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Understanding social resistance to Ebola response in Guinea

This paper seeks to understand the fear many Guineans feel towards Ebola response initiatives and why the educators, doctors and burial teams have sometimes encountered resistance, occasionally violent. Resistance has been catastrophic for the epidemic, preventing treatment, contact tracing and quarantine, permitting its spread. The paper sketches a history of dissent and violence during the epidemic before showing how some actions that Ebola response teams interpret as ‘resistance’ are less actions ‘against’ Ebola response, than actions that have their own cultural logics. But the paper Continue reading →

A year on, Guineans finally lay Ebola souls to rest

GUECKEDOU, 28 April 2015 (IRIN) – Forty-six-year-old Maurice Ouendeno stares silently at the arm of his blue plastic lawn chair. He waits a few minutes before beginning his story. “They said we did not have the right to bury him,” he says, finally looking up. Sadness, mixed with a bit of anger, flashes briefly across his face. “We understood why, but it was painful. It was so painful not to be able to give him the send-off he deserved.” His father, Tamba Lamine Ouendeno, died Continue reading →

Never Again: Building resilient health systems and learning from the Ebola crisis

It took the threat of a global health crisis to illustrate the failings of Africa’s health systems. Resilient health systems, free at the point of use, are evidently a global public good. They are essential for the provision of universal health coverage and for a prompt response to outbreaks of disease. Resilient health systems require long-term investment in the six key elements that are required for a resilient system: an adequate numbers of trained health workers; available medicines; robust health information systems, including surveillance; appropriate Continue reading →

Ebola can be transmitted sexually for weeks after recovery – education is crucial

Conflicting messages on the length of time that Ebola remains in semen after recovery make education and prevention confusing. We need to avoid mixed messages and focus on girls’ rights, says anthropologist Pauline Oosterhoff. When I met members of a women’s secret society in Sierra Leone this February, they proposed drastic measures to stop Ebola from spreading through sexual contact. All survivors should be quarantined for three months, they said. Male survivors need to be locked up because they cannot control their urge to have sex. Women Continue reading →

Policy Briefing on Community-based Ebola Care Centres

A component of the Ebola epidemic control policy in Sierra Leone is triage and isolation in decentralised Community Care Centres (CCCs) or Holding Units, from where transfer to Ebola treatment units (ETUs) is arranged for those diagnosed as positive. The epidemic is currently waning, there are sufficient beds in the ETU, yet new micro-epidemics emerge, raising questions about the future role and relevance of the CCC. This briefing summarizes the preliminary findings of a formative evaluation conducted by the UK based Ebola Response Anthropology Platform Continue reading →

Village Responses to Ebola Virus Disease and its Prevention

The present document is the eighth and final report in a series presenting descriptive results of a survey of responses to Ebola and Ebola control in 26 villages in all three provinces of rural Sierra Leone, fieldwork for which was undertaken in December 2014. The report covers three villages in Gbo chiefdom, in Bo District. Some emphasis is placed on how inconsistencies of Ebola response are perceived at local level, and undermine trust. Ebola responders should not only improve the quality of their messages, but Continue reading →

Ebola’s Ecologies – Limn January 2015 Issue

This issue of Limn on “Ebola’s Ecologies” examines how the 2014 Ebola outbreak has put the norms, practices, and institutional logics of global health into question, and examines the new assemblages that are being forged in its wake. The contributions focus on various domains of thought and practice that have been implicated in the current outbreak, posing questions such as: What has been learned about the ambitions and the limits of humanitarian medical response? What insights are emerging concerning the contemporary organization of global health Continue reading →

How Ebola infection spreads and terminates in rural Sierra Leone

Ebola is a new disease in Upper West Africa. Populations have taken time to learn the nature of the risk it poses. Persons carrying infection initially do not know that they have the sickness. They carry out their daily activities, and seek help from their families and traditional remedies when and where they become symptomatic. Nearly all infection, so far as is known, is associated with the “wet” phase of the illness and handling the corpse of a deceased victim. This period of major infection Continue reading →

What causes Ebola Virus disease?

The four villages in this report are found on the edge of the Gola Rainforest National Park, Sierra Leone and have been studied by members of the present team at intervals since 1987. The aim of this long-term study was to understand social composition and social change in forest-edge communities, and how these communities were adapting to conservation rules and opportunities. These villages have now been restudied as part of the SMAC community mobilization program for prevention of Ebola Virus Disease. This study, which was Continue reading →

Community perceptions of Ebola response efforts in Liberia: Montserrado and Nimba Counties

This study aimed to support Oxfam’s Public Health Promotion (PHP) strategy through a rapid qualitative assessment of the remaining social barriers to compliance with Ebola prevention and treatment messages. At the time of the study, most Liberians had a high awareness of Ebola prevention and treatment information. However, new infections continued to occur in “hot spots” around the country. A preliminary assessment suggested that negative perceptions and fear of Ebola response efforts contributed to non-compliance and resistance in some areas. Research activities assessed the sources Continue reading →