Marginalisation, Ebola and Health for All: From Outbreak to Lessons Learned

Int J Environ Res Public Health. 2019 Aug 21;16(17):3023. doi: 10.3390/ijerph16173023.

Abstract

The Ebola epidemic in West Africa between 2014 and 2015 was the deadliest since the discovery of the virus four decades ago. With the second-largest outbreak of Ebola virus disease currently raging in the Democratic Republic of the Congo, (DRC) it is clear that lessons from the past can be quickly forgotten-or be incomplete in the first instance. In this article, we seek to understand the health challenges facing marginalised people by elaborating on the multiple dimensions of marginalisation in the case of the West Africa Ebola epidemic. We trace and unpack modes of marginalisation, beginning with the "outbreak narrative" and its main components and go on to examine other framings, including the prioritisation of the present over the past, the positioning of 'Us versus Them'; and the marginalisation-in responses to the outbreak-of traditional medicine, cultural practices and other practices around farming and hunting. Finally, we reflect on the 'lessons learned' framing, highlighting what is included and what is left out. In conclusion, we stress the need to acknowledge-and be responsive to-the ethical, normative framings of such marginalisation.

Keywords: Ebola outbreak; West Africa; crisis; epidemic; global health; lessons learned; marginalisation.

Publication types

  • Review

MeSH terms

  • Africa, Western / epidemiology
  • Disease Outbreaks
  • Hemorrhagic Fever, Ebola / epidemiology*
  • Humans
  • Social Marginalization