278

Schmidt-Hellerau, Winters, M., Lyons, P., Leigh, B., Jalloh, M. B., Sengeh, P., Sawaneh, A. B., Zeebari, Z., Salazar, M., Jalloh, M. F., & Nordenstedt, H. (2020). Homecare for sick family members while waiting for medical help during the 2014-2015 Ebola outbreak in Sierra Leone: a mixed methods study. BMJ Global Health, 5(7), e002732–. https://doi.org/10.1136/bmjgh-2020-002732

Singer, M., Baer, H., Long, D., & Pavlotski, A. (2020). Introducing Medical Anthropology: A Discipline in Action (3rd ed., pp. 86-89). Rowman and Littlefield.

World Health Organization. (2011, February 23). Ebola virus disease. World Health Organization. Retrieved June 5, 2022, from https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease

Zhang, X., Rong, Y., Sun, L., Liu, L., Su, H., Zhang, J., Teng, G., Du, N., Chen, H., Fang, yuan, Zhan, W., Kanu, A. B. J., Koroma, S. M., Jin, B., Xu, Z., & Song, H. (2015, September 23). Prognostic analysis of patients with ebola virus disease. PLoS neglected tropical diseases. Retrieved June 5, 2022, from https://pubmed.ncbi.nlm.nih.gov/26398207/

Mind Map

Reflection Questions and Answers

1. What was the most challenging part of this assignment? How did you cope with this challenge?

The most challenging part of the assignment is the critical medical health perspective. It was challenging because I had to learn from a whole new perspective on how to understand diseases and disparities between various health approaches across the world. Learning about these issues helped me discuss how they mainly contributed to the Ebola outbreak and had more impact on the West African countries than in other areas where the cases were reported. Although challenging, I coped with it through intensive reading, especially from the course book.

2. What was one thing you learned about the topic that most surprised you?

When researching the spread of the diseases and causes from the local perspective, I learned about the burial rituals and how they contributed to the spread of the disease. In this case, the close relatives can touch the body and are responsible for washing and dressing it before burial. While this is respectful, it exposed many people to contracting the disease if the dead person had it, yet there was not enough awareness of such risks. I believe cultural values and practices should be respected. However, when it comes to increasing the risk of spreading a disease, there is a need to respectfully educate the masses and ensure they observe precautions to avoid contracting the disease.

3. What is one way this assignment could be improved?

I enjoyed doing the assignment, especially in parts, before finally combining it. This helped me learn much from the process, and I think it should be maintained that way. Overall it was a good experience, and it helped improve the learning and understanding of the concepts instead of rushing to do it at once.

4. What is one thing you wish you had done differently?

Maybe for the Mind map, I could have wished putting the ideas on paper would be easy but using some software is difficult. But it is a learning process, and I could improve on developing a sound mind map with time.

5. What is one aspect you are proud of in regards to this assignment?The aspect I love about this assignment is how it helps one think from an anthropological point of view regarding diseases and health issues. While most times, diseases are analyzed regarding symptoms, available treatments, causative agents, and transmission modes, I got to learn more about how cultures, disparities, and other social issues contribute to the prevalence, cost, and spread of diseases in this case, the Ebola outbreak. It was a great learning experience to use the knowledge learned and apply it to a case scenario that happened.