Despite more than 25 documented outbreaks of Ebola since 1976, our understanding of the disease is limited, in particular the social, political, ecological, and economic forces that promote (or limit) its spread. In the following study, we seek to provide new ways of understanding the 2013-2015 Ebola pandemic. We use the term, ‘pandemic,’ instead of ‘epidemic,’ so as not to elide the global forces that shape every localized outbreak of infectious disease. By situating life histories via a biosocial approach, the forces promoting or retarding
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There have been numerous recent analyses of the different manifestations of ‘resistance’ and ‘reticence’ that continue to be critical in Guinea. The socio-historical context that has contributed to deep-rooted mistrust of the State and authority (a sense of ‘abandonment’ [the West has only returned to intervene in Guinea to ‘count cases’ and international actors will again abandon the country when cases are ‘acceptably low’]; heavy-handed or repressive interventions; the perception that elites treat people as if they are disposable and unworthy etc.) is well recognised.
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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
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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
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This advisory brief aims to provide anthropologically informed guidance to governmental and humanitarian actors involved in the Ebola response at local, national and international levels, about clinical trials for Ebola treatments, therapies and vaccines. It serves to (1) clarify and demystify some of the scientific and technical discussions around the numerous clinical trials; (2) revisit issues surrounding the compassionate use of experimental medications and therapies in and after an emergency; and (3) provide a summary of the cultural, institutional and historical factors that impact the
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This brief summarises some key considerations about the flow and control of money in relation to the Ebola response. The details have been collated from suggestions and insights provided by networks of anthropologists who work in Liberia, Sierra Leone and Guinea (both in country and remotely). These are general considerations that are broadly relevant, but further investigation into local specificities is required. The French version of the brief is available here.
The limited evidence available on age-disaggregated fatality rates of Ebola Virus Disease (EVD) consistently highlights the poor survival rates of older people compared with young adults. The particular roles that older people play in societies put them at differing patterns of risk of contracting EVD compared with younger adults. While many older people will be less likely to undertake at-risk care and burial practices, those with for example fostering or non- formal caring roles may be at increased risk of transmission. Older people, in particular
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The scale of West Africa’s Ebola epidemic has been attributed to the weak health systems of affected countries, their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This briefing for African Affairs argues that these explanations lack important context. The briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, it
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This paper by Anoko J. N., reports on the success of a communication programme among 26 rebellious villages in Forest Guinea during fieldwork in June-July 2014. This was based on listening to complaints and taking into account the customs and culture of those concerned. The main methodologies were socio-anthropological enquiry and action research, based on bibliographic research, observations, formal and informal interviews with resource persons and political leaders from Forest Guinea; women , young and very old people of both sexes, street vendors, restaurateurs, local
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