It has become routine to attribute the tragedy of the West African Ebola epidemic to inexperience and lack of knowledge. The states and citizens of Guinea, Liberia, and Sierra Leone were portrayed as entirely unfamiliar with Ebola and therefore without relevant knowledge. The simplicity of this narrative is disturbed by the experience of Lassa Fever, an infectious and deadly viral hemorrhagic fever (VHF), which is endemic in the three countries most affected by Ebola. This article looks beyond Ebola in 2014 to the history of efforts to control VHFs in the Mano River and challenges the idea that there was a vacuum of knowledge. Highlighted instead are politics of knowledge which have run through global health and which have prioritized particular forms of knowledge and ways of dealing with disease.
Ethnographic research on the emergence of Lassa and the subsequent emergence of Ebola in West Africa is presented, focusing on the development of technologies and institutions to detect and manage both viruses. This provides a lens for exploring what was known and not known, how and by whom; as well as what was counted and what was not, and why. The anthropological literature on emerging diseases has so far focused on the social, economic, and cultural dynamics which produce disease burdens but less on the socio-technical processes which calibrate these burdens. This article contributes to the anthropology of emerging infectious disease by more fully accounting for the intricacies, uncertainties, and implications of diagnostic and surveillance practices for new diseases. The piece will add to post-Ebola debates around preparedness by connecting intricate sociotechnical perspectives on disease emergence with the politics of science and global health and questioning the way priorities, risks, and problems have been conceptualized within this.
![In late February/early March 2016 in Benin, (foreground) Carine, a student at the district school in Tchaourou, smiles as she holds up her slate with the correct answer Lassa Fever to the question posed by her teacher: What disease is making people in our town sick these days and is being transmitted from rats to humans and from person to person? Schoolchildren at this and other schools in the surrounding area are being taught how the disease is transmitted and how to protect themselves against it, and the importance of not discriminating against their fellow students whose parents may have gotten sick from Lassa Fever. Lassa Fever, a viral disease that can be fatal in severe cases, is transmitted through contact with rats infected with the virus and through person-to-person contact. UNICEF is scaling up its emergency response to help prevent further spread of the disease and to support people affected by the ongoing outbreak.
[ORIGINAL TEXT IN FRENCH] Carine sourit car elle a trouvé la bonne réponse : « Quelle maladie fait du mal dans notre ville en ce moment et qui se transmet par le rat et aussi de lhumain à lhumain lhomme? » La Fièvre Lassa a-t-elle écrit sur son ardoise. A lécole de quartier de Tchaourou, comme dans toutes les écoles des environs, les enseignants apprennent aux élèves les modes de transmissions et de prévention de la maladie mais également la nécessité de ne pas discriminer les camarades dont les parents auraient été malades. UNICEF/UN014699/Bonnaud](https://www.socialscienceinaction.org/wp-content/uploads/2017/01/UN014699_Med-Res-1024x683.jpg)