Ebola shines a spotlight on Africa’s poor healthcare systems

THE Ebola virus is creating a “strange, unfamiliar creature in Nigeria called responsible leadership”, Nigerian columnist Pius Adesanmi wrote last week.

Nigerians, he says, are more familiar with a leadership that escapes into “an alternative universe” when confronted by a problem.

“The roads are in a shambles? No problem, we shall escape into our helicopters and private jets. The hospitals are in a shambles? No problem, we shall outsource our illnesses to the healthcare systems of SA, India, Germany, the US and Canada. For every problem, Africa’s most irresponsible leadership has only one solution: escape and leave the people at the mercy of the elements.

“Then comes Ebola. Then comes the democracy of death. And everybody suddenly becomes responsible. Your private jets and helicopters are no answers to this one.”

Nigeria’s president certainly did move quickly on the Ebola crisis, declaring a state of emergency and making millions available to contain the virus as panic spread.

Ministers and state governments supported the president’s efforts — although the firing of 16,000 striking doctors on Friday who refused to return to work to pitch in has taken some of the shine off.

The Ebola crisis has put the spotlight on health facilities in West Africa and, by extension, Africa — a reminder of the time, not so long ago, when outsiders viewed the continent as a region plagued by disease and poverty rather than a new frontier for investment. Getting ill in most African countries is not for the faint-hearted unless you can afford private healthcare, which most cannot.

The desperation of a man to travel while seriously ill in search of better treatment than was available in his homeland — Liberia — is one thing. The fact that he went to Nigeria to get it is another, given that the country’s own citizens spend thousands of dollars getting treatment elsewhere because of a lack of quality facilities.

Africans battle a range of communicable and parasitical diseases. The continent has 10% of the world’s population but it bears 25% of the global disease burden.

Many countries do not have the facilities, drugs and equipment to deal with longstanding diseases and now have to deal with a dramatic increase in lifestyle-related diseases, such as diabetes and cancer.

This leaves little or no capacity to deal with a complex emergency such as the spread of the Ebola virus. In Liberia, where Ebola infection rates continue to rise, the hospital where four doctors became infected has been closed because it ran out of protective clothing.

Fighting disease from a prevention perspective is difficult as the necessary tools, such as sanitation, clean water and nutrition, are generally not in place.

Only a handful of African countries have met a target signed up to 2001 by 53 nations to dedicate 15% of national budgets to improving healthcare. Some have cut spending.

As Adensanmi points out, in Nigeria, as elsewhere, even the president is not safe from Ebola. Staff could bring it right to the state house. This has no doubt helped to inform his proactive approach to tackling the problem.

If political leaders were forced to use public health systems, they would soon find a way to address the challenges that they spend most of their time and energy to avoid.