Historical Parallels, Ebola Virus Disease and Cholera: Understanding Community Distrust and Social Violence with Epidemics

PLoS Curr. 2016 Jan 26;8:ecurrents.outbreaks.aa1f2b60e8d43939b43fbd93e1a63a94. doi: 10.1371/currents.outbreaks.aa1f2b60e8d43939b43fbd93e1a63a94.


In the three West African countries most affected by the recent Ebola virus disease (EVD) outbreak, resistance to public health measures contributed to the startling speed and persistence of this epidemic in the region. But how do we explain this resistance, and how have people in these communities understood their actions? By comparing these recent events to historical precedents during Cholera outbreaks in Europe in the 19th century we show that these events have not been new to history or unique to Africa. Community resistance must be analysed in context and go beyond simple single-variable determinants. Knowledge and respect of the cultures and beliefs of the afflicted is essential for dealing with threatening disease outbreaks and their potential social violence.

Keywords: cholera; community engagement; ebola; resistance; violence.

Grant support

SC is funded by a 'Major Research Fellowship' from the Leverhulme Trust, from 1 September 2014 to 31 August 2017, MRF-2013-068; www.leverhulme.ac.uk. Both authors would like to acknowledge the funding of The Rockefeller Foundation for the conference “Fear of the Foreign: Pandemics and Xenophobia”, Bellagio Center, Italy, June 24, 2015, in which both authors were invited to participate. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.