Last week I went to a talk in Oxford about Sierra Leone’s Ebola emergency response. It was a presentation of a new book — Getting to Zero: A Doctor and a Diplomat on the Ebola Frontline.
The first question from the audience made me mad.
I think it was asked with reference to Kerrytown Ebola treatment centre (built by the British Government for around $80m during the emergency response; a year later mainly inhabited by stray dogs and goats). The audience member asked something along the lines of ‘while it is not very politically correct, is the lack of maintenance due to the inherent inability of Africans to maintain infrastructure?’
I am not sure I have got the phrasing exactly right, but it is the sentiment I want to address.
First of all, this is a racist question. Not just politically incorrect; racist. Any mention of inherent variation of abilities or tendencies across races is racist. Just asking it plants a seed that, as a society (British, in my case), we seem unable to eradicate.
But the issue is far larger than this member of the Oxford audience. One of the areas in which attitudes like this are rife is the international development sector. Throughout my three years working in Sierra Leone’s Ministry of Health and Sanitation (2011 to 2014), I think that this (alongside other related beliefs) was a common underlying prejudice among the white expatriate development community. Granted, it was not the only prejudice, and it was not shared by everyone; but some form of racism was often there.
Jokes about the stupid things Sierra Leonean colleagues would do; stories about the crazy policy and implementation scenarios that would arise as a result (as though part of some exotic, consequenceless adventure); the desire (and sense of entitlement) to outstrip hierarchy and go straight to the relevant Minister; the self-confidence in our own first impressions of ‘what needed to be done’ were all manifestations of the underlying sentiment that ‘I am better able to manage this problem than you’.
And why? Based on what?
For a little context, in the years up to Sierra Leone’s outbreak of Ebola the government had about $600m in domestic revenue a year to spend. With about 6m people, this meant $100 per person to cover agriculture, education, water and electricity, the police, the army, the health system and much more. About $8 to $12 per person per year went on health. Given this, it would be absolutely mad for the government to invest in the maintenance of an $80m hospital.
Unfortunately, the same can be said for a lot of large infrastructure, which does gradually go to ruins. But this has nothing to do with an ‘inherent inability to maintain’ and lots to do with practical unaffordability of some maintenance.
Such poor outcomes may be taken, however, by inexperienced and ignorant fresh-faced expats (such as myself at the time) as ‘Sierra Leonean inability to manage, implement, maintain etc… you-name-it’. This is an echo of that ‘inherent inability of Africans’ sentiment presented by our Oxford audience member. There is just a fine line, if any, between the two.
As anywhere, in Sierra Leone you will find some corrupt people, some with upmost integrity. Some geniuses, some idiots. Some logistical and planning masterminds, some chaotic last-minute scramblers. You will find some who will sacrifice all to help another, others who are just out for a day’s work. And, of course, boundaries are blurred in all cases. True, these traits may manifest differently in different contexts, and it is important for expats to try and understand this in their new environments. But I think there may be a tendency to couple an inflated sense of personal ability with frustration at local outcomes, and without even realising slip into the realm of generalised racist prejudice — ‘me and my expat friends are more capable than my local colleagues’. In this way racism festers (and can grow) within the development community.
Until the development sector can deal with this problem, I don’t see how it will be able to kindle genuinely trusting and respectful relationships with the Sierra Leonean (or any other) government: the sort of relationship needed for a development partnership to work. Local counterparts see this prejudice. It infuriates those local geniuses, logistical masterminds and selfless souls that they are bypassed by the international development sector, who chose instead to place a young and inexperienced European statistician as technical adviser to an agricultural community outreach programme, who may then joke with their friends about the ridiculousness of Sierra Leonean agricultural policy and implementation, be asked to advise senior agricultural officers and given the luxury of the Minister’s ear (only slightly hypothetical example…)
Never, however, will that young expat actually have to deliver what a Sierra Leonean has to deliver. Never will they have to manage the implementation of million-dollar (yet still under-funded) programmes within the family, community, work and social structures of those who earn $1 — $10 per day.
This is absolutely not to excuse corruption and poor management, which are major players. Indeed, to accept such things under the T.I.A (This Is Africa) banner is just another manifestation of a racist prejudice that I think was common within both expat and Sierra Leonean communities.
If you want to contemplate a Sierra Leonean’s ability to maintain something, look at what is maintained with the minuscule funds available: between 2011 and 2014 Sierra Leone’s public health system consisted of 7,000–9,000 health workers, 700–900 peripheral health units (for primary care), about 30 secondary hospitals and three or four tertiary hospitals — all for $10 per person per year. If you want to look at the individual level, think about the skill it takes to maintain an over-crowed panbodi (galvanise/corrugated iron) house through the rainy season. Think about what it takes to maintain a 15-year-old Nissan Sunny, running taxi all day every day over pot-hole-covered roads. For those who have become wealthy, think about what it takes to maintain your community in a Cotton Tree culture (where those who have are expected to provide shade for those who have not).
If you are someone lucky enough to be established in a wealthy country, and you find yourself bemoaning the inability of someone in a very poor country, consider what you would need to attempt whatever they are attempting. What could you do with $10 per person in Sierra Leone? Personally, I would struggle to provide a week’s dinner, let alone a whole public health system.
I doubt there is anyone on this planet who could reasonably maintain Kerrytown Ebola treatment centre within this sort of budget. If there is, however, I’d bet it’s some Sierra Leonean.