Ebola, Culture and Politics: The Anthropology of an Emerging Disease

Description

In this case study, readers will embark on an improbable journey through the heart of Africa to discover how indigenous people cope with the rapid-killing Ebola virus. The Hewletts are the first anthropologists ever invited by the World Health Organization to join a medical intervention team and assist in efforts to control an Ebola outbreak. Their account addresses political, structural, psychological, and cultural factors, along with conventional intervention protocols as problematic to achieving medical objectives. They find obvious historical and cultural answers to otherwise-puzzling questions about why village people often flee, refuse to cooperate, and sometimes physically attack members of intervention teams. Perhaps surprisingly, readers will discover how some cultural practices of local people are helpful and should be incorporated into control procedures. The authors shed new light on a continuing debate about the motivation for human behavior by showing how local responses to epidemics are rooted both in culture and in human nature. Well-supported recommendations emerge from a comparative analysis of Central African cases and pandemics worldwide to suggest how the United States and other countries might use anthropologists and the insights of anthropologists to mount more effective public health campaigns, with particular attention to avian flu and bioterrorism. Contents Foreword Preface Chapter 1: Images and First Contact WHAT IS EBOLA? FIRST CONTACT WHAT IS CULTURE? KEY QUESTIONS ORGANIZATION OF THE BOOK WHAT’S NEW? TERMINOLOGY Chapter 2: Outbreak Ethnography: The Anthropologist’s Toolkit FIELD CONDITIONS THE RELATIONSHIP BETWEEN THEORY AND METHODS WHAT DID WE DO IN THE FIELD? Chapter 3: Indigenous Knowledge about Epidemics: Uganda 2000–2001 BACKGROUND ON UGANDAN OUTBREAK CULTURAL MODELS ISSUES OF CONCERN TO NATIONAL AND INTERNATIONAL TEAMS INTRACULTURAL VARIABILITY CONCLUSIONS Chapter 4: Providing Humanitarian Care: Congo 2003 BACKGROUND ON CONGO OUTBREAK FIRST DAYS IN THE FIELD CULTURAL MODELS ISSUES OF CONCERN TO NATIONAL AND INTERNATIONAL TEAMS INTRACULTURAL VARIABILITY CONCLUSION Chapter 5: Facing Death and Stigmatization: Healthcare Workers and Survivors NURSES AND OTHER HEALTHCARE WORKERS SURVIVORS CONCLUSION Chapter 6: Ebola Outbreaks, Past and Present YAMBUKU, DR CONGO (1976) KIKWIT, DR CONGO (1995) YAMBIO, SUDAN (2004) CONCLUSION Chapter 7: Outbreak Control BELIEFS AND PRACTICES WITH IN THE COMMUNITY BELIEFS AND PRACTICES FROM OUTSIDE THE COMMUNITY CONCLUSIONS Chapter 8: Explaining Human Responses to Acute High-Mortality Epidemics ANTHROPOLOGICAL AND HISTORICAL STUDIES OF HUMAN RESPONSES TO EPIDEMICS AN EVOLUTIONARY BIOCULTURAL MODEL CONCLUSIONS Chapter 9: Policy, Bioterrorism, and Bird Flu POLICY ISSUES EBOLA AS A BIOTERRORIST WEAPON AND THE THREAT OF A BIRD FLU PANDEMIC REFLECTIONS Appendix A: The Role of a Medical Anthropologist in Outbreak Alert and Response PREPAREDNESS EARLY ACUTE PHASE DURATION OF ACUTE PHASE FINAL PHASES NOTES Appendix B: Useful Internet Sites References Cited Index