Ebola epidemic highlights poverty in Africa

By David Brown

1 August 2014

The recent epidemic of Ebola in West Africa has rapidly become the worst outbreak of the disease yet recorded. Over a three day period this past week, there have been 122 new cases and 57 deaths. There are now more than 1,300 cases reported in the current outbreak, and 729 deaths, including of several health care workers.

Ebola is primarily a disease of rural poverty. Outbreaks begin in wild animal populations that are then transmitted to humans through hunting or by way of domestic animals. Although the disease is highly contagious, transmission requires direct contact with the bodily fluids of someone infected, so the spread of the disease can be minimized through basic sanitation and medical quarantine.

The current outbreak, the first in West Africa, affects Liberia, Sierra Leone and Guinea. It began in February and is far from being contained. This outbreak has a relatively low mortality rate compared to many earlier epidemics, where mortality has been estimated by the World Health Organization at 64 percent.

In some outbreaks, as many as 90 percent of those infected die. There is no treatment or vaccine for the Ebola virus, but if symptoms are managed the mortality rate can be lowered.

On Tuesday, Liberia announced it was closing down its schools and most of its border crossings, and placing nonessential government workers on compulsory 30-day leave.

On Wednesday, Sierra Leone announced a state of emergency. The police and military have been ordered to establish quarantines of affected areas, conduct “active surveillance and house-to-house searches,” as well as protect health care workers. While the state of emergency exists, public gatherings are restricted.

Several high profile health care workers have contracted the disease in the course of treating patients. Two prominent African doctors, Samuel Brisbane of Liberia and Sheik Umar Khan of Sierra Leone, have died during this epidemic, and a number of other health care workers have also succumbed to the disease.

The US Peace Corps announced on Wednesday that it was withdrawing from the affected countries due to the epidemic. Aid agencies are removing nonessential personnel or ceasing operations altogether. This has catastrophic implications in the affected countries, which depend almost exclusively on foreign aid for health care.

Sierra Leone, a country of over 6 million, has fewer than 200 doctors in its entire public health sector, while Guinea has just 1 doctor for every 10,000 people; the worldwide average is 13 for every 10,000.

The general statistics for these countries expose the deep poverty and lack of sanitation that has allowed Ebola to spread so rapidly. The countries affected are plagued by dilapidated health care systems and other infrastructure.

Only 3 percent of Liberians have access to running water. Sierra Leone has the highest under-five mortality rate in the whole world, with over a quarter of all children dying before that age, mostly due to lack of sanitation and clean water.

Guinea spends $67 per capita on health care, the most among the three affected countries. Liberia spends $20 and Sierra Leone only $16 per capita on health care. In every possible category the quality of health care in these countries is disastrous. Life expectancy at birth in Sierra Leone is the lowest in the world, at 47.5.

In total the three countries spend under $900 million a year on health care for their 20 million citizens. In response to the Ebola outbreak, the European Union pledged $2.7 billion on Wednesday, the only major foreign aid so far. The sum is about triple the area’s normal health care budget, but less than two days of US military spending.

For the major powers, West Africa, along with most of the continent, is seen primarily as a source of raw materials. The region enormous reserves of untapped mineral wealth. Guinea is the world’s second largest producer of bauxite, while Sierra Leone is famous for its diamonds.

The imperialist powers have jockeyed for position in West Africa, while ensuring continued poverty for the vast majority of those who live there. Both Liberia and Sierra Leone have been subjected to devastating civil wars over the past quarter century, stoked by the economic interests of the United States and Great Britain.

Guinea, in its turn, had a disputed election in 2010 with the rival candidates Condé and Diallo backed by the mining company Rio Tinto and Swiss Bank UBS respectively. Both business interests were seeking to develop new mines in the Simandou Mountains.