In a speech addressing the international community, United States President Obama criticized the world leaders for their slow and inadequate response to the Ebola outbreak. Authorities warn for an exponential increase in the number of infections and even consider the possibility that Ebola could become endemic.
Ebola is war
After long months of relative silence, the world finally heatedly debates on Ebola. The quantity of aid is widely considered to be the major problem. The quality of the aid being offered however, is not under scrutiny. Everybody seems to agree that all the outbreak needs is: more clinics, more medical personnel, more military personnel and central coordination. All this is, of course, necessary. It is questionable though, why and how foreign soldiers will be deployed. The slogan the United Nations uses for the Ebola outbreak may be “Ebola is war”, in reality Ebola is a virus that threatens and affects the poorest people of the affected societies.
Ebola is resistance
The rhetoric the UN uses to ‘fight’ the Ebola epidemic is directly derived from Sierra Leonean society. This slogan captures the very heart of the problem as it symbolizes why the epidemic is so difficult to contain: the unbridgeable gap between the people and their government. Let’s put Sierra Leone at the centre of this discussion, because after all, that is what the international institutions do too.
The war in Sierra Leone was about opportunism of the various governments on one side and the rebels on the other side. The population was caught between the greed of both sides. The illicit diamond trade flourished. The people suffered. The (new) elite left the country and benefited from underground trade. Only the poor suffered from the war. Nobody could be trusted. Government soldiers were called “Sobels”: Soldier by day, rebel by night. It took a civil defence force to turn the tide. The people had to create their own resistance and free themselves from a very violent junta and the rebels, both fighting the defenceless population.
The slogan ‘Ebola is war’ directly refers to the people’s mistrust in their government. Politicians have no authority. Nobody listens to them. Sierra Leone could potentially be one of the richest countries in the world, because of the country’s abundance in natural resources. The country is, however, one of the poorest countries in the world, due to long decades of corruption, nepotism and oppression. Some experts claim that the civil war is the cause of the great distrust that the people of Sierra Leone and Liberia have in their governments. That is a misrepresentation: The civil wars were a result of the great friction between population and government. The civil war and the ending of it without concrete changes and solutions for the people widened that gap.
In Sierra Leone, the protest culture consists mainly of protest songs in pop culture. The biggest hits the post-war country has had call for the death of the politicians and the elite. Politicians are referred to as ‘blood-sucking vampires’ and ‘2 fut arata’ – two-legged rats; because they suck the population dry and reap the rich natural resources. The latest slang to refer to the politicians currently in power is ‘kokobeh’, gluttons, referring to the politicians’ perceived insatiable greed. These politicians are now at the helm of the Ebola epidemic and come up with harsh measures that go against the interests, the way of life and the feelings of the population. Experts analyse that the people are to blame for the spread of Ebola. Liberian President Sirleaf accused her people of ‘making the Ebola epidemic possible’. The (now dismissed) Minister of Health did the same in Sierra Leone. The way of life of the poor masses in the Ebola affected countries is heavily under fire. The culture is regarded as a major facilitator of Ebola. The way the people cope with Ebola is captured in numerous exoticisms: their ‘backward cultural practices’ seem to be responsible for the spread of Ebola.
The way the people of the Ebola affected countries want to take care of their sick relatives is regarded as a cultural problem. And ‘cultural burial rituals and practices’ are widely regarded as the main reason for the spread of Ebola. The way West-Africans care for their sick and deceased, supposedly differs significantly from that of the rest of the world. This is far from true. All over the world, the essence of care for the sick is practically the same: the touching of sick and dead relatives is a natural phenomenon. All over the world the deceased are cleaned up and the body is neatly laid out so that family members and acquaintances can say farewell. In the Netherlands, we have the possibility to lay out our dead loved ones in our parlour for days. And physical contact with the body of the deceased will take place until the coffin is sealed and put into the ground or taken to the cremation ovens.
In the case of the Ebola affected countries, normal human behaviour is dismissed as “old-fashioned and undesirable practices” by the World Health Organization and experts analysing the Ebola outbreak. Nobody questions whether it is reasonable to deny people the care for their loved ones and the right to be in charge of the mourning process. The solution to prevent people from getting infected with Ebola is clear: no touching, under any circumstances. More empathic solutions, like the provision of protective gear to family members so they can bury their loved ones themselves or with guidance, are not being considered. The population is pushed into the corner; if they do not cooperate, they will go to jail. These harsh measures alienate the people from the authorities even further. Ebola is a punishment. Not for the international community, not for the politicians, not for the elite, but only for the poor masses. The people feel alone. Deserted. Huge amounts of money are coming in, more and more reinforcements arrive and still the epidemic wins more ground every day.
‘Munku’ – The people are mute
A fifth of the population of Sierra Leone is now under quarantine. The informal economy that provides the income of the bulk of the population, is completely broken down. The people have to deal with food shortages, their small businesses are ruined, while the multinationals still operate. The latter is of course necessary to keep the formal economy going, but the poor do not have much understanding for this approach. The fruits of the formal economy are for the elite, not for them, as they don’t see the effect of it in their daily lives. The people have no say in the methods being used. Everything is imposed on them, nobody explains why there are no alternatives. The people are left with their own interpretation. They come up with their own truths, which nobody negates.
The nation turns to God, religious leaders and traditional healers. This too is considered as a cultural and undesirable phenomenon. It is attributed to ignorance and backwardness. But a nation that has always found itself at the mercy of those in power has no mechanisms other than hope, for their survival. Especially in times of distress and anxiety, people will turn to that which gives them hope: God and nature. It is certainly not strange or unpredictable that mistrust in the authorities increases when a nation feels threatened. The people are helpless. For a long time, the severity of the Ebola epidemic was denied by the authorities. People died mysteriously. The people have had the time to develop their own perceptions and philosophies about Ebola. That some people still consider Ebola to be some form of witchcraft, is not so much the result of the culture, but rather a direct result of the approach.
Ebola, a poor man’s sickness
Ebola is a “poor man’s sickness,” as they say in Sierra Leone. It affects the poorest people in society. It typically affects those who have no ties with political loyalty networks. Ebola poses a huge health risk, it is however not a revolution. Like anything else in Sierra Leone, the Ebola epidemic offers opportunities for trade and corruption. At checkpoints closing off the quarantined areas for example, money is regularly accepted so people can pass through. Food prices go up despite government warnings and the prices of hygienic products regularly skyrocket. Households and sometimes whole villages under quarantine, sometimes go without food for days to weeks. Protective gear for medical personnel was donated and supposed to be sufficient for at least two months, but it was not distributed adequately, allowing nurses to get infected with Ebola. The emergency hotline is regularly overburdened and often people have to wait for days until the Ebola teams finally show up to collect reported dead bodies. Corpses are rotting in houses and the streets for days.
The people do not have insight into the (in) abilities of their government. They hear about astronomical amounts of money coming in, but the output is not felt on the ground. The distrust in the western community, which was regarded with high esteem until recently, grows by the day. The approach of their government and the sluggish response of the international community create a burning core of discontent. The “yes sir” culture is bigger than ever: the people politely say ‘yes and amen’ to the authorities, but they keep their thoughts deeply hidden from the outside world. They are still hiding the sick. There are virtually no mechanisms in place that could make it attractive for people to send their loved ones to the clinics. The clinics are full, the quarantined households are being starved, their loved ones suffer and die alone, there is no possibility for a proper farewell and no mourning process. Nobody can tell the people how to survive Ebola and the future. Family members that are dependent of each other in economic sense often choose to die together. Their lives have never been more hopeless. For them Ebola is indeed war. Not a war against a virus they can protect themselves against, but rather a war in which they are caught between the government and a rebel (Ebola), once again.
Ebola calls for a Civilian Defence Force
To fight Ebola and keep the country stable, the cooperation of the population is the highest priority. Just like during the civil war, the people need their ‘civil defense force’. They must be listened to. Their concerns must be heard and taken serious and be put at the heart of the anti-Ebola measures. Strategies devised in offices and control rooms with dots on maps and roadmaps that lack empathy, understanding and rapprochement will not win the trust of the population. The harder the people keep being pushed into the corner, the more the country will be destabilized. The population holds on to God and conspiracy theories, which offer them respectively comfort and a visible enemy. If trust erodes completely and distrust in international aid further increases, a fertile breeding ground for resistance and rebellion will be created.
Not coercion but cooperation
Ebola should not be that difficult to contain. It needs a drastic change in approach though, or soon nobody will be able to control the masses. The people of Sierra Leone are gripped by fear and get most of their information form hearsay. The den se culture (hearsay) controls daily life. People’s blind trust in hearsay could be used to spread the desired messages among the people: People can heal from Ebola, if they get medical care when the symptoms first occur, in the early stages of the sickness. The people infected with Ebola should feel responsibility towards their family members. To achieve that, enough clinics with good quality care should be built in all districts, close to people’s homes. The possibility to allow people to visit their sick relatives in the clinics deserves careful consideration. This should go hand in hand with adequate care of the families who are put under quarantine. Above all, understanding and insight in the suffering and sacrifices of the affected people should be the basis for finding solutions that respects people’s humanity. The message of empathy has to be brought. A change in approach starts with the rhetoric: Ebola is not war, but cooperation. A person who might be infected with Ebola is not a ‘suspect’ but a patient. ‘Cause although this terminology might be common in medical respect, it is highly charged and laden with double meaning in social respect. Ebola is not war, but cooperation. Patients are victims, not criminals. If we want to help the people of the Ebola affected countries, we have to give them back their humanity. If we understand their suffering, we are two steps closer to eradicating the Ebola epidemic.
About Ginny Mooy: I am an MSc in Social Anthropology and Sociology of non-western societies. I do (ongoing) PhD research into the long term reintegration of former child soldiers into postwar society and research postwar packages and aid given to them. I focus on the role of girl soldiers and the effect of the changing position of women during and after the war on society. I specialized in extreme violence, tactics of terror, propaganda in (social) conflict and postwar reintegration. I live and work in Sierra Leone since 2006. Since the start of the outbreak of Ebola, I monitor social response in Sierra Leone and the impact of the epidemic on social life and culture. Together with local Sierra Leoneans and Sierra Leoneans in the diaspora, I run an NGO for emergency relief (e.g. food help) and the defense of human rights.