#paulrichards

Theme Paper 3

This essay aims to analyze the commonly perceived dichotomy between science and culture in light of the Ebola epidemic of West Africa. Using Richards (2016) treatise on the role that a people’s science approach played in helping end the Ebola epidemic, I will try to discuss what a people’s science implies, how traditional, rigid definitions of science deter the cause of public health and why the science-culture binary is harmful.

A people’s science refers to scientific pursuits that concern the general public and thus demand their cooperation and participation. Epidemiology, by its very nature, is a people’s science as it demands the participation of the community, and fails to be effective without it.

This is similar to the idea of participatory development, where the people who are the beneficiaries of development projects participate in the decision-making process. Participatory development initiatives are ideally supposed to initiate at grassroots level and travel upwards to seek external help and expertise, unlike externally designed projects, which are oblivious to the on-ground reality, and are imposed by external actors (Hickey & Mohan, 2008). Like participatory projects, people-driven science may appear to be more time-consuming as it involve more stakeholders, each representing different perspectives, demands and desired outcomes, but the solutions derived from having all concerned parties onboard are more effective, sustainable and less likely to cause resentment and disobedience.

In the Ebola epidemic of West Africa, international responders tried to communicate the dangers of Ebola viruses to the community, and tried to impose a blanket ban on all personal and communal activities which had the potential of transmitting Ebola (such as funeral rites) and which were considered as useless and merely ritualistic. This only led to a backlash from the community which refused to comply with many of these strict regulations.

Richards (2016) explains that instead of viewing rituals as unnecessary behavior, they should be viewed as a society’s collective ‘techniques of the body’. Mauss (1973) explains that different human communities develop different sets of techniques as a result of their circumstances, such as their unique way of eating, bathing and sleeping. Different societies embody different techniques, which help them in the articulation and generation of their social and material life. These techniques are formed over, and passed down, many generations. For Mauss (1973), “technique (is) an action which is effective and traditional… there is no technique and no transmission in the absence of tradition”.

The Ebola-affected West African communities had their own pre-existing techniques which were necessary for their successful social organization. These also included some Ebola-transmitting techniques, such as the funeral rites of washing the body, preserving the grave cloth, and lowering the dead body into the ground. These rites had spiritual and social significance. For the afflicted communities, maintaining social balance and wellbeing was as important as maintaining physical health and wellbeing.

Richards (2016) shows us how body-washing was wrongfully regarded as a strange, illogical ritual instead of a practice that was common in most parts of the world and a normal extension of bathing the patient during their lifetime. Similarly, the social significance behind funerals was ignored. For West Africans, funerals are important occasions, where social matters such as debt and personal hatred are settled, which helps the community to function smoothly. Being ignorant of the importance of funerals in the community blinded the policy-makers and medical practitioners to an understanding of why there was such a strong a resistance to the ban on funerals.

The medical community treated these ritualistic practices as unnecessary, and saw no harm in proposing to discard them completely. On the other hand, it viewed nursing practices, which posed an equally great risk of transmission, as a necessary life-saving practice. Richards (2016) proposes that instead of viewing the former as exotic and impractical and the latter as important and practical, both the activities should have been viewed as techniques that could be modified to respond to present circumstances. Ignoring the importance of techniques and attempting to completely remove them is more damaging and impracticable than devising ways to modify those techniques in order to achieve the desired ends.

The spread of Ebola is a good example of why the purely scientific medical practices alone are not the answer to public health problems. In fact, one might even go so far as to say that some of the problems in the Ebola epidemic were elongated or solutions delayed by this very hardcore, mainstream version of medical science which considered only certified medical practitioners as capable of nursing the sick safely. Due to overemphasis on the “no homecare” policy, a gap continued to persist between theoretical and practical ways to address the problem of Ebola containment. In many cases, homecare was the only option because of the lack of medical services available to the community, but there was an absence of detailed guidelines on how to care for Ebola patients at home, which led to people devising their own methods. If brochures and other marketing material had recognized the lack of medical services and addressed this earlier on by increasing the content regarding the provision of home care, then there is a possibility that the epidemic could have been better managed.

This essay does not imply that cultural rituals and practices did not bar or slow down the efforts to eradicate Ebola from West Africa. It only shows that a more effective means to handle Ebola would have been to acknowledge the importance and relevance of cultural practices in order to encourage their modification and adaptation instead of neglecting them as obstacles to be overcome. It also shows that there were bigger obstacles than culture, such as the lack of healthcare facilities, but culture was pinpointed and criminalized. Instead of viewing culture as a force opposed to science, understanding the cultural context and identifying approaches to alter local techniques would have helped in ending the Ebola epidemic faster.

 Bibliography

Hickey, S., & Mohan, G. (2008). Participation, from tyranny to transformation? : Exploring new approaches to participation in development. London: Zed Books.

Mauss, M. (1973). Techniques of the body (B. Brewster, Trans.). Economy and Society, 2(1), 70-88.