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

John Moore
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The man who created the fake Tube sign explains why he did it

"We need to consider the fact that fake news isn't always fake news at the source," says John Moore.

"I wrote that at 8 o'clock on the evening and before midday the next day it had been read out in the Houses of Parliament."

John Moore, a 44-year-old doctor from Windsor, is describing the whirlwind process by which his social media response to Wednesday's Westminster attack became national news.

Moore used a Tube-sign generator on the evening after the attack to create a sign on a TfL Service Announcement board that read: "All terrorists are politely reminded that THIS IS LONDON and whatever you do to us we will drink tea and jolly well carry on thank you." Within three hours, it had just fifty shares. By the morning, it had accumulated 200. Yet by the afternoon, over 30,000 people had shared Moore's post, which was then read aloud on BBC Radio 4 and called a "wonderful tribute" by prime minister Theresa May, who at the time believed it was a genuine Underground sign. 

"I think you have to be very mindful of how powerful the internet is," says Moore, whose viral post was quickly debunked by social media users and then national newspapers such as the Guardian and the Sun. On Thursday, the online world split into two camps: those spreading the word that the sign was "fake news" and urging people not to share it, and those who said that it didn't matter that it was fake - the sentiment was what was important. 

Moore agrees with the latter camp. "I never claimed it was a real tube sign, I never claimed that at all," he says. "In my opinion the only fake news about that sign is that it has been reported as fake news. It was literally just how I was feeling at the time."

Moore was motivated to create and post the sign when he was struck by the "very British response" to the Westminster attack. "There was no sort of knee-jerk Islamaphobia, there was no dramatisation, it was all pretty much, I thought, very calm reporting," he says. "So my initial thought at the time was just a bit of pride in how London had reacted really." Though he saw other, real Tube signs online, he wanted to create his own in order to create a tribute that specifically epitomised the "very London" response. 

Yet though Moore insists he never claimed the sign was real, his caption on the image - which now has 100,800 shares - is arguably misleading. "Quintessentially British..." Moore wrote on his Facebook post, and agrees now that this was ambiguous. "It was meant to relate to the reaction that I saw in London in that day which I just thought was very calm and measured. What the sign was trying to do was capture the spirit I'd seen, so that's what I was actually talking about."

Not only did Moore not mean to mislead, he is actually shocked that anyone thought the sign was real. 

"I'm reasonably digitally savvy and I was extremely shocked that anyone thought it was real," he says, explaining that he thought everyone would be able to spot a fake after a "You ain't no muslim bruv" sign went viral after the Leytonstone Tube attack in 2015. "I thought this is an internet meme that people know isn't true and it's fine to do because this is a digital thing in a digital world."

Yet despite his intentions, Moore's sign has become the centre of debate about whether "nice" fake news is as problematic as that which was notoriously spread during the 2016 United States Presidential elections. Though Moore can understand this perspective, he ultimately feels as though the sentiment behind the sign makes it acceptable. 

"I use the word fake in inverted commas because I think fake implies the intention to deceive and there wasn't [any]... I think if the sentiment is ok then I think it is ok. I think if you were trying to be divisive and you were trying to stir up controversy or influence people's behaviour then perhaps I wouldn't have chosen that forum but I think when you're only expressing your own emotion, I think it's ok.

"The fact that it became so-called fake news was down to other people's interpretation and not down to the actual intention... So in many interesting ways you can see that fake news doesn't even have to originate from the source of the news."

Though Moore was initially "extremely shocked" at the reponse to his post, he says that on reflection he is "pretty proud". 

"I'm glad that other people, even the powers that be, found it an appropriate phrase to use," he says. "I also think social media is often denigrated as a source of evil and bad things in the world, but on occasion I think it can be used for very positive things. I think the vast majority of people who shared my post and liked my post have actually found the phrase and the sentiment useful to them, so I think we have to give social media a fair judgement at times and respect the fact it can be a source for good."

Amelia Tait is a technology and digital culture writer at the New Statesman.