International Journal of Infectious Diseases 29 (2014) 145
Contents lists available at ScienceDirect
International Journal of Infectious Diseases journal homepage: www.elsevier.com/locate/ijid
Letter to the Editor Engaging anthropologists in a more systematic way would strengthen our global outbreak response To the editor A recent article in The Economist entitled ‘‘The Ebola crisis– Much worse to come’’ noted, among other things, that there was still much to be done through community engagement to reduce dangerous practices and make rituals safer, referring to a WHO study conducted six months into the epidemic that estimated 60% of all cases in Guinea were linked to traditional burial practices.1 Several other commentaries have highlighted the need for culturally appropriate outreach, with some suggesting ways to better use the skills sets of anthropologists.2,3 Clearly there is a need to be giving more thought to leveraging the expertise of scientists whose work could strengthen our outbreak response but who are not traditionally involved in disease control and containment efforts. As with all infectious disease, the relationship between Ebola and culture is not neutral. Dangers posed by local funeral practices are one concern, but there are other elements of culture that play roles in helping or hindering the spread of disease. Understanding how myth, mistrust and magical thinking shape people’s explanatory models for disease is important, and helping to educate people through the use of their own local idioms is key.4 When it comes to understanding practices related to notions of purity and pollution, exchange of bodily fluids, the handling and consumption of particular plants and animals —all relevant to disease control and containment—anthropological insights can contribute to the development of well-tailored and maximally effective responses that go beyond the common authoritarian, didactic, and often ‘‘scolding’’ approaches of local health workers that do little to prompt longer-term change. Some ways in which anthropologists have contributed to disease control efforts, such as with HIV in Africa, included: Rapidly drawing upon existing ethnographic knowledge and generating rapid methods to collect needed sociocultural data.
Informing and monitoring the health education transfer process, including the local interpretation and application of new knowledge. Working with the traditional sector including faith leaders and healers to identify the boundaries of biosafety associated with cultural practices, and assisting with promotion of modifications that are both protective and culturally resonant. Tracking and reporting on the circulation of harmful myths, rumors and new practices and assessing their relevance for emerging public health threats. There remains a need to sharpen our cultural acuity as we face the future of emerging and re-emerging disease threats. It is time for anthropologists, long called upon to assist in the after-math of health intervention failures—mostly to help overcome perceived cultural obstacles to intervention success — to play a more central and integral role in disease response from the start. Achieving global health security will demand the full engagement of those who can provide the high-level sociocultural analytics and professional aptitude needed for the job. References 1. The Ebola crisis: Much worst to come. The Economist. Oct.18, 2014 (http:// www.economist.com/node/21625813/print) 2. Abramowitz, S. Ten things that anthropologists can do to fight the West African Ebola epidemic. Science, Medicine and Anthropology-Ebola Series, Sept.26, 2014 (somatosphere.net//ten-things-that-anthropologists-can-do-to-fight-theWest-African-Ebola-epidemic.html). 3. Faye, SL. How anthropologists help medics fight Ebola in Guinea. SciDev.Net. Sept. 24. 2014 (www.scidev.net/global/cooperation/feature/anthropologistsmedics-ebola-guinea.html). 4. Hewlett B, Hewlett B. Ebola, Culture and Politics: The Anthropology of an Emerging Disease. Belmont, CA: Thomson Wadsworth; 2008.
Suzanne M. Leclerc-Madlala Global Health Bureau, US Agency for International Development E-mail address: [email protected] (S.M. Leclerc-Madlala). Received 27 October 2014 Accepted 28 October 2014
http://dx.doi.org/10.1016/j.ijid.2014.10.012 1201-9712/ß 2014 The Author. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
Contents lists available at ScienceDirect
International Journal of Infectious Diseases journal homepage: www.elsevier.com/locate/ijid
Letter to the Editor Engaging anthropologists in a more systematic way would strengthen our global outbreak response To the editor A recent article in The Economist entitled ‘‘The Ebola crisis– Much worse to come’’ noted, among other things, that there was still much to be done through community engagement to reduce dangerous practices and make rituals safer, referring to a WHO study conducted six months into the epidemic that estimated 60% of all cases in Guinea were linked to traditional burial practices.1 Several other commentaries have highlighted the need for culturally appropriate outreach, with some suggesting ways to better use the skills sets of anthropologists.2,3 Clearly there is a need to be giving more thought to leveraging the expertise of scientists whose work could strengthen our outbreak response but who are not traditionally involved in disease control and containment efforts. As with all infectious disease, the relationship between Ebola and culture is not neutral. Dangers posed by local funeral practices are one concern, but there are other elements of culture that play roles in helping or hindering the spread of disease. Understanding how myth, mistrust and magical thinking shape people’s explanatory models for disease is important, and helping to educate people through the use of their own local idioms is key.4 When it comes to understanding practices related to notions of purity and pollution, exchange of bodily fluids, the handling and consumption of particular plants and animals —all relevant to disease control and containment—anthropological insights can contribute to the development of well-tailored and maximally effective responses that go beyond the common authoritarian, didactic, and often ‘‘scolding’’ approaches of local health workers that do little to prompt longer-term change. Some ways in which anthropologists have contributed to disease control efforts, such as with HIV in Africa, included: Rapidly drawing upon existing ethnographic knowledge and generating rapid methods to collect needed sociocultural data.
Informing and monitoring the health education transfer process, including the local interpretation and application of new knowledge. Working with the traditional sector including faith leaders and healers to identify the boundaries of biosafety associated with cultural practices, and assisting with promotion of modifications that are both protective and culturally resonant. Tracking and reporting on the circulation of harmful myths, rumors and new practices and assessing their relevance for emerging public health threats. There remains a need to sharpen our cultural acuity as we face the future of emerging and re-emerging disease threats. It is time for anthropologists, long called upon to assist in the after-math of health intervention failures—mostly to help overcome perceived cultural obstacles to intervention success — to play a more central and integral role in disease response from the start. Achieving global health security will demand the full engagement of those who can provide the high-level sociocultural analytics and professional aptitude needed for the job. References 1. The Ebola crisis: Much worst to come. The Economist. Oct.18, 2014 (http:// www.economist.com/node/21625813/print) 2. Abramowitz, S. Ten things that anthropologists can do to fight the West African Ebola epidemic. Science, Medicine and Anthropology-Ebola Series, Sept.26, 2014 (somatosphere.net//ten-things-that-anthropologists-can-do-to-fight-theWest-African-Ebola-epidemic.html). 3. Faye, SL. How anthropologists help medics fight Ebola in Guinea. SciDev.Net. Sept. 24. 2014 (www.scidev.net/global/cooperation/feature/anthropologistsmedics-ebola-guinea.html). 4. Hewlett B, Hewlett B. Ebola, Culture and Politics: The Anthropology of an Emerging Disease. Belmont, CA: Thomson Wadsworth; 2008.
Suzanne M. Leclerc-Madlala Global Health Bureau, US Agency for International Development E-mail address: [email protected] (S.M. Leclerc-Madlala). Received 27 October 2014 Accepted 28 October 2014
http://dx.doi.org/10.1016/j.ijid.2014.10.012 1201-9712/ß 2014 The Author. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
