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Abstract
From 2013 to 2015, over 11,000 people across West Africa lost their lives to the deadliest outbreak of the Ebola virus in history. Crucially, this epidemic marked the first time the virus was able to spread beyond rural areas to major cities, overturning conventional assumptions about its epidemiology.
With backgrounds ranging from development to disease control, the contributors to this volume - some of them based in countries affected by the Ebola epidemic - consider the underlying factors that shaped this unprecedented outbreak. While championing the heroic efforts of local communities and aid workers in halting the spread of the disease, the contributors also reveal deep structural problems in both the countries and humanitarian agencies involved, which hampered the efforts to contain the epidemic. Alarmingly, they show that little has been learned from these events, with health provision remaining underfunded and poorly equipped to deal with future outbreaks. Such issues, they argue, reflect the wider challenges we face in tackling epidemic disease in an increasingly interconnected world.
Ibrahim Abdullah was until recently a professor of history at Fourth Bay College, University of Sierra Leone. He has published extensively in the area of African social/labor history and contemporary social change and conflict in West Africa, and is the editor of Democracy and Terror: The Sierra Leone Civil War (2004).
Ismail Rashid is professor of history at Vassar College. Among his recent publications are (co-edited with A. Adebajo) West Africa’s Security Challenges (2004),and (co-edited with Sylvia Ojukutu-Macauley) The Paradoxes of History and Memory in Postcolonial Sierra Leone (2013). He currently serves as the Vice President of the West African Research Association (US) and member of the board of the African Peacebuilding Network of the Social Science Research Council.
‘A bold, critical and wide-ranging anthology on the Ebola crisis. It will excite everyone interested in understanding why the Ebola viral disease overwhelmed the Mano River Union states.’
Yusuf Bangura, Senior Research Associate, UNRISD
‘This eye-opening volume restores the social history of an epidemic that can't be understood without first acknowledging the economic policies that have impoverished this region. This book should (and I hope will) be read by anyone interested in global health. And that should include all of us.’
Paul Farmer, Harvard Medical School
‘Rarely has a book recounted such a preventable catastrophe, and from so many perspectives. In the process, it breaks down the boundaries of current thinking, and speaks truth to power.’
Jacques Depelchin, Executive Director, Ota Benga International Alliance for Peace
‘This comprehensive volume offers valuable analyses of the structural roots and social impacts of the West African Ebola outbreak. An excellent resource for anyone interested in learning about the history and political economy of this devastating epidemic.’
Adia Benton, Northwestern University
‘This book successfully turns the neoliberal project on its head, forcing us to demand a different kind of development in contexts (such as Guinea, Liberia and Sierra Leone) where exclusion, exploitation and extraction reign supreme.’
Robtel Neajai Pailey, author and activist
'A valuable contribution to the Ebola literature but also key for anyone interested in the state of Africa, epidemiology, and political economy.'
Africa at LSE
'A fascinating insight into the background of the three countries which bore the brunt of the 2014 Ebola epidemic, showing how the historical and socio-economic status of these countries made them susceptible to such an epidemic, and unable to treat and contain it effectively.'
Medicine, Conflict and Survival
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Cover | Cover | ||
Praise for this book | i | ||
Security and society in Africa | ii | ||
Title page | iii | ||
Copyright | iv | ||
Epigraph | v | ||
Contents | vii | ||
Acknowledgments | ix | ||
Abbreviations | xi | ||
Map 1 | xv | ||
Map 2 | xvi | ||
Map 3 | xvii | ||
Introduction: understanding West Africa’s Ebola epidemic | 1 | ||
Ebola: an unknown enemy? | 1 | ||
MRU, regionalism, and Ebola | 4 | ||
The neoliberal affliction: different countries, similar convulsions | 6 | ||
Development, gender, and its discontents | 9 | ||
Transnational actors and the politics of crisis response | 10 | ||
Notes | 14 | ||
References | 14 | ||
Part One. The regional history and origins of Ebola | 17 | ||
1. Ebola and regional history: connections and common experiences | 19 | ||
Introduction | 19 | ||
Pre-colonial commonalities and integration: continuities | 20 | ||
The “colonial” era: regional similarities and variations | 24 | ||
Economic crisis, dictatorship, war, and popular resistance in the post-colonial era | 30 | ||
Rethinking regional history/networks in the context of Ebola: by way of conclusion | 37 | ||
Notes | 40 | ||
References | 42 | ||
2 . Eurocentric epistemology: questioning the narrative on the epidemic’s origin | 47 | ||
The making of a faulty scientific narrative | 48 | ||
Historicizing the origin of the outbreak | 53 | ||
Western biodefense research and the outbreak | 56 | ||
Conclusion | 62 | ||
Notes | 63 | ||
References | 64 | ||
Part Two. The neoliberal affliction: different countries, similar convulsions | 67 | ||
3. Interpreting the health, social, and political dimensions of the Ebola crisis in Guinea | 69 | ||
Introduction | 69 | ||
Managing illness and death in Guinean families | 71 | ||
Popular views and attitudes on Ebola in Guinea | 72 | ||
Failures and inadequacies | 77 | ||
Effects of EVD on social cohesion | 81 | ||
Conclusion | 82 | ||
Notes | 83 | ||
References | 84 | ||
4. The political economy of the Ebola epidemic in Liberia | 85 | ||
Introduction | 85 | ||
Theorizing the peripheral capitalist state | 86 | ||
Governance and development under the Sirleaf regime | 94 | ||
How the peripheral capitalist state made Ebola a possibility | 102 | ||
Conclusion | 106 | ||
References | 108 | ||
5. Confronting Ebola with bare hands: Sierra Leone’s health sector on the eve of the Ebola epidemic | 112 | ||
Introduction | 112 | ||
Human resources: quality, quantity, and distribution | 115 | ||
Financing wellness: how much money is available and who pays? | 119 | ||
Broken health infrastructure, information system, and inadequatelogistics: a perennial malaise | 122 | ||
The Kenema Government Hospital: the initialtreatment center of the Ebola epidemic | 127 | ||
Conclusion: the limits of fighting Ebola with bare hands | 131 | ||
Notes | 134 | ||
References | 136 | ||
Part Three. Development, gender, and its discontents | 137 | ||
6. Structural violence, public health, and the militarization of assistance | 139 | ||
Introduction | 139 | ||
Development theory and practice: structural violence or expanding capabilities? | 140 | ||
Ebola in context: Sierra Leone’s political economy | 144 | ||
Ebola changes everything? | 147 | ||
Securitization as another form of violence | 152 | ||
Conclusion | 157 | ||
Notes | 158 | ||
References | 160 | ||
7. “I am a woman. How can I not help?”: gender performance and the spread of Ebola in Sierra Leone | 163 | ||
Introduction | 163 | ||
The state, women, and gendered inequality in Sierra Leone | 165 | ||
Four women’s voices: femininity as vulnerability and agency | 173 | ||
Stigmatization, exclusion, and exploitation: the struggle for dignity and livelihood after EVD | 178 | ||
Conclusion | 181 | ||
Notes | 183 | ||
References | 184 | ||
8. “God bless WhatsApp”: neoliberal Ebola and the struggle for autonomous space in Sierra Leone | 187 | ||
Introduction | 187 | ||
Context: the truth behind the fastest growing economy and the third-term bid | 189 | ||
Neoliberal Ebola and broken health infrastructure | 192 | ||
Multiple transgressions as communication: the making of an autonomous public sphere | 197 | ||
“God bless WhatsApp”: cyber activism and the continued struggle for an autonomous space in post-Ebola Sierra Leone | 203 | ||
Conclusion | 209 | ||
Notes | 210 | ||
References | 210 | ||
Part Four. Transnational actors and the politics of crisis response | 213 | ||
9. African Union, ECOWAS, and the international political economy of the emergency response to Ebola | 215 | ||
Introduction | 215 | ||
The context of the pan-African responses | 216 | ||
The continental and regional approaches to the epidemic | 219 | ||
Operationalizing African solidarity: an analysis of key issues | 224 | ||
Beyond crisis | 234 | ||
Conclusion: the way forward | 237 | ||
Notes | 238 | ||
References | 239 | ||
10. The World Health Organization and the Ebola epidemic | 244 | ||
The World Health Organization | 245 | ||
WHO responds to the Ebola outbreak | 246 | ||
The role of surveillance | 248 | ||
The critiques of WHO and the WHO response | 254 | ||
Conclusions | 256 | ||
Notes | 257 | ||
References | 259 | ||
11. The Ebola epidemic moment in US–(West) Africa relations | 263 | ||
Introduction | 263 | ||
The context of the US response to Ebola | 267 | ||
Beyond partisanship: the politics of disease in the United States | 269 | ||
Ebola steals the show at the United States–Africa Leaders’ Summit | 275 | ||
The costs of marginalization | 278 | ||
Conclusion | 280 | ||
Notes | 282 | ||
References | 283 | ||
12. UNMEER and the international response to the Ebola epidemic | 285 | ||
Introduction | 285 | ||
Contextualizing an epic failure | 287 | ||
UNMEER: securitizing Ebola, upscaling the international response | 293 | ||
Empowered leadership or lumbering distraction: evaluating UNMEER | 301 | ||
Notes | 305 | ||
References | 308 | ||
About the editors and contributors | 310 | ||
Index | 313 |