Abstract
BackgroundConcern has been expressed over how well Africa is prepared to cope with the pandemic of Covid-19. Will rural populations with low levels of education know how to apply community-based infection control? We undertook fieldwork in two villages in central Sierra Leone to gain insight into how rural people faced with Covid-19 assess epidemic infection risks.MethodsTwo communities were selected based on prior contrasted exposure to Ebola Virus Disease–one with substantial number of cases and the other having resisted infection through strong community sequestration measures. We assessed understanding of infection risks via an experimental game. This asked players to express a preference for one of two diseases, one resembling Ebola with lower risk of infection and the other resembling Covid-19 with lower risk of death. Players were not told the identity of the diseases.ResultsIn total 107 adult villagers played the game (58% women). Half (52%) preferred the disease model with lower risk of infection, 29% preferred the model with lower risk of death, while 21% saw the combined risk of infection and death as being equivalent. Differences in reactions between the two locations were small despite different experiences of Ebola. Asked to explain their choices 48% of players cited information on infection risks modelled by the game and 31% stated that their choices reflected awareness of the need for personal action and respect for local regulations. We concluded that villagers thoughtfully assess disease risks and that some are good intuitive statisticians.ConclusionsResults suggest rural people in Sierra Leone retain the lessons of experience from the Ebola outbreak of 2014–15 and will be able to apply these lessons to a new infectious disease for which have no prior practical experience. Our expectation is that rural populations will understand Covid-19 control measures, thus reducing need for draconian enforcement.
Highlights
Concern has been expressed in media debate about the potential damage that could be caused by the spread of Covid-19 in Africa on account of weak health systems and lower levels of education
Two communities were selected based on prior contrasted exposure to Ebola Virus Disease–one with substantial number of cases and the other having resisted infection through strong community sequestration measures
Results suggest rural people in Sierra Leone retain the lessons of experience from the Ebola outbreak of 2014–15 and will be able to apply these lessons to a new infectious
Summary
Concern has been expressed in media debate about the potential damage that could be caused by the spread of Covid-19 in Africa on account of weak health systems and lower levels of education. To contribute to a better appreciation of these concerns this paper addresses the question of how well rural African populations understand and apply information relating to risks associated with infectious diseases. The data relate to rural populations in Sierra Leone exposed both to Ebola Virus Disease (EVD) in 2014–15 and to Covid-19 in 2020. Numerical ability among people without formal education has been the subject of some research enquiry by anthropologists and others. By and large these studies have demonstrated that alleged computational handicaps among non-literate populations were more apparent than real. We undertook fieldwork in two villages in central Sierra Leone to gain insight into how rural people faced with Covid-19 assess epidemic infection risks Will rural populations with low levels of education know how to apply community-based infection control? We undertook fieldwork in two villages in central Sierra Leone to gain insight into how rural people faced with Covid-19 assess epidemic infection risks
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