Socialist Worker

West Africa's Ebola crisis is a symptom of capitalism

The Ebola outbreak in west Africa has cost thousands of lives. Ken Olende looks at how inequality and the legacy of colonialism lie behind the crisis. Marcia, an aid worker in Sierra Leone, writes exclusively from the front line

Issue No. 2425

Health workers preparing to treat Ebola patients in Liberia

Health workers preparing to treat Ebola patients in Liberia (Pic: Tommy Trenchard/IRIN)


The spread of Ebola has caused panic around the world. The disease is deadly, sometimes killing up to 90 percent of those who catch it. 

In the current outbreak about half of those infected have died. Symptoms include fever, aching, stomach pain, vomiting and bleeding.

It is highly infectious. But as it spreads through contact with bodily fluids, it is relatively easy to control in a hygienic environment.

But Sierra Leone only has 304 of the 1,148 beds currently needed to stop the spread. The situation in Liberia is worse.

More people have died in the current outbreak of Ebola than in all previous confirmed deaths since the disease was discovered.

But that adds up to a total of about 6,000 people. That is about the same as the number who die from malaria every two days, according to World Health Organisation (WHO) figures. 

Since this year’s Ebola outbreak began, 600,000 people will have died of tuberculosis. Every year 2.5 million people die of HIV, mostly in sub-Saharan Africa.

But the spread of Ebola is out of control. Doctors are talking about 20,000 deaths by the end of November. 

Tributes to hospital workers killed fighting the disease

Tributes to hospital workers killed fighting the disease (Pic: Samwar Fallah/IRIN)


Some fear that a million could die. More than 375 health workers have already died, about 10 percent of those infected.

Many people trying to stem the outbreak are furious that local people don’t listen to the advice they give. They blame superstition and lack of education.

But there are good reasons why poor people don’t trust what their governments say.

Africa remains a net creditor to the rest of the world. At root poverty is fuelling this crisis.

Western intervention brings the potential of modern medicine, but it impoverished the countries so the majority of people can’t access it.

Since independence in 1961, Sierra Leone has seen outside firms trying to control commercial interests and authoritarian governments bleeding the poor.

Both Sierra Leone and neighbouring Liberia suffered brutal civil wars from the 1990s. Up to 300,000 people died in Sierra Leone between 1991 and 2002.

Opposition political movements have been suppressed. Many people, particularly in the east of the country, believe that the government is only trying to take their resources without supplying anything. 

The state offers few if any services in rural areas. Government health care is erratic and most people rely on traditional medicine.

So some people saw the advice on Ebola as an attempt to depopulate the country. They saw the disease as a government plot and renamed it “eastbola”.

One observer wrote, “Why should people believe a government that lies about so many other things when it tells them they will die if they don’t go to hospital?”

There are a series of strikes taking place in the Ebola-affected areas. For instance, health workers in the Liberian Health Workers Association were set to strike as Socialist Worker went to press. Burial 

workers in Sierra Leone went on strike last week demanding to be paid their weekly risk allowance wage.

The British and the US are sending in troops. Britain has sent 750 troops to Sierra Leone. And the US now has 300 marines in Liberia. In both cases they are meant to provide emergency help in expanding medical facilities in rural areas. But the question arises whether the military is really the best organisation to do this.

Another strategy has been tried in west Africa’s most populous nation, Nigeria. It has strategy’s for challenging the spread of disease in place, largely from a recent campaign against polio. 

Despite facing 19 confirmed cases of Ebola earlier in the year it has so far managed to contain the disease. 

Medical staff made 18,500 visits and identified 894 people who had been in contact with disease carriers. As of the end of September no new cases were identified.

It is the lack of doctors and lack of research that creates the problem. And neoliberal medical practices looking only for profit worsen imperial prejudice.


Letter from Sierra Leone: People can't hold hands or bury their relatives

Marcia is a council worker from Britain who has taken two years out to work as a volunteer in Sierra Leone in west Africa. She lives in a district at the heart of the Ebola outbreak where a lockdown forbids people from leaving their homes.

“I am in Makeni town in Bombali district. It was put under quarantine after the lockdown. 

The number of cases has rocketed in the last five weeks. 

The hospitals are not well equipped. Health systems are really basic and are struggling to cope with the enormity of the spread.

Many private hospitals have closed. Protective equipment is beginning to arrive in the government hospitals.

But there are so few doctors that there are none at the holding centres, just nurses and carers.

There have been 180 confirmed cases in Bombali to date of which 146 have died and 15 survivors. 

There are others who have died but aren’t confirmed to have Ebola.

Families with sick relatives are being told they can’t hold the hands of the sick and the dying. 

Then their loved ones die and they are told they can’t prepare them for burial in the normal way. 

The leader of a village about three miles from here died and was buried safely. But local people dug him up in the middle of the night and gave him a second funeral fitting for a leader.

Of those who dug him up, 14 became ill. They soon infected their families and to date 70 people have already died in that village alone. 

The illness takes away every dignity. But attempts to treat the dying with respect put their friends and relatives at risk.

Not all the sick people are infected with Ebola. The symptoms are similar to malaria and other viral diseases. So many people are dying from curable illnesses. 

At the university we lost another student last week. His uncle and brother who he had cared for had already died. 

The student and many like him end up dying miles away from family because the nearest treatment centre is four hours drive from where they live.

People are just buried in the hospital grounds, especially if they are from far away. 

You can only imagine what the psychological effect is going to be like for those who survive. 

Many have already abandoned homes where family members died. There are many new orphans.

But there are many people who are taking in orphaned children—sometimes family members and sometimes complete strangers.

In the town we can move around to the shops and markets but no one can come in or go out of the district.

Everyone has adopted ‘no touching’ as a principle. I try to have my hands constantly crossed around my chest so that I don’t get tempted to touch anyone. 

Even when walking down the road, everyone tries really hard not to touch. 

I pray that this will end soon.”


Firms see no profit in curing the illnesses of the poor

A Medecins Sans Frontieres aid worker

A Medecins Sans Frontieres aid worker (Pic: Tommy Trenchard/IRIN)


Ebola virus

The Ebola virus under an electron microscope (Pic: Cynthia Goldsmith/Centre for Disease Control)


Ebola was first isolated in 1976 after a Belgian nun in Zaire (now called Democratic Republic of Congo) died of a mystery disease. From the outset it was the fact that a European died that brought world attention.

Africa is a resource rich continent. Its current poverty comes from centuries of exploitation by the West.

Both the countries at the heart of the current outbreak Sierra Leone and Liberia were set up to house freed slaves. Sierra Leone by Britain and Liberia by the US.

The WHO drew up a list of 17 neglected tropical diseases in 2012.

They include tuberculosis, rabies, leprosy, river blindness, sleeping sickness and parasitic worm infections, but not Ebola. 

It had not infected enough people to make the list. 

Though these diseases affect more than 1.4 billion worldwide big pharma tends to downplay them as the victims are the poor in Africa, Asia and Latin America.

A study in the Lancet medical journal showed that only four of the 336 new drugs developed between 2000 and 2011, were for these diseases.

The experimental vaccines for Ebola have been largely developed in small publicly funded labs.

Medical research is enormously skewed towards diseases in rich countries.

Pharmaceutical firms don’t see a profit in curing diseases that largely kill people with no money. 

As with Aids, even when medicines do come on the market they are too expensive for most people in Africa.


Expert: ‘Borders can’t stop infectious diseases from spreading’

The British government has announced it will introduce screening “in the coming days” for people arriving from the most infected countries.

This is to be at Heathrow and Gatwick Airports and Eurostar terminals.

Professor David Mabey, who specialises in infectious diseases at the London School of Hygiene & Tropical Medicine, called this “a waste of time”.

He added, “If last week your aunt died of Ebola but you feel fine, are you going to be honest when you get to the airport and risk being detained?”

David Heymann, chair of Public Health England, said “Borders cannot stop infectious diseases spreading.”

He believes that the NHS is fully prepared to deal with any infected people.

In the West concern has mounted over the few cases of Ebola that have been reported outside Africa.

One confirmed case in the US and a nurse in Spain who caught the disease while tending to a priest who had caught it in west Africa.

Spanish healthcare workers in Madrid have protested, saying budget cuts and privatisation have put them at risk.

Workers at several US airports have struck demanding better health and safety conditions when cleaning flights from at risk countries.


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