Ebola exposes Africa’s weaknesses

When Ebola broke out in Guinea several months ago and then spread to Liberia and Sierra Leone, little attention was paid to it. It was a localised disease in the bushes of West Africa and would be contained there. Since then it has spread to the cities and claimed more than a thousand lives, including Americans and Europeans. The initial response has given way to panic in the three most affected countries and across Africa. The alarm is a result of a combination of factors – fear, ignorance, lack of information, superstition and prejudices, and governance weaknesses – and this is making it difficult to contain the disease. This is not the first time that Ebola has broken out in Africa. There have been several incidences in Uganda, the Democratic Republic of Congo and Sudan. But in all these cases, it was contained to the places where it was first detected, in the sparsely populated rural areas away from the population concentration of the cities, and as such did not cause the sort of panic we are seeing today. There was no suspension of international flights, for instance. Nor is it the first time other viral diseases have broken out in the world. In 2003 SARS (Severe Acute Respiratory Syndrome) swept through Asia and caused quite a scare. It was eventually contained. More recently swine flu (H5N1) and bird flu (H1N1) also appeared but were equally checked. So why is this one different? Why has it not been contained when there are lessons that should have been learnt from previous incidences? I think the reasons have to do with weaknesses in some of our countries. The current outbreak of Ebola has exposed a lack of preparedness for this sort of disaster, or indeed any other. There seems to have been no system in place, no plan, equipment or treatment facility for this sort of outbreak. Consequently, the initial response was slow, haphazard and incoherent. There has been no effective information and communication strategy to dispel rumours, superstition, fear and panic especially in societies where ignorance still abounds. Similarly, a coherent containment strategy seems to have been absent, and yet this is not different from the usual way of preventing the spread of communicable diseases, i.e identification, isolation, surveillance and treatment. The absence of any sort of system or plan also reveals weakness in the political leadership. As so often happens in such instances, leadership is surrendered by default to international organisations and medical NGOs, which in normal circumstances should be supporting government initiative. The Ebola outbreak in West Africa has also exposed inadequacies in the public healthcare systems and in this sense is a severe indictment on governments’ insufficient investment in public health care. Where these exist, they are woefully unprepared to handle even a localised incidence of disease. Basic things like testing and other diagnostic materials are in short supply. In one country, patients had to be ferried hundreds of miles to where a treatment centre was located. It should not come as a surprise when people show little faith in the healthcare system and choose to take their patients away. When lack of trust in government health services is combined with ignorance, there is another disaster. People behave in the most stupid and irrational ways. That is why they will attack and loot treatment centres as happened in Monrovia on Sunday. It is for the same reason that relatives steal patients from hospitals and take them home. Even health workers who should know better have escaped from hospitals when they suspected that they may have contracted Ebola. And then the disease spreads. Quacks and others who claim to have found a cure for a variety of ailments sprout all over the place. In East Africa, hardly a year goes by without someone claiming to have found a cure for a wide range of diseases. Such claims range from ordinary herbalists to those alleging divine inspiration. People of all sorts in their hundreds of thousands – politicians, business executives, celebrities and even academics – throng to the shrines of the supposed healers for the miracle cure. Most of us remember the long lines of people who made their way to a mganga in Northern Tanzania a few years ago. He boiled herbal concoctions which he gave to the waiting crowds to drink. One cup of the stuff was supposedly enough to heal every imaginable disease. Many years earlier in Masaka, Uganda, a peasant woman claiming divine guidance fed people on soil as a universal cure for all ailments. Thousands went to her shrine brought back the soil and some still died from whatever it was they were suffering from. Clearly, as Ebola in West Africa has shown, most of Africa has not yet made the necessary social transformation. Even as we speak of the revolutionary potential of ICT, superstition and ignorance of the most basic things remain in many areas. Equally, democratic accolades that are liberally bestowed on some leaders are not enough. They do not translate into good health care, better education, more information and improved livelihoods. More investment needs to be made in the really transformative tools. Hopefully, the Ebola outbreak in West Africa is a wake-up call. Twitter: @jrwagatare

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Ebola exposes Africa’s weaknesses