I assume they knew that ebola was spreading in the area. But the rate of reported ebola infection in Liberia is about 1 in 1000 (I don’t have time right now to give you the link, but it appears somewhere on this blog in a different thread). Not so high they’d immediately think of it, when they had much stronger reason (as I wrote in my earlier comment here) to believe that Marthalene had malaria or some pregnancy complication, and no particular reason to believe that she had ebola or to even suspect it. I doubt they were familiar with all the symptoms of the disease, and it’s not at all clear that even health care workers told them she had it (in fact, it’s not alleged that they were told she had it). And the fact that there were a lot of ebola cases overburdening hospitals in Liberia that are probably usually, even under normal circumstances, fairly crowded, would not have told them that she had ebola.

I also presume that there would be some reporting on this in print and radio of the affected countries, especially since is started in West Africa in late 2013 and by September 14th there were already 4507 cases and 2296 deaths:

http://www.nejm.org/doi/full/10.1056/NEJMoa1411100?query=featured_home&

While I know information and reporting aren’t remotely the same as in the U.S., where 1-3 cases in the entire, much larger country result in the vast majority of the populace knowing about a possible problem, I find it hard to believe that nobody in the car had heard anything about the virus, even if they didn’t know it was specifically Ebola.

I’ve responded to that issue in a different comment on another thread. But I’ll reproduce the gist of that comment here.

I have read perhaps 25 or more articles describing what happened in Liberia with Duncan and the woman who died, and the articles differ somewhat on the facts, and there’s very little sourcing. However, although some of the articles cite the family (and Duncan) as having taken her to an ebola clinic, the vast majority of the articles cite “hospitals” and do not mention ebola clinics.

I referred to that LA Times article not because every word in it is gospel or completely clear (for example, it’s not clear why or how she went to an ebola clinic, since she’d actually been told at another clinic that same evening that she had malaria). I referred to it for the story of how the village reacted and what it knew, which seems consistent with the timeline and the behavior of Duncan as well.

For example (from the same article) [emphasis mine]:

A chain of confusion and denial links the Dallas apartment complex to which he moved to a dark green house about 30 yards from Duncan’s door in Liberia, where the desperate family of a dying pregnant woman treated her illness as malaria…

Duncan had ridden in a taxi with Marthalene, who was seven months pregnant and desperately ill, as they crisscrossed the Liberian capital, Monrovia, going from a clinic to two hospitals, trying to get her admitted. With them were her father, Emmanuel, and brother Sonny Boy.

From the clinic, where she was given an intravenous drip but deteriorated sharply, they were sent to an Ebola treatment unit and then another, at a time when there were no Ebola beds available in the city…

It’s unclear whether the Williamses knowingly misled people, as angry neighbors charge, or whether they were simply convinced that Marthalene didn’t have the virus, like so many other desperate families in Liberia.

And if it was unclear what the Williams family knew or didn’t know about what she actually had, it’s even MORE unclear what Duncan knew or didn’t know, since he (a) wasn’t a family member, and (b) was riding in a cab to help carry her, not in charge of any decisions and probably not even privy to the medical decisions or even the discussions between the family and the medical staff. It sounds to me as though the family went from medical facility to medical facility trying to get her a bed somewhere, because they knew she was critically ill, and so they went everywhere, and there was no room in any hospital of any type.

There there’s this:

What happened in Paynesville is common in parts of West Africa where Ebola has been spreading. When a loved one becomes ill, family members assume, or hope, that it’s something else. They buy malaria, typhoid and headache medicine from a drugstore, or from a nurse, as Marthalene did. They wash and care for the sick person, moving them and touching them and their clothing, and the infection circle widens a little further.

So, what did the family know? We don’t know. But it’s safe to assume that, whatever they family knew (and I doubt they knew all that much, although they might have suspected something), Duncan knew considerably less. The community also knew less:

According to neighbors, people in the community didn’t realize until Wednesday that Marthalene Williams had died of Ebola. That was the day that two other people died – her brother Sonny Boy and her close neighbor Sarah Smith – and news emerged of Duncan’s illness in Texas.

The neighbors—who knew she had taken ill and died, and participated in funeral rites for the her without knowing how she died—did not know she died of Ebola till others had taken sick, and Duncan was already sick by that point.

So people who read an article here and there about it, and who are confidently saying “he lied; he knew” are just not basing that on a preponderance of evidence. I see the bulk of the evidence as going against the notion that he knew—and that evidence includes (as I have said several times) the fact that if he knew, it makes no sense that he failed to inform the Dallas hospital of his exposure.

I think this man pretty much sums up the mindset that Duncan probably had. This man more or less played the same role, and had the same relationship to the Williams family, and has no apparent reason to lie:

Like Duncan, Robert Garway rents a room from the Williams family, his house one pace away from theirs. When he and his wife, Sarah Smith, heard that the landlord’s daughter was sick, he thought they should pitch in, as Duncan did. They helped move Marthalene and touched her. It was difficult to say no to the landlord.

“We thought it was a fever or some other thing. There were plenty of people who touched her, and I was among them,” Garway said, speaking on his cellphone from an Ebola unit where he is undergoing treatment.

Also this:

As a crowd gathered and the shouting grew louder, accusations flew. Some claimed that she had vomited on Duncan. Some said that she had bled from the mouth. Others said the family lied and said she’d been injured in a car accident. Few of the accusations were consistent, other than the general outrage that the family told neighbors she had died of “low blood,” or low blood pressure, and pregnancy complications.

But the Blessing Home Clinic, which examined Marthalene on Sept. 15, had diagnosed malaria, according to staffers. When she started convulsing, they told the family to take her to a hospital.

That’s all from the same article. And yet some people think that, because at one point she apparently was at an ebola clinic, the family and friends knew (including Duncan) that she had ebola? I think, on the contrary, the confusion and lack of knowledge are apparent.

In Africa, by the way, death from pregnancy-related complications or from malaria are common—probably a good deal more common than Ebola. For example, in Liberia, “According to the 2009 Health Facility Survey (prior to the ebola epidemic there), malaria accounts for 34.6% of outpatient visits and 33% of in-patient deaths.” That’s a lot of very serious cases of malaria. And the maternal mortality rate in Liberia is 770 per 100,000 live births. Compare that to the US, 18.5 per 100,000 live births. So you can see why it was very plausible that she had died of either malaria or pregnancy (and convulsions, her main symptom, are the main symptom of a pregnancy-related illness called eclampsia, which is sometimes fatal).

Putting it all together, it is far more likely he didn’t know she had ebola than that he knew. It only became clear to people after he and the others had become ill themselves.

“From the clinic, where she was given an intravenous drip but deteriorated sharply, they were sent to an Ebola treatment unit and then another, at a time when there were no Ebola beds available in the city.”

This isn’t even a case of ‘should have known’, Duncan and everyone else in the Taxi KNEW that Marthalene likely had (or definitely had) Ebola.

What was going through this man’s mind is of much less importance to me than the results.

Containing a fearsome outbreak like this may boil down to a gruesome calculus. If it gets really bad, the goodwill of your fellow man will evaporate.
Let’s hope it doesn’t come to that.

http://pjmedia.com/richardfernandez/2014/10/03/my-hull-is-so-big-and-the-leak-is-so-small/?show-at-comment=942978#comment-942978

‘Tarnsman’:

How will it get here? Very easily I am afraid. Years ago a friend of mine, a businessman living in Southern California and with factories in China, were engaged in conversation during one of our sons’ Scout meetings. Mind you this was same time period as the SARS outbreak. During the course of our conversation my friend talked about his recent trip to China and how while on the trip he started to feel ill with flu like symptoms. I stood in dumbfounded silence as my friend continued his story. Seems in China they are very conscious of the fact that outbreaks of infectious diseases in a country of 1.3 billion people must contained, period. All of the public transportation hubs have special thermal cameras to pick sick people out of the crowd. If you are picked up by one of these cameras you will be quickly apprehended by the health officials and off you will go to quarantine. No arguing, no pleading, no appeal and it doesn’t matter if you are a foreigner or not, off you go. So my friend once he realized that he was coming down with something suddenly had one imperative: get out of China and get home. Never mind who knows what he was ill from, just that he needed to get home. Feeling like crap, he made good his escape with the help of Tylenol and his knowledge of the Chinese health surveillance cameras. He traveled first by train from one of his factories to Shanghai where he boarded a plane for Tokyo where he caught his plane to the States and home. When he got home he was bed-ridden for three days until the fever broke and he felt good enough to get out of bed. At one point his wife wanted to take him to the hospital, but he would have none of that. My friend was quite proud of himself when he finished his story. Me? I wanted to smack him across the face. I did scold him about the fact that not knowing what he was ill from that he was placing the health of all those he came in contact with at risk, including his own family. My friend seem genuinely surprised by my reaction as if he had never once consider that what he did was even remotely wrong. Another one of my friend’s has a saying that sums up the attitude of too many of our fellow human beings: ‘It is all about me” So that is how it will get here. Because someone somewhere will come down with the disease and want to get home and screw everyone else.

It would certainly make sense to want to leave that country and come here, whether a person had had any specific exposure to Ebola or not.

“Duncan flew to the U.S. on Sept. 19 and exhibited the first symptoms of Ebola four or five days later. For weeks his sister, Mai Wureh, a nurse from Charlotte, N.C., and his mother, who was in Texas when family members spoke to her three weeks ago, had been desperately trying to get Duncan out of Liberia and over to the U.S., fearing for his life.” …

[a friend of Wureh] tells TIME she isn’t sure what kind of visa Eric, as the family calls him, has but “many Liberians try to stay as long as they can, trying to avoid the Ebola. Life is hard there. First civil war, then no jobs, no work. Then Ebola. Mai spends all her time working to send money home. She supports her siblings.”

And I bet many of the Liberians living in the U.S. are doing the same thing — trying very hard to get relatives over here.