Lessons from the Ebola pandemic
Clarissa Ai Ling LeePublished: Nov 11, 2014 3:00 AM | Updated: Nov 11, 2014 3:14 AM
COMMENT When the Ebola Haemorrhagic Fever (to be known from now as the EHF) first broke out in West Africa in December 2013, the world was in slumber, blissfully unwary of a plague about to be unleashed upon them that would force the attention of international power brokers.
COMMENT When the Ebola Haemorrhagic Fever (to be known from now as the EHF) first broke out in West Africa in December 2013, the world was in slumber, blissfully unwary of a plague about to be unleashed upon them that would force the attention of international power brokers.
After all, before September 2014, as far as the world was concerned, it was just Africa, a continent that had borne and withstood the ordeal of multiple epidemics and pandemics of infectious diseases for centuries, and it was not the first time the EHF had struck its fatal blow.
Therefore, even if the World Health Organisation (WHO had been notified since March 2014, there was little discussion or interest on the outbreak until it was realised that the conditions of 21st century globalisation equals to more opportunities for the spread of infection beyond a specific geography, however much social and economic inequities make travel in and out of Africa difficult, such as to and from first world nations.
By October 2014, as global equity and commodity markets increase in volatility so as to create panic among investors, a different kind of panic is currently circulating as news broke out that the EHF has travelled to ‘greener pastures’. Moreover, one of the most updated Wikipedia pages is that on the EHF.
The EHF has an older history than AIDs, going as far back as the 1970s. However, it did not receive wide coverage in the mass media until recently. Moreover, the disease had an unfortunate association with poverty and low social status, so much so that it had never aroused much concern from the powers-that-be.
While medical journals had never stopped writing about the problems of the EHF in relation to the societies impacted by the disease, the discourse of the disease at this time has evolved into problems of a political, ecological, and economical rather than as a singular issue of medical science.
Even as interests on these meta-science issues remain mostly at the margins, and not much highlighted by the news providers, including the Malaysian media that receive most of their reports from foreign news agencies, anthropologists who have studied the issue of infectious disease from sociological and cultural perspectives have emerged to warn against taking on arrogant and positivistic attitudes when dealing with disease control and public health.
Such warnings are befitting of Malaysia’s own war against the dengue, especially now that its public health campaign is running parallel to the continuous news updates on the EHF.
It also means not behaving in a superior or condescending manner when collaborating with local communities that have different approaches to the same problem just because their beliefs do not commensurate with that of the ‘recognised’ scientific establishments, and to find ways to work with the communities from bottom up, instead of merely top down.
Even as the recent EHF outbreak reveals the hypocrisy, bigotry, and misplaced priorities of the world at large (and the fact that much of the news, especially from television, had focus on cases in the US, and 'suspected cases' outside of Africa), as well as their complicity in enabling the emergence of the disease through continuous neglect, the crisis is ripe for opening up conversations into the sociology of medicine, history of medicine, and medical anthropology.
Effect of the local communities
These different fields are able to critique and consider the practices of medicine that is itself a socially-embedded science; across different cultures and spectrum of privilege, as well as organisational and social hierarchies.
The mass media has largely focused on what the western medical doctors, especially Doctors Without Borders, are doing, but have done a minimal job in enlightening the public on the efforts of the local communities or even to dig deeper into the foibles of the proposed strategies beyond echoing urgings for more funds and contribution of labour (neither of which are bad, but neither of them are the panacea).
Further, without a more holistic grasp of the problem, the injection of funds (that many of the richer nations appear reluctant to part with) and expertise will find no real long-term solution.
Even as the big players in the media are busy with their fear-mongering, smaller alternative media outfits attempt to understand the problems and issues raised through this epidemic by looking outside the box of immediate contingencies.
For example, they interviewed western anthropologists such as Barry S Hewlett and Paul Farmer, both of whom had studied the problem for decades, and have collaborated with ‘experts’ from local communities, including with local researchers (though it is unfortunate that the names of their collaborators are not as prominent).
Both of them had also made recommendations on how to best confront the problem.
Science journalists such as David Quammen had also written a book on that topic a few years before the outbreak, and he has commented on the recent outbreak. Science, a reputable trade journal published by the American Association for the Advancement of Sciences, once dedicated its April 2000 issue to the history of infectious diseases, with much of the discussions not irrelevant to today’s context.
A quick search on the Internet (such as through Google scholar) would reveal that Ebola has been an ongoing, even if unglamorous, public health concern, and it does not appear that much long-standing research into the disease has made it into the headlines or media discussions.
Nevertheless, the wonderful thing about the growing ubiquity of social media is that one can more easily crowd-source for references and information, with my own favoured medium being Twitter. However, information and references do not mean much to the uninitiated if not put into context, or juxtaposed against a coherent narrative of events, histories, and possibilities.
More concentrated on admonishment
If one were to return to the aforementioned example of the campaign against the spread of dengue in Malaysia, the campaign appears more concentrated on admonishment/penalisation, rather than on the narration of the social and economic consequences of the dengue; nor is the information disseminated in a manner that compels the public to consider the gravity of the issue.
Therefore, it appears that the existing campaign has not succeeded in inculcating any long-term changes in the behaviour of the public, given that the problem has merely been expedited by the rise of slum-like conditions, poor sanitation, and population density.
If Malaysia could derive any small measure of lesson from the EHF crisis, it would be to rethink and restructure its own campaigns and public health education directives by also involving humanists and social scientists studying the conditions of scientific practice and the sociology of science in both the science communication and policy formation.
CLARISSA AI LING LEE is a recent PhD graduate from Duke University, specialising in science and technology studies and comparative media studies. She researches and writes on issues relating to science, history of science and technology, and science policy. She blogs at scandalousthoughts.wordpress.com
After all, before September 2014, as far as the world was concerned, it was just Africa, a continent that had borne and withstood the ordeal of multiple epidemics and pandemics of infectious diseases for centuries, and it was not the first time the EHF had struck its fatal blow.
Therefore, even if the World Health Organisation (WHO had been notified since March 2014, there was little discussion or interest on the outbreak until it was realised that the conditions of 21st century globalisation equals to more opportunities for the spread of infection beyond a specific geography, however much social and economic inequities make travel in and out of Africa difficult, such as to and from first world nations.
By October 2014, as global equity and commodity markets increase in volatility so as to create panic among investors, a different kind of panic is currently circulating as news broke out that the EHF has travelled to ‘greener pastures’. Moreover, one of the most updated Wikipedia pages is that on the EHF.
The EHF has an older history than AIDs, going as far back as the 1970s. However, it did not receive wide coverage in the mass media until recently. Moreover, the disease had an unfortunate association with poverty and low social status, so much so that it had never aroused much concern from the powers-that-be. While medical journals had never stopped writing about the problems of the EHF in relation to the societies impacted by the disease, the discourse of the disease at this time has evolved into problems of a political, ecological, and economical rather than as a singular issue of medical science.
Even as interests on these meta-science issues remain mostly at the margins, and not much highlighted by the news providers, including the Malaysian media that receive most of their reports from foreign news agencies, anthropologists who have studied the issue of infectious disease from sociological and cultural perspectives have emerged to warn against taking on arrogant and positivistic attitudes when dealing with disease control and public health.
Such warnings are befitting of Malaysia’s own war against the dengue, especially now that its public health campaign is running parallel to the continuous news updates on the EHF.
It also means not behaving in a superior or condescending manner when collaborating with local communities that have different approaches to the same problem just because their beliefs do not commensurate with that of the ‘recognised’ scientific establishments, and to find ways to work with the communities from bottom up, instead of merely top down.
Even as the recent EHF outbreak reveals the hypocrisy, bigotry, and misplaced priorities of the world at large (and the fact that much of the news, especially from television, had focus on cases in the US, and 'suspected cases' outside of Africa), as well as their complicity in enabling the emergence of the disease through continuous neglect, the crisis is ripe for opening up conversations into the sociology of medicine, history of medicine, and medical anthropology.
Effect of the local communities
These different fields are able to critique and consider the practices of medicine that is itself a socially-embedded science; across different cultures and spectrum of privilege, as well as organisational and social hierarchies.
The mass media has largely focused on what the western medical doctors, especially Doctors Without Borders, are doing, but have done a minimal job in enlightening the public on the efforts of the local communities or even to dig deeper into the foibles of the proposed strategies beyond echoing urgings for more funds and contribution of labour (neither of which are bad, but neither of them are the panacea).
Further, without a more holistic grasp of the problem, the injection of funds (that many of the richer nations appear reluctant to part with) and expertise will find no real long-term solution.
Even as the big players in the media are busy with their fear-mongering, smaller alternative media outfits attempt to understand the problems and issues raised through this epidemic by looking outside the box of immediate contingencies.
For example, they interviewed western anthropologists such as Barry S Hewlett and Paul Farmer, both of whom had studied the problem for decades, and have collaborated with ‘experts’ from local communities, including with local researchers (though it is unfortunate that the names of their collaborators are not as prominent).
Both of them had also made recommendations on how to best confront the problem.
Science journalists such as David Quammen had also written a book on that topic a few years before the outbreak, and he has commented on the recent outbreak. Science, a reputable trade journal published by the American Association for the Advancement of Sciences, once dedicated its April 2000 issue to the history of infectious diseases, with much of the discussions not irrelevant to today’s context.
A quick search on the Internet (such as through Google scholar) would reveal that Ebola has been an ongoing, even if unglamorous, public health concern, and it does not appear that much long-standing research into the disease has made it into the headlines or media discussions.
Nevertheless, the wonderful thing about the growing ubiquity of social media is that one can more easily crowd-source for references and information, with my own favoured medium being Twitter. However, information and references do not mean much to the uninitiated if not put into context, or juxtaposed against a coherent narrative of events, histories, and possibilities.
More concentrated on admonishment
If one were to return to the aforementioned example of the campaign against the spread of dengue in Malaysia, the campaign appears more concentrated on admonishment/penalisation, rather than on the narration of the social and economic consequences of the dengue; nor is the information disseminated in a manner that compels the public to consider the gravity of the issue.
Therefore, it appears that the existing campaign has not succeeded in inculcating any long-term changes in the behaviour of the public, given that the problem has merely been expedited by the rise of slum-like conditions, poor sanitation, and population density.
If Malaysia could derive any small measure of lesson from the EHF crisis, it would be to rethink and restructure its own campaigns and public health education directives by also involving humanists and social scientists studying the conditions of scientific practice and the sociology of science in both the science communication and policy formation.
CLARISSA AI LING LEE is a recent PhD graduate from Duke University, specialising in science and technology studies and comparative media studies. She researches and writes on issues relating to science, history of science and technology, and science policy. She blogs at scandalousthoughts.wordpress.com
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