22 August 2014

West Africa: Ebola Brings Sickness, Fear, Anger

A Cornell University professor says when responding to the West Africa Ebola epidemic, officials must consider both the physical and social dimensions of healing. Stacey Langwick said the outbreak has dramatically changed the way people care for the sick.

Langwick is studying the Ebola crisis through the eyes of a medical anthropologist - someone, she said, is most interested in "behavior at the intersection of culture, humanity and biology."

"We're very interested in how people think about their bodies. How they're thinking about diseases. How they're thinking about threats and what sorts of action or responses come from those conceptions about diseases and threats," she said.

The Ebola outbreak in Guinea, Liberia and Sierra Leone is a medical emergency. But Langwick said there's more than one dimension to it.

"When we focus only on the very important scientific questions and biological questions of the origins of this disease -- its population dynamics, its spread - we may come up with a set of interventions that look very effective on paper in relation to containing the virus, but they're completely ineffective on the ground."

Past Ebola outbreaks in Africa were often over in a matter of weeks and occurred in small areas. Infected people were quickly isolated and the outbreak ended when the dying stopped. But this outbreak crossed porous borders - has been going on for months -- and the dying and new infections continue.

Langwick said, "Part of what we're seeing is our intense inter-connectedness in today's world. People travel. People need to travel to make their livelihoods, to get food, to see relatives, to care for each other, for their jobs and their profession. And I think we're seeing a very effective and devastating virus take advantage of the fact that we are a very inter-connected world."

The Cornell professor said when people live in an area with poor health care, surrounded by death and the fear of death, it is an infuriating and terrifying situation. That's made worse, she said, when areas are placed under quarantine -- like the West Pointe area of Liberia's capital Monrovia - with little or no warning or education campaigns about Ebola.

"The current violence in Monrovia really shows us that if we do not do that what will then be required is force and violence in a situation -- where there's already so much loss, heartache and death - that adding to it is not what anyone is hoping will happen."

She said that it's a question of how do we care for the people we love, especially in the face of danger. She described it as the ethics of living, the ethics of caring.

Even the way people mourn the death of their loved ones has changed in the affected countries. No longer, said health officials, can people touch dead bodies during funerals.

The professor said, "How can we actually make a meaningful grieving practice together? And parts of that grieving practice might have to be new. And traditions are very strong and so they're not easy to break. But part of what can be a real drawback of highly focused public health interventions is they tell people what not to do, but they do not take the time to imagine with people what they can do. "

Effective interventions, Langwick said, are more easily accepted when their based on consultations with a broad range of community members.

She added that working with traditional healers may help, as long as those healers are fully aware of the risks of Ebola.

"Good healers are skillful in conceiving and promoting therapies that intervene in the dynamics of both biological diseases and human relationships," she said.

More than 1,300 people have died on ebola in West Africa.

West Africa

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