Spread risk: a Monrovia classroom serves as a rudimentary isolation ward. Photo: John Moore/Getty
Show Hide image

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

Getty Images.
Show Hide image

Why Theresa May won't exclude students from the net migration target

The Prime Minister believes the public would view the move as "a fix". 

In a letter to David Cameron shortly after the last general election, Philip Hammond demanded that students be excluded from the net migration target. The then foreign secretary, who was backed by George Osborne and Sajid Javid, wrote: "From a foreign policy point of view, Britain's role as a world class destination for international students is a highly significant element of our soft power offer. It's an issue that's consistently raised with me by our foreign counterparts." Universities and businesses have long argued that it is economically harmful to limit student numbers. But David Cameron, supported by Theresa May, refused to relent. 

Appearing before the Treasury select committee yesterday, Hammond reignited the issue. "As we approach the challenge of getting net migration figures down, it is in my view essential that we look at how we do this in a way that protects the vital interests of our economy," he said. He added that "It's not whether politicians think one thing or another, it's what the public believe and I think it would be useful to explore that quesrtion." A YouGov poll published earlier this year found that 57 per cent of the public support excluding students from the "tens of thousands" target.

Amber Rudd, the Home Secretary, has also pressured May to do so. But the Prime Minister not only rejected the proposal - she demanded a stricter regime. Rudd later announced in her conference speech that there would be "tougher rules for students on lower quality courses". 

The economic case for reform is that students aid growth. The political case is that it would make the net migration target (which has been missed for six years) easier to meet (long-term immigration for study was 164,000 in the most recent period). But in May's view, excluding students from the target would be regarded by the public as a "fix" and would harm the drive to reduce numbers. If an exemption is made for one group, others will inevitably demand similar treatment. 

Universities complain that their lobbying power has been reduced by the decision to transfer ministerial responsibility from the business department to education. Bill Rammell, the former higher education minister and the vice-chancellor of Bedfordshire, said in July: “We shouldn’t assume that Theresa May as prime minister will have the same restrictive view on overseas students that Theresa May the home secretary had”. Some Tory MPs hoped that the net migration target would be abolished altogether in a "Nixon goes to China" moment.

But rather than retreating, May has doubled-down. The Prime Minister regards permanently reduced migration as essential to her vision of a more ordered society. She believes the economic benefits of high immigration are both too negligible and too narrow. 

Her ambition is a forbidding one. Net migration has not been in the "tens of thousands" since 1997: when the EU had just 15 member states and the term "BRICS" had not even been coined. But as prime minister, May is determined to achieve what she could not as home secretary. 

George Eaton is political editor of the New Statesman.