Ebola: How a People's Science Helped End an Epidemic

by Paul Richards, Alcinda Honwana (Editor), Alex de Waal (Editor), Richard Dowden (Editor), Stephanie Kitchen (Editor)

Overview

Shortlisted for the Fage and Oliver Prize 2018

From December 2013, the largest Ebola outbreak in history swept across West Africa, claiming thousands of lives in Liberia, Sierra Leone and Guinea. By the middle of 2014, the international community was gripped by hysteria. Experts grimly predicted that millions would be infected within months, and a huge international control effort was mounted to contain the virus. Yet paradoxically, by this point the disease was already going into decline in Africa itself. So why did outside observers get it so wrong?

Paul Richards draws on his extensive first-hand experience in Sierra Leone to argue that the international community's panicky response failed to take account of local expertise and common sense. Crucially, Richards shows that the humanitarian response to the disease was most effective in those areas where it supported these initiatives and that it hampered recovery when it ignored or disregarded local knowledge.

Product Details

ISBN-13:	9781783608591
Publisher:	Bloomsbury Academic
Publication date:	09/15/2016
Series:	African Arguments
Edition description:	New Edition
Pages:	192
Product dimensions:	5.50(w) x 8.50(h) x 0.56(d)

About the Author

Paul Richards is an anthropologist with over forty-five years' experience of living and working in West Africa. He is emeritus professor of technology and agrarian development at Wageningen University in the Netherlandsand and adjunct professor at Njala University in central Sierra Leone. His previous books include No Peace, No War: An Anthropology of Contemporary Armed Conflicts (2005).
Paul Richards is an anthropologist with over forty-five years' experience of living and working in West Africa. He is emeritus professor of technology and agrarian development at Wageningen University in the Netherlandsand and adjunct professor at Njala University in central Sierra Leone. His previous books include No Peace, No War: An Anthropology of Contemporary Armed Conflicts (2005).

Table of Contents

Figures and Tables
Acknowledgements
 
Introduction
1. The world’s first Ebola epidemic
2. The epidemic’s rise and decline
3. Washing the dead: does culture spread Ebola?
4. Ebola in rural Sierra Leone: a technography
5. Burial technique
6. Community responses to Ebola
Conclusion: strengthening an African people’s science
Postscript
 
Appendices: evidence and testimony from Ebola-affected community members (Chapter 5)
Notes
References
Index
 
 

Editorial Reviews

Policymakers involved in responding to global pandemics [should] read this book and to think more seriously about how to develop approaches that really listen to affected communities.” —Africa at LSE

“The importance of this work for fighting future epidemics cannot be overstated.” —African Affairs

“The book is useful for any individual teaching or practicing in the fields of psychology or medical education, as well as those in social work, education, and public health.” —Choice

“In this provocative book, Richards argues that the international response may actually have extended the epidemic's duration.” —Foreign Affairs

“With some 40 years' experience living, working and writing about the Mano River Region, Paul Richards' manuscript provides a succinct, erudite and important contribution to this debate.” —Jourbanal of Modern African Studies

“[A] first-hand analysis of the complicated situation that arose from the outbreak, a fascinating story of the success and failures of experts, volunteers and village people ... eye-opening reading.” —Medicine, Conflict and Survival

“A must-read for all involved in epidemics, epidemiology and public health.” —Nature

“A book rich in practical examples from extensive knowledge of the region, with theory to underpin observation...fascinating.” —Oxfam 'From Poverty to Power' blog

“A scholarly exercise that will appeal to medical and health policy academics ... convincingly argues the broader lesson for containing future epidemics.” —Publishers Weekly

“Represents the first serious attempt to grapple with some of the practical as well as epistemological questions posed by the local response to the outbreak...Offers important insights, especially concerning the central issue of burial practices, one of the epidemic's main routes of infection.” —The Economist

“A valuable reflection of the experiences of affected communities and aid workers in Sierra Leone. This book is a must for all disease control professionals in Africa and beyond. The book is also exceptionally well written and easily accessible to interested novices.” —Ger J. Steenbergen, first secretary of health, Netherlands Embassy in Ghana

“With his decades of experience in rural Sierra Leone, Richards is almost uniquely placed to write this book, which highlights the strong potential at community level for learning about and acting against a deadly disease. We would do well to implement these principles in future emergency responses of all kinds, as well as within long-term development work.” —Sinead Walsh, Irish ambassador to Sierra Leone and Liberia

From the Publisher

“Ebola’s focus on the comparatively poorly documented role of local responses to the epidemic makes it a must-read for all involved in epidemics, epidemiology and public health. . . . Richards wisely nods to the key role of national and international epidemic control. But his central thesis is that rapid local adaptation and common sense led to the Ebola epidemic’'s downturn. He terms this community action a ‘people's science’ of Ebola control. The book abounds with real-life examples from his long-term research in Sierra Leone.

Nature

“With some forty years’ experience living, working and writing about the Mano River Region, Paul Richards’s manuscript provides a succinct, erudite, and important contribution to this debate.

Journal of Modern African Studies

“Excellent and innovative. . . . Thoroughly researched.

The Conversation

“Richards offers important insights, especially concerning the central issue of burial practices, one of the epidemic’s main routes of infection. . . . Richards’s argument is a surprisingly optimistic one. The Ebola epidemic pitted an underfunded and sluggish international public-health infrastructure against supposedly ignorant rural communities. Doomsday did not result.

Economist

“Richards a lifelong aid worker and researcher, has penned a foundational text informed by his years of experience in Africa—specifically, Sierra Leone. . . . The work’s key strength is that it provides a strong profile on local knowledge as it relates to community health and population health in times of epidemic.

Choice

09/01/2016
In this scholarly approach to a relatively underresearched aspect of the 2014–15 Ebola outbreak in Western Africa, Richards (professor emeritus of technology & agrarian development, Wageningen Univ., the Netherlands; No Peace, No War: An Anthropology of Contemporary Armed Conflicts) premises that the spread of the virus was halted by changes in how responders (primarily family and community members) handled the sick and dead, not by the top-down, high-tech approach of the international community led by the World Health Organization. The author argues that without an understanding of cultural rituals (such as burial practices), the information that the international community disseminated and some of the actions they took were ineffectual. His fascinating, in-depth examination of burial practices within several villages in Sierra Leone explains that it was only when the cultural significance of those methods was recognized and communities were allowed to act with more agency that rates of infection decreased. The rapid increase of local learning that took place during the yearlong outbreak should be factored into any future thinking about epidemic control. VERDICT Most appropriate for anthropologists, ethnographers, and epidemiologists, as well as doctors, nurses, and other first responders interested in understanding the disease.—Ragan O'Malley, Saint Ann's Sch., Brooklyn

Library Journal

08/08/2016
Richards (No Peace, No War), emeritus professor of technology and agrarian development at Wageningen University in the Netherlands, adopts an anthropological approach to analyzing Upper West Africa’s deadly Ebola virus outbreak in 2014 and the success in containing its spread. He concentrates on local efforts that understood customs and culture—suggesting, albeit controversially, that “better-functioning health systems” in that region “might only have made the epidemic worse.” Here, Richards finds that the initial response by international experts to an outbreak in 2013 in Guinea erred by focusing on bush meat when it later became clear that one of the drivers of the epidemic’s spread was “participation in large funerals,” a regional custom that involved secret societies. Disease containment succeeded because of “people’s science,” which Richards describes as the shared knowledge and cooperation of local communities and international medical responders. And what the outbreak in Upper West Africa revealed was “an unexpected capacity for communities and responders rapidly to figure out jointly the nature of the infection threat, and then to respond practically.” This examination is a scholarly exercise that will appeal to medical and health policy academics, but Richards convincingly argues the broader lesson for containing future epidemics should always be a response embracing “common sense, improvisation, distributed practical knowledge, and collective action.” (Oct.)

Publishers Weekly

“A valuable reflection of the experiences of affected communities and aid workers in Sierra Leone. This book is a must for all disease control professionals in Africa and beyond. The book is also exceptionally well written and easily accessible to interested novices.

Ger J. Steenbergen

“[A] first-hand analysis of the complicated situation that arose from the outbreak, a fascinating story of the success and failures of experts, volunteers, and village people. . . . Eye-opening reading.

Conflict and Survival Medicine

“Ebola is not, however, a story of the epidemic, even if much of the story is woven into it. It is rather a handbook and a message of instruction for handling future outbreaks.

Times Literary Supplement

“In this provocative book, Richards argues that the international response may actually have extended the epidemic’s duration, as it offered no medical solution (no cure or vaccine is yet available) and slowed the ability of the affected populations to develop the cultural and behavioral adaptations that were ultimately the key to defeating the virus—for example, changes to practices around care for the ill and burial of the dead. Too often, the well-intentioned international response was shaped by a top-down logic that sought to impose novel practices on people rather than work with them to adapt their existing customs to the new reality.

Foreign Affairs

“Richards offers important insights, especially concerning the central issue of burial practices, one of the epidemic’s main routes of infection. . . . Richards’s argument is a surprisingly optimistic one. The Ebola epidemic pitted an underfunded and sluggish international public-health infrastructure against supposedly ignorant rural communities. Doomsday did not result.

Economist