Three cheers for democracy | April 2015

Muhammadu Buhari was the least bad presidential candidate in Nigeria. May he rise to his task

FOR the first time, Nigerians have ejected an incumbent president at the ballot box, in a broadly peaceful election. Muhammadu Buhari, the former military dictator who has defeated Goodluck Jonathan, will now preside over Africa’s most populous country, biggest economy and weightiest global actor. This is joyful news for Nigeria—and Africa.

One big reason to cheer is that Mr Jonathan has been such a dismal failure. So has his People’s Democratic Party (PDP), which has run Nigeria ever since the generals gave way to an elected civilian government in 1999. His administration has woefully failed to defeat an insurgency by Boko Haram, an Islamist extremist group that has tormented Nigeria’s north-east over the past few years. Mr Jonathan tried to improve farming and provide electricity to all, but proved unable to rebuild much of Nigeria’s hideously decrepit infrastructure. Above all, he was unwilling to tackle corruption, the country’s greatest scourge and the cause of much of its chaos. When the central bank’s respected governor complained that $20 billion had been stolen, Mr Jonathan sacked him. Nigeria is the biggest producer of oil on the continent, but most of its 170m-plus people still live on less than $2 a day. That is an indictment of successive governments.

Thanks to the resilience and vitality of ordinary Nigerians, the economy has been growing fast, especially around Lagos, the thriving commercial hub. But that is largely despite the government, not because of it. And with the oil price sharply down, Nigerians could well become even poorer.

Nobody can be sure that the 72-year-old Mr Buhari will turn things around fast, if at all. His brief stint as the country’s leader 32 years ago, when he was a general, was little better than Mr Jonathan’s. His human-rights record was appalling. He detained thousands of opponents, silenced the press, banned political meetings and had people executed for crimes that were not capital offences when they were committed. He expelled 700,000 immigrants under the illusion that this would create jobs for Nigerians. His economic policies, which included the fixing of prices and bans on “unnecessary” imports, were both crass and ineffective.

http://www.economist.com/blogs/graphicdetail/2015/02/graphics

Yet there is reason to hope that he has learnt from past mistakes. Although not always with a good grace, Mr Buhari accepted defeat in three previous presidential elections. As a northerner, a Muslim and a former soldier, he has a better chance of restoring the morale of Nigeria’s miserable army, which is essential if it is to defeat Boko Haram. His All Progressives Congress is a ramshackle coalition of parties, but the calibre of a number of its leading lights is superior to that of the greedy and incompetent bigwigs who dominate the PDP. Above all, Mr Buhari, whose style is strikingly ascetic, has a reputation for honesty. Corruption in Nigeria is so ingrained that nobody should expect him to root it out overnight. But it is vital that the new president makes a start. His vice-presidential running mate is a pastor who has fought hard for human rights and cleaner government.

Setting an example

Since 1991, when an incumbent leader on the African continent—in little Benin—was for the first time peacefully ejected at the ballot box after three decades without genuine democracy, at least 30 governments and presidents have been voted out of office. Though that is an incomparably better record than in the Arab world, Africa has recently become patchier again. Mr Jonathan’s magnanimous concession of victory to Mr Buhari will be a terrific boost to democrats across the continent. Just hope and pray that Mr Buhari does not let them down.

via The Economist

ISIS, BOKO HARAM, AND THE GROWING ROLE OF HUMAN TRAFFICKING IN 21ST CENTURY TERRORISM | BY LOUISE I. SHELLEY12.26.2014

The list of atrocities committed by ISIS continues to grow, with the latest being a chilling pamphlet that details the organization’s policy on treating the women they kidnap and then use as sex slaves. This is the latest account of ISIS’s dealings in kidnapping and human trafficking in which they target women and children, often from the minority Yazidi religion, and sell them for as little as $25 or keep them as slaves.

ISIS is not the only terrorist group to engage in kidnapping and trafficking. Just a few days ago, Boko Haram kidnapped 200 villagers and killed dozens more in Nigeria, further terrorizing the already tormented community. Indeed, human trafficking plays a growing role in the operation of 21st-century terrorist organizations.

Several years ago I gave a public lecture on the topic and mentioned a case that is in the first chapter of my new book, Dirty Entanglements: Corruption, Crime and Terrorism. The White Lace Case in Los Angeles involved women from the former USSR trafficked into high-end prostitution. Many of the women arrived in the United States as part of sports and religious delegations. In order to extend their legal residence in the United States, they had to obtain other visas. One of the leaders of this trafficking ring registered the trafficked women as students at a language skills school, thereby obtaining “student visas” for the prostitutes in her organization. The language school did not focus on providing instruction but instead was a visa mill. This same language school also provided visas to the 9/11 hijackers. In other words, the 9/11 hijackers and the trafficking victims shared the same “facilitator.” This facilitator was a point of intersection of crime and terrorism.

When I finished this talk, a government official approached me. He informed me that he was on a task force studying human trafficking and his role was to find the links between trafficking and terrorism. In his months in this position, he had not found a single example such as this. He asked how I found it. I answered that I had gone and talked to many members of law enforcement who through their investigations understood these links.

At that time, pre -9/11, the links were more subtle and had to be hunted down. But this case, already 15 years ago, shows that there were links at that time between human trafficking and terrorist activity even in the United States. Today they are more direct, especially in many conflict regions of the world. Yet policymakers focus nearly all their attention on more visible crime-terrorism links—primarily drug trafficking—and miss the important links between human trafficking and terrorist organizations.
Human trafficking now serves three main purposes for terrorist groups: generating revenue, providing fighting power, and vanquishing the enemy. For terrorists, human trafficking is a dual-use crime like drug trafficking and kidnapping. It not only generates revenue, but it decimates communities. As we see in Nigeria and Iraq today, trafficking intimidates populations and reduces resistance just as enslavement and rape of women were used as tools of war in the past.

Trafficking and smuggling are part of the business of terrorism, and constitute one activity in the product mix of terrorist groups. Terrorists smuggle drugs, arms, and people. Maoist insurgents in Nepal have exploited the long-standing trade of young girls taken from their country to the brothels of India to finance their activities. Evidence suggests that the LTTE smuggled Sri Lankans to finance their activities and the PKK exploited the porous mountain borders in eastern Turkey to facilitate human smuggling from countries in the Middle East and South Asia. Cells of the Ulster Volunteer Force of Northern Ireland received narcotics as payment from Chinese “snakeheads” in support of their smuggling networks. German authorities in 2006 arrested an Iraqi and a Syrian who smuggled individuals from their home region and were suspected of having links with the Ansar al-Islam terrorist network.

While trafficking and smuggling does generate revenue, they are not central money-making endeavors for terrorists and are committed primarily for other reasons. Pakistani terrorists buy children to serve as suicide bombers. Rebels in Africa trade in children to fund their conflicts and obtain child soldiers. More recently, Boko Haram shocked the world by kidnapping 276 female students and threatened to traffic them. ISIS members have taken young Azidi girls, raped and sold them off for trivial prices. The girls and women may sell for as little as $25 and sometimes even less, suggesting that this is not a revenue-generating operation when a million dollars daily is gained from oil sales. Rather, human trafficking, like slavery in the past, is a way of demoralizing the conquered.

Those not in the direct sight of terrorist groups may also become victims of human trafficking, even as they flee to safety. People displaced by terrorists are vulnerable to trafficking—both sexual and labor. Young girls fleeing with their families from the Syrian conflict today have been trafficked in Jordan and other neighboring states, just as occurred with earlier waves of refugees from Iraq. In Turkey, crime groups in border areas are exploiting the labor of Syrian male refugees who cannot find legitimate employment. Many more illegal migrants face labor trafficking in Europe as they flee the conflict regions of North Africa and the Middle East.

Human trafficking was once a crime associated primarily with a range of small to large crime groups. But as terrorist groups begin to function more as businesses, we unfortunately observe the expansion of terrorist groups into this criminality. Historically, conquering armies have seized inhabitants of conquered areas and enslaved them. But what is different is that traditional practices of the past have been combined with the business acumen of terrorist groups today. In their effort to diversify their revenue, they have capitalized on traditional practices to new advantage. Women and children are disproportionately victims, but they are not alone. Exploitation of trafficking victims may be most acute in conflict and adjoining regions, but it is not confined to these areas.

Pope Francis, in Christmas Address, Focuses on Children’s Plight | By ELISABETTA POVOLEDODEC. 25, 2014

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Pope Francis on Thursday used a traditional Christmas address to emphasize the plight of children in areas of conflict, pointing out their “impotent silence” that “cries out under the spade of many Herods,” a reference to the ancient king who slaughtered all the male newborns of Bethlehem, according to the New Testament.

Vast numbers of children today are victims of violence, objects of trade and trafficking, or forced to become soldiers, and they need to be saved, he said.

The pope spoke of “children displaced due to war and persecution, abused and taken advantage of before our very eyes and our complicit silence.” He singled out “infants massacred in bomb attacks,” including in the Middle East and in Pakistan, where 132 children were killed in a Taliban attack on a school this month.

“So many abused children,” Francis said, in one of several off-the-cuff asides during the address, known as the “Urbi et Orbi” message — Latin for “to the city and the world” — that popes traditionally deliver to the world’s 1.2 billion Roman Catholics on special occasions like Christmas.

In calling for global peace and for an end to violence and conflict in the Middle East, Ukraine and parts of Africa, Francis went off script to denounce “the globalization of indifference” that permits suffering and injustice to persist.

“So many men and women immersed in worldliness and indifference” are affected by hardness of the heart, he said, calling for reflection and change. And he chided the Vatican’s bureaucratic machine in another address this week for losing touch with its spiritual side in the pursuit of power.

As Christians exchanged gifts and shared family meals, the pope’s thoughts were with the world’s dispossessed; refugees and exiles; those suffering “brutal” ethnic or religious persecution; and those held as hostages or killed because of their religious beliefs.

“Truly there are so many tears this Christmas,” Francis said from the central balcony of St. Peter’s Basilica before thousands of faithful in the square below. The address was also broadcast live on the Internet.

To underscore his closeness to those suffering religious persecution, a theme of his nearly two years as pope, on Christmas Eve, Francis spoke with displaced Christians who are in a tent camp in northern Iraq and told them that they were like Jesus. Many in the camps have been forced to leave their homes by militants of the Islamic State.

“You are like Jesus on the night of his birth when he had been forced to flee,” the pope told them in a telephone call broadcast live by an Italian Catholic television station. “You are like Jesus in this situation, and that means we are praying even harder for you.”

The pope also denounced abortion, and his thoughts turned to “infants killed in the womb, deprived of that generous love of their parents and then buried in the egoism of a culture that does not love life.”

In his message on Thursday, the pope said he hoped that the world would respond to the plight of the needy by increasing humanitarian aid, and he asked “that the necessary assistance and treatment be provided” for the victims of Ebola.

Closing the address, he called on Jesus’ strength to turn “arms into plowshares, destruction into creativity, hatred into love and tenderness.”

In Britain, the archbishop of Canterbury, the Most Rev. Justin Welby, the spiritual leader of the Church of England, pulled out of the traditional Christmas Day ceremony at Canterbury Cathedral because of what his office described as a “severe cold.”

A draft of the sermon he had planned to deliver, and which was released on his website, reflected on the temporary truce on Christmas Day in 1914, early in the First World War, between British and German soldiers.

“The problem is that the way it is told now it seems to end with a ‘happy ever after,’” the draft said.

It added: “The following day the war continued with the same severity. Nothing had changed; it was a one-day wonder. That is not the world in which we live — truces are rare.”

OBAMA: US CAN’T CUT ITSELF OFF FROM WEST AFRICA | October 18, 2014

AFP
AFP
WASHINGTON (AP) — President Barack Obama urged Americans on Saturday not to succumb to hysteria about Ebola, even as he warned that addressing the deadly virus would require citizens, government leaders and the media to all pitch in.

In his weekly radio and Internet address, Obama also pushed back against calls for the U.S. to institute a travel ban. Lawmakers have called it a common-sense step to prevent more people with Ebola from entering the U.S., but Obama said such a ban would only hamper aid efforts and screening measures.

“Trying to seal off an entire region of the world – if that were even possible – could actually make the situation worse,” Obama said.

Growing U.S. concern about Ebola and the three cases diagnosed so far in Dallas prompted Obama on Friday to tap a former top White House adviser to be his point person on Ebola. Striking a careful balance, Obama said there’s no “outbreak” or “epidemic” of Ebola in the U.S., but said even one case is too many.

“This is a serious disease, but we can’t give in to hysteria or fear-because that only makes it harder to get people the accurate information they need,” Obama said. “We have to be guided by the science.”

As Obama sought to reassure anxious Americans, U.S. officials were still working to contain the fallout from the Ebola cases identified in the U.S. so far, rushing to cut off potential routes of infection for those who may have come into contact with individuals who contracted Ebola. Obama said he was “absolutely confident” the U.S. could prevent a serious outbreak at home – if it continues to elevate facts over fear.

“Fighting this disease will take time,” Obama said. “Before this is over, we may see more isolated cases here in America. But we know how to wage this fight.”

AP

What governments can learn from Sierra Leone’s missing textbooks | By Shwetlena Sabarwal and David Evans | Sep 17 2014

Why is improving education so hard? The case of the missing textbooks

Why is improving education so hard? The case of the missing textbooks

Public programmes are designed on assumptions – nice, tidy, convenient assumptions. Then they hit the real world and very little goes as planned. The culprit, some philosophically inclined would argue, is human behaviour. After all, human beings are impossible to predict. They can react in ways entirely unexpected and fairly baffling – until you dig deeper.

We found this happening in one of the most commonplace and straightforward of public programmes: textbook provision to schools. In 2008, the Government of Sierra Leone implemented a scheme that delivered textbooks to primary schools: one core set of textbooks for each student. The government was interested in establishing the relationship between textbook provision and learning outcomes, so implementation was done using a randomized trial. The school sample was randomly divided into a treatment group (books) and a control group (no books).

Straightforward, right?

The first puzzle came when we found no impact on student performance. This was disappointing but not entirely unexpected. At least one other study, in Kenya, found similar results (at least for most students).

What was more odd, at least to the researchers, was what had happened to the books. In many treatment schools, textbooks had not been distributed to students; instead they were being stored on school premises. On our follow-up visits we found storage rooms filled with textbooks, while in classrooms students were still sharing, three or four children to a textbook. What’s more, students in treatment schools were not being allowed to take textbooks home.

What were the headteachers thinking, keeping textbooks from students who clearly needed them? Why did they let them gather dust? We explored several theories and carefully analyzed the correlates of book storage. We asked teachers if they thought the books were useful; they did. We asked students if they already had books at home; they didn’t. It turns out that headteachers who had high uncertainty about government transfers of textbooks were significantly more likely to store them: We measured this uncertainty by whether or not the headteacher knew how many textbooks were allocated to the school the previous year by the government.

Once we took this underlying uncertainty into account, the storing behaviour started to make sense. Think of consumption theory: if there is uncertainty about future transfers then current transfers are seen as a one-time (or transitory) shock. If this is the case, the impact of current transfers on current consumption (defined as intensive use of textbooks by students) will be limited. This is because when there is uncertainty, headteachers have incentives to store part of the current transfers in order to smooth consumption over time, particularly for things, such as textbooks, that depreciate quickly when used. Remember the permanent income hypothesis? This is a permanent public input hypothesis.

Taking uncertainty into explicit consideration makes the seemingly irrational, rational. Clearly, headteachers in this context are acting as forward-thinking agents who – in the classic spirit of homo-economicus – are deciding how to respond to the public programme based on their resources, constraints and expectations.

And these results illustrate what this decision-making looks like when prevailing expectations around government largess and reliability are bleak. And why wouldn’t they be bleak? Our survey data shows that in 2009, 17% of headteachers and 36% of classroom teachers reported not receiving their full pay in the past year. In Zambia, the unpredictability of government transfers to line ministries was well documented a decade ago. Anecdotal evidence tells us this is widespread.

This smoothing behaviour isn’t unique to textbooks. In a project providing grants to schools in Gambia, schools “were directed to use the grant towards some aspect of the school development that relates directly to teaching and learning”. Yet a quarter of schools reported that their biggest expenditure was on infrastructure (i.e. durable inputs rather than fast-depreciating learning materials).

Is this ill-informed decision-making, or are school committees trying to convert the books into goods that can be consumed well into the future?

When programme goals are subverted by beneficiaries (or intermediate agents, as in this case), it is common to blame low capacity, myopic decision-making, lack of information, human error, corruption or increasingly (and more charitably) the poverty-induced burden on mental bandwidth. But what we find here is rational behaviour.

Our modest argument is that public provision of inputs that depreciate quickly when used, such as textbooks, will be fully consumed only if agents have expectations of replenishment. Hence, for public programmes that are designed as recurring transfers, there is a need to establish a reputation of consistent delivery and to reliably communicate the timing of the next transfer. Otherwise, uncertainty can easily wreak havoc on the nice, tidy and convenient assumptions underlying the programme design.

Published in collaboration with the World Bank Blog.

Author: Shwetlena Sabarwal is an economist at the Education Global Practice of the World Bank. David Evans is a senior economist in the Chief Economist’s Office for the Africa Region of the World Bank.

Image: Malian pupils study during a French language class during a French language lesson in Mali’s capital Bamako. REUTERS/Finbarr O’Reilly.

How much economic damage is Ebola causing? | By Cesar Calderon and Maryla Maliszewska | Oct 11 2014

Likely spread of Ebola using flight connections as a proxy.

Likely spread of Ebola using flight connections as a proxy.

The economic impacts of Ebola are already very serious for the three hardest-hit countries.

The economic impacts of Ebola are already very serious for the three hardest-hit countries.

As current and former World Bank employees, we have all worked to speed the development of African economies and have viewed Africa’s recent spectacular growth with mounting enthusiasm. Thus, we have followed with growing sadness and dismay the stories of human suffering emanating from Liberia, Sierra Leone and Guinea in the context of the Ebola epidemic. These horrifying stories of the effect of Ebola in West Africa are now overshadowing continued good economic news from the rest of the continent.

About a month ago we were asked – together with a much larger team – to estimate the economic costs of the outbreak for the West Africa region. The report, titled “The Economic Impact of the 2014 Ebola Epidemic: Short and Medium Term Estimates for West Africa,” was released this week.

Although there is still great uncertainty about the Ebola epidemic, our task was to produce best-effort estimates of its macroeconomic and fiscal impact using the best tools immediately available. But Ebola is quite different from standard shocks to developing countries, including slow-moving diseases like diabetes or hypertension. The standard approach to estimating economic impact of diseases is to compute the cost of medical care (the “direct” cost) and the loss of output from people who can’t work (the “indirect cost”). But given the rapid spread and high fatality rate of Ebola, this approach would not come close to capturing the third quarter 2014 impact already visible to the World Bank’s country teams.

Drawing on previous work on Severe Acute Respiratory Syndrome (SARS), we posit that a rapidly-moving, often fatal disease elicits “aversion behaviour,” as economic agents withdraw from commercial interaction, shun what they perceive to be exposed assets, and postpone or divert investment from affected economies. Since “aversion behaviour” appears nowhere in our economic models, we assume that aversion behaviour leads to the withdrawal or reduced utilization of certain percentages of both labour and capital and to increased transaction costs on both domestic and international economic transactions.

Defining the size of the economic shocks

Epidemiological assessments and the latest on-the-ground economic data helped the World Bank’s country teams assess the impact of Ebola on projected GDP in the core crisis countries – Liberia, Guinea, and Sierra Leone. The effects of the crisis on a wider set of indicators (including trade, private consumption, and poverty), both in the core countries and beyond, were assessed with the help of available Computable General Equilibrium models and databases, both a country model for Liberia (MAMS) and a global model (LINKAGE) in which West Africa was singled out for special attention. The simulations drew on data from the country teams on crisis-related channels – workers stay home, leaving capital and natural resources idle; higher transaction costs constrain domestic and international trade; FDI dries up; and foreign grant aid for health and other interventions is boosted.

For Liberia, the MAMS simulation results indicate that, if the policy response is immediate and effective, the economy may be able to quickly rebound, making up for the losses in 2015. However, a slow and ineffective response may create severe production losses. The impacts on household consumption may be particularly severe with poverty rates in 2015 climbing from current rates of 55-60 percent to 75-80 percent.

Analysis of countries other than the core crisis countries, where very few cases have been registered is more challenging. Gomes et al. (2014) predict the likelihood of an Ebola outbreak in the 16 most at-risk countries and the likely number of cases (conditional on a single case) using flight connections (as in the figure below). We multiply the two figures to estimate the expected number of cases for a given country. Then we divide the expected number of cases for each country by the square root of that country’s GDP; this accounts for the fact that richer countries have better health infrastructure to contain the epidemic. The result of this calculation is an “Ebola Impact Index”.

Likely spread of Ebola using flight connections as a proxy

Next we scale down the factor and transaction cost shocks from Liberia (the hardest hit economy) by the Ebola Impact Index to get the expected shock on each country in the model. Gomes et al. model the spread over 1,000 micro simulations; we use probabilities from the low end of the resulting distribution to simulate a “Low Ebola” scenario (limited spread to other countries) and probabilities from the high end of their distribution to simulate a “High Ebola” scenario (extensive spread).

Impacts on West Africa

Applying the LINKAGE model to the Low Ebola and High Ebola scenarios permits the estimation of the impact of the Ebola epidemic on West Africa as a whole, capturing the spillover and feedback effects across different sectors and economic agents (households, firms, government) across multiple countries and regions.

The result is that, in the Low Ebola case, there is only a modest difference in economic growth for West Africa as a whole for the year 2015. Growth takes a significant hit in the three core countries in 2014 but a much smaller hit for other countries in the region. This reflects a scenario in which the regional economic impact of the crisis is contained. In the High Ebola case, the economic impact on West Africa is much more severe, with projected GDP growth declining from 6.8 percent to 5.6 percent in 2014 and from 6.4 to 4.1 in 2015.
 
This slower growth translates into a moderate loss in GDP volume in the Low Ebola case, amounting to US$3.8 billion by the end of 2015 (2013 dollars) across West Africa. The loss in GDP in the High Ebola case is almost nine times larger, at about US$32.6 billion over the two years (see the figure below): That is 3.1 percent of what regional GDP would have been in the absence of Ebola in 2014. This is an enormous cost, not only for the most affected countries, but for the region as a whole. Ebola has the potential to be deeply destabilizing and requires an immediate response.

Impact of Ebola on GDP and Annual Growth Rates for West Africa

The economic impacts of Ebola are already very serious for the three hardest-hit countries. In broader regional terms, the economic impacts may be limited if immediate national and international responses succeed in containing the epidemic and mitigating aversion behaviour. The successful containment, thus far, of the epidemic in Nigeria and Senegal is evidence that this is possible, given existing health system capacity and a resolute policy response.

A swift policy reaction by the international community is crucial. With the potential economic costs of the Ebola epidemic being so high, very substantial containment and mitigation expenditures would be cost effective if they successfully avert the worst epidemiological outcomes.

One of us has previously co-authored work estimating the impact of HIV as the result of the medical expenditure and withdrawn labour.

Published in collaboration with the World Bank Blog

Authors: Maryla Maliszewska is Economist in the Development Economics Prospects Group (DECPG), World Bank. David Evans is a Senior Economist in the Chief Economist’s Office for the Africa Region of the World Bank. Cesar Calderon is a Senior Economist with the Financial and Private Sector Development Vice Presidency. Marcio Jose Vargas de Cruz has been working on a new version of the Global Income Distribution Dynamics (GIDD) model since 2013 as a researcher for the Development Economics Prospects Group at World Bank. Francisco H. G. Ferreira is the Senior Advisor and Deputy Chief Economist for the Africa Region at the World Bank. Delfin Go is Lead Economist in the World Bank’s Development Prospects Group and the main author of the 2010 and 2011 Global Monitoring Reports. Mead Over is a senior fellow at the Center for Global Development researching economics of efficient, effective, and cost-effective health interventions in developing countries. Hans Lofgren is a Senior Economist in the Development Economics Prospects Group (DECPG). 

Image: A volunteer health worker practises using a personal protective equipment (PPE) suit at a newly-constructed Ebola virus treatment centre in Monrovia, Liberia, September 21, 2014. REUTERS/James Giahyue

Fighting Ebola from the grassroots | By David Norman and Saran Kaba Jones | Oct 9 2014

As a global community, our ability to respond to the Ebola crisis gripping West Africa and to future crises will depend on how much we effectively learn from past interventions, and how best we adapt our practices to improve on coordination, mobilization, impact and long-term outcomes.

When responding to crises and disasters of this magnitude, we can benefit tremendously from local, grassroots organizations and their ability to operate in complex environments, to aid in more timely assessments, and to quickly disseminate information and critical services in the wake of a global crisis. Due to the very nature of their proximity to a potential disaster, community-based organizations become the de facto first responders, witnessing the situation as it begins to emerge. Their knowledge on the ground can play a critical role in assessing the severity of the problem and more accurately projecting its impact.

The first cases of Ebola in West Africa were reported back in September of 2013 and went through a lull before finally resurfacing in early 2014. We can ask ourselves what if, during that period, we had made use of on-the-ground reports by local organizations? Could we have come to learn earlier what we now know about the disease? Would epidemiologists have been able to better predict the capacity of health systems in the region to cope with this new Ebola virus? Could local groups have been able to warn others that the lack of local containment of the disease could pose a serious threat to attempts at intervention?

Unfortunately, as has happened far too often in the past, by the time the world acknowledged the potential consequences of the current epidemic, it was already too late to avoid a completely overwhelmed and unprepared response lagging far behind the spread of the disease.

However, even at the current phase (with a recent CDC estimate suggesting that the virus could infect anywhere from 500,000 to 1.4 million people across the region over the coming months), identifying and empowering local groups as the foundation of intervention could have a significant impact on efforts to contain the spread of the Ebola virus.

Organisations with strong local ties have long understood the importance of engaging with communities in a meaningful, equitable way. Liberians teaching Liberians. Guineans treating Guineans. Sierra Leoneans empowering Sierra Leoneans. In the case of our organisation, FACE Africa, our track record of community engagement in Rivercess County, Liberia allowed us to launch an Ebola awareness campaign far more quickly than a major international player would have been able to. The effectiveness of our campaign was enhanced by the local ties and level of deep-rooted trust we already had within communities. An international team parachuted in would likely not have received the same level of receptiveness from local communities (indeed, there have been numerous cases where health workers and response teams have been met with outright hostility).

Engagement is the pathway to empowerment and when communities are empowered to take control of a situation for themselves, you see meaningful change. They may not have all the expertise, but they have the ability to learn, take charge and even put in place their own solutions. Ian Smillie in the book Patronage or Partnership states that, “supporting the work and strengthening the capacity of local organizations can not only be instrumental in dealing with the situation at hand, but also increase resilience to future humanitarian emergencies. Sending in international emergency teams can help, but is not enough. It is important for the international response to move from a culture of patronage to a culture of partnership.”

We only have to look at the catastrophic 7.0 magnitude earthquake that devastated Haiti in 2010 to understand the importance of local response and long-term planning. As the world’s attention was focused on Haiti after the earthquake, billions of dollars of emergency relief flooded into the country from international donors, supplies were mobilized and doctors and nurses were parachuted in to perform lifesaving medical procedures and care. UN soldiers were deployed to coordinate efforts and governments pledged billions to reconstruct the country so that it was “stronger and more prosperous than ever before”. Four years on, and Haiti is still reeling with nearly a million homeless, the worst cholera outbreak in recent history and an insecure future.

We cannot allow the mistakes in Haiti to happen in Liberia, Sierra Leone and Guinea. As the world rushes in to help eradicate Ebola in West Africa, now is the time to start thinking beyond the current crisis. Now is the time to focus on ways to sustain our efforts and build infrastructure that will last long after the current crisis has subsided. Because in strengthening the infrastructure and capacity of these countries well into the future, we are not only limiting a potential recurrence, but we are tackling the myriad of other health problems from malaria, to diarrhea, to cholera and typhoid that continue to kill far more people every day.

But any efforts at sustainable development cannot be achieved in the absence of local organisations and community groups. These groups must be at the forefront and lead any long-term development efforts. They must be recognized and supported because they represent the long-term health and strength of African communities; they have been on the ground, are currently on the ground and will still be there when everyone else has left.

Authors: Saran Kaba Jones is the Founder & CEO of FACE Africa and a World Economic Forum Young Global Leader. David Norman is the Business Development Officer at FACE Africa.

Image: A health worker checks the temperature of a man at a roadside health checkpoint outside Ganta October 7, 2014. REUTERS/Daniel Flynn

Liberia children orphaned, ostracized by Ebola | BY KRISTA LARSON | OCT. 9, 2014

First 16-year-old Promise Cooper’s mother complained of a hurting head and raging fever, and she died days later on the way to the hospital.

The following month, her father developed the same headache and fever. Her baby brother grew listless and sick too, and refused to take a bottle.

That’s when Promise knew this was not malaria.

She had heard about Ebola on the radio. When she tended to her father, she washed her hands immediately afterward. Desperate to keep her three younger siblings safe, she urged them to play outside their one-room home. Yet she was powerless before an invisible enemy, as her family of seven disintegrated around her.

In the meantime, neighbors and relatives were starting to become suspicious. No one came by to check on the kids, not even their grandparents.

Word, like the virus, was spreading through Liberia’s capital: The Coopers had Ebola.

___

In Liberia’s large, deeply religious families, there is usually an aunty somewhere willing to take in a child who has lost a parent. But Ebola, and the fear of contagion and death, is now unraveling bonds that have lasted for generations.

At least 3,700 children across Liberia, Guinea and Sierra Leone have lost one or more parents to Ebola, according to the U.N. children’s agency, and that figure is expected to double by mid-October. Many of these children are left to fend for themselves, and continue to live inside infected houses.

Promise was used to looking after her younger siblings, and often carried a baby cousin on her hip around the neighborhood. When her mother was alive, they would alternate weeks of cooking. She knew how to make porridge for breakfast, rice with potato greens for dinner.

When her father fell sick, she took over all the things her mother used to do. There was no school because of the Ebola epidemic, so she had time to wash her brothers’ soccer jerseys and jeans.

But nothing she did could help 5-month-old Success, whose name reflected his parents’ dreams. Just like their mother, the little boy died. There was nobody to help them and no ambulance to spare, so his body stayed in the house for several days.

By the time the ambulance finally came to take away her father and the tiny corpse bundled in blankets, 11-year-old Emmanuel Jr. was stricken too.

Promise watched as medics packed half her family into the back of the ambulance. She was now alone with 15-year-old Benson and 13-year-old Ruth.

She could not afford a phone call to see how their father and brother were doing, even if she could get through on the hotline for relatives that was almost always busy. A taxi to the Ebola clinic across town cost even more. An uncle stopped by to drop off some money, but left without touching the children for fear of infection.

Promise resolved to keep the family together until her father came back.

She decided to use what little cash she had to buy plastic bags of drinking water. The family had a cooler, and she planned to sell the bags she bought at $1 a piece for $2.

Day after day, though, no customers came. Nobody wanted to buy water from the girl whose mother died of Ebola, and whose father and brother were at the clinic. Promise looked healthy, but fear was overcoming compassion in the St. Paul Bridge neighborhood where they lived.

If the children sat down somewhere, people would spray bleach after they got up. When they tried to buy something with what little money they had, vendors refused to serve them.

Neighbors didn’t want the Cooper boys playing with their children. And even though health workers had disinfected the path from the well that went right past their house, women took their brightly colored plastic buckets the long way around instead.

Promise, overcome with grief and beaten down by stigma, became depressed.

“Why don’t you want to talk to me? Why God does nobody want to come around?” she sobbed. “We are human beings.”

____

Finally she scraped together enough change from a cousin to take a taxi to the gates of the Ebola clinic. A security guard said he would check whether Emmanuel Cooper Sr. was on the list of the living.

Promise and Ruth paced outside the barbed-wire topped walls of the clinic for what felt like hours, waiting for an answer on when he would be coming home.

The guard came back. He said he was sorry, but their father was dead.

The girls broke down sobbing.

No one could tell them if 11-year-old Emmanuel was still alive.

___

Even as Promise lost both her parents, another man in the community was trying to document just how many children were orphaned in the St. Paul Bridge community. Kanyean Molton Farley, a human rights researcher by day, devoted all his spare time to making a list of the now 28 parentless children living alone. In most cases, teenagers like Promise are now raising their siblings amid an overwhelmed social welfare system.

“The story of the Cooper children touched my gut, and I never stopped coming back,” he said one morning, as he dropped off soap for the children.

The family’s rent was already paid through the end of the year, but they soon ran out of money to pay the electricity. Farley worried most of all that Promise could fall prey to an older man. At 16 and hungry, she was vulnerable to abuse.

Then the Cooper children caught a lucky break: Promise saw her brother’s face on television, among government photos of children who had survived Ebola at the city’s clinics but were still separated from their families.

“It’s him, it’s him!” she told Farley. Off they went to get Emmanuel — the first in the family to survive the plague sweeping their neighborhood.

Not long after Emmanuel came home, Ruth became feverish and unwell one night. How could this be happening again? A terrified Promise called their friend Farley late at night. He couldn’t come until morning because of the curfew.

So he told her to use the family’s mattresses as room dividers in the single bedroom where they all slept. Ruth would stay on one side; the healthy children would sleep on the other.

At first light, an ambulance called by Farley took Ruth to the hospital.

___

Now it is just Promise and the boys.

She insists they will never go live with strangers. Yet they no longer want to stay in the house where their parents lay dying and their brother’s body sat for days.

On a Sunday afternoon after church, there is no television to watch without electricity. The TV set sits gathering dust with a soiled stuffed unicorn on top of it.

The children sleep together in their parents’ bed at night, instead of crowding on the floor below as they did in their previous life. Some nights her brothers weep for their mother, and Promise tries to be firm but caring.

“I tell them Ma and Pa are no more, and that they shouldn’t worry about that,” she says. “We must concentrate on living our lives because they are gone.”

Just a few weeks ago, their aunt Helen came around to the house — the first family member to do so in months. She had been upcountry when the children’s parents died and wanted to see how they were doing.

It pains her to think of her brother, and what he would say about the children out of school, cooking and cleaning for themselves.

“I have to come back because everyone has abandoned them,” says Helen Kangbo, breast-feeding her 1-year-old daughter Faith after joining her nieces and nephews for a paltry dinner of rice. “I must have the courage to come.”

Of course, now that Helen is in contact with the children, she is shunned by the same extended family that fears Promise and her siblings.

Each day Promise mixes up bleach and water in bottles to keep the house and her brothers clean. “Don’t go around people. Don’t touch your friends. Anything you touch, you wash your hands,” she scolds them.

Days later, she says her prayers have been answered: After three weeks at an Ebola treatment center, 13-year-old Ruth is cured. She is still weak, so she is staying with Farley’s family. When Ruth is well enough she will return home.

Here in their house, there is little trace left of dead loved ones, because authorities have burned their parents’ clothing in a bid to stop the spread of the disease. The only photos of their parents are on their voter ID cards. And the only reminder of Success is the two bottles of baby powder, still sitting on a table in the room.

___

AP

Follow Krista Larson at https://www.twitter.com/klarsonafrica

Spanish Ebola patient’s condition worsens as seven people are quarantined | Ashifa Kassam in Madrid | Thursday 9 October 2014

Police stand at the entrance of the Carlos III hospital in Madrid. Photograph: Paul Hanna/Reuters

Police stand at the entrance of the Carlos III hospital in Madrid. Photograph: Paul Hanna/Reuters

Brother of first known person to contract Ebola outside west Africa, Teresa Romero Ramos, tells reporters her state has deteriorated

The condition of Teresa Romero Ramos – the Spanish nurse who is the first known person to contract Ebola outside west Africa – has worsened, according to relatives.

On Thursday afternoon, her brother José Ramón Romero told reporters at the Carlos III hospital that her state had deteriorated and she was now intubated. In a television interview with La Sexta he said she was having lung problems.

Four more people have been put in quarantine in the Carlos III hospital in the past day, bringing the total to seven. Another 80 or so are under observation, including health workers who treated Romero Ramos, and two employees at the hair salon where the nurse went for an appointment a week and a half ago.

Her husband, who has not shown any symptoms, remains in isolation as a precautionary measure.

On Wednesday the nurse gave several phone interviews to Spanish media outlets, sounding exhausted as she offered answers that ranged from monosyllabic to a 12-minute conversation. The doctor attending to her told reporters that he had spoken to her in an effort to retrace her steps as part of the investigation into how she contracted the disease.

The doctor, Germán Ramírez, said the nurse believed she might have touched her face with her gloves as she was taking off her protective equipment after attending to the second Ebola patient repatriated to Spain. Later in an interview with the Spanish television network Cuatro, the nurse said her training in how to get into and out of the suit had lasted “a short time”.

On Thursday more details emerged regarding the handling of Romero Ramos’s case, reinforcing health workers’ claims that this was an improvised response, lacking in top-down guidance.

One of the doctors who treated the nurse when she arrived at the hospital in Alcorcón on Monday described the 16 hours he spent treating the nurse in a report to his superiors. Published by several media outlets in Spain, the report said the team treating Romero Ramos initially wore impermeable gowns, double gloves, hats and masks to protect themselves.

As the nurse’s state worsened, the health workers changed into more protective clothing. The patient was suffering from diarrhoea, vomiting and coughing, the doctor said. His protective equipment was ill-fitting. “At all times the sleeves were too short,” he wrote, leaving his skin exposed.

Despite being on the frontline of treating the nurse, he was not updated when her test results proved positive, he said. “I learned of the results from journalists rather than the relevant authority.” The doctor is now one of the seven people in quarantine.

Other lapses emerged, including the fact that the ambulance that initially brought Romero Ramos from her home to the Alcorcón hospital carried seven other patients after her before it was sterilised.

Speaking to journalists at a conference on youth employment in Milan on Wednesday, the Spanish prime minister, Mariano Rajoy, said European colleagues thought Spain was managing the Ebola case “very well”.

At a conference that included the German chancellor, Angela Merkel, and the French president, François Hollande, Rajoy said many leaders had expressed interest in what was happening in Spain. “My colleagues are telling me that we’re doing things very well,” he assured the journalists.

via the guardian

Ebola outbreak: Spread of deadly disease across Europe is ‘unavoidable’, warns WHO chief | By JAMES RUSH | October 7, 2014

The Spanish nurse infected by Ebola is moved by ambulance to Carlos III Hospital, in Alcorcon, Spain

The Spanish nurse infected by Ebola is moved by ambulance to Carlos III Hospital, in Alcorcon, Spain

Spanish patient, Catholic priest Manuel Garcia Viejo, died after being repatriated from Sierra Leone

Spanish patient, Catholic priest Manuel Garcia Viejo, died after being repatriated from Sierra Leone

Four people in Spain are in hospital after a nurse tested positive for the virus on Monday

The spread of Ebola across Europe is “quite unavoidable”, a health chief has warned as four people were hospitalised after a Spanish nurse became the first person known to have contracted the virus outside Africa.

The World Health Organisation’s European director Zsuzsanna Jakab has said while more cases will spread in Europe, the continent should be well prepared to control the disease.

Health officials in Spain today said four people – the nurse, her husband and two others – were being monitored in hospital in a bid to stem the spread of the virus.

“Such imported cases and similar events as have happened in Spain will happen also in the future, most likely,” Ms Jakab told Reuters.

“It is quite unavoidable … that such incidents will happen in the future because of the extensive travel both from Europe to the affected countries and the other way around,” she said.

Ms Jakab said European health workers were most at risk of becoming infected, but added that “the most important thing in our view is that Europe is still at low risk and that the western part of the European region particularly is the best prepared in the world to respond to viral haemorrhagic fevers including Ebola.”

It has emerged that the nurse, who had helped treat two Spanish missionaries who died after returning from the region with the disease, first complained of feeling ill a week before she was diagnosed with Ebola on Monday.

The 40-year-old is understood to have contacted health workers after complaining of a low fever on September 30. She was only given tests for Ebola however when she turned up at hospital with a high fever on Monday, The Telegraph has reported.

Meanwhile, 22 people who came into contact with the nurse are also being monitored, health officials have said. They have not been isolated but they are having their temperature taken twice a day to check for signs of infection.

The EU has now asked Spain to explain how the nurse contracted the deadly disease, according to an AFP report.

Public health director Mercedes Vinuesa told a parliamentary committee: “The husband is already in hospital and is being monitored so that he can have a quarantine situation with better monitoring.”

The 40-year-old nurse, who has not been identified but is said to be in a stable condition, had up to 30 colleagues who also treated the missionaries who died of Ebola at the Carlos III Hospital in Madrid.

A spokesman for the European Commission said the case, the first known case of Ebola spreading within a European country, would be discussed at a Health Security Committee meeting on Wednesday.

“The priority remains to find out what actually happened,” he said.

Officials said they were still investigating how the nurse was infected.

She went on holiday after the second of the missionaries she had been caring for died on September 25, although, they stressed, she had not left Madrid.

Jonathan Ball, a professor of molecular virology at the University of Nottingham, said the Spanish nurse should not have contracted the deadly disease if appropriate containment and control measures had been taken.

“It will be crucial to find out what went wrong in this case so necessary measures can be taken to ensure it doesn’t happen again,” he told Reuters.

Local media in Spain yesterday reported that staff at the Madrid hospital where the nurse became infected had claimed their protective suits did not meet health and safety requirements – though this has yet to be substantiated.

Additional reporting by Reuters