This report is for supervisors managing ongoing Ebola outbreaks, or working on preparedness and recovery activities in regions at risk of, or affected by, Ebola epidemics. It is based on rapid and intensive ethnographic field research in Equateur Province, Democratic Republic of Congo, undertaken less than a month after the epidemic was declared over in July 2018. The research comprised 60 separate open-ended, semi-structured interviews with local health workers, government officials and administrators, Ebola survivors and their families, community leaders, and national and international responders.
The overall finding of the report is that an Ebola epidemic, along with the way the response itself is conducted, can have significant social, psychological, economic, and health impacts for the communities involved. By providing a close, qualitative reportage on perceptions of the epidemic and the response in Equateur Province, the report aims to render tangible the social,
Key considerations about the context of North Kivu province including insecurity and local actors.
Key socio-anthropological considerations regarding ‘indigenous communities’.
Key considerations about the context of Équateur Province, including climate, infrastructure and politics.
Why did Ebola response initiatives in the Upper Guinea Forest Region regularly encounter resistance, occasionally violent? Extending existing explanations concerning local and humanitarian “culture” and “structural violence,” and drawing on previous anthropological fieldwork and historical and documentary research, this article argues that Ebola disrupted four intersecting but precarious social accommodations that had hitherto enabled radically different and massively unequal worlds to coexist.
The disease and the humanitarian response unsettled social accommodations that had become established between existing burial practices and hospital medicine, local political structures and external political subjection, mining interests and communities, and those suspected of “sorcery” and those suspicious of them.
Sociocultural, economic, and political dimensions play a defining part in epidemics and pandemics. Anthropological involvement is increasingly recognised as important, however, integration of social sciences during global health crises remains, for the most part, delayed, inconsistent, and distant from the centre of decision making and resource prioritisation.
This problem is representative of much larger systemic barriers to academic and practitioner coordination in global health, humanitarian aid, and development practice. While anthropological insights on-the-ground can and do inform extraordinary containment and education efforts during medical humanitarian emergencies, they are all too often not scaled up.
Key populations, specifically people who sell sex (PWSS), people who inject drugs (PWID) and lesbian, and gay, bisexual, transgender and intersex (LGBTI) people experience significant human rights violations which underpin the continued high HIV incidence in these populations.This rapid assessment of human rights violations in Eastern and Southern Africa focuses on three priority key populations – PWSS, LGBTI (including MSM), and PWID. The report outlines the normative international treaties that establish a basis for a human rights framework for the HIV response, and explores the emerging evidence of how to promote and protect human rights of key populations and potential key entry points.
In its key findings, the report highlights that evidence from Eastern and Southern Africa suggests there is a large gap between state commitments to protection and promotion of human rights, as agreed to under numerous international and regional human rights treaties,
Failings during the early months of the Ebola outbreak caused the epidemic to become an unprecedented health crisis in West Africa. This cannot be repeated.
Although sometimes over used, the word ‘crisis’ accurately describes many challenges of today’s world, such as climage change, war and refugees, economic volatility, pandemics, and the continuing unmet needs of the poor, hungry, and neglected.
While much has been achieved — in reducing the incidence of poverty and infant mortality, especially — our bright hopes for the future could be dimmed by shocks that can overwhelm nations, international organizations, communities, and citizens.
In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need for alternative solutions, including a socio-political understanding of cholera responses at different levels of scale and at different stages of an outbreak.
Important areas that need to be understood include the multiplicity of actors and the complexity of their interaction, the importance of building local capacity, the need for varying responses at different levels of scale, the need for improved inter- and intra-country co-ordination and information exchange, the importance of cultural belief systems and the impact of the media on the response to cholera outbreaks.
This Rapid Response briefing from the Dynamic Drivers of Disease in Africa Consortium sets out recommendations for a new, integrated ‘One Health’ approach to zoonoses that moves away from top-down disease-focused intervention to putting people first.Over two thirds of all human infectious diseases have their origins in animals. The rate at which these zoonotic diseases have appeared in people has increased over the past 40 years, with at least 43 newly identified outbreaks since 2004.
In 2012, outbreaks included Ebola in Uganda (see Ebola box), yellow fever in the Democratic Republic of Congo and Rift Valley fever (RVF) in Mauritania. Zoonotic diseases have a huge impact – and a disproportionate one on the poorest people in the poorest countries. In low-income countries, 20% of human sickness and death is due to zoonoses. Poor people suffer further when development implications are not factored into disease planning and response strategies.
Although the H1N1 ‘swine flu’ pandemic of 2009-10 was less severe than anticipated, the event revealed weaknesses in the world’s current configuration of planning for and responding to pandemic influenza, according to new research outlined in this briefing.
Science, public health policy makers and people worldwide were confounded by the uncertainty, complexity and politics inherent in influenza – as well as the high emotions that come with pandemics.Amid this confusion, the global and national institutions responsible for protecting public health were shown to be over-reliant on a reductive, science-led approach that prioritised a one-size-fits-all response, and failed to address the needs and priorities of the world’s poorest and most vulnerable people.
