A new must-read site on Ebola and capacity building in Liberia

I don’t know who’s behind the site Codex Lector, but they’re writing about the Ebola response in Liberia through the lens of critical anthropology, and it’s fascinating.  Here are two posts on the World Bank’s descriptions of “traditional” healthcare practices:

[First post] The World Health Organization has a post about why the Ebola outbreak centered in Guinea, Liberia, and Sierra Leone has been so devastating that uses a fairly standard term for one of the aggravating factors of the epidemic in a section titled “Reliance on Traditional Healers”:

Traditional medicine has a long history in Africa. Even prior to the outbreaks, poor access to government-run health facilities made care by traditional healers or self-medication through pharmacies the preferred health care option for many, especially the poor.

Some day, I should like to go back to the United States, and tell someone who took the Hippocratic oath, and is proud of her storied alma mater, that it is so nice that she practices non-traditional medicine, lacking in a long history. In this dream, she would also be blessed that none of her patients ever go to a pharmacy to purchase medications over the counter when they feel ill.

[Second post] … Sometimes the World Health Organization post about the aggravation of Ebola risk is not performative, but rather just silly, as when it says, “The traditional custom of returning, often over long distances, to a native village to die and be buried near ancestors is another dimension of population movement that carries an especially high transmission risk.”

Considering how normal going home when you get sick, or have a terminal illness, is in Europe and the United States, I do not imagine it would have terribly harmed the WHO to have not referred to the practice as a “traditional custom” peculiar to West Africa.

This post on the challenges of carrying out a census in rural towns served by bad roads will be familiar to anyone who’s done quantitative data collection in a low-income place.  However, there’s also a novel point here about how “there are fewer lower limits on the size of settlements” in places without schools or clinics, as it suggests that the type of practices used to manage population density in the precolonial era are still in use today.

I’ve spent much of the last two weeks poring over government and NGO tables and maps of settlements in southern Liberia, and having discussions about the same.  …  Part of the issue is that much of rural Liberia is fantastically difficult to survey, with the result that well-meaning statisticians and demographers do their counting in places that are easy to count, and presume that places that are hard to count are rather like them. In other cases, tables include data only from parts of the country where the ministry doing the counting has an office, or has an employee. …  [In addition,] when it is the case that schools, roads, clinics, and so forth are not available for long periods of time (or that their presence is actually a risk factor for violence, as it might be in a civil war), there are fewer lower limits on the size of settlements, and thus great profusion of places that may or may not be counted in a particular tally.

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