For a while in the early noughties I worked in the back office of an engineering firm doing back office stuff: procurement, dispatch, marketing, web stuff, travel and tender arrangements, and so on. One of my duties was to ensure matters of occupational health and safety were appropriately addressed for staff involved in onsite operations and in executing this duty I was required to come to terms with the surprisingly arcane world of PPE, Personal Protective Equipment. There is a vast array of PPE to choose from depending on what the circumstances require.
The company I worked for provided end-of-pipe solutions to nasty emission problems arising from industrial production. The company provided filters, extraction, storage and disposal services (all the same really). These toxic nasties required all sorts of PPE. The range and variety of things that onsite staff might need protection from was an eye-opener for me. There was PPE for heat, for cold, for vapour, for dust, for remote breathing apparatuses, for confined spaces, for gaseous environments. Similarly, there was PPE for the whole body, as well as PPE specifically for eyes, hands, mouths, ears, skin, lungs, knees, forearms, and the head. And for those times when the PPE didn’t quite fit, or wasn’t quite right, there was always gaffer tape. After a while in the job it was clear to me that PPE worked. PPE protected, it provided an effective barrier against most toxic materials, and the onsite staff went home safe and sound.
So I’ve watched the footage out of West Africa, Texas, and elsewhere of the Ebola outbreak with great interest. I’ve been looking closely at the PPE and it is not enough. It is inadequate PPE, which is really shocking considering that Ebola doesn’t transmit easily (it’s infectious but not particularly contagious), meaning that PPE on a patient-carer level will be, for the most part, effective in shutting down outbreaks, as it has been on numerous occasions since 1976. I saw a news story from CNN about a young Liberian woman, a trainee nurse, used garbage bags and gaffer tape as PPE while she was caring for her Ebola affected relatives. It worked; three of her four infected relatives survive. PPE works, gaffer tape works, but you wouldn’t know it when you watch the evening news.
This is because lurking behind every story about Ebola is Richard Preston’s book The Hot Zone. Full of haemorrhagic splendour The Hot Zone evinces the horror which is attached to filoviruses and the bloody fevers that result from infection. In The Hot Zone being infected with a filovirus (such as Ebola, or Marburg, or Hendra, et al) is characterised as a process of liquefaction in which infected persons literally dissolve on their beds, patients “bleed out” and the virus rapaciously moves onto new victims. That Preston’s book is not really accurate in this regard is not relevant because what the book is really about is fear: fear of the unseen killer, fear of exotic horror, fear of otherworldly-ness, fear of some unprotected vulnerability.
The Hot Zone suggests something apocalyptic; the viruses are a keyhole through which our end might be unlocked. By situating the virus outbreak in suburban Virginia, a mere fifteen miles from Washington D.C, The Hot Zone suggests that harboured deep in Africa (a cave in this instance) are horrors that, once unleashed, might reveal our terrible vulnerability, even at a point so close to the centre of power and authority. Watching the stories played out on the evening news regarding the Ebola outbreak in West Africa it’s pretty clear that a similar set of tropes is being deployed despite The Hot Zone being not very true. In this schema Ebola is simply Mistah Kurtz’s latest affliction, it is the latest breakage in the quarantining of civilisation.
What’s striking is that instead of sending Marlowe up the river to contain the breakage as per Heart of Darkness this time there is an urge to quarantine whole countries, as if there can be a kind of national or continental PPE applied by closing borders or ceasing flights, as if patient isolation can be duplicated on a national scale, throwing up as many Berlin walls as required to ensure the safety of the civilised world. National isolation is a pre-emptive practice of PPE for the rich, rather than for the sick or their carers, a prophylactic protection for those not afflicted. It is a suggestion that involves turning away from those in need.
This doesn’t seem very civilised to me: let’s prioritise the sick and provide as much PPE as possible to those caring for them, doing otherwise is simply turning our backs and ignoring the problem.