BBC News reports on dalits in India whose job it is to empty non-flush toilets and carry away the shit for disposal.

Human Rights Watch has called on the Indian government to end “manual scavenging” – the practice of cleaning human waste by low-caste communities – in a new report.

The practice is banned by law in India, but it is rampant and activists say nearly 10 million are involved in this demeaning work which opens them to prejudice and abuse.

The report calls on the government “to ensure that local officials enforce the laws prohibiting this discriminatory practice”.

Check out the BBC story, because it’s full of vivid and tragic photos.

Munnidevi of the state’s Etah district says she does not get any money for her work. “Sometimes they give two rotis (home-made bread), sometimes just one. One house did not give me anything for two or three days. So I stopped going there. If they give me nothing, why should I go? Then they came to threaten me: ‘if you do not come, we will not let you on our land. Where will you get food for your animals?’ We own four buffaloes. I went back to clean. I had to.”

“The panchayat (village council) hires people to work as water suppliers, messengers, clerks, garbage collectors, and this work that I do – cleaning toilets,” says Anil of Dhule district in the western state of Maharashtra. “If you are from the Mehatar caste, you have to do this work. You are not told this directly, but it is what you are hired to do and what is expected, even from the villagers. If there is excrement to clean, they will come and call us to do it.”

“A village council brought our family here [from our native village in Maharashtra] to clean the dry toilets, water toilets, and open defecation. I collect all the excrement and throw it elsewhere. We actually want to go back home. We don’t like it here,” says Rajubai. “Because of this work, my health has declined. I eat very little food. It is very dirty work. But people are saying, the council will not allow us to leave and that is why they are not giving us the full payment.”

Horrible.

The Human Rights Watch report starts from here.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Another day another tweet.

Richard Dawkins @RichardDawkins
I apologise for impugning the morality of the approximately ten percent of women who deliberately choose NOT to abort a Down’s fetus.

It’s a Basil Fawlty apology.

One of the reasons I’ve always found Basil Fawlty so hilarious is that I’m like that myself. There’s generally a snotty asshole in me roaring to get out, and it often does get out. (I usually regret it when it does.) Some of Basil’s rages are my rages too, and I sympathized with some of them and cringed at others. It’s much the same with Richard. His Basil Fawlty runs away with him sometimes.

There’s an interesting exchange on his site between a commenter and him, on a post by Kevin Drum about the “brutality” of the intersection of social justice liberalism and social media. In a comment Richard underlines the claim that “the vitriol pours in, and it’s soul-crushing.” Katy Cordeth replies:

Sorry Richard but it sounds like you can dish it out but you can’t take it. You do have your own tidy line in hurling the vitriol.

I don’t myself tweet but I’d be surprised if all the criticism you’re subjected to is as one-dimensional as you’d have us believe. The responses on this site to your recent abortion tweets have for the most part been measured, even from those who couldn’t be considered part of the Dawkins fan base.

You and Mr Drum are free to try and disseminate the idea that all the negative feedback you’re on the receiving end of is ugly and irrational, but isn’t that a bit self-serving? You’re giving yourself carte blanche to say whatever you like without fear of reprisal. I’m sure there are plenty of ugly things tweeted at you, many of them quite hurtful. But hidden among the trollery there are, I have no doubt, many sensible, rational things being said. What the ratio is I have no idea. It’s your duty to sort the wheat from the chaff, not try and kid the world that it’s all chaff.

I don’t actually agree with those who say you should quit the medium; as I said in one of my deleted posts, I think you’re playing the role of carnival barker, both to drum up business for this site and to keep the atheism flame lit in the popular consciousness, and tweets about what you’re having for your tea or pictures of your kitty cat just won’t serve that end. I’m sure it’s hard-going for a deeply divisive public figure to have to run the gauntlet of unmoderated public opinion every day, but you can ameliorate this by injecting a little kindness and compassion into your Twitter submissions. Cold, clinical analysis may be the order of the day in the world of academia and even on this site, but the men and women who ride the Clapham omnibus are a passionate and mercurial lot. The same rules don’t automatically apply.

I think that’s all pretty sensible advice. Richard’s response is

Katy Cordeth, of COURSE I have no problem with those tweets that are indeed measured, sensible disagreements. My whole life as an academic has been largely devoted to such conversations. I’m used to that sort of discussion and thrive on it. There’s all the difference in the world between disagreeing with somebody on a question of moral philosophy, and calling them a twat, a cunt, an idiot, an ignoramus and a Nazi simply because you disagree with them. And if you are asking the ratio of vitriolic abuse to measured argument, a conservative estimate would put it at more than ten to one. Isn’t it OBVIOUS that that is what Kevin Drum is talking about? And his “avalanche” is not an overstatement.

I was particularly interested by “There’s all the difference in the world between disagreeing with somebody on a question of moral philosophy, and calling them a twat, a cunt, an idiot, an ignoramus and a Nazi simply because you disagree with them.” Yes, there is, and that’s what we meant by the relevant passage in the joint statement.

Disagreement is inevitable, but bullying and harassment are not. If we want secularism and atheism to gain respect, we have to be able to disagree with each other without trying to destroy each other.

In other words we have to be able to manage disagreement ethically, like reasonable adults, as opposed to brawling like enraged children who need a nap. It should go without saying, but this means no death threats, rape threats, attacks on people’s appearance, age, race, sex, size, haircut; no photoshopping people into demeaning images, no vulgar epithets.

Emphasis added.

I think Richard is not used to being on the receiving end of the avalanche. I hope he is remembering to extrapolate from his experience of the avalanche to our experience of it for the past more than three years.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

I’ve long disliked Vandana Shiva, and here’s more reason to dislike her: Michael Specter in the New Yorker:

Like Gandhi, whom she reveres, Shiva questions many of the goals of contemporary civilization. Last year, Prince Charles, who keeps a bust of Shiva on display at Highgrove, his family house, visited her at the Navdanya farm, in Dehradun, about a hundred and fifty miles north of New Delhi. Charles, perhaps the world’s best-known critic of modern life, has for years denounced transgenic crops. “This kind of genetic modification takes mankind into realms that belong to God and God alone,” he wrote in the nineteen-nineties, when Monsanto tried to sell its genetically engineered seeds in Europe. Shiva, too, invokes religion in her assault on agricultural biotechnology. “G.M.O. stands for ‘God, Move Over,’ we are the creators now,” she said in a speech earlier this year. 

Oh piss off, both of you. You could say the same thing about farming of any kind, including “organic.” You could say it about houses (how many of those do you have, Charles?) and medical care and cooking.

Piss off.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Steven Salzberg at Forbes points out that Whole Foods Markets does some very good things, like having a seafood sustainability policy and offering humanely-raised chicken and beef. On the other hand it also does ridiculous things, like flogging homeopathy, opposing GMOs, and refusing to sell aspirin.

Whole Foods sells homeopathic medicines that are little more than snake oil. They make claims for health benefits, both on their shelves and on their website, that are based on little more than magical thinking. For example, they sell “homeopathic flu remedies” claiming that “when taken at the first sign of sickness, these can provide temporary relief of symptoms including fever, chills, and body aches.” This is simply false: no homeopathic treatment has ever been shown to be effective at treating flu symptoms. (I’ve written about homeopathy in more detail here and here.)

It’s ironic that on the one hand, Whole Foods proclaims “We’ve long believed that consumers have a right to know what’s in your food”. But when it comes to homeopathic remedies, they neglect to inform consumers that these remedies do not contain the ingredients on the bottle at all.

Well that’s because there aren’t any! That’s what makes it work!!

Wait…

Whole Foods has an anti-GMO policy, adopted across all their stores, that ignores the science of GMOs. They announced last year that they would label all products in their stores to indicate whether they contained Genetically Modified Organisms. They also have announced that they are trying to eliminate GMOs from their shelves.

That’s just…superstitious.

Whole Foods won’t sell the pain relievers aspirin and ibuprofen, because they’re not “natural.”Instead, their Whole Body department sells a wide range of nutritional supplements, for which they make claims such as this:

“Not sure which supplement to choose? Grab a full-spectrum wellness or immune support formula. These combinations of herbs, vitamins, minerals and antioxidants are specifically designed to effectively improve overall wellbeing and enhance immune support.“

And you can’t tell us they didn’t, because that’s so vague you won’t be able to tell!

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Gosh, even Sarah Palin got in on it. I wouldn’t have thought she’d know who Dawkins is.

Mr. Dawkins, I’d let you meet my son if you promised to open your mind, your eyes, and your heart to a unique kind of absolute beauty. But, in my request for you to be tolerant, I’d have to warn Trig he must be tolerant, too, because he may superficially look at you as kind of awkward. I’ll make sure he’s polite, though!

Love,

Sarah Palin & family

It would be interesting if he actually took her up on it.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

In Dublin this afternoon, thousands of people marched in support of extending marriage rights to gay and lesbian people.

Organisers said 8,000 people took part in the march, many of whom held signs reading “equal”. Some dressed in sashes and tiaras after the news that the newly crowned Rose of Tralee, Maria Walsh had publicly come out as lesbian.

Comedian and writer Tara Flynn introduced speakers at a stage on St. Stephen’s Green. Ms Flynn recently starred in an LGBT Noise ‘Armagayddon’ video, which went viral internationally.

…

The march was notable for the number of straight people marching alongside LGBT people, along with families, and an almost endless array of colourful banners and signs. Representatives from LGBT youth organisation BelongTo, INTO LGBT Teachers’ Group, the USI, trans rights organisation TENI, and LGBT Pavee representing the Traveller community also spoke.

Also Atheist Ireland.

Irish Times journalist Fintan O’Toole called for Irish society to replace “tolerance” of LGBT people with “citizenship”.

Yes, the hell with tolerance. There’s nothing to “tolerate.”

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Kenan Malik did this talk at the Global Humanist Conference a couple of weeks ago that I’ve been meaning to read.

Right at the beginning we run into a funny (odd and haha both) idea.

Every year I give a lecture to a group of theology students – would-be Anglican priests, as it happens – on ‘Why I am an atheist’. Part of the talk is about values. And every year I get the same response: that without God, one can simply pick and choose about which values one accepts and which one doesn’t.

Ye-es…and?

Of course one can pick and choose about which values one accepts and which one doesn’t, and one had damn well better do exactly that, because the alternative is simply unconditional obedience and the perils of that ought to be blindingly obvious.

Yes, clerical friends, that’s exactly what one can and should do. Yes, you do actually have to think about what values to accept and what values to reject. There are plenty of values that ought to be rejected – aversion to other races for instance, or to same-sex pairing, or to women in public life.

Kenan of course says the same thing.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

You know what English needs? It needs a word that’s the opposite of “want.” It needs a word for want-not. Just adding a not doesn’t do it, because it’s too limp, too reactive, too mere. We need a word that’s more forceful, more feeling, than “don’t want.” An unwant word. A verb form of aversion.

Is there a verb form of aversion? If so it’s certainly not in active use. English needs a word like that that is in active use, and so is available to use.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

This time it’s former UK attorney general Dominic Grieve, in the Telegraph, with a candlestick.

Britain is at risk of being “sanitised” of faith because an “aggressive form of secularism” in workplaces and public bodies is forcing Christians to hide their beliefs, a former attorney general has warned.

What an arrestingly fresh and novel thought!

Dominic Grieve said he found it “quite extraordinary” that people were being sacked or disciplined for expressing their beliefs at work.

So do I! But they aren’t. So I don’t. I find it “quite extraordinary” that political talkers keep telling whoppers about this. People don’t get sacked just for “expressing their beliefs at work.” They get sacked for, for instance, refusing to do the work at work. They get disciplined for insisting on wearing dangling jewelry when there are safety rules forbidding it.

He described Christianity as a “powerful force for good” in modern Britain and warned that Christians should not be “intimidated” and “excluded” for their beliefs.

Quite right! They shouldn’t. And they’re not.

On the other hand people who don’t share their beliefs shouldn’t be intimidated and excluded either. That includes atheists, Muslims, Jews, Hindus, Buddhists, Sikhs – shall I go on?

He said that politicians and public figures should not be afraid of “doing God” and that they have a duty to explain how their beliefs inform their decisions.

The “appalling” scenes in Iraq, which have seen Islamic extremists behead and crucify religious minorities including Christians, showed that it was “more important than ever” for people to express their religious beliefs, he said.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

You know: the comma before “and” in a list of three or more items.

Have some paradigms:

The two main rationales for choosing one style over the other are clarity and economy. Each side has invoked both rationales in its favor. Here are some quotes that have served as shots exchanged in the Oxford comma wars.

Pro: “She took a photograph of her parents, the president, and the vice president.”

This example from the Chicago Manual of Style shows how the comma is necessary for clarity. Without it, she is taking a picture of two people, her mother and father, who are the president and vice president. With it, she is taking a picture of four people.

Quite. The “Oxford” comma is necessary there; it simply does one of the jobs a comma is supposed to do.

Con: “Those at the ceremony were the commodore, the fleet captain, the donor of the cup, Mr. Smith, and Mr. Jones.”

This example from the 1934 style book of the New York Herald Tribune shows how a comma before “and” can result in a lack of clarity. With the comma, it reads as if Mr. Smith was the donor of the cup, which he was not.

Ok well I tell you what, that’s not a good sentence, with or without the comma. Just re-do the sentence. That’s the other way to fix these little problems – just re-do the damn sentence.

The commodore and the fleet captain were at the ceremony, along with the donor of the cup (Susan Milligram) and Steve Jones and Bob Smith.

Still not elegant, but at least you can figure it out without getting a crick in your neck.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

So now I’m going to have to allow more cuteness into my aesthetic range than I usually do, so that I can say yes to Mary Engelbreit and no to the people who said no to her.

St. Louis artist Mary Engelbreit‘s work typically epitomizes “non-controversial” art: She makes comforting cartoon illustrations of apple-cheeked children, often accompanied by cheerful slogans about friendship and family. She has a large and devoted following, both for her art and for Engelbreit-branded products of various types, and she is an official inductee in the St. Louis Walk of Fame. These are not normal times, however, and when Engelbreit posted an image on her Facebook page on Tuesday in response to the current unrest rocking the St. Louis-area town of Ferguson, a section of her fan-base turned on her.

The print in question, called In the USA, depicts an African-American mother and child, in Engelbreit’s signature orbicular style, contemplating a newspaper that reads “Hands Up! Don’t Shoot.” Floating text reads, “No One Should Have to Teach Their Children This In The USA.” The print was priced at $49.99, with all proceeds going to the Michael Brown Jr. Memorial Fund, which supports the family of Michael Brown, the Missouri teenager who was gunned down by police two weeks ago. “[T]hese events unfolding now in my hometown and across the country, shining a light on the ugly racism that still runs rampant in our country, made me think that maybe this drawing could help in some small way,” wrote Engelbreit in her post.

But what happened? A lot of malevolent people left malevolent comments, and Facebook took down her post. Fortunately it has now restored it.

Here’s a public Facebook post she did an hour ago:

So far, we’ve raised almost $25k for the Michael Brown Jr. Memorial Fund!! I can’t thank you guys enough for your support and for sharing the image on your pages and in your profile pictures– I could not have done this without you!

Let’s keep it going! You can order the print online at: http://www.maryengelbreit.com/store/In-The-USA-Fine-Print.html

And if this print isn’t really your cup of tea, you can always send your contributions directly to:

The Michael Brown Jr. Memorial Fund
c/o Lesley McSpadden
P.O. Box 52011
St. Louis, MO 63160

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Brilliant move. Have a panel to discuss expanding leadership opportunities for Buddhist women and…well, take a look.

Featured panelists – James Coleman, Gary Gach, Charles Prebish, Christopher Queen, Paul David Numrich, Justin Whitaker, Eisel Mazard. Photos go: man, man, man, man, man, man, man.

Hmm.

Rita Gross, an author and dharma teacher, wonders what they were thinking.

Earlier this week the website Patheos published a panel on the topic “2014 Religious Trends: Expanding Leadership Opportunities for Buddhist Women—Which Way Forward?” The panel introduction ended with this question: “What are the risks and benefits of opening Buddhist leadership to women?” As a Buddhist-feminist scholar who has watched and participated in the rise of female leadership in the Buddhist world for the past four decades, I have my own question to ask in response: Risks? What risks? What could possibly be dangerous about women taking leadership roles in Buddhism? We have been doing so in large numbers for quite some time and nothing untoward has happened to Buddhism or to Buddhists as a result. 

Oh come now. To talk about it only in terms of benefits would be unbalanced and extreme. You can’t expect them to just say “it’s time to do much more to expand leadership opportunities for Buddhist women” and then go on to do just that. They have to fret and consider and wring their masculine hands over it first. Changing the status quo without considering the benefits and the risks is never ever permissible.

Far more serious and problematic, however, is the fact that this panel discussion on Buddhist women includes no women! Seven men—but no women—were called upon to discuss the “risks and benefits” of opening Buddhist leadership . . . to women! Rather than solving any of the centuries-old problems of Buddhist male dominance and patriarchy, such a panel only perpetuates it. Someone who didn’t know better but encountered this panel might draw the conclusion that Buddhist women are too passive to speak for themselves and lack the knowledge to do so. 

Maybe, but on the other hand if you had women on the panel someone would be sure to pop up and say the women were there only because they had the right genitalia.

I do not fault the seven men who wrote short essays for this panel, in part because I suspect that they were not informed ahead of time that only men had been invited to contribute. I know some of these men and know that they themselves are supportive of expanding leadership opportunities for Buddhist women. But I most definitely do fault whoever put this panel together for unbelievable levels of ignorance and arrogance. If this were 1970, not 2014, such an all-male panel might be explicable, even relevant. But in 2014, it is too late to speak and act as if men alone are still in charge of everything and can creditably speak for and about women, as if no women were confident and competent enough to speak for themselves, and hadn’t already begun to transform Buddhism into its post-patriarchal future.

I suppose whoever it was just figured it was more of a guy thing.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

One of those zany Islamic “scholars” in Egypt has issued a very useful bit of advice in a video. (Is it still called a fatwa if it’s on a video? Is there some different word for it if it partakes of the novel technology? Is there a fatwa for that?)

Men can spy on women in the shower, an extremist cleric has argued in Egypt, prompting outrage from other Islamic scholars.

According to Osama al-Qusi, a Salafist or ultraorthodox preacher, peeping toms can watch a woman wash as long as they are interested in marrying her.

“If you were really honest and wanted to marry that woman, and you were able to hide and watch her in secret, and see the things that she wouldn’t usually let you see before marrying her, then it is acceptable as long as your intentions are pure,” Qusi said in an online video translated by the al-Arabiya news network.

Well sure. That makes sense. For one thing of course “you” are a man. “You” are never a woman, because women don’t count. It’s only men who do things and need fatwas so they know what they can do. Women are just things, for men to watch in the shower or not, depending on the fatwa. For another thing obviously mean need to know how good the tits and ass are before they buy. (It’s hard to see the genitals even in the shower, unless you’re peering from underneath through some clear glass, but in that case she might possibly notice you.)

Egypt’s minister for religious affairs, Mohamed Mokhtar, condemned the cleric “and his ilk”, saying: “Where is the glory and masculinity in watching a woman shower? Would you allow this to happen to your daughter?”

Mokhtar stressed that fatwas, or Islamic edicts, should only be issued by qualified clerics, and denounced Qusi’s claims as anathema toIslam.

The minister also confirmed plans to launch a grassroots campaign against both atheists and Islamic extremists. He has already banned tens of thousands of unlicensed preachers, accused of extremist teachings, from working in Egyptian mosques.

Maybe the “extremists” are there to make people like the minister look good, with his campaign against atheists.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

“It’s simply subsidized self-indulgence.”

//www.youtube.com/watch?v=dgDxvaCsZMI

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

Originally a comment by Eric MacDonald on Guest post on Sam Harris and the duties of public intellectuals. (So yes, a meta-guest post.)

I think there are two sides to this story, and Atran’s claims cannot be taken as scientifically confirmed. For example, in the article Ophelia links entitled: “Here He Goes Again: Sam Harris’s Falsehoods,” Atran makes claims which, while true in terms of his own research, do not necessarily subvert some (at least) of Harris’s conclusions.

For example, Atran says: “Harris’s generalizations of his own fMRIs on belief change among a few dozen college students as supportive of his views of religion as simply false beliefs are underwhelming.” This is unquestionably true, as I have said before in connexion with Boghossian’s claims in his book “How to make atheists.” Specific beliefs, as such, are very often either very poorly understood or provide simply the background of religious action. But it does not follow that explicit beliefs do not underlie the actions of many religious people.

For example, jihadists may not consciously be following the classical interpretations of Islamic texts regarding jihad, but the motivation of whole groups may be based on such interpretations. Atran seems to think that questionnaires provide accurate answers to the question Atran puts to religious people: “Why are you acting this way?” But religious people generally act from within a social context the theological meaning of which many of them do not understand and accept on trust. Asked to give reasons for “the hope that is in you,” (to quote First Peter) people may not give standard theological answers, but those may nevertheless be the reasons underlying their actions. Asked whether they support abortion, most orthodox Roman Catholics would say no, but very few of them could give detailed answers as to why it is believed by the Roman Catholic Church’s moral theology that abortion is wrong. I find Atran’s analyses of the reasons why religious people do things very inadequate and shallow. Most religious people, when push comes to shove, do things because their religion demands it, even though they do not know why. Asked to give their own reasons, they will give the first answer that occurs to them, without adverting to the theological framework within which they are acting, so they will give the kinds of answers that Atran’s studies attract. But this does not mean that underlying the actions of (to take but one example) jihadists are not very complex arguments concerning the Qur’an and the Sunna. It just means that they have accepted these argumentations on authority. Their personal reasons may even be orthogonal to the arguments from authority, but do not in the slightest change the fact that theological authority at some point underlies their actions.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

The Deputy Director of the Committee to Protect Journalists remembers James Foley.

He was already well known to CPJ staff, who along with many other groups and individuals had advocated for his release when he was captured by pro-Qadaffi forces in Libya in 2011 and held for six weeks.

Foley had been with three other journalists when they came under fire near Brega. One, Anton Hammerl, a freelance South African photographer, was killed.

Captivity in Libya, and the death of a colleague who was working on a shoestring budget, seem to have intensified Foley’s passion to help fellow journalists, particularly those risking their lives in conflict zones without the training, equipment, and finances afforded by major news organizations.

In addition to the normal band of war-hardened reporters, the Libya conflict attracted many less experienced freelancers and newcomers. Journalists had to help one another. Even so, some were unlucky. Acclaimed freelance photographer Tim Hetherington bled to death after taking shrapnel in the leg in Misrata; none of his colleagues knew how to save him. This prompted his friend Sebastian Junger to set up an organization to teach reporters basic first aid–Reporters Instructed in Saving Colleagues, or RISC.

James Foley attended the first-ever RISC course at the Bronx Documentary Center in April 2012. During that course, we sponsored the screening of a filmtitled “Bearing Witness” about five intrepid women journalists, including another victim of the Syrian war, Marie Colvin. When we spoke after the screening I wanted to hear about his experience, but Foley would have none of it. He wanted to talk about raising money for Anton Hammerl’s family. And he did more than talk.

He also helped to raise a bunch of money for Hammerl’s children.

Foley said he kept returning to the frontlines to follow Colvin’s exhortation to bear witness, but he went beyond observing. He helped. After documenting the toll taken on civilians, particularly children, by the fighting in Aleppo in a piecefor GlobalPost, Foley launched a campaign to raise money for the hospital he had filmed.

That’s the kind of person Islamic State thinks it good to murder by cutting off his head with a knife.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)

What can cure Ebola? Apparently if it’s prompt enough and intensive enough, aggressive supportive care has a good chance of curing it. The better the hospital, the better the cure rate. Poverty is key here.

The two American Ebola patients, medical missionaries Nancy Writebol and Dr. Kent Brantly, have walked out of Emory University Hospital in Atlanta infection-free.

They were the first human beings to receive an experimental drug called ZMapp. But they are not the first people to have recovered from Ebola, and good hospital care is likely more responsible for their recovery than any mysterious “serum,” as the charities they work for termed it.

“They are the very first individuals to have ever received this agent,” Dr. Bruce Ribner, director of Emory’s Infectious Disease Unit, told a news conference. “There is no prior experience with it, and frankly, we do not know whether it helped them, whether it made no difference, or even, theoretically, if it delayed their recovery.”

But there is plenty of prior experience with dehydration and rehydration and electrolytes.

There’s no specific cure for Ebola, but doctors with experience treating it say they have found that if people get early supportive care, including saline solution and fever reducers, they are far more likely to recover.

Ribner says three weeks of treating Writebol and Brantly have shown them something else: Just like with cholera, patients have severe diarrhea and they lose important chemicals called electrolytes. Replacing these minerals — notably potassium, magnesium and sodium — helps patients recover better, he said.

“The key to resolving Ebola virus infection was aggressive supportive care,” he said. This level of care just isn’t available in most parts of Liberia, Sierra Leone and Guinea, where clinics struggle to even provide clean water and beds for patients.

“We knew certainly we could do that at a better level than the facility that they were in in Liberia,” Ribner added. The equivalent, he said, would be if “we took all of our patients in the intensive care unit here and sent them home and see how well they survived.”

Heartbreaking, isn’t it. I suspected it and wondered about it, as I’m sure everyone did – was the sky-high death rate partly to do with the poverty of the medical infrastructure? The answer seems to be yes, it is.

The World Health Organization, the relief group Doctors Without Borders and other experts in Africa have all called on rich nations to help poorer countries, especially those hit by Ebola in Africa, to develop their health systems so they can provide better care to patients.

Brantly, who walked out of an ambulance into Emory three weeks ago and Writebol, who remains weak, according to her husband David, both started out in better physical condition than the patients they were working to help.

“And clearly for any acutely ill patient, nutritional status is extremely important,” Ribner said. “If you have somebody who’s well-nourished and somebody who is poorly nourished and they suffer the same illness, infectious or otherwise, the person with better nutrition has better survival outlook.”

Poverty kills, just as we’ve always known.

(This is a syndicated post. Read the original at FreeThoughtBlogs.)