Ebola epidemic – Cuba sends doctors, imperialists send soldiers

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The deadly and highly contagious ebola virus has been ravaging West Africa since December 2013. By the end of September, the World Health Organization (WHO) estimated that nearly 3,000 people had died. But the real figure is likely to be much higher, and the epidemic has spiralled out of control, with cases in Liberia, for example, reportedly doubling every 15 to 20 days. The lethally inadequate response by both the international community and the corrupt neo-colonial governments of the countries affected, whose frail health care systems are overwhelmed, have created a humanitarian crisis of appalling proportions.

Devastation in West Africa

The worst outbreaks have been in Liberia, Sierra Leone and to a lesser extent Guinea. The situation in Nigeria (which reported only 21 cases and eight deaths) and Senegal, with only one case, appears under control. But WHO figures for 25 September record more than 3,000 cases of contagion and 1,677 deaths in Liberia; 1,940 cases and 597 deaths in Sierra Leone, and 1,000 cases and 635 deaths in Guinea. Treatment and containment have been hampered by a lack of health facilities. Many hospitals initially closed for fear of infection, and treatment centres, including those set up by health charities such as Medecins sans Frontiers (MSF), have been overwhelmed, with reports of people dying in queues outside, or having to be taken back home in a ballooning cycle of contagion. At least 70% of those infected would need to be isolated and treated for there to be any chance of stopping the disease in its tracks: in Liberia the figure actually being treated is 18%. Today, Liberia has not a single bed available for the treatment of ebola patients anywhere in the entire country, and in March had only 50 doctors for a total population of four million people. Sierra Leone has fewer than 100 doctors practising in the public sector, very few of them specialists. Many health workers have died because they lack basic personal protective equipment (PPE). In September, nurses and doctors at Liberia's largest hospital went on strike over not being paid, food shortages and a lack of PPE.

These are poor countries, where many people are forced to share the same living space and the virus spreads quickly. Corpses are often left in houses for several days, and there is a lack of clean water to take essential hygiene precautions. In addition, in many rural areas there is mistrust of government and health workers, and some hospitals have been attacked and medical workers killed.

In the face of this catastrophe, national governments have introduced draconian measures. National borders have been closed and a state of emergency was declared in both Liberia and Sierra Leone, with soldiers being used to quarantine entire communities. In September, Sierra Leone imposed a three-day lockdown on the whole country.

International response: too little, too late ...

The ebola virus was first discovered in 1976. Yet nearly 40 years later, there are no licensed vaccines nor properly tested drug therapies available. The big drug companies have clearly not thought it profitable to develop treatments for a disease that to date has only affected poor people in Africa – claiming hundreds of lives every few years in cyclical epidemics. For presumably similar reasons, international health organisations were slow to act at the beginning of the current outbreak. Now, faced with the unprecedented scale of the current epidemic, the WHO and the United Nations have held emergency summits, and new treatments are in the pipeline. But no drugs, vaccines or therapies will be ready before November 2015. And despite promises of action and millions of dollars of aid from the imperialist countries, almost none has so far translated into the kind of response on the ground that organisations such as MSF have been desperately calling for. As MSF's international president Dr Joanne Liu said pointedly at the end of September:

'Generous pledges of aid and unprecedented UN resolutions are very welcome. But they will mean little, unless they are translated into immediate action. The reality on the ground today is this: the promised surge has not yet delivered.'

... and too militaristic

The main intervention offered is by imperialist armies, ostensibly to build treatment centres. The US is sending 3,000 troops to Liberia, with a US Africa Command (Africom) centre in the capital, Monrovia. The intention is to build 17 100-bed units, but aid agencies warn that these will be useless without the medical personnel to staff them. France is setting up a military hospital in Guinea, while British military engineers and medical experts will build and operate a 62-bed facility in Sierra Leone. In 2012, US Army Africa, a component of Africom, announced a ‘pilot programme’ of 3,000 troops to deploy to Africa in 2013 for ‘multiple missions at different locations’. What an opportunity ebola has turned out to be, allowing imperialism to extend its reach into the oil-rich region.

It has been left to volunteers to provide actual medical care. 164 medical workers from Britain's National Health Service have courageously offered their services – but this hardly counts as an adequate government response to the crisis. For that, we need to look to socialist Cuba.

Cuba shows the way

Cuba, with a population of just over 11 million people, is already training up a team of 165 highly qualified medical specialists to work in Sierra Leone from October. This will double the total number of doctors in Sierra Leone. It is by far the largest health team sent by any country and has been warmly welcomed by the WHO.

'Those of us who have been working on the response efforts at WHO know how truly valuable this offer is. Many countries have offered money but no other country has offered such a large number of workers to go in and help do the most difficult jobs in this crisis,' said Dr Bruce Aylward.

On 26 September, as British politicians gathered to discuss launching a new imperialist war on the Middle East, Cuba announced it was sending a further 300 health workers to West Africa. The contrast between imperialism’s militaristic and socialism’s humanitarian responses couldn’t be clearer.

Charles Chinweizu

Fight Racism! Fight Imperialism! 241 October/November 2014