Building Trust Among Communities Vital To Containing Ebola, Other Outbreaks

New England Journal of Medicine: An Epidemic of Suspicion — Ebola and Violence in the DRC
Vinh-Kim Nguyen, medical team leader at Médecins Sans Frontières in the Democratic Republic of Congo (DRC)

“…Ebola is worsening despite medical progress because trust is breaking down. Medical innovations need social traction to deliver results. … Since 2014, anthropologists have pointed out that resistance to Ebola control efforts reveals ongoing, legitimate concerns about the conduct of interventions, respectful treatment of local populations, and resource distribution. Yet we have not learned how to alleviate distrust or establish mechanisms for recognizing and addressing underlying anxieties and actual injustices. The mistrust of authority in the DRC also reflects a growing global mistrust of experts and science. Vaccine refusals are a growing problem worldwide, and they have already resulted in measles epidemics in the United States and France and in outbreaks elsewhere. Mistrust of public health authorities may thus be the new norm, and smoldering epidemics merely a symptom. State-of-the-art medical interventions won’t be enough without serious efforts to rebuild trust, informed by social science rather than pious liturgies. Displays of armed force feed a vicious cycle of mistrust, infection, and violence. If we continue down that path, those seemingly fantastical dystopian outbreak movies, with their heavily armed global health forces and rebelling populations, may not be so far from reality in the near future” (3/6).

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