Fevers, Feuds, and Diamonds

August 10, 2020
Medical anthropologist Farmer (coauthor, Reimagining Global Health), cofounder of the international health-care organization Partners in Health, delivers an incisive and deeply informed account of the Ebola outbreak (“the largest in recorded history”) that engulfed West Africa in 2014. Placing the epidemic within the historical context of the transatlantic slave trade, European colonial rule, and more recent “diamond-fueled” civil wars, Farmer argues that the disastrous “control-over-care paradigm” used to combat Ebola had its roots in centuries of exploitation and neglect. He rejects explanations blaming the outbreak on “exotic practices and beliefs held to be common in this part of the world,” and characterizes Guinea, Liberia, and Sierra Leone, the three countries most severely afflicted, as “clinical deserts” where it was rational for people to be suspicious of authorities whose clear priority was to contain the disease rather than to provide adequate patient care (the mortality rate in some treatment centers was 50%). Farmer’s detailed synthesis of the history behind the crisis enlightens, but poignant profiles of victims, survivors, and physicians, including Dr. Humarr Khan, Sierra Leone’s “Ebola czar” who died from the illness, are the book’s greatest strength. This fierce and finely wrought chronicle offers essential perspective on fighting epidemics.

Starred review from September 1, 2020
In Albert Camus's The Plague, the protagonist, a doctor, ultimately decides "the only means of righting a plague" is "common decency." Renowned physician and global health expert Farmer echoes that conclusion in his report on the 2014 Ebola outbreak in Sierra Leone, Guinea, and Liberia. Farmer provides poignant personal accounts by Ebola survivors and health-care workers, a detailed history of the three Ebola-affected countries, and coverage of post-Ebola life, including the complications of the viral infection. Acts of caregiving and funerals were the chief sources of acquiring this contagion during the epidemic. Farmer's writing can be distressing with nightmarish scenes involving repulsive sights and smells. He criticizes the international health bureaucracy's policy of "control-over-care," where containment of the illness is prioritized over actually treating the disease. Farmer explains why Ebola hammered these three West African countries, citing already impoverished health-care systems, violence, and poverty. Previous colonial rule and slave trade, armed conflicts, exploitation of the natural resources of poor nations, victim-blaming, and health disparities all connect with the Ebola outbreak. A challenging, consequential, and tragically timely book about the forces that sculpt epidemics and the necessity of compassion and altruism in caring for their victims.(Reprinted with permission of Booklist, copyright 2020, American Library Association.)

September 15, 2020
This story of the 2014 West African Ebola outbreak by an expert lacks the media hysteria common at the time but manages to be even more disturbing. Farmer, the chair of Global Health and Social Medicine at Harvard and founding director of Partners in Health, has spent his life delivering medical care to undeveloped nations--and writing engagingly about his experiences. In his latest, the author describes the epidemic that likely killed many more people than officially reported. Readers will be surprised to learn that, despite lurid accounts such as Richard Preston's The Hot Zone, Ebola is not a death sentence. Treatment involves routine hospital care, especially the replacement of lost fluids intravenously. Deaths were rare in victims evacuated to Europe or America but more than 50% in Africa. Farmer reserves special ire for international organizations proclaiming that simply treating individuals would never defeat the epidemic. Aggressive control measures, including quarantine, contact tracing, and sanitation upgrades, were required. It's a no-brainer, Farmer points out, that sick people want care, and he continues his careerlong, morally sound argument that access to proper health care should be a universal right. Having recounted the epidemic in the first third of the book, the author steps back to describe how the region's history made disaster inevitable--and what the future may hold. Of the nations involved, Sierra Leone and Guinea were colonies until after World War II. Trade has always supported the economies, at first via the slave trade and then extraction--mostly lumber and mining--which benefits wealthy locals and foreign industries. Often kleptocratic governments have built little health infrastructure, and what they did create was often destroyed by vicious civil wars. A final chapter reveals that Farmer and colleagues are now dealing with the Covid-19 pandemic, which many developed nations are handling more or less efficiently. Though not yet severely affected, many countries in Africa are unprepared. Insightful, as always, but hardly encouraging.

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October 1, 2020

A University Distinguished Professor of Psychology at Northeastern University, Barrett (How Emotions Are Made) gives us Seven and a Half Lessons About the Brain, explaining the origin, structure, and function of that blobby gray mass (50,0000-copy first printing). In This Is the Voice, New Yorker staffer Colapinto, author of the New York Times best-selling As Nature Made Him, explains how this most efficient means of communication defines humans individually and as a whole (75,000-copy first printing). The Dalai Lama's Our Only Home calls on politicians--and encourages the younger generation--to save our planet (50,000-copy first printing). Cambridge historian Falk's The Light Ages shows that the so-called Dark Ages were actually lit up by a keen scientific culture, as universities, eyeglasses, and mechanical clocks got their start. The Kolokotrones University Professor and chair of Global Health and Social Medicine at Harvard University, public health giant Farmer offers an account of the 2014 Ebola crisis that should be especially revealing for us today; as suggested by the title, Fevers, Feuds, and Diamonds, there's sociopolitical context here (20,000-copy first printing). Fung follows up his internationally best-selling The Diabetes Code and The Obesity Code by discussing not just the origin and treatment of cancer but its prevention in The Cancer Code (100,000-copy first printing). Having explored the mental life of octopuses in Other Minds, Godfrey-Smith, a scuba-diving professor of the history and philosophy of science at the University of Sydney, now looks more deeply into animal consciousness in Metazoa. Barnard astrophysicist Levin, a PEN/Bingham Prize-winning novelist and director of sciences at the arts-and-sciences center Pioneer Works, has the wherewithal to provide a Black Hole Survival Guide explaining the cosmos.

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