The Ebola crisis death toll might not have been so severe were it not for assisting nations ‘dumb’ aid programme and ‘lumping in aid and then walking away’, according to a leading humanitarian and health expert from Manchester.
Professor Mukesh Kapila CBE claims the short-term and reactionary nature of the response to the Ebola epidemic caused the collapse of healthcare systems in the worst affected countries of West Africa, including Sierra Leone, Guinea and Liberia.
Assisting nations were so obsessed with numerical results that they failed to effectively bolster the struggling healthcare systems in the affected countries, according to the professor of global health and humanitarian affairs at the University of Manchester.
This meant that the affected countries’ infrastructures ground to a halt and ‘crumbled’ under the proliferation of Ebola patients.
“The institutions created all those years ago crumbled so quickly in the face of what is actually a very stupid virus,” said Professor Kapila.
“They [assisting nations] basically lumped in aid and then walked away without understanding the basic basis of human development and nation building which could take a generation – 20 years.
“I think our aid program tends to be short term minded. Short term objectives, results, and is being counted. How many babies have you saved? How many children have you immunised? I think this is dumb.”
Professor Kapila, who has held leadership positions in the UN and World Health Organisation, believes institutions need to re-evaluate their solutions for the long-term.
“Obviously if you start going around immunising children [for other diseases] you’re bound to have high numbers, but then it doesn’t tell you anything about sustainable health systems, about self-reliance, local capacity building, and those take long-term measures,” he said.
“Development is a long-term business. How long has it taken the NHS here to grow from 1948 to now? Along the way, how many ups and downs do we have and continue to have?
“Development is not about measuring things that are measurable because by and large, things that are measurable are not the most important, and things that are important are unfortunately not measurable – and this is our dilemma.”
The Ebola outbreak had many consequences for the worst affected nations, as people were too frightened to go to hospitals fraught with Ebola patients.
Other deadly diseases such as malaria were ignored by doctors and nurses because of the sheer number of Ebola cases.
Malaria can kill more than 100,000 people in the region in an average year.
Professor Kapila, a former head in the UK department for international development, pointed towards the development of Sierra Leone after their civil war as an example.
Sierra Leone is the country most affected by Ebola. The civil war occurred from 1991 to 2002. The country called for post-conflict recovery from assisting nations after it was left in ruin.
“When the war [in Sierra Leone] ended in 2002, there was nothing left,” said Professor Kapila. “Infrastructure broke down, roads weren’t functioning, institutions weren’t functioning, and the people who were there to start with were left impoverished.
“So in the last 10 years a lot of effort has gone into post-conflict recovery. And you know, people are trying to pull themselves up from their bootstraps.
“It’s not to say there hasn’t been progress, but there is a lot of corruption. And a lot of the money has gone astray. I mean, you drive down where I was and there’s no electricity. You go down the road and a lot of the villages are all black. How come there’s not even a single light bulb?
“So our post-conflict reconstruction assistance was to bring security, helping with setting up a new government and democracy, but then we said ok job done, time to go and do something else.”
The British government announced on Monday that they will be giving a further £33million to help relieve financial pressure on countries affected by the crisis.
However, a study in the British Medical Journal revealed that only around 40% – or $1.9billion – of the initial pledge funds managed to reach those countries.
“It [Ebola] had a huge effect in terms of mobilizing resources and now, probably we have overdone it in that hundreds of millions have gone in,” he said.
“The world have obliged certainly in terms of a couple of billion dollars, and when I was in West Africa for the last ten days, most of the emergency treatment centres are empty and the epidemic is falling. Maybe the number of cases are halving every two weeks.”
Ebola also affected other areas, such as food being delivered to people, children going to school and local community activities, to say the least.
Professor Kapila believes nations need to remain cautious as an epidemic ‘will happen again’.
“[Ebola] is reducing, which is good news. But now we have to ask some critical questions, which are about the underlying vulnerabilities of people there which is related from poverty to broken down health systems.
“It’s then important that the real legacy of Ebola is not lost, and the real legacy of Ebola is that people need to invest in the long-term and not short-term projects. In the long run, to bring up governance and healthcare systems and such like.
“But we will have to remain vigilant, this will happen again. And when it does, like many other infections, it can be controlled through basic public health measures.
“Now what we have to do is move on with transitional recovery, making sure that Ebola’s legacy is one of a different way of providing healthcare, rather than completely depressing the nations affected.”
When quizzed on why he thought Ebola was a stupid virus, Professor Kapila responded: “The virus is stupid because it kills everyone.
“Normally an organism that kills its host means that it’s going to die itself, but if you were really interested in propagating yourself as a virus or an organism, you wouldn’t kill your host – you’d want your host to stay alive and pass onto others.
“So this is a virus which is not well adapted to the human body, it just kills. And with that the virus also dies. So it’s possible to control it and quickly so it doesn’t evolve either.”
Image courtesy of EC Echo Cyprien Fabre, with thanks.