The Ebola Crisis in Sierra Leone: Mediating Containment and Engagement in Humanitarian Emergencies

Luisa Enria

doi:10.1111/dech.12538

Abstract

ABSTRACTThis article explores how framings of the 2014–16 outbreak of Ebola as a crisis, its causes, nature and consequences gave rise to two seemingly contradictory types of interventions within affected communities in Sierra Leone: a militarized state of emergency on the one hand, and efforts to foster local engagement and ownership on the other. Teasing out explicitly the underlying logic of these two modes of response, we are able to discern the convergence between containment and engagement approaches that are at the heart of contemporary humanitarianism. Rather than being opposed or contradictory, the article shows how they were mutually constitutive, through negotiations between different ways of knowing and responding to the Ebola crisis. The resulting divisive practices, juxtaposing ‘Ebola heroes’ and ‘dangerous bodies’, re‐ordered the landscapes that individuals had to navigate in order to manage uncertainty. Tracing these logics through to the ‘subjects’ of intervention, the article tells the story of one traditional healer's ‘epistemic navigations’ in his efforts to survive both the epidemic and its response. Bringing these dynamics and their consequences to the fore in the Sierra Leonean case invites broader reflections on a humanitarian assemblage increasingly reliant on the mutual constitution of containment and engagement, security and resilience, in its approach to managing ‘at risk’ populations.

Highlights

In March 2014, the first official cases of Ebola were recorded in Guinea
By the end of the epidemic in March 2016, over 28,000 people had been affected by the disease: 11,310 died and countless others suffered as a result of the significant socio-economic setbacks associated with the outbreak (WHO, 2016)
The tortuous two-year battle that seemingly caught the world off guard gave rise to innumerable analyses (e.g. Abramowitz, 2017; DuBois et al, 2015; GHRF Commission, 2016; Kamradt-Scott, 2016; Panel of Independent Experts, 2015; Moon et al, 2015; Ross et al, 2017). These have in turn generated recommendations for the reform of national health systems and global response mechanisms, pointing to failures at all levels during the West African outbreak: from systemic underfunding of the global health apparatus, slow resource mobilization and inadequate leadership on the part of World Health Organization (WHO), to disastrously ill-prepared national health systems and ineffective engagement of affected communities

Summary

Introduction

By August of that year, the World Health Organization (WHO) had announced a Public Health Emergency of International Concern (PHEIC) as the epidemic reached hundreds of cases a week in Liberia, Guinea and Sierra Leone. Abramowitz, 2017; DuBois et al, 2015; GHRF Commission, 2016; Kamradt-Scott, 2016; Panel of Independent Experts, 2015; Moon et al, 2015; Ross et al, 2017) These have in turn generated recommendations for the reform of national health systems and global response mechanisms, pointing to failures at all levels during the West African outbreak: from systemic underfunding of the global health apparatus, slow resource mobilization and inadequate leadership on the part of WHO, to disastrously ill-prepared national health systems and ineffective engagement of affected communities. Retracing that road entails telling the story of how scientific and humanitarian communities, as well as national and international publics, came to understand the kind of problem emerging in West Africa, including disputes and shifts in Ebola’s meaning and adequate avenues for response

Objectives

Conclusion