The Ebola outbreak in West Africa caused global alarm. As one of the world's most infectious and deadly diseases the level of fear surrounding Ebola is to an extent expected. However, much of the fear is rooted in misunderstandings. Dispelling these is a major challenge in tackling Ebola and is critical to furthering our knowledge about the disease and efforts to control it.
At IDS, researchers are investigating the complex forces behind the emergence and spread of diseases which are transmitted from animals to people and are known as zoonoses. Although Ebola is now being spread by human-to-human contact, it is zoonotic in origin. Fruit bats are thought to be the most likely natural host for the Ebola virus. IDS researchers are also investigating the social contexts in which zoonoses often emerge and the contending narratives surrounding disease control. Research – drawing together social and natural science, and engaged with local people, international agencies, and national and local governments and practitioners - can lead to better theory, improved mutual comprehension, and better-informed measures and practices to manage and control disease.
Misunderstanding one: Chopping down trees causes Ebola
While there is good evidence that bats are the natural reservoir for the Ebola virus, the complex interactions that cause the disease to spillover to humans are as yet unclear.
A popular environmental narrative claims that rapid and unprecedented deforestation of primary forests is leading to increased human-bat contact in West Africa for the first time, making transmission of the disease to people from bats more likely. However, research by IDS's Melissa Leach and others has shown the upper Guinea forests have been a dynamic mosaic of forest, savannah, and farmland for centuries, with people in this region having long co-habited with bats.
Over-simplified views of one-way deforestation feed popular ideas that stereotype and blame rapacious farmers and loggers for their current disease predicament. They do not help us understand Ebola's origins. Meanwhile misleading messages that Ebola comes from eating bushmeat have dangerously deterred people's appreciation of the real risks of transmission – from bodily contact with infected humans.
Find out more:
- Ebola in Guinea - people, patterns and puzzles. Melissa Leach blogs at Lancet Global Health
- Misreading the Africa Landscape: Society and Ecology in a Forest-Savanna Mosaic. Book authored by James Fairhead and Melissa Leach (1996)
- Haemorrhagic Fevers in Africa: Narratives, Politics and Pathways of Disease and Response. STEPS Centre Working Paper by Melissa Leach
Misunderstanding two: People in Africa are ignorant of effective ways to deal with diseases like Ebola
The difficulties medical teams have sometimes had in establishing effective community relations during the current Ebola epidemic have led to some wild generalisations. People in West Africa are not living in archaic, unchanging tradition, refusing to engage with modern concepts of health.
However, the dimensions of cultural context remain real and relevant as disease possibilities, and therefore as logical explanations of worrying events and circumstances, even to the educated. People can live with multiple framings of disease and outside intervention, and can switch between them according to context. So, although outside scientific knowledge is crucial to containing the Ebola virus, local public behaviours and attitudes can and should be seen as part of cultural logics that make sense given regional history, social institutions and experience.
For this reason, an anthropological perspective is important for disease control efforts, which should include building good community relations, working with traditional authorities and seeking to understand local ideas and practices.
Find out more:
- Ebola Response Anthropology Platform. Co-ordinated by anthropologists at Londong School of Hygene and Tropical Medicine, IDS and the Universities of Sussex and Exeter, this platform aims to contribute to a co-ordinated, adaptive and iterative response to the Ebola outbreak.
- Time to put Ebola in Context. Interview with Melissa Leach in the Bulletin of the World Health Organization
- Ebola: failures, flashpoints and focus. Blog by Anne Wilkinson on the STEPS Centre blog
- Ebola: The Challenges. Summary of roundtable event held as part of African Studies Association Conference 2014
Misunderstanding three: Ebola is a one-off event
Ebola is one of a group of diseases transmitted to people from animals that are known as zoonoses. Ebola is rightly gaining much attention as it was only identified in 1976, is extremely contagious and has a high fatality rate. It is also proving far more difficult to control than previous epidemics of zoonotic disease such as SARS and avian influenza.
However, since 1940, more than 60 per cent of infectious diseases newly affecting people in Africa have been transmitted via animals. Globally, the top 13 zoonotic diseases are responsible for 2.2 million human deaths every year, most in low- and middle-income countries. Even where they don't kill, their effects still devastate poor people's lives and hamper development efforts. Ebola is a terrible disease, but known deaths from it still number fewer than 8,000 to date.
To say all this is to highlight the terrible impact of other zoonoses, which receive relatively little attention. It is also to stress the importance of increasing our knowledge about neglected zoonoses. IDS researchers are working alongside vets, geographers, epidemiologists and others in multidisciplinary projects helping to tease out the complex forces behind zoonotic disease emergence and transmission, offering new theory as well as practical solutions.
It is not reason to be less concerned about Ebola. The current exponential increase in Ebola infections and the resulting terrible social, economic and political consequences demonstrates the dangers and tragedies of an unchecked epidemic. It also highlights the underlying development and health system failures that have contributed to this becoming a crisis of such proportions.
Find out more:
- Ebola and beyond: Equality, sustainability, security - interlaced challenges in a global development era. Sussex Development Lecture, background document and podcast by Melissa Leach
- Ebola: Difficult questions for development. Huffington Post blog by Ian Scoones
- The Dynamic Drivers of Disease in Africa Consortium is a 20-partner, multidisciplinary international research programme considering the linkages between zoonoses, ecosystems and wellbeing.
- STEPS Centre researchers are working on a range of other zoonoses-related projects. This October, STEPS Centre researchers will begin work with a new four-year research consortium, Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ).
Image credit: European Commission DG ECHO (cc on Flickr)
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Epistemologies of Ebola: Reflections on the Experience of the Ebola Response Anthropology PlatformAnthropological Quarterly (forthcoming)
Socio-Cultural Determinants of Human-Bat Interaction in Rural GhanaAnthrozoos (forthcoming)
Engaging ‘Communities’: Anthropological Insights from the West African Ebola Epidemic’Philosophical Transactions of the Royal Society B (forthcoming)
Comparison of Social Resistance to Ebola Response in Sierra Leone and Guinea Suggests Explanations Lie in Political Configurations not CultureCritical Public Health 01.27 (2016)
Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. More details
Real-time Monitoring in Disease Outbreaks: Strengths, Weaknesses and Future PotentialIDS Evidence Report 181 (2016)
This Evidence Report analyses the potential contribution of epidemic real-time monitoring (ERTM) initiatives to enhancing and augmenting disease surveillance systems in developing countries. More details
One Health: Science, Politics and Zoonotic Disease in Africa
Zoonotic diseases – pathogens transmitted from animals to people – offer particularly challenging problems for global health institutions and actors, given the complex social-ecological dynamics at play. More details
The Ebola Crisis and post-2015 DevelopmentJournal of International Development 27.6 (2015)
This article argues that the recent Ebola crisis is the result of structural violence, as interlocking institutions have produced interlaced inequalities, unsustainabilities and insecurities. More details
Building a Resilient Health System: Lessons from Northern NigeriaIDS Working Paper 454 (2015)
The overarching aim of this paper is to address the issue of building resilient health systems in the context of the Ebola outbreak in West Africa which has brought renewed attention to this challenge. The paper highlights insight gained from two decades work creating resilient health systems in Nigeria—in Northern Nigeria in particular. More details
Ebola and Lessons for DevelopmentIDS Practice Paper in Brief 16 (2015)
As the Ebola crisis continues to unfold across West Africa and the international community belatedly responds, broader questions arise beyond the immediate challenges on the ground. More details
Global Governance and the Limits of Health SecurityIDS Practice Paper in Brief 17 (2015)
The Ebola outbreak in West Africa has exposed the limits of the current approach to the global governance of infectious diseases, which mixes public health and security interests. More details
Strengthening Health Systems for ResilienceIDS Practice Paper in Brief 18 (2015)
In countries with high levels of poverty or instability and with poor health system management and governance, people are highly vulnerable to shocks associated with ill health, including major epidemics. More details
Return of the Rebel: Legacies of War and Reconstruction in West Africa’s Ebola EpidemicPractice Paper in Brief 19 (2015)
The spread of Ebola in West Africa centres on a region with a shared recent history of transnational civil war and internationally led post-conflict reconstruction efforts. This legacy of conflict and shortcomings in the reconstruction efforts are key to understanding how the virus has spread. More details
Ebola, Politics and Ecology: Beyond the ‘Outbreak Narrative’IDS Practice Paper in Brief 20 (2015)
The origin of the Ebola outbreak in West Africa has been traced to the likely confluence of a virus, a bat, a two-year-old child and an underequipped rural health centre. More details
Ebola and Extractive IndustryIDS Practice Paper in Brief 21 (2015)
The economic effects of the Ebola health crisis are slowly unfolding as the virus continues to affect Sierra Leone, Liberia and Guinea. More details
Urbanisation, the Peri-urban Growth and Zoonotic DiseaseIDS Practice Paper in Brief 22 (2015)
Ebola has had significant, negative effects in the rapidly expanding, unregulated areas of peri-urban and urban West Africa. The residents of these areas maintain vital connections with rural populations while intermingling with and living in close proximity to urban and elite populations. More details
The Pathology of Inequality: Gender and Ebola in West AfricaIDS Practice Paper in Brief 23 (2015)
The international response to Ebola has been decried for being ‘too slow, too little, too late’. As well as racing to respond, we need to consider what has happened over the past decades to leave exposed fault lines that enabled Ebola to move so rapidly across boundaries of people’s bodies, villages, towns and countries. More details
Local Engagement in Ebola Outbreaks and Beyond in Sierra LeonePractice Paper in Brief 24 (2015)
Containment strategies for Ebola rupture fundamental features of social, political and religious life. Control efforts that involve local people and appreciate their perspectives, social structures and institutions are therefore vital. More details
Ebola: Limitations of Correcting MisinformationThe Lancet (2014)
Communication and social mobilisation strategies to raise awareness about Ebola virus disease and the risk factors for its transmission are central elements in the response to the current Ebola outbreak in West Africa. More details
Impact and Implications of the Ebola Crisis
This rapid literature review looks at the available evidence on the impact of the Ebola crisis on four key areas: political, economic, social, and security. More details
Briefing: Ebola–Myths, Realities, and Structural ViolenceAfrican Affairs 114 (2014)
This briefing examines responses to the Ebola outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. More details
The social life in infectious diseases07 Dec 2016
By Nathan Oxley
Ebola anthropology: real-time social science to building future local capacity27 Oct 2016
By Melissa Leach
Investing in health is not cheap, but it is not a luxury either25 May 2016
By Sara Bennett, Edward Kelley
Welcoming the medics to the One Health movement21 Jul 2015
Aid agencies must adapt to changing demands of Ebola crisis19 Jun 2015
By Brendan Paddy
Ebola can be transmitted sexually for weeks after recovery05 May 2015
By Pauline Oosterhoff
Beyond the medical crisis: The politics of Ebola in Sierra Leone15 Apr 2015
By Lisa Denney
Entrenched inequality and violence underlie the Ebola outbreak01 Apr 2015
By Linda Waldman, Elizabeth Mills
Ebola: Time to strengthen health systems and global health governance10 Mar 2015
By Hayley MacGregor, Gerry Bloom, Anne Roemer-Mahler