Abstract
This chapter offers a summary account of the Ebola epidemic in Sierra Leone 2014–2015, paying particular attention to local level response. The role of social and cultural factors in both supporting and hindering medical response to the disease is discussed. Local public authority was important in determining the success of response efforts. A lesson for pandemic preparedness is that responders should focus on improving coordination at the local level. In some cases, this required local conflict resolution. An example is given where unaddressed community conflicts complicated epidemic management. Ebola, however, is a readily legible disease; local communities quickly understood how infection spread. A comparison with COVID-19 shows that infection patterns are much harder to read with the SARS Cov-2 virus. In this case, public trust will be a decisive issue.
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Notes
- 1.
Eventual CFR was as low as 23%, a figure achieved at Kerry Town ETC late on in the epidemic (Haaskjold et al., 2016).
- 2.
The success of ERAP has been generalized to cover epidemic and pandemic disease threats, along with health and other emergencies, in a similar platform and network model known as the Social Science in Humanitarian Action Platform (SSHAP, www.socialscienceinaction.org).
- 3.
Election is a pre-colonial practice (Alldridge, 1901, p. 245).
- 4.
In a workshop at Njala in 2015, a women’s society elder from Jawei chiefdom asked for a PPE “moonsuit.” Her plan was to construct a “dancing devil” to teach children how it protected the wearer from infection.
- 5.
Experience of the COVID-19 pandemic (not least in the United States, approaching a bitterly divisive presidential election in 2019) makes it clear that political factionalism has a major influence over whether people believe messages about infection threats or accept the need for measures such as quarantine and vaccination. It should also be added that the Norwegian-assisted ETC was a replacement for a notorious case handling facility in Moyamba with very poor survival rates (Richards et al., 2020). It is unclear if these disaffected villages saw the two Ebola treatment facilities as distinct.
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Acknowledgments
This chapter draws data from two research projects. Financial support for the Ebola Gbalo project and PPP (Pandemic Preparedness research project) is gratefully acknowledged from the UK Medical Research Council and the Wellcome Trust. Ebola Gbalo: MRC Grant MR/N015754/—title: Building resilient health systems: lessons from international, national and local emergency responses to the Ebola epidemic in Sierra Leone. PPP: Wellcome Trust (212536/Z/18/Z) Collaborative Award, Pandemic preparedness: local and global concepts and practices in tackling disease threats in Africa.
The authors would also like to thank Musa Kallon, Paramount Chief of Jawei Chiefdom, and Fayia Sundifu Brima Sovula IV, Paramount Chief of Kamajei Chiefdom, for the information provided.
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Babawo, L.S., Kamara, F.M., Mokuwa, E.Y., Mokuwa, G.A., Nyakoi, M.BM., Richards, P. (2022). Ebola in Sierra Leone: Leveraging Community Assets to Strengthen Preparedness and Response. In: Manoncourt, E., Obregon, R., Chitnis, K. (eds) Communication and Community Engagement in Disease Outbreaks. Springer, Cham. https://doi.org/10.1007/978-3-030-92296-2_6
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