FEATURE ARTICLE

Wednesday, April 8, 2020
SILO@depaul.edu
Chicago, USA
IN THE FIGHT AGAINST COVID-19, AFRICANS MUST LEARN FROM HISTORY

ecently, the head of the World Health Organization (WHO), warned African countries against complacency in the fight against Covid-19. Tedros Adhanom Ghebreyesus, who is the first African to head the world body, warned that "Africa should wake up, my continent should wake up" and learn from the devasting impact of this pandemic in other parts of the world. In order to accelerate the fight against Covid-19 outbreak, Africa must apply the lessons which West Africans learned in the failings during Ebola Virus Disease (EVD) outbreak.

Ebola Outbreak in West Africa a Continental Catastrophe

Between December, 2013, when the outbreak of EVD was first reported, and September, 2015, more than 27,000 cases were reported with 11,000 reported deaths. It was, according to experts, the worst Ebola outbreak in history. In less than six months after the first case was reported, it had spread to three capitals of three African countries-Conakry, Monrovia, and Free Town.

In terms of the recorded number of affected persons, countries involved, and longest persistent transmission, the West African strain of the Ebola disease was the deadliest and the most destructive with high case-fatality rate of between 400-500 deaths every week.

Africa is Ill-Equipped to Fight Covid-19

According to the study by the Independent Panel on the Global Response to Ebola, this epidemic exposed the systemic weaknesses in the healthcare systems of the affected West African countries. African countries lack the core capacity to prevent, detect, contain, mitigate and rapidly respond to outbreaks. West African governments particularly in Nigeria, Gambia, Sierra Leone, and Liberia have failed to build effective and efficient healthcare systems and medical tourism continues to be a flourishing outlet for the rich and powerful in countries like Nigeria who suffer less collateral damage from failing their people and allowing the healthcare sector to decline at a frightening rate. Our hospitals in Nigeria are places where those who are healthy go to become sick, and where those who are sick go not to recover, but often to die.

Paul Farmer, and his team, in a research published in the Journal of American Medical Academy, argue that Ebola exposed, the pathology of chronic neglect of Africa's public healthcare system and global inequities. African countries lack the capacity to deliver quality healthcare as reflected in the absence of these basic components-trained and competent healthcare workers, availability of medical equipment like ventilators, personal protective equipment, isolation units, regular power supply, and clean water among others. The high fatality rate of Ebola disease, according to Farmer and his research team, "is related to lack of adequate systems in which the healthcare staff and resources can be effectively deployed."

What these point to is the painful truth that Africa is ill-equipped to fight Covid-19 and she might not get any humanitarian support from Western countries who are presently overwhelmed with this pandemic. In addition, global health inequities have always reflected in the failed humanitarian intervention in Africa in the past; nothing shows that it will change even now.

How West African Countries can Mitigate and Contain Covid-19

The recently released report of the Imperial College's Covid-19 Response Team propose two fundamental strategies for the non-pharmacological Interventions (NPIs) to reduce the mortality rate of the Covid-19 outbreak and its potential capacity to overwhelm national healthcare systems. First, is mitigation, which focuses on slowing but not necessarily stopping epidemic spread - reducing peak healthcare demand while protecting those most at risk of severe disease from infection. Second, suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.

How can African countries with a very fragile and inefficient healthcare systems meet these two fundamental benchmarks?

First, in the absence of the core capacity, African countries must embrace what worked for them in the fight against Ebola. The Panel on Ebola proposes that future outbreaks can only be contained when there is a reliable system for sharing epidemiological, genomic and clinical data among all the stakeholders, frontline workers, first responders and the populace.

Second, in his study of the factors which led to the successful outcome of the fight against the Ebola outbreak, Paul Richards points to what he calls the use of 'people's science' to fight outbreaks. This refers to the resilience of African communities and the capacity of African cultures to adapt itself to changes and threats in order to create a new pathway for survival and growth. The success of all the measures, which eventually rolled back the hand of death in West Africa, was dependent on the use of communal social networks, communal surveillance, tapping into the social capital in the complex and rich chain of African communal and social ties, neighborhood groups, and social solidarity.

These measures were also strengthened by the use of the traditional channels of authority to enlist the co-operation of everyone in both urban and rural communities. What emerged was a very well-coordinated response that involved rapid and effective messaging on the nature of the disease, prevention and available treatment. In addition, communities embraced the strictest measures in terms of social distancing, avoiding personal/bodily contact with people, isolation, sanitation and changes in personal and cultural practices all of which helped West Africans to win the battle against Ebola.

Coronavirus vs Corrosive Anointing

Many people believe that one of the reasons for the high mortality of Ebola in West Africa during the initial phase of 2014 outbreak was because people sought for spiritual healing rather than self-isolating and avoiding bodily contact. As former Liberian President, Ellen Sirleaf points out in a recent letter to the world published by the BBC, the initial missteps in Liberia during the Ebola outbreak included lack of adequate information, fear, lack of proper communication, and manipulation of information. Many of the traditional and Christian healers who claimed to have supernatural powers to cure people of the Ebola virus ended up dying and infecting so many others.

West African government, religious leaders and healthcare advocates must fight the current misinformation about Covid-19 especially coming from religious leaders. I recently saw a clip of a Nigerian pastor who was claiming that coronavirus cannot stand his 'corrosive anointing.' In Enugu state, a religious leader in a dangerous show of religious grandstanding verging on empty pietism and effete fideism is endangering public health and undermining social order by asking Anglicans to pour into churches this Holy Week. As funny as these 'corrosive anointing', and 'you cannot close the healing churches of God' claims may sound, this is the kind of misinformation and false religiosity which many Nigerians are relying on, especially when some of the national and local leaders are showing no leadership in this fight.

What is obvious is that Covid-19 is an invisible enemy that is spreading rapidly. It is now spreading silently in Africa. Because African countries do not have the capacity to fight this lethal disease, the only option they have is to contain it in order to mitigate its effects. This can be done through a rapid dissemination of scientific and correct information about the nature of the disease, communal solidarity, and high level of alert.

African communities must immediately adopt those basic changes in daily personal, religious, communal and national life for suppression which might help stem this rising tide of infections. Religious leaders should become part of the solutions and not the problem. Rather than invite people to churches and take collections from them, they should open their coffers and reach out to the poor, for whom Covid-19 is another painful and heavy burden on multiple layers of suffering, pain, anguish, and sickness.

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