… a highly contagious one. It arrived without warning, despite my strict observance of the Ebola-driven public health measures currently in force in Sierra Leone. (These measures include the ABC rule: ‘Avoid Body Contact’. I’ve had no hugs, handshakes or high-fives for several weeks now.)
Since my virus had no cure, all I could do was treat the symptoms and hope for the best. And so I plied myself with Lemsip, the enemy of the common cold. While I lay in bed watching Downton Abbey and feeling sorry for myself, I realised it could be worse. All around me, communities nationwide are caught in the clutches of another highly contagious virus. An infinitely more devastating one: Ebola.
Since it first hit West Africa six months ago, the Ebola virus disease has cast a grim shadow over the region. The current outbreak is the worst the world has ever seen. The death toll in West Africa has exceeded 1,900, but officials believe the true figure is far higher. Although there is no vaccine and no cure, the earlier it’s caught, the more likely you are to survive. All health workers can do is treat the symptoms (diarrhoea, vomiting, bleeding, nausea etc) and hope for the best. With this particular strain, survival rates are approximately 50 per cent. It’s as though people’s lives are subject to the toss of a cosmic coin: heads you win, tails you lose.
Here in Sierra Leone there has been much mistrust, fear, denial and suspicion: for a long time too many people refused to believe Ebola actually existed. Some thought it was a myth perpetuated by doctors, western NGOs and governments. And so the virus spread, undetected, as sick people went into hiding and as family members cared for ill relatives themselves or sought the ‘help’ of traditional healers. In some areas, treatment centres have been raided and sick patients have been forcibly removed by their relatives.
It is now a crime to harbour an Ebola victim in Sierra Leone, but in many respects the disease is still underground. Cases are still going unreported. Why don’t people know any better? Why don’t they just go online and do a quick Google search on Ebola? Because this is a country where 1.3 per cent of people are internet users. The average person gets 2.8 years of schooling. 90 per cent of women and 80 per cent of men don’t have secondary education.
Nearly 60 per cent of Saloneans cannot read or write.
I was reminded of this last week, as my new night time security guard struggled to write his name on a salary receipt: it took him five painful minutes. “Don’t blame me,” he pleaded, over and over again. He told me he’d dropped out of school to find work after his mother had died. I told him I didn’t blame him. I told him I was sorry. Sorry that Sierra Leone is ranked 183 out of 187 countries on the United Nations’ 2014 human development index, making it the fifth least developed country worldwide. Sorry that 117 babies of every 1,000 born don’t survive. Sorry that 182 of every 1,000 children don’t live beyond their fifth birthday. Sorry that anyone who makes it past their 46th birthday is a statistical anomaly.*
That’s why the Ebola virus is taking a huge toll on the country. Before now, Sierra Leone had around a dozen ambulances for its entire population of 6 million, and just two doctors for every 100,000 people (to put it in perspective, the US has 245 doctors per 100,000). Now that Ebola has killed three of the country’s top physicians, the figure is even worse than before. In fact, over 120 medical workers have died from the virus across West Africa.
“The world is losing the battle to contain it,” said the international president of Médecins Sans Frontières Dr Joanne Liu, on 2 September, as she briefed the UN on the Ebola outbreak. “Riots are breaking out. Isolation centers are overwhelmed. Health workers on the front lines are becoming infected and are dying in shocking numbers. Others have fled in fear, leaving people without care for even the most common illnesses. Entire health systems have crumbled. Ebola treatment centers are reduced to places where people go to die alone, where little more than palliative care is offered. It is impossible to keep up with the sheer number of infected people pouring into facilities. In Sierra Leone, infectious bodies are rotting in the streets.”
It’s a tragic situation. And one thing seems clear: Ebola is a disease fuelled by poverty, deprivation and under-development. Poor healthcare facilities, low education levels, a lack of trained medical personnel, weak infrastructure, limited access to clean water and inadequate sanitation.
That’s why, once the outbreak is over, governments, NGOs and global institutions need to focus on tackling the root causes of poverty, and not simply treat the symptoms. This is a drum that organisations like Christian Aid have been banging for a very long time. The more we challenge the systems, beliefs and structures that keep people poor, the more we can prevent the spread of diseases that can all-too-easily thrive in developing countries.
Because it goes without question: when it comes to poverty, prevention is always better than cure.
*United Nations Human Development Index 2014: http://hdr.undp.org/en/countries/profiles/SLE