Since this last spring Ebola has generated so much suffering and fear, and I appreciate the opportunity to reflect on ways to understand Ebola and disease from a social and historical perspective.
A few weeks ago I read a piece on the Ebola outbreak with the headline “Maine doesn’t matter, Mali does” that covered how the threat of Ebola still isn’t really much of a threat in the States (and in fact for the moment the US is free from Ebola), but continues to be such a danger across West Africa.
To begin understanding how Ebola and contagious infections are more easily transmitted in West Africa, we have to consider the making of African cities – of course, Africans have long been members of global trade networks that pre-date European colonization and living in towns was often a part of this.
But, all in all, pre-colonial Africans had mechanisms in place to prevent illnesses from becoming epidemics. For example, people spread themselves out to limit transmissions. So if one group is exposed to mosquitoes that transmit malaria, it won’t take out a whole population and minimized the spread of contagious diseases. But the building of colonial cities, very ruthlessly some cases, changed preexisting settlement patterns that Africans had used to ensure their health and longevity.
As colonization and urbanization grew across the continent, segregation became the standard. This was a tricky attitude for European settlers to maintain, as colonization called for labor – so we see Africans move into growing urban environments and live in deplorable conditions and sectioned off neighborhoods and naturally have a hard time maintaining their health both because sanitation in these slums is so terrible and they also have limited access to either traditional medicines (where one generally needs to be in rural areas to have access to good medicines and specialists) or Western health care clinics in the cities (because most are priced out of these services). So living in urban areas has come too often to mean you had limited to no access to any kind of health care.
This problem of controlling and treating contagious diseases starts in colonial era, but remains today. To illustrate, even with all the attention and money pledged for Ebola treatment and prevention (governments., international organizations, private donors like Paul Allen publically pledging $100 million to fight Ebola) in Conakry the capital of Guinea (the where this 2014 outbreak originated) as of Nov. 12 there’s only one treatment center for Ebola patients with just 85 beds.
To further understand issues of health care in Sub-Saharan Africa, we have to also consider the ways that Africa has been underdeveloped in the world system. In African Studies there’s discourse around Africa being treated as a factor rather an actor. That is to say that Africa has long been a factor in international relations, in that the continent holds so many resources, but Africans have been largely kept as marginal actors. There’s a standard wherein Africans are valued for their resources and labor, but that Africans ought to leave the technological advancements and innovations to the outside world, and that Africans should mine diamonds and gold, grow food, raise livestock, work in rubber plantations and oil fields, and so forth. So often there becomes an overall valuing of Africans for menial labor, not for their potential to help address the problems that threaten them, like Ebola.
Moving forward, it’s necessary to confront the ways that focusing on developing resources, not people, has led to an uneasy dependence by Africans on the outside world for treatment, cures, and volunteers. And we should be sensitive to how colonization ruptured community structures and that neo-colonialism has prevented them from being restored.
We should think about ways that human beings feel human not only when they receive the kindness of others, but are valued for their participation and ability to cooperate in these efforts.
I’m thankful to be here at Vanderbilt, where the research at the medical center is at the forefront in not only bringing access to better technologies and medicines for all, but also working with Africans in Africa and making them a true part of these innovations.
And of course conversations like this are such a positive step in the right direction to understand the politics behind race and disease.
Dianna Bell is a Mellon Assistant Professor of Religion and teaches in the Department of Religious Studies at Vanderbilt University.