On May 24, 2014, a young woman arrived at the Kenema Government Hospital in Sierra Leone, seeking admission. She had miscarried her pregnancy and doctors feared that she might have Ebola, the contagious virus that can cause internal bleeding and killed 3 in 4 people who contracted it.
These and other policies triggered a massive outcry, deepened distrust, and increased people’s reluctance to seek treatment for Ebola. The situation grew so untenable that medical first responders turned to their social science colleagues in desperation. With social scientists’ input, first responders from outside came to see established traditions and values not as obstacles but as foundations for effective disease control. This revised outlook is now shaping the way medical teams around the world are tackling the COVID-19 pandemic.For the people of Sierra Leone, a majority Muslim country, cleaning and dressing the body of the deceased are integral to traditional burial and mourning practices.
Almost right away, officials inundated the fledgling platform with urgent questions. “We found ourselves advising the WHO,” Wilkinson recalls, “who were just completely overwhelmed and didn’t know what to do.” Over and over, people told Suluku’s team that they viewed health responders’ actions as disrespectful to them and their relatives. Their stories suggested people whisked away bodies and failed to report where the remains were located. People were upset that they could not bear witness to their loved ones’ last rites.
Public health teams were also shooing away grieving relatives so they could put the bodies into enclosed bags. When this happened, “the women cried while saying ‘bonakuya mukamata,’ which means ‘they’ve come to take it,’” Sibilondire says. “This was the source of a lot of tension.” With social scientists’ encouragement, medical first responders such as the WHO, the Red Cross, and UNICEF have adopted these recommendations, which, Wilkinson explains, helped families feel more respected and included in the process. “Burial is done by people’s loved ones, people that they know,” she says. “There’s rituals associated with the end of life.”
Distrust of these health officials naturally spurred speculation. Rumors began to fly that the centers’ stated function of treating people for Ebola was a scam—that the staff were harvesting patients’ body parts to make a profit.
Anthrofuentes F-yes they can! (Thoughtfully deployed, and eminently familiar with the communities they serve in, of course).