Increasing early presentation to ECU through improving care

Current Ebola epidemic control policy in Sierra Leone focuses on (a) triage and isolation in decentralised, ideally community-based Ebola Care Units (ECUs), leading to (b) transfer to Ebola treatment units (ETUs) for those diagnosed as positive. Increasing early presentation to ECUs is essential for this strategy to be effective in reducing Ro. This note outlines ways in which improved and socially-appropriate care – in ECUs, and at home – can assist this.

Mobilising youth for Ebola education: Sierra Leone and Liberia

This brief summarises some key considerations about mobilising youth and youth groups in the Ebola response in Sierra Leone and Liberia. The details have been collated from suggestions and insights provided by networks of anthropologists in the UK and US who work in Sierra Leone and Liberia (both in-­‐country and remotely). These are general considerations that are broadly relevant to mobilising youth in the response, but further investigation into local specificities is required. The French version of the brief is available here.

Sierra Leone: Gift giving during initial community consultations

This brief summarises appropriate gift giving during initial community consultations in Sierra  Leone. It is intended to provide an overview of good practices to support UNICEF, the WHO and other agencies as they interact with Paramount Chiefs prior the implementation of CCCs. It does not focus on the community consultation process more broadly, but specifically on gift giving during the first meeting. The details have been collated from suggestions and insights provided by networks of anthropologists in the UK and US who work in Sierra Continue reading →

Care and Burial Practices in Urban Sierra Leone

Funeral practices in Freetown are varied with differences between typical Muslim and Christian practices. Muslims typically bury the body the same day, or the day after, the death, whereas Christians might wait for up to several weeks while arrangements are made. Muslims normally bury bodies in a shroud, whereas Christians use a coffin. The bodies are typically prepared for burial (washed) by family members.  This background paper gives more information on care and burial practices in Urban Sierra Leone.  

Burial/Other Cultural Practices and Risk of EVD Transmission in the Mano River Region

While this briefing note identifies arenas of particular significance with regard to burial practices, such practices are not standardised, are likely to change as social responses to Ebola evolve, and therefore need to be discussed on a locality by locality basis. Key points are given in this policy brief, followed by a more substantial discussion of burial and cultural practices that increase risk of EVD transmission.

Local beliefs and behaviour change for preventing Ebola in Sierra Leone

‘The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times.  Never before in recorded history has a biosafety level four pathogen infected so many people so quickly, over such a broad geographical area, for so long’ (Margaret Chan, 26th September 2014, WHO). This report focuses on the local beliefs and practices around illnesses and death, the transmission of disease and spirituality, which affect decision-making around health-seeking behaviour, caring for relatives and the nature of burials.  Continue reading →

The significance of death, funerals and the after-life in Ebola-hit Sierra Leone, Guinea and Liberia: Anthropological insights into infection and social resistance

The aim of this briefing paper is to consider the various ways in which widely reported fear and resistance to the Ebola response can be understood, and what each way of understanding offers to those battling with the current epidemic. As far as this paper is concerned, there is no single ‘right way’ to comprehend resistance to educators, medics and burial teams, as this is a very complex social phenomenon. The aim instead is to outline the variety of ways in which resistance can be Continue reading →

Social Pathways for Ebola Virus Disease in Rural Sierra Leone, and some Implications for Containment

The current outbreak of Ebola Virus Disease in Upper West Africa is the largest ever recorded.  Molecular evidence suggests spread has been almost exclusively through human-to-human contact.  Social factors are thus clearly important to understand the epidemic and ways in which it might be stopped, but these factors have so far been little analyzed.  The present paper focuses on Sierra Leone, and provides data on the least understood part of the epidemic – the largely undocumented spread of Ebola in rural areas.  Various forms of Continue reading →

Ebola: failures, flashpoints and focus

As the worst Ebola epidemic on record shows no signs of abating in West Africa, fear and ignorance are increasingly said to be playing a role in its continued spread. Meanwhile, local practices such as the consumption of bushmeat and deforestation are the go-to explanations for the epidemic’s underlying causes. However, decades of anthropological research in the region by STEPS Centre and Institute of Development Studies (IDS) researchers, indicates not only that this picture is an over-simplification, but that disease control policies based on these ideas may be unhelpful.