Sociocultural dimensions of the ebola virus disease outbreak in Liberia.

Abstract

S ince December 2013, an outbreak of Ebola virus disease in the West African nation of Guinea has rapidly evolved into a humanitarian crisis of unforeseen proportions, overwhelming vulnerable communities in Liberia, Sierra Leone, Nigeria, and Senegal. While previous outbreaks of Ebola cumulatively resulted in 2,486 cases and 1,590 deaths, the current Ebola epidemic has so far resulted in 8,376 infections and claimed 4,024 lives (as of October 10, 2014), prompting the World Health Organization (WHO) to designate it as a public health emergency of international concern. Officials from the US Centers for Disease Control and Prevention (CDC) estimate that, in the absence of public health interventions, Liberia and Sierra Leone could experience as many as 550,000 cases (or 1.4 million after correcting for underreporting) by January 2015. Few research initiatives thus far have analyzed the community dynamics of Ebola outbreaks. Similarly, current relief efforts have not focused on ways to address the social and cultural factors shaping West Africans’ perceptions of and responses to Ebola or their perceptions of the international community’s efforts to mitigate the epidemic. To date, surveillance and infection control measures have failed to stop the outbreak, prompting WHO to call for greater community engagement efforts to enhance ongoing relief activities. This article examines some of the social and cultural factors at play in the Ebola outbreak in Liberia and suggests the type of sociocultural investigation that has been largely absent in attempts to thwart the Ebola threat. WHO assessments show that Liberia has borne the brunt of the current outbreak, having reported the most cases (more than 3,000) and deaths (nearly 2,000), as well as the highest case-fatality rate (70.8%). Some of the practices and social norms shaping the trajectory of the Liberian outbreak include funeral rituals, disparate gender roles, and the stigma faced by those who contract Ebola.