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November 16, 2018

Why diseases should not be named after places

UNFAIR: Ebola disease is named after Ebola River (above) in Congo. Photo/COURTESY
UNFAIR: Ebola disease is named after Ebola River (above) in Congo. Photo/COURTESY

Across the world the naming of a new baby is a major event.

It signifies the acceptance of this new individual into society by acknowledging that this person now exists and that society has some responsibility towards the individual.

The name differentiates the baby from any other person and from that point onwards the baby, no matter what happens subsequently, is a part of history. In earlier generations in most societies only a few names were used.

In communities where a sense of ancestry was important babies would get their names from the family tree, a common method being to name a baby after their grandparents or earlier. It is not unusual to hear a grandmother talk of ‘her husband’ in reference to her grandson. In other communities, especially nomadic, the name might come from an event that occurred around the pregnancy.

There are also those communities where names are divined through a ceremony and an appropriate name for the individual is identified. Whichever way it was done and continues to be done, today there are just so many more names that parents choose for their children.

With increased communication among communities, people no longer feel tied to choose names only from their community so names have become so much more diverse. No longer is it a simple matter to hear a name and assume that the child must therefore come from community ‘X’ or ask how old a child is to know when a particular famous person died. The implication of this is oral literature is slowly being replaced with the written word, documentation becomes ever more important to get a sense of where people are coming from.

The changes in naming of names are not peculiar to families naming babies. Medicine too has undergone a change. In general, the person who discovers a new disease or medicine is like a parent and has the privilege to name the thing. Two hundred years ago the culture in medicine and science in general was the person who first described the disease appended their name to it. It was an honour to do so.

Occasionally there would be some disagreement when given the slower pace and spread of communication two people would claim a discovery and a disease would have two names. An alternative was to name the disease after the place where it was first found. Given that most diseases are found in ‘remote’ places, the people living there are often surprised and disturbed, that rather than presenting as an ideal tourist destination their home is associated with an alarming disease the cure of which is yet to be discovered. A much rarer approach to naming has been to name the disease after a patient. The problem with the use of such naming conventions is that it can be difficult to classify the disease and therefore understand how this disease is perhaps related to others. For example the "Ebola virus" is named after the Ebola River a tributary of the Congo River the area where it was first identified in 1976. That sentence alone brings up scary images of primitive jungles and screams ‘run away’; and probably contributed to the initial reaction of the world to the latest outbreak.

Ebola virus belongs to the family Filoviridae and is therefore a filovirus, single stranded RNA viruses, which cause haemorrhagic fevers. A contrasting example is Burkitt’s lymphoma, described by Dr. Denis Burkitt in 1958 as a form of cancer, which was found to have an infectious cause and could be cured. Today the use of eponymous disease names as a medical name is discouraged because as illustrated the western bias can lead to problems including slandering certain communities. The only information the name provides is historical, different societies can have different names for the same medical term. So the convention is to move towards more ‘scientific’ names such as the H1N1 influenza virus that was a worldwide problem in 2009. A more recent variant was the Middle East Respiratory Syndrome Coronavirus, or MERS-CoV, which has killed almost 50% of persons infected since 2012. As the name suggests it is found in Middle Eastern countries like Saudi Arabia, Qatar and the United Arab Emirates.

A good name medical name should provide a lot of information about the disease. By using the right name the patient can better understand the symptoms, how the disease comes about, what are the possible strategies and behaviour changes needed to avoid or cure the disease. In the same way the naming of a person should do a lot for the person. No longer is it enough for a family to give a newborn a name.

The name must be recorded in the system. Unfortunately for us as a country our vital registration processes remain very weak. One of the key responsibilities of the health system is to ensure safe delivery of every pregnant woman. When that happens a baby is born and is named. That name needs to be recorded. If the newborn’s name is recorded at birth together with that of the parents then eventually a census would be a confirmatory exercise, not a primary exercise of establishing our population. Vital registration done through the health system would have people’s names, where they were born, to whom, that is, much more information that just numbers. No country has developed without first developing its health system. The contract a citizen has with society begins at birth, when they are named and only a functioning health system can deliver on that.

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