Ebola in Liberia: The Intersection of Culture, Care, and Infectious Disease

Abstract This interdisciplinary dissertation in Social Work and Anthropology focuses on the intersection of culture, care, infectious disease—specifically, the ebola virus disease—and mortuary practices in Liberia. In particular, I explore the effects of the 2013 to 2015 ebola pandemic on the everyday life of Kissi communities in West Point, an “unplanned settlement” in the capital city of Monrovia, Montserrado County, and in the rural settings of Barkedu and Foya in Lofa County. My project seeks to understand the dynamic and multi-level harm and consequences of ebola on residents’ health, familial, and communal lives in both counties. I chose to work among Kissi, an indigenous ethnic group domiciled in rural border towns of Guinea, Sierra Leone, and Liberia, for several reasons. Barkedu, a Kissi village, was an early hotspot of the pandemic; West Point, a majority Kissi neighborhood in Monrovia, was the epicenter in Montserrado; and Foya, a Kissi town, became the epicenter of ebola in Liberia. Hence, Kissi communities were blamed for the spread of the disease on account of their multi-stage mortuary practices. In response to political pressure and public health concerns, culturally significant death rituals involving burials were suspended to allow for mass cremations. This study is driven by my interest in documenting the many ways in which families navigated, responded to, and survived the complex care arrangements necessitated by both a highly lethal disease and official crisis management. It also underscores the remarkable resilience and adaptability of Kissi communities in the face of such a devastating crisis, inspiring us with their strength. A multi-sited, qualitative study, this doctoral project employs rigorous ethnographic methods spanning over six years of fieldwork to understand how Kissi in multiple locations think about social relatedness, care, death, dying, and burials in post-ebola times. My overarching goal is to understand what the interruption of “from cradle to death” care during the outbreak has meant to people in the communities I visited. A multi-sited approach allowed space for comparisons between urban and rural experiences of ebola transmission and disease management. Highlighting the impact of ebola on marginalized Kissi communities shifts the focus from victim-blaming to poverty, disease, and the structural factors that create inequalities in the distribution of access to healthcare. This study demonstrates why, in social work, it is vital to employ ethnographic methods when examining public health crises and other humanitarian emergencies. Doing this helps us to better understand people’s experiences of the disease during and post-pandemic. Anthropologically, my research furthers the argument that kinship elements—including, houses, substances, genealogies, and cosmologies about death and the afterlife—are not simply unifying, sustaining, and protective of groups but also can cause tension, conflicts, and divisions. However, these have a way of self-resolving. While cultural practices may have contributed to infection transmission, the ebola pandemic in Liberia was largely the result of prevailing structural problems of poverty, inadequate health and social infrastructure, and a top-down approach to care during an unprecedented medical emergency.