Constructivism and the Ebola Epidemic

Paul Richards writes “Ebola is a disease of social intimacy” (Richards 1). Ebola is transferred through bodily fluids, and therefore is often transferred to those caring for the sick or washing the bodies of the dead. There is no cure for Ebola, simply palliative care. Although there have been several recorded outbreaks of Ebola, the 2013 outbreak in Upper West Africa quickly turned into an epidemic. With inadequate domestic health systems, Doctors without Borders, among other NGOs, were the main actors on the ground (Arreguín-Toft and Mingst 420).

The efforts of such aid agencies can be understood through the constructivist lens. A book published in 2017 notes that constructivists would focus on “how we think we know what world health means, and how that meaning came to be established” (Arreguín-Toft and Mingst 424). This means that all foreign aid efforts and healthcare infrastructure must be evaluated in terms of their cultural and historical contexts. As mentioned previously, Ebola is a very intimate disease. There are many social practices deeply engrained in local cultures that contributed to the spread of the disease. For example, ritual burials where the bodies are washed before they are buried is a very dangerous practice during an Ebola epidemic. Due to the spiritual and social implications of a traditional burial, however, many Africans continued to wash and bury bodies in the traditional way. Western aid workers, however, drew problematic assumptions based on this fact. Many assumed that Africans were “stubborn” in their “unsafe” traditions and unwilling to listen to the recommendations of aid workers (Richards 48). This apparently problematic assumption does not recognize that from a social and spiritual perspective, an “epidemiologically safe” burial is deemed spiritually unsafe by the local population (Richards 52). The issue is the social disconnect between the Western aid workers and the African locals, who are acting on their ingrained social practices. This idea exemplifies the fact that cultural ‘norms’ and ideas drive the behavior of a country’s citizens.

Despite providing medical resources, the aid workers were primarily responsible for “changing the ideas” of the people in Western Africa (Richards 28). This, in itself, exemplifies the “constructivist” viewpoint. Western aid workers acted in ways that reflected their individualistic, direct, and informal upbringings. They struggled to understand the communal, traditional, and spiritual characteristics of African culture. This led the aid workers to act in a way that did not include locals in the Ebola eradication efforts.

In a 2014 post, Susan Shepler describes the popular coverage of the Ebola crisis, “People on radio call in shows have asked: Why can’t they understand what needs to be done?  Why they need to submit themselves and their loved ones to quarantine? (Shepler)” This type of coverage highlights the “ignorance” of African citizens. This is not “ignorance,” however, and can be explained by several cultural factors. The most important factor that highlights the ‘constructivist’ viewpoint is that African citizens have a “mistrust for the state” (Shepler). Because of this “mistrust,” many ignore public health warnings from the state. This “mistrust of the state” that Shepler mentions is something that is deeply woven into the actions and decisions made by many African people. This exemplifies the ‘constructivist’ viewpoint in that politics and decisions of people are shaped by “non-material” elements.

The “constructivist” viewpoint can also be explained by the differences in the “norms” between the home countries of the aid workers and Western Africa. In developed countries, it is common to have a surplus of household supplies including trash bags, rubber gloves, and rain jackets. In developing countries, however, these items are not common. In 2014, as the international push to stop Ebola began, The World Health Organization developed their agenda to fight Ebola based on what they call ‘the messaging approach’ (Richards 124). The “messages” spread by the World Health Organization included how Ebola is spread, how to safely care for someone who supposedly has Ebola, and how to create protective clothing from “common” household items. The World Health Organization, however, did not acknowledge the impracticalities of these messages. Resources such as raincoats, trash bags, and gloves are difficult, if not impossible, to find locally in Western Africa. The differences in resource constraints, and the “norms” in each society influenced how The World Health Organization initially responded to the Ebola crisis and how locals reacted to the messaging.

As a final point, it is important to recognize that while the Western response of aid workers to the Ebola epidemic can be explained by the “constructivist” point of view, the situation entirely violates the ‘liberalist’ view. From a liberal perspective, the efforts to end the Ebola epidemic should have been a group, “holistic” approach. It is clear that this is not what occurred. The efforts to end Ebola were more divisive than communal.

Domestic and Foreign Effects of International Aid

“The urge to help” is a common phrase that resonates throughout many academic works. While, in many cases, the “urge to help” may be less pragmatic and more self-benefitting, there are domestic social benefits that result from these trends. Evidence of this can be seen throughout the ethnographic report The Need to Help by Liisa Malkki.

It has been established that positive intentions do not directly correlate with positive outcomes. Nonetheless, it is important to consider the implications of positive intentions in a domestic atmosphere. In The Need to Help, Malkki discusses the implications of international aid efforts in the country of Finland. Finland’s culture stresses the importance of the individual; community is not integral to Finnish society (Malkki 137). In her book, Malkki refers to the community that has been built as a result of the “Aid Bunnies” (a project of the Finnish Red Cross). This “community” is largely archived on crafter’s blogs and internet sites (Malkki 119). This community can also be exemplified by the various knitting groups that have arisen from the project. In Finland, many people, especially the elderly, gain community from these domestic volunteer efforts. It is important that Finnish people are encouraged to find community, as loneliness can lead to several negative factors including an increased mortality rate (Malkki 138). This contrasts the American need to help, which stems from the American values of self-improvement and reliance on fake humility.

It is evident that as many Fins participate in humanitarian efforts to achieve community, they are not acting in complete selflessness. It is also apparent that in many (if not most) humanitarian efforts the actor is not completely selfless. The “Aid Bunny” project allows for people to participate in humanitarian efforts in a more “human” way while creating a sense of community for its participants and allowing them to fulfill a specific internal need. The question that remains is: where do we draw the line between preserving domestic humanity and, the more pragmatic option, effectively meeting the needs of foreign aid-recipients. An effective answer to this question requires more analytical research on the impact of aid in foreign countries.

While it is difficult to interpret the fine line between the two aforementioned values, it is important to consider the impact of citizens’ imagination on foreign aid-recipients. Imagination in humanitarian efforts have two main effects: imagination makes performing humanitarian efforts more meaningful, and it de-individualizes foreign aid-recipients. It is important that aid workers and volunteers understand the implications of one’s “imagination.” In The Need to Help, Malkki writes “The suspension (if not erasure) of the child’s parents, siblings, grandparents, and other relatives, and also friends, teachers, and neighbors, was a striking feature in the imagining of the needy children” (9). Adding imagination to the visualization of the needs of foreign aid recipients neglects many important factors. This omission can perpetuate a problematic image of foreign aid recipients. The use of imagination in foreign aid is an important factor to consider when evaluating the efficacy and value of international aid projects.

In a recent discussion with Betty Bigombe, she was asked about the effectiveness of campaigns such as The Enough Project. Although it has garnered national attention, The Enough Project has long been criticized for their ineffective and incomplete messaging about conflict minerals in the Congo. Bigombe remarked that it is difficult for American activists to tell the complete story and still gain support. Despite this, the publicity that the campaigns provide is very important (Bigombe). This idea parallels that of the “Aid Bunnies.” Although it may not be the most effective or pragmatic way of addressing an issue, it garners national attention and allows a wide range of participation in philanthropic acts.

The provision of foreign aid affects both the provider and the recipient countries. When evaluating the effectiveness of various humanitarian efforts, the social domestic benefits must be evaluated in addition to the more pragmatic foreign effects. Foreign aid efforts in Finland, specifically the “Aid Bunnies” have been successful in boosting Finnish morale. These domestic effects are important to recognize when determine the efficacy of various international aid projects.

International Group: The International Business Student Association

The IB Student Association is a group of International Business majors. This group allows us to share information regarding business in the international community. One of the retirements of the IB curriculum is to study abroad for a semester. The IB Student Association helps us keep up with our peers as they study and complete internships abroad.