30 Jul 2014

Poverty is at the root of west Africa’s ebola crisis

The fact that the foreign secretary is chairing a Cobra meeting on ebola on Wednesday is the reason the deadly disease is unlikely to take hold in the UK. It’s also an explanation of why it has spread so fast in west Africa.

Highly contagious, spread by contact with bodily fluids, ebola can be contained by standard infection control methods which are easy to implement in a developed country like the UK and almost impossible in Guinea or Sierra Leone. There is a danger that an infected person could arrive here by plane from west Africa and infect other members of their family, but we are lucky enough to live in a country with a modern public health system and effective government institutions.

Dr Peter Piot, the scientist who discovered ebola hemorrhagic fever, recently returned to the remote villages of what was then Zaire, now the Democratic Republic of the Congo (DRC), where he did his research in 1976.

What horrifies me about his account is not the descriptions of the gruesome disease but that facilities have not improved in the intervening 37 years. There is no running water in Bumba, the nearest town to the village of Yambuku where ebola started. Electricity is supplied intermittently by generator. The state provides nothing so patients have to pay for all medicines – not that there are any in the crumbling public hospital.

A health worker with disinfectant spray walks down a street outside the government hospital in Kenema

How many hospitals have I visited in Africa where patients lie two or three to a bed, lackadaisical (often unpaid) nurses and doctors watching them suffer because there are no medicines let alone disinfectant and rubber gloves to stop infection from spreading?

In many they don’t even have soap. Needles are re-used because they are in short supply.

War, state collapse and corruption have all taken their toll so the people return to the witch doctors who give them herbs, which may or may not work, or cut them and rub in magic potions which are more likely to spread disease further.  In some places heroic health staff – some local, some foreign – provide the best care possible under the circumstances. Aid agencies and mission hospitals help, but state systems have failed across much of the continent.

No wonder ebola is spreading through Guinea, Liberia and Sierra Leone, all desperately poor countries where conflict has destroyed what little infrastructure there once was. People often only go to hospital as a last resort, so their experience is that hospitals are places where people go to die not where they are cured. Such is the terror of the disease, and lack of education about how to contain it, that villagers in parts of Guinea have attacked health workers, blaming them for the contagion.

“Villagers flee at the sight of a Red Cross truck,” reports the New York Times. “When a Westerner passes, villagers cry out, ‘ebola, ebola!’ and run away.”

The disease is not the problem. Under-development, poverty and the lack of state institutions are the problem. Sadly, years of development aid have done little to remedy that.

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6 reader comments

  1. Ben says:

    The editorials evaluation of the causes appears to miss the ‘elephant’ in the room. From Leopold to Obama and Co, DRC serves only one purpose. The UN supports it as do most ‘democratic’ countries, how then can you miss it?

  2. Bob says:


    if they spent no money on arms, did not have their medical people ‘poached’ by western hospitals to save cash, if we stop companies in the west bribing their officials to buy junk, how much money would this leave for building more hospitals,

    sadly if this virus gets out of hand ie it reaches the west then the money will suddenly appear for the research needed,

    if we stopped fighting wars we should not start but waged others wars to stop evil such as in the congo, wouldnt the world start to improve a bit,

    is it really true, the best people never get to the top in politics because if they are any good, they never try, but excel -elswhere,

    finally would the world be better if governments were only run by women, old men over 70, or people who have had a bit of a pasting in life

    best wishes


  3. citizen says:

    Ebola is INCURABLE. The USA knows it, the GB knows it.
    CDC in Atlanta know it.

    Apparently the only thing a medic can do, (that is IF they can recognise the “signs” of Ebola which are very difficult to detect) in an African country, is to :
    1. Isolate.
    2. Burn all bedding/clothing after use.
    3. Soak all medical masks/treatment suits etc in STRONG disinfectant
    4. Medics to wear an disinfected mask AT ALL TIMES.
    5. Avoid all but essential contact with suspected Ebola case and prohibit visitors unless you wish to infect them too.
    There is NO CURE for Ebola.
    Also if a medic does NOT recognise Ebola case and treats patient without adequate protection, then he/she is the next case!
    THERE IS NO CURE for Ebola!

  4. Bob says:

    Hi, not necessarily for publication but a question from today’s reports,

    Ebola came out of the Congo?, could I ask if the root has any connection with HIV, could any of the treatments for this help?

    or could the stockpiles of Tamiflu we have help tackle this virus?

    if some people have survived, could their anti -bodies provide some form of vaccine for people?

    best wishes


  5. Jay says:

    Ebola became a dreadful disease even though it is a preventable disease with some simple measures. Also a threat to the public health on reduction of poverty as the health education alone not possible to eliminate it.
    . As I recall my memory when I was visiting in a brothel of Thailand as a public health student asked to a brothel girl which is as follow: I said “why are you doing this job ?shortly you will die of AIDS.” She smiled and replied me “yes I know it but what to do if I do not do this job I will die earlier than AIDS because I would not have any other means to solve my daily hand to mouth problem of my family and myself.” I closed my mouth and put her saying to my Acharn ( teacher) ,he replied me ” yes she is right, poverty is greater than AIDS.”
    I agree to Lindsey Hilsum “Poverty is at the root of west Africa’s ebola crisis” “.
    Since it is a disease of the poor people of the poor countries .Big brother are sleeping without listening their pains and less likely without any humanitarian responsibilities in this concern. However , this is not only their .isolated fact but it should be realized as a common problem of all the . nations of the world .
    Forward the steps to work together to overcome the epidemic!Otherwise it may eat all of the poor people ! Let us facilitate to do something to save the lives from the terrible Ebola !.
    Jay B Tandan, Nepal

  6. Gbolahan Oladeji says:

    It is human to share the pains of fellow men and women living in terrible community conditions and poor environmental lives, coupled with hopeless nutritionall supply as a result of their low income and inadequate process of socialization,however it is criminal to keep silence on the causes of failed states and their leadership in the tropical Africa .

    I am of the opinion that a standard should be set by revolutionaries in the United Nations,World Health Organization and the African Union on the average level of living for the endangered peoples of the developing counties, I am talking about purposeful utilization of the limited wealth to meet peculiar needs of all. There should be intensified introduction of concepts of emotion ,contentment and love into the curricula subjects of the primary and secondary schools to discourage treasury looting in our future leaders -Arise oh humanity ! let us fight the root factor of Ebola- hydra-headed poverty,

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