Review of Crisis in the Red Zone by Richard Preston


What would you do if a loved one came down with Ebola? Do you remember when if you went to a doctor’s office they asked if you had traveled outside the U.S. within a certain time period and where?

That is what Richard Preston’s forthcoming book, Crisis in the Red Zone is about. It is the account of the 2014 Ebola outbreak in Guinea, Sierra Leone, Liberia, and other countries in West Africa that started with one boy and then traveling through the Makong Triangle and spreading outwards until it reached Dallas, Texas and New York. Ebola killed thousands as it spread like wildfire until finally villagers began taking the fight to Ebola through implementing the Ancient Rule — understanding that Ebola is not a white man’s myth but a deadly wet virus that is spread through contact with bodily fluids, recognizing the symptoms of Ebola, isolating of and removal from contact with those infected with Ebola, and destruction through fire or protected burial of the deceased and everything that the deceased may have come in contact with. It is the story of giving (or protecting) life through temporarily changing practices, habits, and deeply ingrained customs and a way of life so that those who are not already infected with Ebola do not break with it and succumb.

Crisis in the Red Zone is also the story of the intersection of modern medicine and ways with ancient tribal medicine, folk healing, and culture and the clash between the two as seen in the struggle of Doctors of Without Borders in their “moon suits” to locate and then isolate and treat those infected with Ebola. To be clear, there were other similar conflicts elsewhere that rose to the level of near war between villagers and those who fought Ebola.

Preston’s account also delves into the conflict that developed between the World Health Organization, Doctors with Borders, and governmental agencies, in Africa and outward including the U.S. and how this clash led to the death of the doctor of the of the Kenema Government Hospital’s Ebola ward, Humarr Khan. It is the story of how adherence to inflexible practices and procedures can kill through ignorance of and the overriding local traditions that in turn creates conflict with local populations who have had limited contact with outsiders. This conflict and misunderstanding then creates myths and superstition in the minds of the villagers that eventually leads into war between the villagers and outsiders.

Crisis in the Red Zone also relates the superhuman efforts of Doctors Without Borders, World Health Organization doctors, outside experts and local medical personnel to struggle beyond the point of collapse and utter chaos to combat Ebola in situations that were war-like inside the treating areas.

Preston also details the evolution of Ebola vaccines and treatments, the Level 4 containment and care that is required to stop an outbreak through in essence creating a fire break in the path of the disease and the history of Ebola including the 1976 outbreak in the Democratic Republic of the Congo and the lessons learned there which became known as the Ancient Rule and was ultimately implemented by the villagers and medical personnel in the 2014 outbreak.

This reader learned a lot through Preston’s cogent and in-depth writing and analysis that was easy to understand. At times, in the early part through mid-way, the writing had the annoying quality of like talking to a child. It was not enough to distract this reader. Also, at some point, Preston begins to write part of the time in the first person as he starts to relate to readers his investigation and research for the book. The first time a section appears this reader thought it was an error. It is not as later in the narrative, it becomes clear what the author is doing. Other than that, Preston’s account is a fascinating, if chilling, account of how linked this world and how societies and worlds can be destroyed by a microscopic invader.

Copy provided by the publisher via Net Galley in exchange for an honest review.