After the Ebola Epidemic... What's Next for Africa?

Just a few months ago, our airwaves were blasting with the words, "Ebola in America!" Many well meaning American health personnel traveled to Africa to fight this deadly epidemic that took the lives of hundreds of West Africans. The U.S. government committed soldiers to help build medical facilities and several non-profit organizations volunteered to combat this scourge.

Several months later, the news coming out of West Africa is promising as the tide of the disease has receded and children in these ravaged areas returned to school to finish the year. The long-term economic impact of this epidemic is huge and the world should not forget these countries. As with many other disasters of this magnitude in Africa, the West is often quick to turn its eyes away once the tragedy ends. We know that credible and sustaining institutions are needed to forestall future catastrophes. What happened in these African nations was controllable as evidenced by the quick progress made once the Western governments and charities turned their attention to tackling the problem.

Disease in Africa is a perennial problem and cannot be resolved with short-gap measures such as occasional interventions when there are epidemics. The problem is structural and systemic and requires the West to address the actual problem and not make Africa recipients of perpetual Western charity. One of the major problems faced by the African health care system is the dearth of properly trained medical professionals. Most of the early victims of the epidemic resorted to the use of traditional healers (aka native doctors). As is often the case, when these doctors cannot provide cures for certain diseases, they spiritualize the illness and claim that there is witchcraft involved and accusing fingers are pointed at family members or relatives. This was one of the primary reasons for the rapid spread of the disease. The presence of well trained medical professionals in the rural areas would have helped tremendously to reduce the mortality rate.

As West African governments attempted to combat this scourge, the most generous gift they received was the presence of many Western doctors and health personnel. These must be commended for their courage and generosity of heart. Offering to volunteer their services was risky as some of them ended up contracting the disease. The question that has not received much attention is why these African nations were reliant on the West for medical personnel? Nigeria alone can boast of more than 25 accredited medical schools. There are thousands of qualified students who try to get into these schools each year but cannot because of admission caps. These schools also graduate hundreds of doctors and medical personnel each year. Yet, thousands of communities in Nigeria are not served by even a single medical doctor. It is sad to note that there were more medical doctors in my county in the 1980s when I was a child than there are today. Some local governments (counties) can only boast of a few doctors. Given that Nigerian medical schools are graduating more students today than in the eighties, one would expect the counties to be served by more doctors today. Where have all these African doctors gone?

This question has a simple answer. These doctors are living and working in the West. The economic hard times that befell most West African countries in the early 1980s and the ensuing impact of the IMF mandated Structural Adjustment Programs created an exodus of African health professionals beginning in the late 1980s and onward. This movement became even more rapid in the late 1990s and thereafter when some Western countries such as Britain and Canada introduced immigration policies that targeted highly skilled individuals. These policies have done unquantifiable damage to the African health sector. Health professionals trained with limited national resources find themselves working in the West rather than serving in their own countries. In most sub-Saharan African countries, medical school education is heavily subsidized by the government. Graduates are expected to provide this vital service to their country. This is a social compact that is often broken as people general seek for their own personal interest and greener pasture abroad than returning to their communities to work.

There are possible solutions to this problem. The West can make direct investments in African medical schools by providing them with resources they need to expand enrollment. An extreme measure that could be adopted by governments of African countries is to require all students who receive subsidized medical education to commit seven to 10 years of service in their country either in private or public practice before they can migrate. Should they choose to leave the country earlier, they must be made to pay the actual cost of their medical education. The West must cooperate with African governments to stop the next epidemic before it happens.

This article originally appeared in my personal blog