Desperate: Liberian health workers at the NGO Medecins Sans Frontieres Ebola treatment centre in Monrovia, 18 October. Photo: Getty
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Monrovia, the city at the heart of the ebola outbreak

At least 200 health workers have been infected with ebola and 90 have died, according to the latest government figures, yet pay is modest. Last week they staged a two-day strike. 

Monrovia is a city where ambulances rush back and forth and burial teams in white hazmat protective suits have become so commonplace as to arouse no more curiosity. As the clock struck midnight on 13 October, health workers planned to abandon their posts at hospitals and ebola treatment units in the Liberian capital in a pay protest. Patients infected with the deadly haemorrhagic fever and vomiting, those who were “toileting” and bleeding, would be left alone in bed without food or care.

With close to 500 infected people in treatment centres, and almost three times as many yet to access care, the strike threatened to derail efforts to contain the crisis in Monrovia, now the centre of the ebola outbreak in West Africa. Given the huge risks and sacrifices endured by local medical staff, it is not hard to understand their anger.

At least 200 health workers have been infected with ebola and 90 have died, according to the latest government figures. Yet pay is modest.

At Island Clinic, a recently refurbished hospital that had been converted by the World Health Organisation into an ebola clinic, workers said they did not have contracts and that the government was skimping on hazard pay. Nurses and other staff claimed they had been promised $750 a month, and that the government was now offering them $435.

Workers elsewhere told similar stories. “They [the patients] are our people – we have to save their lives – but the government is not treating us fair,” said Matilda Weah, a 30-year-old nurse who had worked at Redemption Hospital, a government facility where five nurses and a doctor died after being infected.

In the end, the industrial action was called off, but only after a last-minute appeal from President Ellen Johnson Sirleaf as well as desperate negotiations between the government and the workers’ union leadership. Nurse Weah said it was concern for the patients, many of whom would have died, that persuaded them not to strike.

“When you see how sick they are, you cannot leave them like that,” she said.

Monrovia has teetered on the edge of chaos in these past few months. Desperate families transported loved ones in yellow taxis to hospitals because none of the city’s dozen or so ambulances was able to pick them up. Some died in the streets outside treatment centres even before being admitted. Others were turned away, returning home to infect relatives.

Schools were shut. The economy ground to a halt. Work stalled on the Mount Coffee hydropower plant, slowly being reconstructed by Norwegians; one of the darkest cities in the world could remain so for years to come.

Chinese workers building roads across the country were suddenly nowhere to be seen. Other foreigners –NGO workers, oil and mining company staff – scrambled for flights out. Coming the other way were specialists from the Centres for Disease Control and Prevention and WHO and USAID’s disaster assistance response team, with their safari waistcoats and caps.

US troops and military personnel are also trickling in as part of Operation United Assistance, announced by President Barack Obama last month. Their mandate is to build 17 ebola treatment units across the country, though these will not be staffed by Americans.

Many people welcome the assistance but some are suspicious of the motives of the US, which is widely seen as pulling the political and economic strings in Liberia. At a recent press conference, the US ambassador, Deborah Malac, felt compelled to assure people that US troops were not here to overthrow the government.

“They are here to provide additional heft to the effort that is already ongoing to fight ebola, period,” she said.

That fight remains a big one. Outside a former cholera clinic that has been turned into an ebola treatment centre sat five people: three men in their thirties, a young woman and a five-year-old boy. They had survived the virus and were waiting to go home.

“It was hell in there,” said one man, who wished to go unnamed because of the stigma associated with the disease. “We are traumatised. People were dying all around us.”

A jolly nurse who brought food to them while they were sick arrived to greet them. This was the first time they had seen her face; before, she was merely a figure in a mask. They thanked her for her help.

Yet the boy, who had lost his parents to ebola, was not on his way home but off to a centre built to care for some of the thousands of orphans who are expected to be created by this deadly outbreak. 

This article first appeared in the 15 October 2014 issue of the New Statesman, Isis can be beaten

Photo: Getty
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On the important issues, Louise Casey all too often has little to say

Far from moving the debate on, this new report on integration adds little to the report I commissioned in 2001. 

For 15 years, “numerous government reports on community cohesion and integration have not been implemented with enough force or consistency” concludes Louise Casey’s review of  integration.  The government’s lukewarm response suggests their effort will be as “diluted and muddled” as all the rest.

There’s a deeper reason why governments shy away from the measures that are needed. The report's wealth of data sets out a stark if sometimes contestable picture of a divided society.  But no amount of data can really bring the lives of our fellow citizens to life. As the Brexit vote underlined, this is now a nation divided by class, geography, education, wealth, opportunity and race. Those divisions colour the way we live our lives, the way we see problems in society, the relations we have with others, and our political choices. The report, like many before it, stops short of setting out that reality. It’s easier to pretend that most of us pretty much agree on most things; but just few people don’t agree and they must be the problem. Predictably, much of the early coverage has focussed on the Muslim community and new migrants. If only it were so easy.

According to Casey “in this country, we take poverty, social exclusion, social justice and social mobility seriously” and we do it “across political divides”. Apparently “creating a fair, just society where everyone can prosper and get on” is a cornerstone of British values. Yet for page after page the report chronicles the serial failure of this benign consensus to tackle educational under-performance, and economic and racial disadvantage. If we all agree, how come we haven't done anything about it?

These problems are not certainly easy to solve, but more lip service is paid to tackling them than effort. The practical material issues documented here need addressing, but punches are pulled when hard answers are needed. Given the dramatic impact of mass migration on cohesion, is integration possible while current rates of immigration persist? Can we find the political will to tackle poverty and disadvantage when those who might benefit from the effort are divided against each other by suspicion, race, geography and values? After all, rather than progressive policies producing a cohesive society, social unity is the precondition for the introduction of progressive policies.

We don't actually actually agree on what our “fundamental values” mean in practice. We can all sign up to democracy and the rule of law, but as soon as those are put into practice – see the court case on Article 50 – we are divided. When judges are popularly seen as “enemies of the people” and a vote in an elected parliament as a threat to democracy, in what sense are law and democracy fundamental?

Casey usefully highlights how treating homeless families equally, irrespective of ethnicity and length of residence can create the perception that minorities are being favoured over long standing residents. Our differing views on what is “just” and how “fairness” are defined can tear us apart. Is it fair to favour the newcomer over the indigenous? Is it just to put length of time on the waiting list above housing need? We often don't even acknowledge the legitimacy of other points of view, let alone try to find common ground.

The continual invocation of Britain and British values lends an air of unreality to the report.  Most people in England include British in their identity, but Englishness and English interests are of growing importance. In a worrying development, some areas of England  may be polarising between a white Englishness and an ethnic minority Britishness. Integration won't happen without a shared national story that combines a unifying national identity with the acceptance that we all have more than one identity that matters to us. Ignoring the reality of complex and multiple identities closes off one essential way forward.

None of this means that the criticism of some reactionary and occasionally dangerous ideas and practices in the Muslim community should be ignored and not confronted. But in a country where the established church opposes homosexual relationships and praise for Vladimir Putin's Russia is now mainstream politics it is hard to believe that all our problems can be reduced to the behaviour of a minority of a minority community.

John Denham was a Labour MP from 1992 to 2015, and a Secretary of State 2007 to 2010. He is Director of the Centre for English Identity and Politics at Winchester University