Barry Hewlett, an anthropology professor at WSU Vancouver, does not scare easily. Close contact with obscure bacterial infections and tropical diseases with names like river blindness and malaria may be off-putting to some, but Hewlett has traveled to Africa several times over the past 30 years to eagerly investigate many such communal outbreaks.
Still, when the World Health Organization contacted him last February, inviting him and his wife, Bonnie, a nurse and doctoral student in WSU Vancouver’s anthropology department, to help combat an Ebola virus epidemic in the Republic of Congo, he admits having felt concerned.
“I traveled to the 2001 Uganda Ebola outbreak, but arrived at the end of the epidemic,” Hewlett said. “(Accepting WHO’s invitation) would mean being a member of the initial evaluation team, when it is uncertain who does or does not have the disease.” Since he and Bonnie share seven children and Ebola’s fatality rate is 80 percent, his apprehension was valid.
Ebola Hemorrhagic Fever (EHF) is a severe viral disease that is transmitted through bodily fluids, such as blood or saliva, and skin-to-skin contact. While the origin of Ebola is still unknown, it is believed that the virus is maintained in an animal host native to the African continent, since EHF is unknown to other continents. There is no vaccine for the Ebola virus, and no known cure.
A deciding factor for the Hewletts was the groundbreaking opportunity being offered specifically to the couple.
“Never before has the WHO included a social scientist in the earliest response stages of an epidemic outbreak,” Hewlett said. “This indicated that what I’m able to contribute to their overall mission is growing in credibility and relevance.”
Hewlett serves as a cultural liaison between the village and WHO health educators (Red Cross), local and international physicians, and epidemiologists in their efforts to control the epidemic. Last year’s Ebola outbreak did not involve anthropologists, and WHO was asked by the local people to leave when medical tactics were misunderstood and perceived as threatening.
“The villagers generally desire the help WHO can provide, but to be successful, the organization must be aware of local feelings and issues,” he said. “An understanding of local practices enables us all to be more efficient in our work. Developing trust and confidence with the villagers is key to identifying local customs and beliefs that influence the transmission of the disease. It’s important to remember that African people have been living with these types of epidemics for hundreds, if not thousands, of years,” Hewlett commented.
Indigenous practices of isolating infected persons, limiting interaction between children, transferring family dwellings into the forests (where it is believed the dense trees would alleviate airborne infections), and eliminating public gatherings has helped cripple EHF outbreaks in the past. There are, however, continuing practices that can enhance the spread of infection, such as eating infected animals found dead in the forest, or sleeping next to a loved one after death, before burial.
The Congolese Ebola outbreak has waned, partly because of the work accomplished by medical anthropologists such as the Hewletts. And progress continues.
Health education is presented in village communities with an increased sensitivity toward local beliefs; hospital staff are incorporating local practices in their treatment of the sick and dead, so villagers are more inclined to seek appropriate medical treatment; and village teachers are committed to educating children about Ebola and how to avoid the virus.
Barry and Bonnie Hewlett view life at home with new eyes.
“To see people dying on such a massive scale emphasizes what’s really important, so I try to keep things simple,” says Hewlett, who was deeply impressed by the will and spirit of the people he met and came to know so well. “Even in the midst of all that death, the people maintained an attitude that life does go on.”
Creating policy with a greater knowledge and consideration for native community customs and concerns is an ideal that Hewlett strongly advocates. He travels to Harvard University at the end of April to share his findings with EHF and HIV/AIDS researchers involved in developing public policy. He has found a supportive audience in his Vancouver classroom.
“When students hear that the World Health Organization has asked their teacher to help evaluate an Ebola outbreak, they see that WSU Vancouver professors are cutting-edge researchers, actively involved in what’s happening in the world and using their skills to make a difference,” Hewlett said. “It’s the best education they can get.”
