Academic questions about the ebola crisis

In this blog post, Kerrie Thornhill discusses how academics can contribute to the ongoing ebola crisis by addressing its root causes in global inequality. Kerrie is a doctoral candidate in Geography at University of Oxford. Her research on gender violence in postwar Liberia has been generously funded by the Trudeau Foundation, the Clarendon Fund, and SSHRC. The cartoons featured in this blog come from a youth programme at the We-Care Library in Monrovia. They reflect a variety of viewpoints, and the artists do not necessarily share the opinions in this post. Currently, the librarians are actively working to prevent the spread of ebola.

Before, I never worried that my academic work was too distant from the humanitarian imperative. Over five fieldwork visits to Monrovia, Liberia from 2008-2013, I investigated social perceptions of sexual and gender-based violence in the postwar period. I am now completing my doctoral dissertation thanks to the grace of host communities and interview respondents in the ‘Lone star nation’, whom I believe could be positively impacted by the results. Now I wonder if the people I’m writing for will survive to share and discuss the rich findings we co-produced. Like other anthropologists, I watch in disbelief as vibrant Monrovian neighbourhoods like Westpoint and New Kru Town struggle with ebola deaths and the associated threat to life, love, and livelihood.

My contacts in Liberia do not have time to indulge in pessimism. My closest host partner, ‘Bosslady’, lives in a tin-roofed informal settlement on the outskirts of Monrovia. In our latest phone conversation, she described the strategies that she and the neighbours had adopted. These include placing buckets of disinfectant outside households, avoiding strangers, and stocking up on commonly-needed medications. With her experience in HIV/AIDS awareness, poverty reduction, and gender equality, ebola is one of many crises she has managed during intensely difficult circumstances of forced migration and postwar reconstruction. “Everyone is fine”, she reported, “we are all taking precautions”. I admitted that I had feared the worst when she did not respond to my emails. She replied that I should get on Whatsapp, which “all the Liberians are using these days”, if I wanted to stay in touch better. Moreover, she declared that the “depressing” news reports were misleading, and we should both avoid Facebook because of them. By contrast, her teenage son ‘J.D.’ was spending more time online at the downtown library, in part to disseminate his awareness-raising artwork. Like the trodden-upon dust in Maya Angelou’s poem, Liberians will always rise. But why should they have to? Why shouldn’t their lives simply be tolerable?

This article has two purposes. Firstly, it joins the dialogue recently sparked by leading anthropologists, in particular Sharon Abramowitz’ timely list of ‘Ten Things that Anthropologists Can Do’, and the October 2014 special issue of Cultural Anthropology: Ebola in Perspective. I contribute my own findings where they may inform an improved health intervention. In the spirit of academic modesty, I direct these findings towards a list of emergent questions that I contend will become pressing ones, rather than being overly confident in proffering answers. Secondly, while concurring with Abramowitz’s explanation of how anthropologists can help, I extend the argument further from the view of an interdisciplinary social scientist. I do so by widening the lens to the context of global inequality that, as numerous researchers have shown, is vital to explaining the severity of the ebola outbreak. This raises the question: to what extent academic work can resist structural violence? Throughout, I foreground Liberian voices and argue for the centrality of everyday Liberians in coordinating a humane ebola response.

 How will the ebola crisis transform citizen-state relations?

Widespread distrust and ambivalence towards state and international organisations was apparent in my research on gender-based violence interventions in Monrovia. The postwar administration under President Sirleaf inherited nearly two centuries of ‘Americo-Liberian’ elitism and indigenous or ‘country’ peoples’ marginalisation. The social and political cleavages arising from this history impede progress on gender violence and other health/development indicators.

Public perceptions of corruption and state inadequacy are inseparable from critiques of the UN and international organisations, because of the intimacy between these institutions for most of the postwar period. Many residents of ‘slum’ areas feel excluded from the country’s development efforts, and have not found sufficient grounds to trust authority of any kind. Whether this level of suspicion is deserved or not is beside the point. The implication for today’s emergency intervention is clear: the neutrality that many organisations claim is simply not a reality on the ground. This applies even to highly competent projects and the results, such as attacks on aid workers by fearful residents, are painful to behold.

On a more positive note, some organisations such as Medecins Sans Frontières, the International Rescue Committee, and the American Refugee Committee have a longstanding and respected history working directly with rural and urban communities. Their good reputations are the result of their dedication to engaging respectfully with locals and putting gifted regional staff in top leadership positions. Despite the well-publicised story of Liberian state corruption, I have encountered individual government staff who work tirelessly and bravely for the betterment of the human condition. In my fieldwork I observed ‘everyday’ Liberians, including ‘elites’, actively working to overcome past conflicts and redefine their identities in a more peaceful manner. Their efforts deserve support.

How will ebola influence trauma and indigenous healing mechanisms? How will it impact traditional authority structures?

‘Even a baby in the womb remembers the Charles Taylor days’, a Liberian colleague said of the emotional trauma he and his peers experienced growing up during the war years. Fiction and non-fiction writers such as Elma Shaw, Chris Coulter, and Sharon Abramowitz articulate issues of long-term and ‘collective’ trauma, and local understandings of trauma. What will be the long-term and collective consequences of trauma caused by ebola, and how might they intersect with ongoing long-term recovery from the Liberian war?

How will traditional medicine, and indigenous institutions, be affected? In 2011, the government coordinated with traditional Sande and Poro leaders to report on traditional trauma healing mechanisms for gender violence. My interviews with a diverse cross-section of adults reflect a range of views on the value of traditional institutions. There is a consensus that much was lost due to war and forced migration. What will be the impact on traditional authority as it becomes clear that ebola is outside their capacity to heal?

To what extent do occult beliefs mesh with fears of the virus? Catherine E. Bolton  highlights how witch-craft narratives have become bound up with people’s understandings and fears of the virus in Sierra Leone. This is congruent with past research such as Rosalind Shaw’s work on popular associations between witchcraft, consumer culture, and deprivation and excess. There are so many more questions. In my research, suspicions about witchcraft, juju, or ‘that society business’ infused discussions of sexual violence and other social ills, especially when an interview was trying to make sense of a harm that seemed otherwise inexplicable. These beliefs were particularly strong in Westpoint neighbourhood, a ‘ghetto’ very close to Monrovia’s richest areas. In most cases, interviewees perceived a connection between witchcraft and high-level political and financial success. Based on these statements, I would expect a confluence between ‘inexplicable’ ebola deaths, unpopular government-led containment efforts, and a deepening mistrust of the state and outsiders in Westpoint.

How will ebola influence economic development and natural resources?

In addition to the obvious negative consequences such as restrictions to business operations, trade and movement, there will be unforseeable changes with more ambivalent outcomes. Charles Lawrence points out that an influx of aid funds will create winners and losers. In the past, a ‘UN economy’ escalated prices while also creating employment opportunities.

What about other areas of the country’s political economy? In the hinterland, how will this affect mining and logging operations, and the already conflicted relationship between extractive resource industry and rural community networks? Will companies such as ArcelorMittal and Firestone protect lives under their corporate social responsibility frameworks, or will they take advantage of regions made vulnerable by the health crisis?

Will the crisis response reinforce the militarisation of aid?

With 3000 troops pledged by the USA, and the creation of UNMEER, the first ever UN emergency mission fighting a disease, Adia Benton is right to say that the ‘epidemic will be militarised’. For many years now scholars such as Mark Duffield and Patricia Daley have critiqued the increasing militarisation of aid. I anticipate that some political scientists will consider ebola a ‘game-changer’ for the development-security nexus, and others will argue that it reinforces a game already well in place.

Duffield’s critique of international development as a discourse of containment applies to the current situation. J.D.’s cartoon puts the point more bluntly. A suffering ebola patient receives a harsh kind of ‘help’ from US foreign policy, which is more interested in containing deaths than preventing them.

How can social scientists contribute to the ebola response?

Like Abramowitz, I initially ‘left ebola to the medical experts’ because my research is in sexual and gender-based violence. Over time, it became clear that there are parallels between rape and ebola in Liberia. Both attract high-profile international news coverage. Both are crises indeed, but their severity has been ill-served by sensationalism in the press, which often depicts Africa as the ‘heart of darkness’ where such horrors are to be expected. A New York Times headline, for example, declared ebola to be a ‘grim, African reality’,as if this unprecedented outbreak was a part of everyday life. News reports and human rights literature, with similar fatalism, describe rape anywhere in Africa as an ‘epidemic’. This is a misnomer that casts a gendered social problem in the language of a biological disease. By contrast, ebola is an actual epidemic, whose discourses have spread according to codes of social hierarchy.

A critical response to these kinds of narratives is gaining attention. African and diaspora scholars, already accustomed to the ‘thousand tiny paper cuts’ of casual racism, demonstrate how these (metaphorical) cuts escalate into real fatalities. Writers such as Nanjala Nyabola and Lola Okolosie point out the abundance of racist tropes depicting West African societies as inherently unclean, chaotic, uncooperative, ungrateful, and childlike. This racism reinforces a global culture of disregard for black African lives, and the perception that they are a source of social and biological contamination.

This critique is a common refrain throughout Ebola in Perspective. As Mike McGovern points out, the media’s attentiveness to bushmeat as a vector of the disease is not medically neutral. Rather, it is part of a wider ‘politics of disgust’, which dehumanises the victims of ebola and conceals the ways in which systemic global inequality contributed to the outbreak. Global health experts add their own critiques. Belluz and Hoffman illustrate the link between a chronic lack of funding for diseases affecting the poor and high mortality rates from preventable and curable illnesses. Meanwhile, medical anthropologist James Pfeiffer recalls the role of structural adjustment programmes in weakening African states’ health sectors.

To summarise, social scientists of all disciplines can contribute to a multi-dimensional understanding of the ebola crisis. The questions I presented above all show where social science research is needed or where it already contributes to a more effective prevention and response model. These add to Abramowitz’ list of ‘ten things ethnographers can do to help’. However, there are two caveats to keep in mind. Firstly, no foreigner’s expertise can replace the lived experience of those struggling to survive the outbreak. Of the ten points that Abramowitz lists in support of engaging ethnographers, at least six equally apply to engaging local populations. Secondly, Western academics are positioned to provide expertise thanks to the same racism and double standards that most of us decry. “The foreigners have all run away”, Bosslady chuckled over the phone, “and we the African ‘monkeys’ are staying to fight ebola”.

This leads us to the core question of this article:

 What is the value of academic inquiry under conditions of global economic apartheid?

What is the value of academic research on complex social phenomena, within more fundamental conditions of stark and simple injustice? Is it even appropriate that our responses be sophisticated? This is a sincerely open-ended question, not a rhetorical one. To conduct academic research on issues of popular humanitarian interest requires that we rise above the platitudes of donors, that we confront the most baffling aspects of human social behaviour, and that we dig under, around, and through walls of ignorance that have for so long imprisoned the possibility of an egalitarian response to human suffering.

In general, the ethnographic literature on the Mano River region clearly attempts to bring marginalised perspectives to the centre, and to understand and command respect for local practices whose logic is not immediately apparent to outsiders. This is academic complexity at its best. In the introduction to Ebola in Perspective, Danny Hoffman and Mary Moran explicitly ground the whole project within an anti-racist framework.

Ethnographers can inform global health best practises, as Abramowitz argues. But privileged, mainstream First World society is chillingly apathetic towards the lives and deaths of black Africans. That is the underlying problem. Our efforts to deliver high-quality information and sharp analysis are undermined by the inequities of our privileged audience. Let’s just admit that ‘what are local perceptions of [social problem x] in [marginalised population y]’ is enticingly complex, yet answerable. The way scholars prefer things to be. By contrast, ‘why does pointless racism exist?’ and ‘how can we stop it?’ is simple, less answerable, and more important. Do we spend enough time on these simplistic yet crucial questions?

We know that we benefit from double standards. Social scientists are swiftly credited with expertise after even a few weeks of fieldwork, whereas the marginalised populations we work with are still objectified as ‘victims’, ‘participants’, or at best, ‘community leaders’ despite decades of frontline activism. Anthropologists’ services in cultural translation should not be required. Rather, crisis response systems should be better equipped to converse directly with vulnerable populations. When we academics provide ‘solutions’ to the ‘problem’ of African inscrutability, to what extent are we complicit with epistemic violence towards African subjects?

The inherent value of Liberia’s bright, beautiful, black, resilient and resourceful population should be self-evident. And this self-evident truth of African worth is not diminished by the shortcomings of any African individual or their society. Like star dust, Liberians will rise again to each new challenge. But why should they have to? Why shouldn’t their lives simply be tolerable?

Anthropologists must use their privileged platform not only to translate marginalised cultural practises, but to challenge the inequalities that make possible that marginalisation. From the epistemic to the epidemiological, many academics already resist global economic apartheid. How can we do so more effectively? Scholarly sophistication can be useful when, and only when, it proceeds from this simple first question.