327 research outputs found
Citizens, dependents, sons of the soil
The impact of biomedicine and biomedical technologies on identity and sociality has long been the focus of medical anthropology. In this article we revisit these debates in a discussion of how unprecedented encounters with biomedicine during the West African Ebola outbreak have featured in Sierra Leoneans’ understandings of citizenship and belonging, using the case study of an Ebola vaccine trial taking place in Kambia District (EBOVAC Salone). Analysing our ethnographic material in conversation with a historical analysis of notions of belonging and citizenship, we show how participation in a vaccine trial in a moment of crisis allowed people to tell stories about themselves as political subjects and to situate themselves in a conversation about the nature of citizenship that both pre-dates and post-dates the epidemic
Shadowlands and dark corners
Viral haemorrhagic fevers (VHFs) persist in darkness. The pathogenicity of viruses like Lassa, Marburg, and Ebola is partly explained by their ability to survive on surfaces outside their infected hosts, provided they are not exposed to heat, disinfecting chemicals, or ultraviolet light. Taking these basic virological insights as our starting point, we seek to elaborate ethnographically the links between disease transmission and gradations of luminosity. An interdisciplinary research project into the control of Lassa fever in West Africa provided the empirical prompt for this article, which we then extended through our experience working in the region during the 2014–2016 Ebola virus outbreak. The spectral dimensions of zoonotic exchange and the apprehensions they engender help us come to grips with the complex interface of viral biology and human-animal sociality, and, we suggest, add nuance to global health framings of disease transmission and control
Myths, Risks, and Ignorance: Western Media and Health Experts’ Representations of Cultures in Ebola-Affected West African Communities
The 2014 Ebola outbreak, mostly affecting Liberia, Sierra Leone, and Guinea, is the largest ever recorded. The Ebola response encountered resistance in some affected communities, where some residents accused relief agencies from the Global North of denigrating local cultures. This thesis examines mainstream Western media and health experts’ representation of culture in the Ebola-affected region and employed Foucauldian analysis of discursive power to discuss the impact of such a representation on the concerned communities. Through a content analysis of selected journal and news articles by Western scholars and media and official reports by some relief agencies involved with the Ebola response, the study discovers evidence of culture bias. There was a use of significantly negative words in describing aspects of culture in the Ebola-affected region. Western media and health experts also largely associated the epidemic with African “backwardness.
Lassa fever: The politics of an emerging disease and the scope for One Health
One of a series of seven working papers considering the political economy of One Health.This paper explores the politics of knowledge and disease control for Lassa fever, a zoonotic viral haemorrhagic fever which is endemic in parts of West Africa. The Lassa virus has been classified as a Category A pathogen, meaning it is considered to be one of the world’s most dangerous organisms and a potential bioweapon. Unusually for a Category A pathogen it also causes endemic human disease with public health implications.
As a rodent-borne virus, Lassa fever is of interest to One Health. The interplay between security, public health and One Health perspectives are explored in Kenema, Sierra Leone, a long-term treatment and research hub. Running through policy processes are institutionalised responses to uncertainty which have privileged certain types of evidence leading to significant gains in laboratory and technology-based interventions. In securitisation debates public health priorities are often judged to be undermined. However this case shows that animal, human and environment interactions, and their socio-economic dynamics, have been marginalised on both national and international levels by political economies of knowledge and policy which tend to overlook the needs and perspectives of poor and rural populations.Ecosystem Services for Poverty Alleviation (ESPA
Responding to the 2018-2020 Ebola Virus Outbreak in the Democratic Republic of the Congo: Rethinking Humanitarian Approaches.
The Democratic Republic of Congo (DRC) presents a challenging context in which to respond to public health crises. Its 2018-2020 Ebola outbreak was the second largest in history. Lessons were known from the previous West African outbreak. Chief among these was the recognition that local action and involvement are key to establishing effective epidemic-response. It remains unclear whether and how this was achieved in DRC's Ebola response. Additionally, there is a lack of scholarship on how to build resilience (the ability to adapt or transform under pressure) in crisis-response. In this article, we critically review literature to examine evidence on whether and how communities were involved, trust built, and resilience strengthened through adaptation or transformation of DRC's 2018-2020 Ebola response measures. Overall, we found limited evidence that the response adapted to engage and involve local actors and institutions or respond to locally expressed concerns. When adaptations occurred, they were shaped by national and international actors rather than enabling local actors to develop locally trusted initiatives. Communities were "engaged" to understand their perceptions but were not involved in decision-making or shaping responses. Few studies documented how trust was built or analyzed power dynamics between different groups in DRC. Yet, both these elements appear to be critical in building effective, resilient responses. These failures occurred because there was no willingness by the national government or international agencies to concede decision-making power to local people. Emergency humanitarian response is entrenched in highly medicalized, military style command and control approaches which have no space for decentralizing decision-making to "non-experts". To transform humanitarian responses, international responders can no longer be regarded as "experts" who own the knowledge and control the response. To successfully tackle future humanitarian crises requires a transformation of international humanitarian and emergency response systems such that they are led, or shaped, through inclusive, equitable collaboration with local actors
The Case of Ebola in West Africa - Swedish Healthcare Workers' Experiences of Navigating Global Health Interventions
In this time of global health interventions, preventing borderless diseases, such as Ebola, is a question of implementing global health policies in different cultural contexts. Although these interventions are mediated by international organs, the healthcare workers on the ground are actually those who implement policies. From this starting point, this thesis investigates the extent to which Swedish healthcare workers, when combating the Ebola virus disease in West Africa, take into consideration the local context in their application of global health preventive measures. It does so by exploring healthcare workers’ experiences of navigating global health interventions, while negotiating culture. Qualitative semi-structured interviews were conducted with participants in the Swedish Civil Contingencies Agency’s medical mission, which aimed to combat Ebola in Liberia and Sierra Leone. To understand their experiences, Michael Lipsky’s ‘bottom-up’ theory and conceptualization of the street-level bureaucrat inspired this study’s theoretical foundation. Three themes were prevalent in the interview material: Navigating the field and establishing trust, Consolidating objectives and Negotiating culture. This thesis argues that constant flexibility and adjustment to the pre-existing challenges in the field are vital in the adaptation of health policies. Moreover, flexibility is dependent on the information transferred from the field. Without rapid information transferal, bureaucracies and their employees have false perceptions of the field, on which they articulate their objectives for partaking in the health interventions. It is further argued that these actors continuously have an internal negotiation of ‘Self’ in relation to ‘Other’ and the bureaucracy that they work for, while trying to navigate health interventions in a foreign context. In conclusion, the ‘one size fits all’ approach does not work and this mindset (re-)produces a dichotomy between ‘us’ and ‘them’ where a certain way of doing things is seen as predominant
Community Engagement in the International Emergency Response to Ebola, 2014-2016
An unsafe and illegal burial conducted in Port Loko, Sierra Leone during the Ebola epidemic of 2014-2016 exposed competing risk perspectives between emergency responders and the affected community, and called into question community engagement (CE) efforts in the response – particularly regarding strict, but culturally-problematic burial protocols. This work interrogates the effectiveness of CE through development of a novel, two-dimensional metric. The first dimension builds on the work of Davidson (1998) and others to parse CE efforts into four distinct domains: Information Provision, Consultation, Participation, and Community Empowerment. The second dimension builds on the work of Arnstein (1969) and others to create a semi-quantitative scale which assigns an Empowerment Score from zero to two, assessing the degree to which community feedback leads to material changes in interventions in each domain.
The Empowerment Score methodology was applied to analyze CE efforts reported in literature and in the CE standards of international response organizations. The methodology was then used in a modified Delphi survey of responders and anthropologists with experience in the Ebola response in Sierra Leone, to characterize the successes and shortcomings of CE efforts, with a focus on burial of persons who had died of Ebola. Quantitative analysis of Delphi panelists’ numeric scores, combined with qualitative analysis of their textual comments, revealed substantial disagreement between diverse experts regarding the appropriateness or success of CE efforts in the response. However, there was general agreement among the experts that future epidemic responses should take into account cultural concerns in the negotiation of burial protocols or other interventions that may collide with cultural values.
For future emergency responses, the incorporation of social scientists such as anthropologists into CE structures, as well as intentional involvement of community members in the planning and implementation of disease-control measures, is recommended. Additionally, the international emergency response community is called to a posture of humility, acknowledging that realities other than the medicalized and materialistic drive human behavior, including health-affecting behavior. Respectful engagement with risk as understood by a community, combined with a Harm Reduction philosophy to define interventions, may save more lives than biomedically pure, but coercive approaches
Furthering perspectives
Includes bibliographical references.Spring 2020.Taxonomic identification of dentally-unassociated postcranial fossil elements in Early Eocene (~56-52 MA) mammals / John Johnson -- Size matters: testing dental-based total body mass estimate formulae-more than a means to determine diet in Early Eocene (~56-52 MA) primates (OMOMYOIDEA, ADAPOIDEA) in the Bighorn Basin, WY / Kristina Magyar -- Moshing: a game with complex and subtle undertones / Denise Frazier -- The importance of the social sciences in climate change research / Danielle Beckman -- The resilience of immigrant populations in the United States within the food system / Julia Greer -- Vulnerability, resilience, and social justice: addressing systemic inequality in disaster recovery / Shadi Azadegan -- Rockport residents and life After Harvey: results from the 2019: Colorado State University ethnographic field school study / Sarvis Anarella, Althaea Kress, Zoe Schutte, Julie Spawn, Sydney Vander Waerdt, Michelle Anderson, Charlotte Dorsey, and Amanda Kircher -- Cultural forests of Amazonia: a historical ecological analysis of forest management in Amazonia / Grace Ellis -- Traditional ecological knowledge and the National Environmental Policy Act: integrating Indigenous perspectives, sustainable resource stewardship, and environmental impacts analysis / Paul Buckner -- Curbing disease, building a system: Partners in Health's response to the West African Ebola epidemic / Julia Reedy -- The role of public libraries in community health / Sheri McCaskill -- An epidemic crisis: the disastrous HIV infections among rural blood donors in China / Yan Xue -- The legacy of classical sociological theory: androcentrism and universalism in the tradition of the canon / Carolyn Conant
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