Opinion

It’s a great (if unfair) world

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Publicity about the newest and most astonishing healthcare development of our time vied for attention recently with a disease that is responsible for the deaths of thousands of ‘untouchables’ in underdeveloped countries.

In Poland, history was made when 38 year-old Polish fireman Darek Fidyka, who was paralysed when his spinal cord was completely severed after a knife attack four years ago, regained the ability to walk through the redeployment of his olfactory cells.

Olfactory ensheathing cells (OECs) influence the regrowth of olfactory nerves, which transport smells to the brain and regenerate every 30 days. Neurosurgeons at Wroclaw University Hospital in Poland extracted the left olfactory bulb via Mr Fidyka’s skull, and cultured OECs. These cultured cells were then transplanted into the spinal breach, along with strips of ankle nerves to act as a scaffold along which the nerves could regrow.

After less than a year and a half, the effects of the pioneering transplant became evident. Mr Fidyka grew left thigh muscle, felt movement in his lower limbs, and sensation returning in his legs. He even recovered some bladder sensation and sexual function. He says he feels like he has been reborn. Scientists are astounded and, of course, thrilled.

Meanwhile, in West Africa, Ebola – an infectious disease that under normal circumstances would be relatively easy to contain – has been transformed into an epidemic of death, terror and despair in Guinea, Sierra Leone and Liberia.

Conditions are so primitive in these underdeveloped countries, and the people are so poor, that they cannot afford basics like soap and water to even begin to fight the virus. It is estimated that 10,000 people have already been infected, and 50 per cent have died. The World Health Organization (WHO) has been criticised for its slow response to the crisis.

As is usual in these circumstances, poor people are the most affected, particularly those who travel in search of work or something to eat. And 75 per cent of Ebola deaths are among women. This is because care demands what nurses well understand, and most people consider an impossible response to suffering: taking a distance from it. The human need to show compassion and care to infected people is what is killing so many.

These countries have been through tough times. Sierra Leone and Liberia endured civil wars from 1991 and 1999 respectively, and Guinea suffered military coups. All three are heavily reliant on development aid. But there is a catch.

Aid donors insist that their priorities, and not those of the recipient countries, are given precedent. For example, they may want to focus on subsistence farming or ‘appropriate’ technology, or gender-based violence. This leaves elected politicians answerable to donor agencies, not their citizens, thus undermining recipients’ right to determine their own countries development priorities independently. Consequently, the fragmented approach to investment and development results in inconsistency, poor infrastructure and maintenance, inadequate health and social care provision, and limited access to basic education.

I do not for a minute begrudge the outcome that scientists have achieved for Darek Fidyka. After decades of research, Professor Geoffrey Raisman from the spinal repair unit at University College London’s Institute for Neurology, and the surgeons in Poland, deserve our respect for perseverance and innovation. I just wish that people in the developing world had equally good care.

But where some see problems, others see potential solutions. In the United States, staff at Palos Community Hospital in Illinois use a robot with sensors – Tru-D – to detect harmful bacteria, virus and spores, and kill them with ultraviolet light. They believe the $85,000 (£53,000) device could help stop the spread of Ebola. If it is suitable, that would be a small price to pay to prevent more deaths.

About the author

Bríd Hehir is a fundraising manager for Do Good Charity which sponsors nurse training and education in Africa. She worked in the NHS until 2011, as a nurse, midwife and specialist heath visitor, and latterly a senior manager. She is a regular contributor to spiked and is a Battle of Ideas committee member