Anthropology in Action

The articles in this special issue demonstrate, through ethnographic fieldwork and observations, how anthropologists and the methodological tools of their discipline became a means of understanding the Ebola outbreak in West Africa during 2014 and 2015. The examples, from Liberia, Guinea and Sierra Leone, show how anthropologists were involved in the Ebola outbreak at different points during the crisis and the contributions their work made. Discussing issues including health promotion, gender, quarantine and Ebola survivors, the authors show the diverse roles played by anthropologists and the different ways in which they made use of the tools of their discipline. The case studies draw upon the ethical, methodological and logistical challenges of conducting fieldwork during a crisis such as this one and offer reflections upon the role of anthropology in this context.

Health promotion is dependent upon sharing information with local populations and adapting health-care services to make them more acceptable, and is an essential part of any Ebola intervention. Listening to the concerns of local communities and engaging them as active participants ensures that health promotion messages are relevant, acceptable and understandable as well as culturally appropriate. Ebola is associated with fear and death, thus understanding the significance and meanings of life, death, disease and sickness for the Kissi of Guinea Forestière (Guinea) is essential for ensuring acceptable health services. Community engagement was essential for this research to gain the trust of the Kissi and to facilitate the sharing of knowledge and information to reduce the transmission of the Ebola virus. This technical account is based on three periods of ethnographic fieldwork and health promotion activities conducted in Guinea between May 2014 and February 2015.

This article examines how populations affected by the Ebola epidemic in Liberia reacted to the implementation of mandatory, state-imposed quarantine as a way of curtailing transmission. The ethnography, based on in-depth fieldwork in both urban and rural areas, shows how mandatory quarantine caused severe social consequences for both people’s perceptions of epidemic control and their health-seeking behaviours. The authoritarian imposition of this public-health measure soon became a driver of social fear that contributed to the divide between institutions and population, jeopardising the control of transmission. Its implementation overshadowed more acceptable local quarantine measures that communities were organising to protect themselves from transmission. The analysis argues that quarantine in Liberia was counterproductive and suggests alternatives to epidemic control rooted in social acceptance and local practices.

As Response and Resilience Team Anthropologist for Oxfam GB, my role was to support an inclusive, community-led Ebola response through a better understanding of gender dynamics in the context of the outbreak. This case study identified stigma and blame of affected people as key factors in the ongoing epidemic. Despite social mobilisation efforts to address these attitudes, they remained ingrained in the Ebola response at multiple levels: in Government of Sierra Leone quarantine policies, in community by-laws and in everyday social interactions. Negative attitudes put pressure on the roles of men and women in ways that produced barriers to acting on Ebola prevention and treatment advice or creating an inclusive Ebola response. Our findings prompted several improvements in Ebola response activities that Oxfam Sierra Leone carried forward in their work, demonstrating the key role applied anthropology can play in creating a reflexive process to improve the effectiveness of humanitarian aid.

Survivors of the Ebola virus have been widely profiled as the success stories of the outbreak, yet they still face challenges relating to their identity and reintegration. A survivor’s body takes on new meanings after experiencing Ebola, and the label ‘survivor’ is as problematic as it is celebratory. Using data conducted during fieldwork in Monrovia, Liberia, this article discusses the complex identities of Ebola survivors. In Monrovia, most of the stigma and discrimination relating to survivors was directed towards men, who were considered ‘atomic bombs’ because of concerns that they could transmit Ebola through sexual intercourse. Health promotion messages around sexual transmission were often misunderstood, and communities requested the quarantine of men to reduce what they felt was a threat to the wider community. Understanding the meanings and sources of such stigmatisation is necessary to be able to work with and support survivors through psychosocial care and health promotion activities.