The Morning After: Anthropology and the Ebola Hangover, by Anne Menzel and Anita Schroven (2016)

The morning after a long night a well-deserved hangover can be treated with a variety of potent remedies. There is black coffee with lemon, raw egg with Tabasco, or just staying in bed and waiting for the hangover to pass. These antitoxins work for the alcohol-induced hangover. However, some anthropologists specialised in West Africa or medical (research) topics have been experiencing a lingering type of hangover which is primarily Ebola-induced. It results from the disenchantment that followed the sudden and unexpected attention anthropologists[1] experienced (and welcomed) for their particular expertise during the course of the Ebola epidemic – (see e.g. American Anthropological Association 2014; UN News Center 2015).20160117_173356_resized

We are among those experiencing this hangover. It started some time after December 2014, when we (together with colleagues from Germany) published an open letter explaining that anthropology could play a vital role in the fight against the epidemic (see Beisel et al. 2014). We claimed that, by providing alternative perspectives informed by field research and longer-term relationships with local informants and by confronting exotification and misleading simplifications, anthropology could enable a deeper and more nuanced understanding of the situations in the most affected countries. We deliberately chose to make this claim in a modest and cautious fashion so as not to overstate the possible influence that any type of academic advice may have on policy – let alone its implementation. Nonetheless, our ultimate goal was to advocate anthropological perspectives in order to facilitate more appropriate humanitarian measures and better international and national policies to combat the epidemic. “Better” was to mean taking the needs of those affected seriously and allowing them a say in the matter. We hoped that such improvements might contribute to a future prevention of Ebola and to public health policies more suitable to respond to people’s basic needs.

Unfortunately, enthusiasm for and widely declared policy relevance of anthropological expertise did not lead to such results. Instead, it seems that deadly infectious diseases are meant to be accepted as inherent elements of West African realities ‒ as long as they are kept “under control”. The World Health Organization (WHO) is already practicing expectation management along these lines. In light of the new Ebola cases discovered in Sierra Leone in January 2016, the WHO Assistant Director-General for the Ebola Response Bruce Aylward said: “We still anticipate more flare-ups and must be prepared for them” (WHO 2016a).

Participating in a number of conferences and workshops over the course of the last year[2], we came to realize that disappointment over the practical consequences of policy-relevant anthropology is wide-spread. It seems that policy relevance comes with the practical consequence that anthropologists relinquish more than they are gaining in influence. Critical perspectives are not welcome, particularly those concerning current humanitarian practices and the structural conditions of national and international health policies in and for the most affected countries.

Given these disappointments, it is certainly time to (self-) critically reflect on Ebola and on anthropological (and more broadly social science) engagements with the humanitarian response in order to draw conclusions form the lingering hangover. This short review is intended as a contribution to this task. Consulting our own experiences and impressions, we begin by detailing some significant developments of the last year. For current purposes, we differentiate between developments “on the ground” in the most affected countries – Sierra Leone, Guinea, and Liberia – and developments in   anthropological engagements with Ebola and the humanitarian response. The latter have clearly been dominated by anthropologists from the Global North. We then discuss connections and rifts between developments “on the ground” and in the humanitarian response and present topics and questions that have become obscured in the course of growing policy relevance but are worth picking up again. These topics and questions particularly concern the relations between humanitarian aid, development cooperation and the disastrous health care situations in the most affected countries.

Back to “normal suffering”

A little over a year ago we not only wrote about the possible impact of anthropology in the fight against the epidemic, we also sought to describe the conditions of everyday life and survival in Guinea and Sierra Leone – the two of the most affected countries that we are most familiar with (see Schroven 2015; Menzel 2014). To recap: the first cases of Ebola were confirmed in March 2014. Our two blog posts aimed to contextualise the ensuing state of emergency. This seemed highly appropriate, as uncertainty and insecurity by no means began with the outbreak of the epidemic. Since well before Ebola, large parts of the Guinean, Sierra Leonean and Liberian populations have had to deal with occasional and, for some, more permanent food shortages (usually in the sense that sufficient quality and quantities of food could not be afforded), which came along with a lack of socio-economic perspectives and affordable health care and with neglect and/or repression by national and local authorities. It is against this backdrop that we must gauge the ambivalent relief a Sierra Leonean friend recently expressed in a telephone call. He thanked God for the end of the epidemic and then added:

“We are back to normal suffering for now” (phone conversation with Anne Menzel, 2015-11-14).[3]

While we were preparing this post, the WHO officially declared Sierra Leone and Guinea Ebola-free in November and December 2015 respectively, in each case after 42 days had passed without any known new infections – 42 days being considered double the maximum incubation time (to the best of medical knowledge). On 14 January 2016, Liberia was declared Ebola-free for the second time. After the end of the epidemic had been declared in September 2015, new cases of Ebola were confirmed in November and the 42-day-countdown began anew. After an “Ebola-free” declaration, the WHO stipulates a 90-days follow-up phase “of heightened surveillance” (see WHO 2015). Whether any such heightened surveillance will actually be implemented is another story. In the Guinean capital Conakry, for example, information posters and chlorine water tanks for the obligatory hand washing had completely disappeared from public life right after the country was declared Ebola-free (28 December 2015). Only after the confirmation of a new Ebola-case in Sierra Leone were yellow hand-washing stations re-established near the Sierra Leone-Guinea border (observation by Anita Schroven, January 2016).

Together, Sierra Leone, Guinea and Liberia suffered more than 11,300 confirmed Ebola-deaths (see WHO 2016b). The number of undetected cases including those who died due to “side effects” of the epidemic will possibly figure considerably higher. For the Moyamba District in Sierra Leone, for example, the international NGO Doctors of the World estimates as many deaths from November 2014 to March 2015 as during an entire year prior to the Ebola outbreak. Children have been particularly at risk, as they are more severely affected by common infectious diseases like Malaria. Many died, because their parents did not take them for treatment out of fear of an Ebola infection – or because the facilities no longer offered treatment for “normal” diseases. The already scarce staff and resources had all been mobilised to fight Ebola (see Doctors of the World 2015: 76-83).

However, as all figures in the context of the epidemic, even this apparently well researched estimate should be met with caution. It is based on officially registered funerals in the Moyamba District –data which might well present a distorted picture. The Ebola emergency laws enacted in Sierra Leone during the second half of 2014 stipulated that all deaths must be registered and the deceased “safely buried”, so that proportionally more deaths might actually have been reported and registered than before the Ebola crisis. Hence, it is entirely possible that the recording rather than the number of deaths has increased[4]. As a counterargument, Doctors of the World claim that due to the unpopularity of the government-decreed “safe burials” – which preclude the relatives of the deceased from washing and touching the dead body – it may well be that to avoid “safe burials” significantly fewer deaths than usual may have been reported (see Doctors of the World 2015:83). We simply do not know.

As uncertain as the “hard facts” of the epidemic are its social and political ramifications, although it is possible to identify some trends. One of these is the common experience that in all three of the most affected countries it is the socially and economically marginalised who apparently bear the brunt of the epidemic and its “side effects”. These marginalized classes include, for example, the urban poor in Freetown, Conakry and Monrovia and large portions of the populations of remote and neglected rural areas such as the Guinée Forestière Region, which has been systematically neglected by the central government in Guinea for decades. Furthermore, the governments of all three countries have often met the lack of compliance with quarantine and emergency measures with threats and sometimes violence. Particularly those belonging to marginalized social strata had to face police and military violence or were put under observation (see e.g. Menzel 2014; Schroven 2015; Mogelson 2015). At the same time, the marginalised often felt – quite accurately – that well-connected authorities and business and education elites profited from the epidemic, because international humanitarian measures offered chances to grab aid money and/or take profitable jobs (see e.g. Shepler 2014; Moran 2015; Enria 2015). Those “locals” who found jobs with humanitarian NGOs due to their high level of formal education and previously established connections, in turn, found themselves on the global bottom rank, both concerning their payment, which is always significantly higher for expats working in crisis regions, and their professional recognition. A friend from Freetown, whose college education and NGO connections helped him to find work with an NGO in the international Ebola response, explained:

“I think there was room for improvement. At times the attitude of some of the expats shocked me … I mean, I was shocked. Their lack of empathy, their lack of respect for our tradition and our culture … They did not understand these things. But, you know, at least they could have tried to learn from us. Some of them didn’t show much respect. Some of them were outrightly disrespectful and arrogant. And, you know, for me that was one of my biggest disappointments. I wanted to see more local involvement. […] We used to have meetings … briefings. And in these briefings … I mean, we the locals just take backseats. And we would sit there and listen to the expats and they would talk and talk and talk. […] At times we wanted to make a contribution and it was difficult. […] I think the whole way the thing was structured … it’s like we didn’t have a voice” (Interview, 22.06.2015).[5]

The various experiences of marginalization (which, in their form and content, always depend on one’s current position within national and global relations) must be expected to deepen existing feelings of inequality and mistrust – in local, national and global contexts.

From critique to service provision

The anthropological high on the sudden Ebola-induced policy relevance described in the introduction was the kind of high that from the start contains a hint of the headache to come. The mobilisation of the scientific communities on both sides of the Atlantic, which began in autumn 2014, was accompanied by doubt – and, at the same time, by the wish to contribute to the fight against the epidemic and to the improvement of humanitarian measures. This ambivalence is evident, for example, in many contributions by anthropologists participating in the forum of the Emergency Initiative on the Ebola Outbreak on 6 and 7 November 2014 in Washington D.C.[6] Following the forum, Doug Henry and Susan Shepler summarized and reinforced these hovering doubts. They raised the question how anthropologists can be critical without being seen as mere critics. They stressed two perspectives that had thus far not been given much attention. They argued that it was not only necessary to provide contextual knowledge about “exotic” cultures but just as important to examine the practices and structures of organisations that provide and distribute aid:

“We need a humanitarian anthropology that is embedded in that response, yet is able to be critical of it” (Henry/Shepler 2015: 21).

In addition, the current crisis also demands the scrutiny of the global power relations that structured conditions for national and international health policies before the crisis and will continue to structure them for the foreseeable future after the crisis. These power relations will determine whether the fight against the epidemic will remain just that or develop into a path towards better health care:

“If […] we are truly concerned about the health and wellbeing of African populations […] then humanitarian assistance cannot be for just this one disease, but must attend to its aftermath, and the investment in infrastructure necessary to prevent future suffering” (Henry/Shepler 2015: 21).

But what if the relevant actors in international organisations and NGOs demand anthropological expertise that will fit their existing packages of policies and practical measures? In this case, the maximum of welcome critique is that already envisioned measures should be optimised according to donors’ priorities so that intended results will actually be reached. And exactly this is the height of accepted critique. Anthropologists and social scientists more generally are mainly understood as service providers, who are to yield knowledge that can make the international response to Ebola (or other policies, programs, projects, reforms etc.) more effective – within strictly set parameters that are decided upon very early on, and often by institutional habits, rather than the specificities of the given humanitarian context. A public statement by the UN Special Envoy on Ebola, David Nabarro, may be seen as a reflection upon the idealised and publicly esteemed cooperation between epidemiologists and anthropologists in the interest of combatting Ebola most effectively.

“To maintain a situation where we’re keeping a lookout for disease and where we’re able to respond quickly, the most important requirement is to have experienced people, people who know about disease. They’re called epidemiologists. And that means they study epidemics. But because this disease is very much driven and spread through the way in which people behave, particularly around the time of sickness or death, we also need to have another group of people working on it called anthropologists. The people who study behaviour. Taken together, teams of epidemiologists and anthropologists need to be scattered throughout the affected countries, keeping a close watch on the levels of disease and on what’s happening in the population to respond to it” (UN News Center 2015).

The reality of the international Ebola intervention, however, was far removed from this portrayal. There can be no talk of the most affected countries being scoured by interdisciplinary teams of epidemiologists and anthropologists working together to keep a close watch on the disease at all times and in all (or even most) places. International organisations and NGOs often only used external consulting and had few, if any anthropologically trained staff members “on the ground”.[7] Due to their low rank in the organisations’ hierarchies and late arrivals “on the scene”, with measures already fixed prior to their employment, this personnel had essentially no influence on the programme designs or even the most basic terms of implementation.

Nonetheless, there is a popular success story that seems to conform to the policy-relevant idea of anthropological contribution. It probably gained prominence exactly because of its perceived conformity with the ideal and was even featured in international media coverage of the Ebola outbreak (see e.g. Kupferschmidt 2014; Maxmen 2015). It is the story of the culturally sensible conflict management of the WHO anthropologist Julienne Anoko. To summarise: During her mission in Guinea, Anoko became confronted with an epidemiological nightmare. A young pregnant woman had verifiably died of Ebola in a hospital in Guéckédou (Guinea) and was to be “safely buried” according to the established protocol. However, the elders of the affected village refused the procedure. Instead of exacting the greatest possible precaution in handling the dead body and its highly infectious bodily fluids, the elders demanded that the foetus be separated from the mother’s body. Burying the mother in her pregnant state would impede agricultural production, contaminate the women in the village, and might lead to them not surviving their current or future pregnancies. In case of a “safe burial” against their will, the villagers threatened to no longer cooperate with the responsible authorities and organisations such as no longer providing information for “contact tracing”, which is vital to identifying potentially infected persons. Due to the high danger of infection, the doctors at Guéckédou refused to perform a C-section on the deceased. Anoko encouraged conversations, mediated and ultimately reached a solution satisfactory to all sides. During the course of Anoko’s talks with the village community, she was able to uncover a cleansing ritual, which could be performed after the pregnant woman’s burial and would counteract the contamination. The WHO agreed to cover the costs of the ritual (US$ 660) and the pregnant woman could finally be buried (see Fairhead 2015: 6). Anoko’s work supposedly also inspired the villagers’ compliance so that other epidemiological measures could be carried out as planned.

During the course of the epidemic, anthropologists working for international organisations and NGOs no doubt quickly realised their service providing function – if they had not anticipated this role from the very beginning. The physician and social anthropologist Fred Martineau, who was stationed in Sierra Leone during the crisis, recently emphasised in a presentation that it was only the role of service provider that gave anthropologists the opportunity to do something at all (see Martineau 2015). In this role, they can be directly useful to international organisations and NGOs. In order to have any positive effect within the prescribed measures and priorities – as in the aforementioned case of Julienne Anoko in Guéckédou – “embedded” social anthropologists have to play by the existing rules. Some might have hoped that they would in turn be able to influence the rules in order to adapt them to local realities and needs, for example, by institutionalizing community consultations that would give local people an actual say in activities that directly affect them. These expectations were seldom met. Even success stories like the Guéckédou case that fit the desired image of policy-relevance and intended results did not prompt the involved organisations to design and implement more participatory approaches. Instead, examples such as Julienne Anoko’s were used for public relations in the Global North (conversations with staff members of international organisations and NGOs in Guinea, by Anita Schroven in January 2016).

From emotional investment to “good projects”

The service providing pragmatism described by Fred Martineau has an ethical logic that is certainly persuasive in times of crisis when everything needs to happen fast and when “quick and dirty” often appears preferable to more participatory and time intensive approaches (however, the problem remains that the decision whether or not “quick and dirty” actually is preferable is seldom made by those who are most affected by the decision). In addition to this ethical logic, the service providing role was affirmed by yet another development in 2015, which further contributed to the domestication of the anthropological engagement. The emotional investment of the early times was increasingly replaced by involvement in “good projects” (see Krause 2014) – or by retreat from the policy-relevant engagement with Ebola.

The first mobilisation of the anthropological communities took shape as crowd sourcing via mailing lists and at several events since autumn 2014. These mailing lists and events were mostly US-American, British or French dominated affairs. In addition to a surprisingly harsh language barrier (English-French), there was also a division into neo-colonial areas of responsibility (Great Britain for Sierra Leone, France for Guinea, USA for Liberia). Only very few anthropologists from Germany or other countries without colonial-historical connections to Sierra Leone, Guinea or Liberia were actively involved in the unfolding debates. And even fewer were willing or able to bridge the neo-colonial and language barriers in order to communicate inside and across all three (humanitarian and academic) communities.

In any case, the involved social anthropologists attempted finding answers to practical questions or solutions to problems that the international organisations and NGOs communicated or that had already been reported by the international media. They did so on the basis of their existing knowledge and continuing field contacts in the most affected countries. Next to eminent academic authorities, this situation also offered a say to young researchers presently working on doctoral theses or postdoc projects in and on the region. Controversial topics were widely discussed, such as the benefits, risks and political implications of the significant involvement of national and external armies (British, US-American and French) in the fight against the epidemic (see e.g. American Anthropological Association 2014: 12-13). The procedure was often chaotic, the engagement unpaid – which soon made active involvement difficult for anyone without tenure – and opinions and information were often offered unfiltered. At the same time, key topics (such as questions on burial practices, cross-border mobility, local political hierarchies etc.) were successfully synthesised as UNMEER briefs, translating complex socio-historical information into short guides for humanitarian practitioners.

During 2015, many anthropologists and organisations demanding information aimed to formalise their cooperation in order to ensure planning and financial reliability. This is particularly evident for the British engagement. The British Welcome Trust and the Department for International Development financed a number of research projects in Sierra Leone and the establishment of the “Ebola Response Anthropology Platform”. This is an information and communications platform also used by the US-based Emergency Anthropology network and it also officially cooperates with French networks[8]. In France, funding was mainly provided to the development of treatments and vaccines without any specific references to social sciences, but anthropologists were often employed for social engagement and community mobilisation. The predominantly francophone network “SHS Ebola” was the result of the engagement of social and medical anthropologists whose institutional networks between major French research institutions of IRD and INSERM had already existed before the outbreak.[9]

This formalisation made the anthropological engagement more systematic and bound the researchers to both the commissioning organisation and to the logic of log frames inherent to humanitarian aid and development cooperation. The engagement thus became part of “good projects” (see Krause 2014), which are characterised by achievable goals that can be evaluated upon completion. These projects do not leave room for challenging questions concerning humanitarian practices or international power relations.

A plea for the re-animation of neglected perspectives

In our introduction we suggested that it was time to draw conclusions from the Ebola-induced hangover. The above reflection provides the backdrop to this idea: the hangover results from nagging disappointment over the lack of space for critical perspectives on humanitarian practices and international power relations in the current anthropological engagement with Ebola and the humanitarian response. This narrowing of perspectives might have been expected. The state of emergency created a kind of immediate need for action that deemed critical reflections almost dishonourable. After all, such reflections may be time-consuming and may not result in immediate action. But now that the crisis has significantly slowed in pace, the time is certainly ripe for breaking away from the state of emergency and again including critical perspectives – irrespective of the fact that national governments and international actors and agents of the Ebola intervention would rather present some success stories and return to “business as usual”.

The existing anthropological and sociological research on humanitarian and development practices already provides much inspiration and useful directions for the return to critical perspectives (see e.g. Li 2007; Mosse 2011; Donini 2012; Fassin 2012; Krause 2014; Abramowitz and Panter-Brick 2015). Particularly with regard to the Ebola crisis, we would like to suggest some specific starting points.

Our first suggestion concerns the blinding out of histories of suffering and repeated development disappointments that has been achieved by a policy oriented reduction of affected people’s difficult living conditions to the “Ebola state of emergency”. What this reduction suggests is that Ebola created a moment of exceptional suffering, when, for most people, it probably presented more of a gradual escalation of “normal suffering”. This kind of reduction implies that effective Ebola interventions – first humanitarian assistance and then development and reconstruction efforts – will produce solutions and generate actual improvement for the lives of Sierra Leoneans, Guineans, and Liberians. The fact that such projects, programmes, reforms etc. are certainly not new to the region and, especially in post-war Sierra Leone and Liberia, have been ongoing for more than a decade has so far not nearly disturbed the policy oriented picture as much as it should. While some have pointed out that humanitarian and development aid have been coproducing the disastrous state of national and local health systems, it is worth asking why and how exactly these insights do not translate into more widespread and actually practiced scepticism vis-à-vis established actors, agencies and practices. Why, we would like to ask, has it remained so immensely difficult to break with the improvement of improvement measures that have been producing much less than desirable results. Ebola and the anthropological engagement with the humanitarian response certainly offer promising fields for empirical inquiries into this question.

Secondly, we find that the focus on established forms of international assistance tends to side-line people’s desires and their pursuit of a life that has more to offer than humanitarian and development aid, whose proclaimed aims continue to consist of education opportunities, health measures, and economic perspectives that remain vastly inferior to those in the Global North and, in consequence, have long ceased to inspire hopes and dreams. Instead, the hopes of many in all three most affected countries have shifted towards recent foreign direct investments in mining and export-oriented agriculture, which already generated impressive growth rates in the years immediately preceding the Ebola epidemic. In addition, these investments were to create jobs, numerous economic spill-over-effects and highly beneficial corporate social responsibility projects. However, these expectations in tangible results have, in many places, already been disappointed. The created jobs were much less in number and paid far worse than expected; loss of land (including the loss of livelihood) was often not or not adequately compensated or the compensation did not reach the concerned party. What is more, protest has often been condemned as a disturbance of the investment climate and even been answered with police violence (see e.g. Menzel 2014; 2015; Schroven 2015; Millar 2015). We suggest that research into those struggles that are not “covered” by the epidemic – but that may have changed, escalated or cooled down due to Ebola-related developments –, is of major importance to provide a more complete picture and expose reductionist interpretations.

Last but not the least, we ask what exactly we are to make of the creation of “resilient” health systems (see e.g. World Bank 2015), which has been announced as the focus of future health sector development efforts: “The national governments, assisted by external partners, need to develop and implement strategies to make their health systems stronger and more resilient. Only then can they meet the essential health needs of their populations and develop strong disaster preparedness to address future emergencies” (Kieny et al. 2014).

The adjective certainly sounds promising – but how and against what exactly is a more “resilient” health system to be established? What is it going to look like in practice? At worst, “resilience” may turn into a financing criterion, just as “sustainability” or “gender mainstreaming” did before, promoting “good projects” designed to prepare national health systems to contain infectious diseases that inspire fear in the Global North. Resilience would then mean that international health emergencies could be met with effective local and national measures in the Global South. In this case, we should expect to see comparatively high investments into “contact tracing” systems and procedures, while everyday services for local populations would likely be neglected. In consequence, such health needs that are not limited to the fight against Ebola and similar infectious diseases would probably not benefit from “resilient” health systems.

There is much to be done. We need to shake off the hangover.

 

A German language version is available on:
http://www.medizinethnologie.net/ethnologie-mit-ebola-kater/

 

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[1]For the sake of brevity and readability we refer to anthropology or anthropologists, meaning social, cultural, political or medical anthropology and anthropologists. Individuals from other social science disciplines were also always involved, but anthropologists were by far the most visible.

[2] E.g. “The AAA/Wenner-Gren Ebola Emergency Response Workshop”, 6-7 November 2014 in Washington D.C.; EBODAKAR 2015 “Epidémie d’Ebola en Afrique de l’ouest: Approches ethno-sociales comparées”, 19-21 May 2015 in Dakar; “Targeting Ebola World Congress 2015”, 28-29 May 2015, Institut Pasteur Paris; “European Conference on African Studies”, 8-10 July 2015 in Paris; MAgic 2015 “Anthropology and Global Health: interrogating theory, policy and practice” at the University of Sussex, 8-11 September 2015; “Beyond Ebola: knowledge production and the limitations of translation” at the Max Planck Institute for Social Anthropology in Halle, 28-30 October 2015; “American Anthropological Association” in Denver, CO., 16-20 November 2015.

[3] In the Sierra Leonean lingua franca Krio he said: “We dae pan normal suffering for now.”

[4] The registration of deaths in Guinea was also carried out by observers who have not been paid since late December 2015 (conversations of Anita Schroven with staff members of the national and local Ebola coordinations in Guinea, January 2016). We suspect the situations in Sierra Leone and Liberia to be similar. It is thus even more uncertain for suspicious deaths to occur in remote areas.

[5] At the time of the interview, the acquaintance had already given up his NGO job again. The interview was conducted by Anne Menzel via Skype in English over the course of “The Ebola 100 Project”, see http://www.ebola100project.net/ (accessed: 12-01-2016).

[6] The contributions are available as YouTube videos, see “Emergency Initiative on the Ebola Outbreak 2014”.

[7] It must be seen against this backdrop when British social anthropologist Juliet Bedford, who worked for UNMEER during the epidemic, continues to consider the career opportunities for social anthropologists in humanitarian aid and development cooperation as rather limited. In September 2015 she touched on the subject in an interview: “Ebola, Bedford said, has the potential to be a turning point in terms of the marketability of anthropologists in development, but it’s ‘not a sea change,’ she said. ‘What I do think it’s done is give the discipline greater visibility in development and humanitarian emergencies, and it has also given us a good platform to show how we add value and how qualitative data can be used alongside some of the harder scientific or medical epidemiological data,’ she added” (Lei Ravelo 2015).

[8] For more information see the website of the platform, e.g.: http://www.ebola-anthropology.net/about-the-network/ (last accessed: 20-01-2016).

[9] In Great Britain, social anthropological expertise on Sierra Leone was quickly integrated into the strategic planning of the nationally coordinated Ebola response via the well-positioned office of the Chief Scientific Adviser and a number of research projects considered to be policy-relevant were financed. Each ministry has its own scientific adviser who in turn supports the Chief Scientific Adviser of the British government (see https://www.gov.uk/government/organisations/government-office-for-science/groups/chief-scientific-advisers, last accessed: 19-01-2016). In France and the US, social anthropological expertise was neither systematically supported nor integrated into the Ebola response despite numerous opportunities. Instead, independent dynamics developed, which provided information through internet platforms and personal contacts.

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