Rather than formal health systems, it was local ingenuity that was crucial in ending the recent Ebola epidemic in West Africa. The disease was unprecedented. It was unknown in the region until December 2013. And yet the Ebola epidemic was overcome in a matter of months, and a large part was played by local responses based on observation and common sense.
When the epidemic struck, formal medical systems in West Africa were weak and unable to cope with the new challenge. But these formal systems were beside the point as far as Ebola prevention was concerned. What actually ended the epidemic was the introduction of new and safer ways of handling the sick and dead.
Since Ebola is only spread by contact with body fluids, burials were a particular point of danger in West Africa where the culture dictates corpse washing and other procedures to prepare the body carefully for its last journey. But communities came to see quickly that a “no touching” rule had to be applied in Ebola cases to prevent further infections. There are all kinds of stories that have been collected about improvised safe body handling techniques using strong black plastic garbage liners, as well as hammocks to transport the bodies. Paul Richards calls this “citizen science”. It worked!
Paul Richards is the author of the upcoming book Ebola: How a People’s Science Helped End an Epidemic (African Arguments, Zed Books). He is an adjunct professor at Njala University, Sierra Leone.