On December 30, The New York Times devoted its full Tuesday ScienceTimes section to a massive, groundbreaking investigation of one critical question: Why wasn’t West Africa’s huge Ebola outbreak prevented? The exhaustively reported piece, by Kevin Sack, Sheri Fink, Pam Belluck (a former Knight Science Journalism Fellow), and Adam Nossiter, assigns blame judiciously but unsparingly.
There were the now-familiar geographical and cultural factors: the fact that the outbreak began in a poor, isolated region where members of extended families could easily cross borders between Guinea, Sierra Leone, and Liberia; inexperience diagnosing Ebola (which is endemic to Central Africa, and whose symptoms resemble cholera and other more common conditions); burial traditions that involved extensive contact with the virus-laden bodies of the dead; the history of war, corruption, and exploitation that left many West Africans distrustful of outside medical help.
But the report also shines light on institutional weaknesses and breakdowns, including recessionary cuts that had left local branches of the World Health Organization woefully understaffed; bungled public-information campaigns; bureaucratic barriers that meant key reports went unread; and “most tragically,” in the report’s words, the failure of W.H.O. and health ministry officials to share information that would have shown the virus was spreading, not receding, during the weeks in April and May 2014 when W.H.O. officials, thinking they’d contained the outbreak, were pulling out of Guinea.
Here’s the key takeaway sentence: “If the epidemic in West Africa has demonstrated anything, it is that a foe as remorseless as Ebola must be met with a killer instinct that is just as unrelenting.” In the best tradition of investigative and service journalism, the Times story highlights the urgent need for structural reform in the global public-health community. It drives home the need to keep epidemic-response agencies at a high level of readiness, whether or not there’s a panic-generating outbreak underway, and to find ways to overcome cultural and bureaucratic barriers at the regional level.
After the Ebola story appeared, I wrote to Pam Belluck, a staff writer at the Times since 1995, to ask for behind-the-scenes details on the production of the special issue. Belluck was a Knight Science Journalism Fellow in 2007-2008, and is also the author of Island Practice, about Nantucket based surgeon Timothy Lepore (the book is reportedly being developed as a TV series for CBS). She wrote back on New Year’s Day; here’s the complete Q&A.
Wade Roush: The Times has been covering the Ebola story aggressively all year, but how closely has the Science section been involved? When and how did your team realize that it might be feasible to do a large-scale story about the institutional responses to the outbreak during its early phase?
Pam Belluck: The Science department has been involved in Ebola coverage from the beginning, especially reporters Donald G. McNeil Jr., Denise Grady and Sabrina Tavernise. A couple of others and I helped out on some stories. Celia Dugger, the deputy science editor for health, coordinated much of the coverage, working with editors on the international desk and other departments as the story broadened to involve Texas, New York, Washington and the pharmaceutical industry, among other things. It was Celia’s very smart idea to assemble a team of reporters to investigate the early part of the outbreak – because that period had received little attention, and because there had to be unexplored reasons why this epidemic has become such a behemoth compared to all previous Ebola outbreaks.
WR: How long has the story been in the works?
PB: We worked on the story for about two months.
WR: What was your role in the reporting?
PB: This was a team effort involving some exceptional colleagues, and throughout the process there was continual sharing of reporting and sources, and cross-pollination of findings and tips. Celia Dugger coordinated and stayed on top of everything. Matt Purdy, the deputy executive editor for investigations and enterprise, gave important feedback. We had two reporters in Africa: Adam Nossiter, the West Africa bureau chief, and Sheri Fink, who is a physician and has previously worked in disaster medicine and was one of the people who reported extensively for several months from the region, especially in Liberia and also in Sierra Leone. Kevin Sack, based in Atlanta, interviewed CDC officials and others, read many reports, and had the job of pulling together the reams of material we were sending in and asking us for additional reporting as the piece took shape. I spent a lot of time finding and talking with first responders and others who were on the ground at that time in all three countries: doctors, aid workers, epidemiologists, virologists, nurses, emergency coordinators, anthropologists and others. Often there were multiple conversations or other follow-ups. We were assembling detailed timelines, gathering vivid anecdotes, triple-checking facts and people’s recollections, and obtaining documentation in the form of letters, emails, scientific analyses, reports, data and photos.
WR: How was the decision made to devote the entire Science Times section to this investigation? That’s a first as far as I know – do you know whether that’s ever happened before?
PB: Science Times periodically produces sections revolving around one theme, like climate change or technology and medicine, but it’s unusual to devote an entire Science Times section to a single story. It was done last year with Dennis Overbye’s deep dive into the discovery of the Higgs boson, and also with a set of stories by Natalie Angier, timed for Thanksgiving, about the changing American family. For our Ebola investigation, Science Times provided an ideal platform for a 7,500-word narrative accompanied by a powerful and informative visual presentation.
WR: I was impressed by the amount of space devoted to photos, maps, and graphics in the print version of the special issue. How much of the team’s work went into the visual side of telling this story?
PB: A cast of talented colleagues, too numerous to name, in the graphics, photo, video, and art design departments became involved in the project early on. The reporting team worked with them to provide sources, dates and details, and to fact-check. We were thrilled with the visual results because they did much more than illustrate our work – they provided invaluable information and other ways for readers and viewers to enter the story and absorb the subject matter. We have already heard from many people about the penetrating poignancy of Daniel Berehulak’s photographs, and about how illuminating they found Jonathan Corum’s graphic on the history of Ebola outbreaks and the video animation produced by Sergio Peçanha and other members of the graphics/multimedia/video team.
WR: From watching the Frontline clips embedded in the online version of the story, I get the impression that the special section is part of a larger NYT-Frontline investigation, with the television version to appear later. How are the two projects linked?
PB: Frontline is working on a big Ebola special that will run in the spring. In partnering with them for a portion of our project, we shared some sources and information with them, and they provided us with the two breathtaking videos that ran along with our piece.
WR: The piece is remarkably non-judgmental, given the number of failures identified, but the key message is about the need for a “killer instinct” when dealing with viruses like Ebola. What are the chances, in your mind, that W.H.O. and local health ministries will learn the right lessons from the failure to contain this outbreak earlier?
PB: Thanks for remarking on the non-judgmental tone. It’s always more powerful to let evidence speak for itself. Regarding the future, of course it’s hard to say, but it seems clear from our reporting that all the major groups involved acknowledge that they made mistakes and missed opportunities, and I’m sure they will not want to make those mistakes again. In reality on the ground, of course, that’s much harder to predict. Many of the issues in the affected countries are the reflection of deeply-rooted systemic problems and withering poverty. And while some problems that occurred in this outbreak could be avoided with better preparation, it’s not necessarily easy to persuade countries and global agencies to spend money to prepare for outbreaks when there’s no certainty when and where they will strike. I do think that agencies and countries will be very mindful of the cultural and communication issues we pointed out. And we’ve actually heard very positive comments about the story from top W.H.O officials, among others, so perhaps it’s the kind of reporting that will provide some justification for people in these organizations who see the need for change.
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