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Understanding West Africas Ebola Epidemic

Understanding West Africas Ebola Epidemic

Ibrahim Abdullah | Ismail Rashid

(2017)

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