Ebola: How a People's Science Helped End an Epidemic by Paul Richards (review)

At a guest lecture given at Rutgers University in 2003, renowned anthropologist Tania Li made the point that she had not gone to the field seeking to write about violence in Southeast Asia. Instead, violence found her already in the field and demanded her response as an anthropologist.

Paul Richards found himself in a similar position in 2014 when Ebola virus came to Sierra Leone. With over 40 years of research and life experience in Sierra Leone, and extensive personal and professional connections between Sierra Leonean and UK universities, governments, and communities, Richards and his colleagues found themselves at the center of a firestorm of debates over how to lead a response to the West African Ebola epidemic. To respond to the Ebola epidemic, Richards drew upon his 40 years of life and fieldwork in Sierra Leone to craft this memorable, approachable, and accessible guide to the grassroots experience of Ebola outbreak and response. The book itself is divided into six chapters with an appendix that is not to be ignored. zed Books commissioned Ebola: How a People's Science Helped End an Epidemic to give anthropologists a platform to analyze the West Africa Ebola epidemic and its international response with an anthropological orientation towards community-based experiences, population health, sociocultural factors, and international and local capabilities and limitations. This work is distinct in the growing oeuvre of Ebola anthropology and Ebola epidemiology for its qualitative attention to rural communities' knowledge, experiences, beliefs, and practices.

In the introduction and Chapter 1, "The World's First Ebola Epidemic," Richards sets forth the context of the Ebola outbreak, and offers a classical anthropological framing for understanding the axis of mutual misunderstanding and miscomprehension that failed both the clinical and epidemiological responses, and local communities in the early onset of the outbreak. He asserts that any understanding of the grassroots experience of Ebola requires consideration of both global scientific and local sociocultural and moral priorities. Richards calls on the international community to recognize the existence of a "people's science"—the capacity of local communities to engage in systematic, rational, grassroots-informed analyses of disease risk, disease prevention, and disease response—that he believes was evident throughout the West Africa region.

Chapter 2, "The Epidemic's Rise and Decline," traces the social, cultural, geographic, and political histories of the Mano River region, and uses historical evidence to challenge key epidemiological assumptions about population movement, transmission, local ecologies, and association with zoonotic risks. He summarizes key sociodemographic drivers of the epidemic like urban and rural community composition, gender, and age; and highlights the insufficiently attended to roles that the lack of access to information and transportation played in starting and sustaining micro-epidemic outbreaks. Notably, Richards—like many anthropologists (American Anthropological Association 2014)—breaks with conventional human rights and humanitarian discourse to argue in favor of controls on mobility like quarantines, road blocks, and close surveillance of the arrival and departure of strangers in local communities.

In the third through fifth chapters, Richards dives into the qualitative data from his field-based research across Sierra Leone at the height of the epidemic. In addition to setting forth the practical, humane, and responsible ways in which Sierra Leone communities responded to the Ebola outbreak in their localities, these chapters continue to advance a set of anthropological theories that are based heavily upon Durkheim and Mauss's theories of the body, bodily techniques, and practice. These chapters focus somewhat disproportionately on caregiving, mobility and transportation, and burials, to the detriment of other factors, like nosocomial infection, transmission, the introduction of clinical trials, and social mobilization. The book is not harmed by this prioritization of topics—the topics he chooses to address are precisely those that were addressed either inexpertly or quite late in the epidemic in the epidemiological literature. As a fellow admirer of Durkheim, Mauss, and Mary Douglas, I welcomed Richards's rejection of efforts to posit culture as playing a "causative" role, and...