Comparison of social resistance to Ebola response in Sierra Leone and Guinea suggests explanations lie in political configurations not culture

Abstract

Sierra Leone and Guinea share broadly similar cultural worlds, straddling the societies of the Upper Guinea Coast with Islamic West Africa. There was, however, a notable difference in their reactions to the Ebola epidemic. As the epidemic spread in Guinea, acts of violent or everyday resistance to outbreak control measures repeatedly followed, undermining public health attempts to contain the crisis. In Sierra Leone, defiant resistance was rarer. Instead of looking to ‘culture’ to explain patterns of social resistance (as was common in the media and in the discourse of responding public health authorities) a comparison between Sierra Leone and Guinea suggests that explanations lie in divergent political practice and lived experiences of the state. In particular the structures of state authority through which the national epidemic response were organised integrated very differently with trusted institutions in each country. Predicting and addressing social responses to epidemic control measures should assess such political-trust configurations when planning interventions.