Drawing upon the recent discovery of the first case of Ebola in Europe via the nurse Teresa Romero – who was in contact with the two Ebola-infected missionaries brought back to Spain to receive healthcare – it is time to review the causes behind one of the biggest public health crises of our times.
Phase 1) Prevention:
Taking for granted that, after the recent withdrawal of the proposed abortion legislation (which would have criminalised the majority of abortions last year in Spain), leaving two Ebola-infected priests in Africa would have constituted an ultimate insult towards the right-wing Catholic People’s Party (PP) electorate, the government of Mariano Rajoy had no choice but to bring the two Spanish priests back to Madrid. However, due to budget shortages driven by austerity measures in the public health sector, this may not have been the best idea ever. There are a few factors that should have been foreseen.
Staff were not sufficiently trained for the treatment of Ebola patients. Nurses’ representatives stated that, by no means, had they received the appropriate training, consisting of 30 hours just to learn how to put on and take off the protective suits, but had instead only received 15-minute long ad-hoc chats with the hospital responsible the day before the arrival of the patients. Also, they pointed out that the facilities were not sufficiently adapted to treat such infectious diseases. Moreover, the anti-Ebola suits that were delivered by the pro-austerity government were in fact simple surgeon suits, and even when some hospitals could afford appropriate suits, they were mostly too short, leaving hospital staff even more vulnerable to accidents.
Phase 2) Infection:
Taking into account all the aforementioned shortcomings, security failings were just a matter of time, and as expected a nurse finally got infected. What failed in the security protocols to allow a nurse to get infected? How did austerity infect the Spanish labour system? There are two possible theories:
A) If the nurse realised that she could have been exposed to the virus, why didn’t she communicate that fact to her supervisors? It could be that, due to the last labour reform in 2012, she was afraid of possible repercussions or sanctions regarding her infection. The reforms allow the health service to dismiss employees without any justification, minimising worker protection in case of irregular dismissal. It would not be a strange situation in Spain: her brother – who has not seen her since July – was automatically fired as soon as the name of the infected nurse was made public.
B) If the nurse did not realise that she could have been exposed to the virus, why didn’t her supervisor? Where was the supervisor who should have been overseeing the entire process of putting on and taking off the protective suits as required by protocol? Could it be that the lack of active labour policies and the lack of public investment prevented the hiring of ad-hoc experts and a sufficiently qualified work force to control the crisis?
Phase 3) Crisis Management:
Having reached this point, Spanish citizens started to ask questions. It was a legitimate concern, but again the PP government tried to talk down the crisis and demonstrated that they only work when there is black money or they are protected by revolving doors. Their lack of leadership, political skills, authoritarianism and demagogical manners inherited from their Franquist roots become obvious. As in the economic crisis, they privatised the benefits of the crisis, but they socialised the pernicious trait. The shameless behaviour was so obvious, that even the public health counsellor of the Madrid Community, Javier Rodriguez – admitting the systematic deficiencies – blamed the Ebola-infected nurse, Teresa Romero. He made a number of statements which provoked outrage among the general public: “Teresa could have been lying about her fever”, “Wearing a protection suits does not require a Master’s degree” or “She was not so ill when she went to a hairdressing salon” were some of the pearls.
Spanish citizens were not reassured. In an awkward press conference which took place on the 6th October, public health minister Ana Mato – who should have been a professional authority on public health, and who is ultimately accountable for the public health of the country – delegated the lead of the press conference to her officials. To questions like “Do you regret having repatriated missionaries ? Have any errors been detected? Will there be resignations?”, they could not provide answers – Giving a sense of improvisation, insecurity and mismanagement. The bad management of the crisis worsens the already-poor reputation of Ana Mato who in 2009 denied knowledge of a luxury jaguar in her garage, previously owned by one of the leaders of the Gurtel plot, and gifted to her husband, Jesus Sepulveda.
Phase 4) Impact:
All eyes were on Spain, a country once proud of its public health system, and all eyes have seen the failures which have led to the first case of Ebola in Europe. Failed austerity experiments, corruption, the Caja Madrid black cards scandal and the lack of solutions for the unemployment crisis have all deeply affected the credibility of Spain. Something must be seriously rotten in the system when potential cases of Ebola, which are later proved negative, are greeted by the Spanish Vice-President Soraya Saenz de Santamaria with a big smile because they are not Ebola but Malaria.