22 July 2014

Africa: Dispelling the Myths of Ebola

Blog

The Ebola outbreak in Guinea and its spread to other areas of West Africa has caused global alarm. As one of the world's most infectious and deadly diseases, with no cure, the level of fear surrounding Ebola is to an extent expected. However, much of the fear is rooted in misunderstandings. Dispelling these misunderstandings is perhaps the biggest 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 (or 'drivers') behind the emergence and spread of diseases such as Ebola which are transmitted from animals to people and known as zoonoses. They are also investigating the social contexts in which these diseases 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.

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. 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.

Misunderstanding three: Ebola is the only important disease transmitted by animals

Ebola is one of a group of diseases transmitted to people from animals that are known as zoonoses. It gets a lot of attention as it has only relatively recently been identified, is highly contagious and has a high fatality rate. However, since 1940, more than 60 per cent of infectious diseases newly affecting people in Africa are 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. Ebola is a terrible disease, but known deaths from it number fewer than 3,000 to date. Even where other zoonoses don't kill, their effects still devastate poor people's lives and hamper development efforts. Increasing our knowledge about neglected zoonoses is essential.

Misunderstanding four: Zoonoses are a health problem and only health workers are required for control efforts

The main factors behind zoonoses and the spread of infections relate to where and how people live, and the contacts people have with animals, both wild and domestic. The health of people and animals are thus interconnected and linked to the environments both inhabit. 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.

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