EBOLA: HOW A PEOPLE'S SCIENCE HELPED END AN EPIDEMIC
By Paul Richards
Zed Books, 2016, 180 pages
Review by Michael Beach
Just the Facts?
Among the arguments Richards makes, I'd like to examine the area of messages originating from official channels.
Is it possible to be factually correct and still misunderstand? Perhaps it is if one only has (or shares) some facts, or if the facts come too late to have any real meaning. In his book on how ‘people’s science’ helped end Ebola in three countries, Paul Richards makes this case in terms of messaging by international and state organizations attempting to ‘educate’ residents in upper west Africa. Richards does not make the case for or against Ebola origination through eating or handling of ‘bush meat’ (zoonotic spillover). He does make the case that once transmission was obviously moving person-to-person (nosocomial and family care), continued public messages about bush meat did more to increase mistrust than to curb the disease (25).
People in the forest border area were particularly targeted with bush meat messages. Likely this would be due to assumptions that these areas were where hunting was most likely to occur. Despite this, even when Ebola moved along roads and began to display in urban areas messaging was slow to change. Villagers, and later urbanites, quickly lost faith in messages coming from official sources in part due to this dissonance. As messages shifted toward person-to-person transmission, highlighting danger in caring for the sick and handling of bodies, mistrust was still lingering. Facts about people not adopting safe practices lead to untrue assumptions by official decision makers about culture as a route cause of Ebola spread (51).
People in affected areas had already figured out on their own health how care and body handling were risky behaviors, but again the messaging from official sources was dissonant. Authorities offered centralized care and body removal, but were often not available when actually called. People were not able to see their family once removed either for care or burial. Many decided if death was inevitable it would be better to just die at home among family. Despite assumptions that locals were unreasonably resistive, growing cries to train people, supply the tools, and allow for more dispersed care and body removal using ‘safe burial’ practices resulted in a quicker drop off of cases. Once people understood the disease (transfer limited to contact with body fluids, hydration focus) many figured out how to improvise protective gear through use of things like trash bags and raincoats. One might ask the question, is unfamiliar different than uninformed?
As regular people and respected local leaders understood the nature of Ebola, use of those facts lead to incorporation of new social adoption of care and burial. Once local trusted social leaders incorporated relevant facts to actual experience, the link of science and society, ‘people’s science’, all three countries reviewed in the book became strong examples of effective disease control.
By Paul Richards
Zed Books, 2016, 180 pages
Review by Michael Beach
Just the Facts?
Among the arguments Richards makes, I'd like to examine the area of messages originating from official channels.
Is it possible to be factually correct and still misunderstand? Perhaps it is if one only has (or shares) some facts, or if the facts come too late to have any real meaning. In his book on how ‘people’s science’ helped end Ebola in three countries, Paul Richards makes this case in terms of messaging by international and state organizations attempting to ‘educate’ residents in upper west Africa. Richards does not make the case for or against Ebola origination through eating or handling of ‘bush meat’ (zoonotic spillover). He does make the case that once transmission was obviously moving person-to-person (nosocomial and family care), continued public messages about bush meat did more to increase mistrust than to curb the disease (25).
People in the forest border area were particularly targeted with bush meat messages. Likely this would be due to assumptions that these areas were where hunting was most likely to occur. Despite this, even when Ebola moved along roads and began to display in urban areas messaging was slow to change. Villagers, and later urbanites, quickly lost faith in messages coming from official sources in part due to this dissonance. As messages shifted toward person-to-person transmission, highlighting danger in caring for the sick and handling of bodies, mistrust was still lingering. Facts about people not adopting safe practices lead to untrue assumptions by official decision makers about culture as a route cause of Ebola spread (51).
People in affected areas had already figured out on their own health how care and body handling were risky behaviors, but again the messaging from official sources was dissonant. Authorities offered centralized care and body removal, but were often not available when actually called. People were not able to see their family once removed either for care or burial. Many decided if death was inevitable it would be better to just die at home among family. Despite assumptions that locals were unreasonably resistive, growing cries to train people, supply the tools, and allow for more dispersed care and body removal using ‘safe burial’ practices resulted in a quicker drop off of cases. Once people understood the disease (transfer limited to contact with body fluids, hydration focus) many figured out how to improvise protective gear through use of things like trash bags and raincoats. One might ask the question, is unfamiliar different than uninformed?
As regular people and respected local leaders understood the nature of Ebola, use of those facts lead to incorporation of new social adoption of care and burial. Once local trusted social leaders incorporated relevant facts to actual experience, the link of science and society, ‘people’s science’, all three countries reviewed in the book became strong examples of effective disease control.
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