The challenges of containing an epidemic in West Africa
August 12, 2014
Despite reports that Ebola is actually a “fragile” virus easily killed with bleach, not especially contagious and avoidable with relatively simple precautions, the disease continues to spread at an alarming rate in Sierra Leone. To understand why, it’s important to remember that the large majority of people alive in the country today can still vividly remember a decade-long civil war that ended in 2002, destroying trust of the government and even between neighbors and friends. A recent post about the lingering effects of that war can be read here. In the absence of trust, many people simply do not believe that Ebola is a transmissable disease, but yet another perpetration of harm against them.
The government now warns against human touch, but people in this part of the world are a highly relational society and have low physical inhibition. There is much touching, hand-holding, hugging and other displays of communication through contact, a cultural behavior so ingrained that stopping it is not an easy matter – especially in rural areas, where information isn’t easily disseminated.
Among the traditional practices being discouraged by those in authority are the way in which Sierra Leoneans mourn their dead. Body washing and embracing of the body are long-held rituals that reflect beliefs about how loved ones will fare in the after-life, and how ancestors will bless or curse those still living. These are not simple formalities that can easily be cast aside based on the words of an outsider (or even some insiders).
Another recommendation from the government and outside organizations (such as the CDC) is to stop eating bush meat, including monkeys. As we have previously reported, Sierra Leoneans spend a large majority of their time and resources on procuring food – as much as 70%. When food security is this threatened, it’s hard to accept that one of the few sources of protein is now off-limits.
In a nutshell, organizations that people do not trust are issuing recommendations to behave counter-culturally, shun fundamental, traditional practices, and avoid a food source in a land where food is already scarce. Add one more complication – the virus can take as long as three weeks for symptoms to appear – and it should no longer be a mystery why the disease is spreading.