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How fear and mistrust in West Africa makes Ebola spread faster

A Liberian health worker dressed in an anti-contamination suit and a boy at a hospital in Monrovia, Liberia.
A Liberian health worker dressed in an anti-contamination suit and a boy at a hospital in Monrovia, Liberia.
John Moore/Getty Images

Understanding local beliefs and customs is an essential part of any disaster relief effort, and anthropologists have been dispatched to West Africa to study the interplay between the disease and human culture in the Ebola epidemic.

Vox spoke to Almudena Mari Saez, an anthropologist and researcher with Charité-Berlin who has been working in Guinea, following hunters to figure out how the virus works its way into humans from animals. She arrived in Gueckedou — a remote, rain forest region on the border with Sierra Leone and Liberia, where the outbreak started — three weeks after an international epidemic was declared in March.

Here's what she had to say about how Guinean customs and fears perpetuated Ebola and how the social fabric in the country has been torn apart by the virus.

Julia Belluz: In the news here, we've been hearing that eating "bush meat" is very dangerous for people and potentially the cause of this epidemic. Can you tell me what you found?

Almudena Mari Saez: While I was there, I was talking with the hunters and the family of the hunters to know which animals they are killing, who is killing them, how they are killing, then who is involved in the cooking process or in the selling process. To find out, I was interviewing people and following them.

Most of the time, people go hunting once a month or twice a month, depending on the size of the animal. Bush meat can be anything: small rodents, bats, monkeys. They smoke the animals over fire, and then cook them in soup.

So the problem is not eating the bush meat. The virus will die, it can't survive [during cooking]. The problem is handling the animal, because Ebola is transmitted by the bodily fluid of the animal. So the problem is the person who touches the blood, or if the animal is still alive and the animal pees in your hands, and you touch your eyes and touch your mouth. This is the way the virus can come into your body.

JB: One disquieting feature of this epidemic is that so many health workers have been harassed or even killed while caring for the sick or trying to spread public-health messages about Ebola. What's going on?

AMS: People need to empathize with this population. Someone in a village said this to me: "Imagine you are in your house and then 10 foreigners come into your village and then start saying to you, 'There is a new virus, there is a new disease. The disease has these symptoms. To be protected you need to not touch the person who is sick.' What should you do?"

At this moment, people are afraid. There were rumors that Ebola was being spread by westerners. There were moments that were very difficult. You're in the village and one car arrives with a death, and the village starts moving, with all the conspiracy theories and rumors. You are trying to explain something crucial and then there is all this mistrust, and you can do nothing.

JB: As an anthropologist, your work depends on you being able to build trust with people. How did you do that in this environment?

AMS: In these circumstances, you don't have the time. You can't touch anyone. Because you are at risk, because you don't know if they have cases of Ebola in the village. Sometimes the only thing you can use as a tool to make people confident with you is use your eyes, your voice, the way you to talk.

JB: It's very sad that Ebola can rip apart the social fabric of communities, that people can't touch each other or even express their affection for sick and dying family members. What were people saying about that?

AMS: In Guinea people were telling me that when someone dies they want to express the love they had for that person. When someone dies, they will touch the person, cry, hug the dead body to express how much they love this person. Then they clean and dress the body with new clothes. Then they bury the body. And then there are special rituals.

But now burials are one of the principal modes of transmission of Ebola. So the social relationships are broken. You are afraid of everyone because you are not sure who has been infected. There is an atmosphere of mistrust, and you don't know from where this disease is coming. You don't trust the NGOs, the health workers. There is a big mistrust in  human relationships.

This transcript has been edited for length and clarity.

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