Spread risk: a Monrovia classroom serves as a rudimentary isolation ward. Photo: John Moore/Getty
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West Africa on a hope and a prayer: the desperate efforts to contain ebola

The 16 August attack on an ebola clinic in the Liberian capital, Monrovia, is a sign of just how deeply western medicine is mistrusted.

Ebola, a virus with a 60-90 per cent death rate, has already killed at least 1,145 people in West Africa. There is no cure, which adds to the rising sense of fear in the affected countries and their close neighbours. There have been no confirmed cases yet in Gambia, but on crowded buses, crackling radio reports relay the latest death toll, a constant reminder that the threat is not far from home.

Having spread from a single Guinean village across swaths of Liberia and Sierra Leone and into Nigeria, this outbreak is the deadliest to date. There is little trust in doctors, a by-product of local traditions and popular reliance on faith healers. After months of bad news, many people lack hope.

The disease was first detected in February and was declared a Liberian national “public health emergency” by the president, Ellen Johnson Sirleaf, in June. In early August, the World Bank pledged $200m to Sierra Leone, Guinea and Liberia, and the UK offered a further £3m in aid. Yet the death toll continues to mount.

The 16 August attack on an ebola clinic in the Liberian capital, Monrovia, is a sign of just how deeply western medicine is mistrusted. It is hard to convince people to put their faith in new medicine when it can offer no cure.

The fragile economies and weak infrastructure of many countries in the subregion also limit their ability to manage the disease. On average, West African states spend $100 per capita on health care each year – nothing compared to the $3,600 per person in Britain.

The slow response by affected governments hasn’t helped. Kudzi Makopa, a student volunteer from London, flew to Sierra Leone in late May. “When we arrived there, the disease was the subject of jokes among the general public and there was even a comedy film on the matter being sold nationwide,” he told me. “No one really believed ebola was happening because they’d never seen it, and they thought that witch doctors or God would send it away.” Today, posters and billboards line the streets of the capital, Freetown, reading “Ebola is real”, but perhaps it is too late.

In Liberia, experts called in by the government insisted that the first wave of a disease is often less destructive than those that follow, which arguably made the country’s response slower than it might have been. “We were acting appropriately. But because of weak health systems, the disease spread, and now we are responding again,” Tolbert Nyenswah, an assistant minister in Liberia’s health department told me.

Gambia risks making some of the same mistakes. Despite its proximity to the epidemic, few plans have been put in place to combat the virus. There is no sign of the ebola isolation facility that was due to be set up months ago, and testing for the disease is not available in the country.

At the Medical Research Council in Fajara, on Gambia’s Atlantic coast, doctors are disappointed that promises of resources have not been met. Outside the hospital, crowds of patients, including rows of mothers cradling malnourished babies in their colourful wraps, sit waiting on benches in the heat. Should an ebola victim be treated inside, these walk-in patients would be turned away. Doctors say people are turning to prayer to deter the virus.

West African countries have tightened their border controls, but the World Health Organisation has said that official figures may “vastly underestimate” the spread of the virus, making it harder to contain. Despite the international attention, the measures in place to combat ebola are inadequate. It feels as though people are still waiting for some intervention, whether governmental or divine, to end this crisis. 

This article first appeared in the 20 August 2014 issue of the New Statesman, What the Beatles did for Britain

GARY WATERS
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In defence of expertise: it’s time to take the heart out of “passionate” politics

What we need is cool logic.

We are living through a bonfire of the experts. During the EU referendum campaign, Michael Gove explained that people had had enough of them. A few weeks later, his fellow Tory MPs took him at his word and chose a relative ingénue to run against Theresa May.

After declaring for Andrea Leadsom in the Tory leadership race, Michael Howard was asked whether it might be a problem that she had never held a position higher than junior minister. Howard, whose long career includes stints as home secretary and opposition leader, demurred: “I don’t think experience is hugely important.”

Even in this jaw-dropping season, that comment caused significant mandibular dislocation. I thought: the next Tory leader will become prime minister at a time of national crisis, faced with some of the UK’s most complex problems since the Second World War. If experience doesn’t matter now, it never does. What does that imply about the job?

Leadsom’s supporters contended that her 25 years in the City were just as valuable as years spent at Westminster. Let’s leave aside the disputed question of whether Leadsom was ever a senior decision-maker (rather than a glorified marketing manager) and ask if success in one field makes it more likely that a person will succeed in another.

Consider Ben Carson, who, despite never having held elected office, contested the Republican presidential nomination. He declared that Obamacare was the worst thing to happen to the United States since slavery and that Hitler may have been stopped if the German public had been armed. Yet Carson is not stupid. He is an admired neurosurgeon who pioneered a method of separating conjoined twins.

Carson is a lesson in the first rule of expertise: it does not transfer from one field to another. This is why, outside their domain, the most brilliant people can be complete dolts. Nevertheless, we – and they – often assume otherwise. People are all too ready to believe that successful generals or entrepreneurs will be good at governing, even though, more often than not, they turn out to be painfully inept.

The psychologist Ellen Langer had her subjects play a betting game. Cards were drawn at random and the players had to bet on whose card was higher. Each played against a well-dressed, self-assured “dapper” and a shabby, awkward “schnook”. The participants knew that it was a game of chance but they took more risks against the schnook. High confidence in one area (“I’m more socially adept than the schnook”) irrationally spilled over into another (“I’ll draw better cards”).

The experiment points us to another reason why we make poor judgements about competence. We place too much faith in social cues – in what we can see. As voters, we assume that because someone is good at giving a speech or taking part in a debate, they will be good at governing. But public performance is an unreliable indicator of how they would cope with running meetings, reading policy briefs and taking decisions in private. Call it the Boris principle.

This overrating of the visible extends beyond politics. Decades of evidence show that the job interview is a poor predictor of how someone will do in the job. Organisations make better decisions when they rely on objective data such as qualifications, track record and test scores. Interviewers are often swayed by qualities that can be performed.

MPs on the Commons education select committee rejected Amanda Spielman, the government’s choice for the next head of Ofsted, after her appearance before them. The committee didn’t reject her because she was deficient in accomplishments or her grasp of education policy, but because she lacked “passion”. Her answers to the committee were thoughtful and evidence-based. Yet a Labour MP told her she wasn’t sufficiently “evangelical” about school improvement; a Tory asked her to stop using the word “data” so often. Apparently, there is little point in being an expert if you cannot emote.

England’s football team is perennially berated in the media for not being passionate enough. But what it lacks is technique. Shortly before Wales played England in the European Championship, the Welsh striker Gareth Bale suggested that England’s players lacked passion. He knew exactly what he was doing. In the tunnel before kick-off, TV cameras caught the English goalkeeper Joe Hart in a vessel-busting frenzy. On the pitch, Hart allowed Bale to score from an absurdly long range because he was incapable of thinking straight.

I wish there were less passion in politics and more cool logic; less evangelism and more data. Unthinking passion has brought the Labour Party to its knees and threatens to do the same to the country. I find myself hungering for dry analyses and thirsting for bloodless lucidity. I admire, more than ever, those with obscure technical knowledge and the hard-won skills needed to make progress, rather than merely promise it.

Political leadership is not brain surgery but it is a rich and deep domain. An effective political leader needs to be an expert in policy, diplomacy, legislative process and how not to screw up an interview. That is why it’s so hard to do the job well when you have spent most of your time in boardrooms or at anti-war rallies.

If democratic politicians display contempt for expertise, including their own, they can hardly complain if those they aspire to govern decide to do without the lot of them. 

Ian Leslie is a writer, author of CURIOUS: The Desire to Know and Why Your Future Depends On It, and writer/presenter of BBC R4's Before They Were Famous.

This article first appeared in the 21 July 2016 issue of the New Statesman, The English Revolt