Early media narratives about the West African Ebola epidemic concentrated heavily on bushmeat and the so-called ‘dangerous’ burial beliefs and practices of Africans. Anthropologists, on the other hand, questioned many of these normative assumptions, and their contribution to the international response (as interlocutors, mediators and collaborators) has been widely recognised.
With some 40 years experience living, working and writing about the Mano River Region, Paul Richards’ manuscript provides a succinct, erudite and important contribution to this debate. Interweaving social theory with empirical research in Sierra Leone conducted at the height of the epidemic, Richards’ argument focuses on the need for epidemic response to understand what he calls the ‘techniques of the body’. As a disease of social intimacy, Ebola challenged long-established social meanings associated with the rites, customs and techniques of nursing the sick and burying the dead. These were not ‘backward cultural’ beliefs, impregnable to empirical observation; rather, once people were provided with necessary information, improvisation and common sense drove social learning and risk reduction. As an example, Richards describes the use of local bylaws, contact tracing methods and new socially acceptable burial techniques enacted by chiefs and burial societies (p. 126).
Promoting a ‘people's science’ of Ebola epidemiology, as Richards maintains, recognises the need for bio-professional response strategies and local knowledge, logics and social worlds to co-evolve. In this sense, the author picks up on his seminal book Indigenous Agricultural Revolution, published in 1985, in which he argued that African farmers often know more about their own environment than the crop scientists trying to help them. With Ebola, both scientists and communities were learning on-the-run, in a time of great uncertainty and fear, and it was this need for a co-production of epidemiological knowledge and practice that Richards aims to highlight.
The international response was far from perfect, with a strong emphasis on professional knowledge, biosecurity and Ebola Treatment Units (ETUs). To use Mark Hobart's terminology: there was a cultivation of ignorance by international responders about how local populations were adapting to the virus. Two examples stand out in the book. First, the neglect of home nursing, despite its widespread practice and the difficulties encountered in moving patients with ‘wet’ stage symptoms. A second was the strong focus on centrally organised burial teams, in comparison to working through existing community-based groups.
The various examples provided, together with the epidemic data, provokes the question: should the money spent on constructing expensive, centrally located ETUs have been better used in supporting a people's science? Answering this question will be essential to thinking about how best to respond to the next emerging disease pandemic. In this sense, the book is timely, and will likely stand out for its succinctness and accessibility for a general readership.
As scholars, practitioners and policymakers continue to discuss how Ebola is changing the contours of the debate, we now need to get past the rhetoric about the inclusion of social science expertise and community engagement in epidemic response. As Richards maintains, we need to start the hard work of ensuring that a ‘people's science’ can be better supported in the future.
