Contesting the (Super)Natural Origins of Ebola in Macenta, Guinea: Biomedical and Popular Approaches
In December 2013, a two-year-old child died from viral haemorrhagic fever in Méliandou village in the South-East of Guinea, and constituted the likely index case of a major epidemic. When the virus was formally identified as Ebola, epidemiologists started to investigate the chains of transmission, while local people were trying to make sense out of these deaths. The epidemic control measures taken by national and international health agencies were soon faced by strong reluctance and a sometimes aggressive attitude of the affected communities. Based on ethnographic work in Macenta (Forest region) in the autumn of 2014 for the Global Outbreak and Alert Response Network (GOARN) of the World Health Organization, this chapter shows that while epidemiologists involved in the outbreak response attributed the first Ebola deaths in the Forest region to the transmission of a virus from an unknown animal reservoir, local citizens believed these deaths were caused by the breach of a taboo. Epidemiological and popular explanations, mainly evolving in parallel, but sometimes overlapping, were driven by different explanatory models: a biomedical model embodying nature in the guise of an animal disease reservoir, which in turn poses as threat to humanity, and a traditional-religious model wherein nature and culture are not dichotomized. The chapter will argue that epidemic responses must be flexible and need to systematically document popular discourse(s), rumours, codes, practices, knowledge and opinions related to the outbreak event. This precious information must be used not only to shape and adapt control interventions and health promotion messages, but also to trace the complex biosocial dynamics of such zoonotic disease beyond the usual narrow focus on wild animals as the sources of infection.
I would like to thank Tenin Traoré, a Guinean sociologist and consultant to WHO, and Joseph Kovoïgui, assistant coordinator of the Philafrican Mission and then consultant to WHO, for their commitment and engagement in the fight against Ebola, their generosity, their knowledge, their experience and our fruitful collaboration in many respects. I would also like to thank the coordination team and the DPS (Prefectural Health Direction) of Macenta for their welcome and sincere attention; GOARN/WHO, Antwerp Institute of Tropical Medicine, and in particular Prof. Marleen Boelaert for emotional, financial and logistical support; Dr. Alain Epelboin for field preparation and numerous sharing with the Francophone Anthropological Platform; and Christos Lynteris for his invitation to connect and exchange with the Anglophone ‘Anthro-Zoonoses’ network and contribute to this timely collection.