Rebuilding Health and Education in Africa: Lessons from Spanish Flu and COVID-19

As the tempest of the pandemic rages, leaving carnage in its wake with healthcare sectors and national economies being the worst hit, there is no disputing that the world will never be the same again, a sentiment, echoed by many observers during these unsettling times. The pandemic and its scourge on humanity has made certain of that.

Right across the globe, there is a general all-pervasive air of uncertainty. Undoubtedly, everyone from all walks of life has been directly or indirectly affected by the COVID-19 pandemic and, as is the case with every devastating crisis, the already disconcerting disparity between the middle class and economically disadvantaged is set to be more glaring as the latter (with less access to resources, infrastructure and social services) grapple to cope with the situation. This crisis has revealed the inadequacies in African social infrastructure. Going forward, if we are to be prudent with a view to preparing for the next pandemic and make adequate provisions – history has shown us that there will most certainly be others – then it is incumbent on us to address these systemic issues.

With every major global crisis, there are shifts in received wisdoms and paradigms that had hitherto reigned supreme, that result in policy changes for the overall good of society. We have seen this to be the case after both world wars and, more pertinently, after the 1918 Spanish flu pandemic. Likewise, with the toll this current pandemic is taking on the global population and economy, one would not be wrong to equate it with other world-altering events.

Devastating as the Spanish flu was – the global death toll is estimated to have been between 50 million and 100 million – it acted as the much-needed catalyst for the Global North to revolutionize their health systems and change preconceived notions about healthcare. Being unprepared and susceptible to dire consequences of future pandemics was not something they wished to contend with. This determination led to the emergence of centralised health systems with the concept of universal access to healthcare elevated in public policy considerations.

A century on, centralised and extensive health coverage is the norm in the Global North, with governments spending significant portions of their budgets on free healthcare for all citizens. Russia was the first country to put a centralised public healthcare system in place after the Spanish flu, closely followed by countries in Western Europe. Eventually the idea spread across the developed world and came to be adopted as the standard. The US was the exception as it opted for an insurance-based corporate sponsored health scheme.

Although the Spanish flu also affected Africa on a significant scale infecting up to 80 percent of the population with a 15 percent death toll, a corresponding health revolution was muted on the continent afterwards. Possibly this was because the nation states were in the hands of colonialists and their priorities in terms of administration were different compared to what we would expect if the wellbeing of the citizen was at the centre of public policy. That notwithstanding, this pandemic has revealed weaknesses not only in our health systems and economies but has likewise highlighted the gross inadequacies of our education sectors. On one level, these inadequacies have combined to dampen the efficacy of measures adopted to combat the pandemic, and on another, they have undermined our abilities to join the race to develop a vaccine or therapeutics to contain the virus as our global counterparts are doing. Sadly, this has proved to be a tall order as universities and research centres on the continent are inadequately resourced. This fact is borne out by the inability of African countries to undertake widespread testing, as most are struggling with expertise and equipment. Even the production of reagents necessary for testing for the presence of the novel coronavirus, have proved beyond us. To put it bluntly: We have university teaching hospitals, but we do not have enough labs.

Looking beyond our dilapidated health systems, the staggering levels of illiteracy across the continent are alarming. The poor who are, more often than not, illiterate will presumably be hardest hit by the pandemic because of the combination of a lack of comprehension of the disease, the inability to safely isolate due to their deplorable living conditions, and a lack of access to information and basic utilities such as water.

It is perhaps because of this that a good number of the population believe the pandemic to be untrue and an elaborately orchestrated lie to cause hardship on them, or see it as a test of their faith. As such they are more susceptible to make decisions or engage in activities that will exacerbate their exposure and vulnerability to the novel coronavirus. From popular media, we have seen vulnerable people taken advantage of by their faith leaders who peddle miracle cures for COVID-19, people trying on cloth masks in open markets- completely defeating their intended purpose, disregard for social distancing rules with crowds pushing and shoving to get into public buildings or access ATMs, rural and urban dwellers alike overcome by mirth at the thought of “a common cold” being a killer, and so on. Equally as disturbing perhaps is the demographic of the supposedly enlightened who espouse disturbing views and rehash far-fetched conspiracy theories relating to the pandemic. It would seem that our education, where present, is devoid of critical reasoning.

We can perhaps be forgiven for not having developed our health systems when the rest of the world did. In our current situation however, we can no longer claim ignorance of the sheer importance of having proper education systems alongside other social infrastructure in place. This pandemic should serve as a clarion call to improve on both healthcare and education infrastructure for posterity.

Therefore, as we plan for life after COVID-19, we must take the whole gamut of social infrastructure into consideration as central to our development and wellbeing in the future is having robust systems in place. Critical as they are, it is our contention that preparedness is more than just about adequate health systems. Increasing awareness amongst the populace of the impacts of pathogens, efficacies of measures to combat epidemics or pandemics, mean that education must be given necessary condition. Preparedness means an educated populace, only with education would our society be able to lift itself out of poverty and its attendant complexities and hardships, and be able to provide necessary healthcare and public health measures that are currently lacking.

While the world is focused on healthcare and the debate concentrates on life and sustaining livelihoods as different countries are emerging from their lock-downs, Africa must focus on building both its health and education sectors. Only such an approach will result in an enhanced state of wellness, improved standards of living, improved employment opportunities and economic independence on a sustainable basis.

Image by Pete Linforth from Pixabay

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