Ebola: The virus of corruption

Published 31 st December 2014 by Daniel Kirkpatrick
Ebola medical workers
Since the outbreak in March 2014 to December 27 th Ebola has claimed 7,857 people's lives in six countries with deaths predominantly in Liberia (3,413), Sierra Leone (2,732) and Guinea (1,697) highlighting the crisis facing West Africa. Ebola is a virus disease with a death rate of up to 90% primarily spread through human-to-human transmission [1]. Health workers have explained that to stop its spread it needs early detection, isolation and swift treatment [2] and has notably been contained within Nigeria and Senegal where government responses were much more decisive [3]. Thus the primary media and public focus has been on the medical causes and the humanitarian effort aimed at tackling the crisis. Whilst I accept the need for improved medical aid and international coordination in tackling Ebola, I can't help but ask why it was able to reach this stage with thousands dead.

The three main countries - Liberia, Sierra Leone and Guinea - have all suffered from recent conflicts. Liberia experienced decades of conflict ending officially in 2003 with the Accra Comprehensive Peace Agreement but only after the economy was left in ruin with estimates of 250,000 dead; the health system needing urgent improvements to offer basic healthcare never mind deal with any disease outbreaks such as Ebola [4]. Similarly, Sierra Leone suffered a brutal civil war from 1991 to 2002 resulting in poor health infrastructure, corruption and overall a crippled economy [5]. Guinea also is emerging from a troubled past having been ruled by a military junta from 2008-9 previously being heavily involved in the neighbouring conflict in Liberia [6], but despite vast mineral wealth it again suffers from widespread corruption [7]crippling any of the much needed investment in national healthcare. It is estimated that "a typical seven-year civil war leave[s] a country 15 per cent poorer than it would otherwise have been." [8] The conflicts specifically in these countries were characterised by warlordism, looting and exploitation of resources where the war economy was financed through the extraction of resources. Sadly the end of the conflicts did not see the end of the exploitation, rather the corruption that existed during the conflict became institutionalised in the new state institutions.

Conflict creates an environment where, like a virus, corruption can infect a nation reproducing itself until all areas of public life suffer from its illness. Politics and economics become subject to clientelism and patronage: "The practice of bribery and embezzlement spread from top to bottom, from politicians to tax collectors, customs officers, policemen, postal clerks and dispensary assistants." [9] Transparency International compiles an index on the corruption levels of all countries across the world ranking countries(0-174) based on an index of between 100-0 (least to most corrupt); Liberia was ranked 94 with 37, Sierra Leone 119 with 31, Guinea 145 with 25. [10] For a comparison the UK is ranked 14 with 78 and the USA 17 with 74. Transparency International Corruption Index Corruption in West Africa is a serious issue but its relationship with Ebola is due to its contribution to state fragility. If a country struggles with corruption funds may be diverted from investment in health institutions; health officials may have poor education due to a lack of investment in medical schools, clinics and supplies; and road/transport infrastructure may be inadequate making it difficult for the population to reach medical facilities and receive treatment early. Overall corruption results in private interests - of politicians, business CEOs, warlords - competing with national interest [11] and the much needed investment in health infrastructure.

This brief overview starts to paint a very unpleasant picture of the region, whilst Ebola is evidently a medical problem the failure to contain its spread is evidently in part linked to corruption and poor healthcare systems due to years of conflict. Corruption should be dealt with wherever it is manifest but in countries with such embedded systems of corruption - like those of West Africa - a further question must be asked: Will aid get to those who need it?

These nations have some of the world's greatest mineral wealth - diamonds, iron ore and gold - yet corrupt governments, greedy international corporations and opportunistic warlords prevent the much needed investment in health infrastructure. Therefore I ask a very difficult question, can we by sending aid to these nations resolve the underlying causes or merely perpetuate them? This is not to deny the great need for humanitarian aid going to these nations but rather that it should go through legitimate and reliable organisations such as Medicines San Frontier, not the government institutions. And before anyone accuses me of western cultural imperialism, I am also referring to the corruption which we are perpetuating ourselves by wilful ignorance of the source of the resources we use. The spread of Ebola could have been better contained if proper health infrastructure had been in place - as has been the case in Nigeria - but the climbing death toll rings at least in part due to structural corruption being allowed to fester and develop much like the virus we now see claiming so many lives.

[1] "Frequently asked questions on Ebola virus disease", World Health Organisation, August 2014. http://www.who.int/csr/disease/ebola/faq-ebola/en/

[2] "From Senegal and Nigeria, 4 Lessons on How to Stop Ebola", National Geographic, October 24 th 2014. http://news.nationalgeographic.com/news/2014/10/141024-ebola-nigeria-outbreak-lessons-virus-health/

[3] Ibid.

[4] "Liberia Conflict Profile", Insight on Conflict. http://www.insightonconflict.org/conflicts/liberia/conflict-profile/

[5] "U.S. Relations With Sierra Leone", Bureau of African Affairs, U.S. State Department, January 22 nd 2014. http://www.state.gov/r/pa/ei/bgn/5475.htm

[6] "Guinea Conflict", Global Security. http://www.globalsecurity.org/military/world/war/guinea.htm

[7] "Crying foul in Guinea", Economist, 6 th December 2014. http://www.economist.com/news/business/21635522-africas-largest-iron-ore-mining-project-has-been-bedevilled-dust-ups-and-delays-crying-foul

[8] Ramsbotham, O. et al., (2011). Contemporary Conflict Resolution. 3 rd Edition. Cambridge: Polity Press. p89.

[9] Samuel Mondays, "Corruption and State Instability in West Africa: An Examination of Policy Options", KAIPTC Occasional Paper No.21, December 2007. http://www.kaiptc.org/Publications/Occasional-Papers/Documents/no_21.aspx

[10] "Corruption Perceptions Index 2014: Results", Transparency International. http://www.transparency.org/cpi2014/results

[11] Mondays, 2007.