Going into disease prevention
Luo’s year in Malawi has affected his entire life since. He experienced the truth of “an ounce of prevention is worth a pound of cure” at first hand, and realized that when the public has an accurate understanding of prevention, it becomes possible to limit the spread of even deadly diseases and save lives.
After working back in Taiwan for a few years, Luo decided to join Taiwan’s Centers for Disease Control as an epidemiologist. In 2008, Taiwan’s CDC sent him to the United States’ Centers for Disease Control and Prevention for further training and to get him up to speed on international prevention practice.
In 2009, the US’s CDC was seeking a doctor with Africa experience to join a team it was sending to investigate unexplained deaths of children in Nigeria. Luo immediately signed up.
He soon discovered that local villagers were using their homes to process ore from a nearby mine, exposing their children to poisonous lead dust and in some cases killing them. The team negotiated with local elders, religious leaders and the government to build a smelter at the mine site, thereby keeping ore out of the village and preventing more children from being harmed.
Though that trip lasted only one month, it made Luo realize that “little things can have a big impact in Africa,” and made him still more committed to his disease prevention work.
Standing with patients
Because he had previously visited Nigeria and had built relationships within its medical system, he was able to visit the normally restricted Nigeria Centre for Disease Control.
Luo realized that although Taiwan had created a solid disease prevention system following the SARS outbreak, Nigeria’s CDC nonetheless had two valuable lessons to offer.
The first involved focusing on clearing up rumors and bad information. “In Nigeria, inaccurate information has killed more people than Ebola.” Luo says that at one point there was a rumor going around that drinking a large glass of salt water at midnight would prevent you from contracting viruses. Many people ended up dying from acute renal failure as a result. Taiwan has not been immune to this kind of dangerously bad information and recently saw rumors circulate that certain herbal remedies could prevent an Ebola infection.
“Countering bad information is even more important than treating the disease.” Luo recognizes that panic can cause the disease prevention system to collapse and therefore accepts all media requests for interviews, appears on talk shows and makes himself available for conversations with well known radio and TV personalities. He doesn’t care if he is criticized for doing so because, “When there’s a lack of accurate information, rumors will fill the void.”
The second lesson has to do with taking care of the non-medical needs of victims. When an infectious disease begins to spread, the public begins to worry about coming into contact with people who have the disease. Victims feel even more distressed when avoided by neighbors, classmates and colleagues. One Liberian Ebola patient ended up committing suicide because her entire village had continued to shun her even after she recovered from the disease.
Such stigmatization makes some patients unwilling to seek treatment and can even cause them to flee their homes, spreading the disease still further. In one Nigerian case, a man who feared he had contracted Ebola traveled to a city 600 kilometers from his home to seek treatment in secret. His subterfuge was discovered two weeks later when the doctor who treated him died from the disease.
Nigeria’s CDC therefore created a psychological support team consisting of psychologists, psychiatrists, counselors and social workers. Team members provide companionship and counseling to quarantined patients with a positive diagnosis to alleviate some of their distress. Social workers offer guidance to individuals whose diagnosis hasn’t been confirmed and to those on the mend, visiting their neighborhoods, workplaces and schools in an effort to minimize discrimination.
Taiwan could further enhance its own disease prevention efforts by creating taskforces to clear up misinformation and provide psychological support to patients. Understanding the public’s perceptions and reactions is essential to minimizing the potentially deadly social costs of disease.
Disease prevention is an endless journey, with improvements to be made at every step along the way. Luo maintains the passion and idealism of youth in spite of having worked in the field for more than a decade and witnessed countless deaths. Always active and perpetually curious, he never ceases looking for new and better ways to address outbreaks of disease.