Volume 90, #2

Spring 2017

SPECIAL COLLECTION
Producing Ebola: Creating Knowledge In and About an Epidemic

Volume 90, #2 • Spring 2017

 

SPECIAL COLLECTION:

Producing Ebola: Creating Knowledge In and About an Epidemic

 

INTRODUCTION:

by Catherine Bolten, University of Notre Dame

and Susan Shepler, American University

 

ARTICLES:

Emerging Disease or Emerging Diagnosis? Lassa Fever
and Ebola in Sierra Leone

Annie Wilkinson, Institute of Development Studies, University of Sussex

ABSTRACT— It has become routine to attribute the tragedy of the West African Ebola epidemic to inexperience and lack of knowledge. Guinea, Liberia and Sierra Leone were portrayed as entirely unfamiliar with Ebola and therefore without relevant knowledge. The simplicity of this narrative is disturbed by the experience of Lassa fever, an infectious and deadly viral hemorrhagic fever (VHF), which is endemic in the three countries most affected by Ebola. This paper looks beyond Ebola in 2014 to the history of efforts to control VHFs in the Mano River and challenges the idea there was a vacuum of knowledge. Highlighted instead are politics of knowledge which have run through global health and which have prioritized particular forms of knowledge and ways of dealing with disease. Ethnographic research on the emergence of Lassa and the subsequent emergence of Ebola in West Africa is presented, focusing on the development of technologies and institutions to detect and manage both viruses. This provides a lens for exploring what was known and not known, how and by whom; and what was counted and what was not, and why. The anthropological literature on emerging diseases has so far focused on the social, economic, and cultural dynamics which produce disease burdens but less on the socio-technical processes which calibrate these burdens. The paper contributes to the anthropology of emerging infectious disease by more fully accounting for the intricacies, uncertainties and implications of diagnostic and surveillance practices for new diseases. The paper will add to post-Ebola debates around preparedness by connecting intricate sociotechnical perspectives on disease emergence with the politics of science and global health and questioning the way priorities, risks, and problems have been conceptualized within this. [Keywords: Diagnosis, emergence, Sierra Leone, Lassa, Ebola].

 

Missing Bodies and Secret Funerals: The Production of “Safe and
Dignified Burials” in the Liberian Ebola Crisis

Mary H. Moran, Colgate University

ABSTRACT— During the height of the Ebola crisis in West Africa, public health responders and the international media focused on dead bodies as sites of disease transmission when early contact tracing discovered the relationship between attendance at funerals and emerging clusters of new cases. Anthropologists were central to the emergence of new protocols for “safe and dignified” disposal of the dead, emphasizing alternative rituals and the flexibility of local practice. In the process, I suggest that the emotional impact of loss and bereavement was subordinated to the focus on ritual. The new knowledge produced about safe and dignified burials in West Africa reveals the absence of knowledge about the handling of dead bodies and the emotional impact of bereavement among journalists, anthropologists, and biomedical professionals alike. [Keywords: Ebola, Liberia, funerals, bereavement, safe and dignified burials, knowledge production].

 

Ebola Through a Glass, Darkly: Ways of Knowing the State and
Each Other

Adam Goguen, University of Makeni
Catherine Bolten, University of Notre Dame

ABSTRACT— The Ebola epidemic unfolded in radically divergent manners in two neighboring villages in Sierra Leone, with one recording 40 cases and 20 deaths and the other recording zero cases, though they are located only 100 meters apart. Presented with identical information about Ebola’s cause and modes of transmission, one chief reacted by attempting to shield his village from outside knowledge and influence, encouraging his people to continue their normal practices of care and communion, and the other by instituting self-isolation, rapidly enforcing Ebola-specific practices among his residents. We argue that these opposing courses of action were the result of the chiefs interpreting health communications with respect to their social, historical, and political relationships with each other and with the state, and not as a result of one embracing medical knowledge and the other rejecting it. “Through a glass, darkly” refers to historical practices of knowledge interpretation in which knowledge is never treated as neutral information, but as implicated in relationships of power, rendering its political implications more important than the information conveyed. We distinguish between orthodoxy and orthopraxy—right belief versus right practice—to argue that the epidemic ended locally not through the circulation of knowledge, but through the circulation of Ebola-specific practice. We caution against treating knowledge only in terms of its production, circulation, and consumption, and urge a new focus on knowledge non-production, obfuscation, and rejection. [Keywords: Ebola; Sierra Leone; ways of knowing; states of emergency; orthodoxy; orthopraxy; ignorance]

 

“We Know Who is Eating the Ebola Money!”: Corruption, the State,
and the Ebola Response

Susan Shepler, American University

ABSTRACT— Sierra Leonean production of knowledge about Ebola was, in large part, production of knowledge about “who ate the Ebola money.” This paper traces people’s responses to the Ebola crisis through a number of different moments, at each point reflecting on how their concerns about how Ebola money was being spent illuminate their expectations of their state. It argues that the Ebola crisis reveals people’s contradictory relationships to their own states, wherein they simultaneously mistrust their politicians and look to their politicians in a moment of crisis. The paper also investigates Sierra Leone’s relationship to the international community, concluding that the state’s weakness is produced, in part, by its place in the international system. The research is based on three field visits to Sierra Leone and Liberia in April 2014, July 2014, and January 2015 and draws on interviews and focus groups in urban and rural settings. [Keywords: Sierra Leone, Ebola, weak states, corruption, money, state informality].

 

SOCIAL THOUGHT & COMMENTARY:

Epistemologies of Ebola: Reflections on the Experience of the
Ebola Response Anthropology Platform

Fred Martineau, London School of Hygiene & Tropical Medicine
Annie Wilkinson, Institute of Development Studies, University of Sussex
Melissa Parker, London School of Hygiene & Tropical Medicine

ABSTRACT— By September 2014, it was clear that conventional approaches to containing the spread of Ebola in West Africa were failing. Public health teams were often met with fear, and efforts to treat patients and curtail population movement frequently backfired. Both governments and international agencies recognized that anthropological expertise was essential if locally acceptable, community-based interventions were to be designed and to successfully interrupt transmission. The Ebola Response Anthropology Platform was established against this background. Drawing together local and internationally based anthropologists, the Platform provided a coordinated and rapid response to the outbreak in real time. This article explores how the Platform developed and interacted with other epistemic communities to produce knowledge and policy over the course of the outbreak. Reflecting on the experiences of working with the UK Department for International Development, the World Health Organization and other agencies, we ask: what do these experiences reveal about the politics of (expert) knowledge and its influence on the design and implementation of policy? Did differing conceptions of the place of anthropology in humanitarian crises by policymakers and practitioners shape the contributions made by the Ebola Response Anthropology Platform? What are the implications of these experiences for future anthropological engagement with, and research on, humanitarian responses to health crises? [Keywords: Anthropology, Ebola, medical humanitarianism, epistemic communities, Sierra Leone]

 

Ebola at a Distance: A Pathographic Account of Anthropology’s Relevance

Adia Benton, Northwestern University

ABSTRACT— Drawing on a year of researching and writing about the West African Ebola epidemic from afar, I use the heuristic of virality to critically examine the collective US anthropology response to Ebola, a viral disease, and the anthropological knowledge networks formed to address the 2013 – 2015 outbreak. Specifically, I describe how digital media facilitated an entry point to build connections and knowledge around the epidemic in American anthropologists’ quest to prove the discipline’s relevance, the viral circulations of and replications of anthropological ideas in the Ebola response, and the attempts to shed pathogenic racial legacies of Africanist anthropology shaping US anthropology’s official response. [Keywords: Ebola, marginalization, racism, inequality, relevance, history of anthropology.]