Ebola virus has been sweeping through West Africa since Spring 2014, plunging Guinea, Liberia, Sierra Leone, and Nigeria to a lesser extent, into poverty, social and political turmoil, and death. Although Africa is not unfamiliar with Ebola and its deadly symptoms, this epidemic is particularly devastating, as it is harder to contain than the previous ones. It has also stretched local health facilities to the breaking point and it has put a tremendous amount of pressure on the international community, which has intervened to treat the sick and prevent the spread of the virus. Despite representing an issue of extreme urgency, the current Ebola epidemic has been mostly narrated from a univocal point of view. Indeed, the international media usually focus on the Western perspective of the Ebola outbreak, while this article will try to talk about the Africans’ interpretations of the deadly virus that is ravaging their States. This work will analyse the social, political, and economic dimensions of the current Ebola epidemic from the point of view of the African people. What emerges from this analysis is the pressing need to understand the way Africans conceptualize Ebola and the prevention of contagion, their fears about it, and the economic impact of it on the African economy. A good grasp of these aspects will enable Western actors to manage the epidemic more effectively.
Ebola virus, which has spread in Guinea, Sierra Leone, Liberia, and Nigeria since March 2014, is among the most fatal viruses known in science. According to the latest official figures provided by the WHO, this epidemic has infected 20747 people and claimed 8235 lives1. Unfortunately, science has not discovered yet Ebola’s natural reservoir, from which it spreads to humans. Fruit bats are suspected to be the very source of infection.
The symptoms of Ebola make it one of the deadliest viruses. Indeed, Ebola causes high fever, bleeding, vomiting, diarrhoea, and pain; it has a very high fatality rate, ranging from 50% to 90%, and the only measure that can be taken to prevent its diffusion is the treatment of infected patients in high-containment facilities2. The WHO also lists among anti-Ebola preventative measures the provision of health information regarding the symptoms of Ebola and its mode of transmission to the population, and the monitoring for twenty-one days of individuals who have come into contact with an infected person3. Indeed, the transmission of Ebola is relatively easy, as it occurs through direct contact with infected blood, bodily fluids, or organs of humans and animals. As in Africa bush-meat (i.e. monkeys, apes, and antelopes) is part of the usual diet, as it is a high protein kind of food, Africans are exposed to the risk of becoming infected by the virus if the animals they butcher and eat have died from Ebola4. Moreover, the poorly equipped health-care facilities existing in the continent can become fertile soil for the transmission of the virus. Along with its uncertain natural reservoir, its deadly symptoms, and its relatively easy mode of transmission, what makes Ebola particularly dangerous is the difficulty in diagnosing it in the early stages, when the symptoms may be common to other diseases, and the lack of an officially tested cure. Crucially, although Ebola outbreaks have punctuated the medical history of Africa since 1976, a cure has not been discovered yet5. The latest outbreak has fuelled frantic attempts to find a treatment: so far, experimental treatments are being used on a limited basis.
Having outlined the peculiarities of Ebola and what makes it one of the deadliest viruses, it is now significant to analyse the population’s perceptions of the Western-devised measures to contain it. Ebola is indeed a biological and a social pathogen: while the biological aspect is self-explanatory, it is worth dwelling on the social element. The health-workers’ fight against the spread of the virus, in fact, subverts the social fabric of African communities, as it interferes with deeply rooted local traditions regarding motherhood, death, and kin relationships. Africans do not ignore Western medicine, but their understanding of it is mediated by local cultural practices6. As a MSF doctor working with Ebola patients poignantly said, Ebola poses an ethical challenge for doctors and the local population alike. Preventing its spread means that infected mothers cannot breastfeed their children, which is seen as outrageous according to local traditions surrounding motherhood7. Additionally, the containment of Ebola demands women, who traditionally participate in the common experience of childbirth, not to take part in it, as it would let them come into contact with potentially infected blood and bodily fluids8. The limitation of the transmission of Ebola also clashes with burial traditions, as it requires the cremation of infected corpses to eliminate any trace of the virus, which is considered as unacceptable by the locals9. Moreover, preventative measures require women not to perform their traditional functions in the preparation of the body before burial, so to prevent them from coming into contact with potentially infected bodily fluids and blood. Lastly, the prevention of Ebola tends to tear kin relationships apart, since health-workers ask relatives to stay away from their infected loved ones and they take the latter away to hospitals10. Therefore, it is advisable to interpret Ebola from an anthropological point of view, which takes into account local beliefs about the Ebola epidemic response. Anthropologists can explain local beliefs about Ebola and about the Ebola epidemic response to Western health-workers.11
Hewlett & Hewlett provide an insightful analysis of how local beliefs and traditions do not always clash with the Western measures to prevent the spread of Ebola. Sometimes, indeed, they can help to control the epidemic, which is a possibility health-workers often ignore, as – according to Hewlett & Hewlett – they are convinced that local traditions necessarily pose a challenge to health-workers preventing the transmission of the virus. Despite being written in 2007, this analysis is still useful and health-workers can draw upon it to help local communities to mobilize against the spread of Ebola and control it12. First of all, local people do not ignore the importance of the containment of the disease, and have indigenous protocols and cultural behaviours to control epidemics, such as monitoring systems and isolation procedures. Children, in particular, seem to easily learn about contagion and can be used by health-workers to teach the population the golden rules that prevent contagion13.
It is useful to assume the standpoint of anthropologists also in order to analyse the local beliefs about the ontology of Ebola. It appears, indeed, that Ebola has strong political connotations in the Africans’ minds. On the social media people often deny its real existence and believe it is merely a government’s plot to drain economic resources in order to prevent development14 or, on the contrary, it is a government conspiracy to receive international aid15. The power of the social media in shaping conspiracy theories is testified also by the fact that on the social networks the rumour that Ebola is a pharmaceutical companies’ plot organized to boost their businesses circulates virulently16. Finally, some Africans believe they have been excluded by the medical industry, which has allocated the first experimental serums available to treat the virus to Western health-workers. A Burkina Faso newspaper regretted that African infected health-workers did not have the same chances to benefit from anti-Ebola treatments as their Western counterparts17. Africans in general, indeed, call for a more inclusionary allocation of the scarce treatment available18, and some of them even conceive Ebola as a racist plot to let Africans die without offering them a vaccine19. These conspiracy theories fuel the population’s distrust of the government and Western organizations and companies, which, in turn, encourages Africans not to comply with the measures to prevent contagion. This increases mortality and mortality leads to further distrust, thus creating a vicious cycle20.
African governments, on their part, are not well equipped to deal with Ebola and often fail to mount an effective response to it. Indeed, they have insufficient and poorly equipped health-care facilities and resources. They often minimize the risks related to Ebola, take ill-conceived measures to prevent contagion, which meet with local resistance, and obstacle the spread of accurate information about the deadly virus. For instance, the use of quarantines of entire neighbourhoods does not effectively stem the spread of Ebola and increases the people’s distrust of the government, which results in people hiding their infected relatives and friends21. It was against this backdrop that Sierra Leone launched the “Operation Western Area Surge“ (WAS), a campaign that meant to identify the infected people and take them to appropriate treatment centres. This campaign was a success, but it only lasted from 17 to 31 December 2014 and was confined to the West of the country. Therefore, it is hoped that it will resume soon and will be extended to a wider area22.
Finally, Ebola has an economic dimension, as it devastates the economies of the countries affected and it takes up the government’s time and resources so much that it becomes hard for policymakers to focus on economic issues. Policymakers should, therefore, devote attention and resources both to the fight against Ebola and to the economic growth of the countries affected. Ignoring the economy would lead to catastrophic effects that, added to the effects of the Ebola epidemic, can cause devastating consequences. Paying attention to the economy, on the other hand, can help to boost development and, crucially, to build confidence in the government among the population. As of now, Ebola has caused unemployment, as shops and companies may shut down due to the lack of demand and of personnel. Sales have fallen and prices increased, due to the lack of demand. Agricultural production has decreased, as Ebola takes away lives from agriculture. Finally, tourism has drastically fallen, as tourists are terribly scared of becoming infected with Ebola23. Moreover, the international media coverage of Ebola has been badly affecting tourism in the African continent as a whole, causing further repercussions on economic growth24. A thorough understanding of the social, political, and economic dimensions of Ebola from the perspective of Africans, who are the primary victims of the disease, is essential in order to allow Western governments and international organizations to respond effectively to Ebola, while respecting local beliefs, gaining the population’s acceptance and trust, and not neglecting the economy of the countries affected.
- 1 Jeune Afrique,Ebola: les trois dernières nouvelles du front, 8 January 2015.
2 Hewlett B. and Hewlett B., Ebola, Culture and Politics: The Anthropology of an Emerging Disease, 2007, p. 3.
3 Ibid., p. 5.
4 Ibid., p. 4.
6 Wilkinson A., Ebola: failures, flashpoints, focus, Africa at LSE, 21 August 2014.
7 Black B.,Practical and ethical dilemmas of working in the current Ebola crisis, LSE conference, 15 October 2014.
8 Thornton P.,Assessing the economic effects of Ebola, Africa at LSE, 29 September 2014.
9 See, among others, Dockins P.,WHO: Traditional Burials Hamper Ebola Fight, Voice of America, 25 June 2014.
10 Human Rights Watch,West Africa: respect rights in Ebola response, 15 September 2014.
11 Abramowitz S.,Ten things that anthropologists can do to fight the West African Ebola epidemic, Africa at LSE, 18 November 2014.
12 See note 2.
13 Hewlett B. and Hewlett B., Ebola, Culture and Politics, 2007, pp. 4-5.
14 Lipton J.,Mixed Messages: social media, rumours, and responses to the #Ebola outbreak in #Sierra Leone’s capital Freetown, Africa at LSE, 19 August 2014.
15 Amon J.,What turns few cases of disease into thousands?, 12 September 2014.
16 Falade B.,Ebola epidemic: when science is not enough, Africa at LSE, 22 October 2014.
17 Jeune Afrique,Ebola: vrai ou faux, six questions sur un sérum « miracle », 11 August 2014.
18 Furman K.,The international response to the Ebola outbreak has excluded Africans and their interests, Africa at LSE, 20 August 2014.
19 See note 13.
20 Cooper J., Ebola-a social pathogen in an epidemic of distrust, Africa at LSE 28 November 2014.
21 See note 14.
22 See note 1.
23 Thornton P.,Assessing the economic effects of Ebola, Africa at LSE, 29 September 2014.
24 Nkwanga W.,The Ebola outbreak in West Africa is bad news for the whole continent, Africa at LSE, 24 October 2014.