Ebola and Covid-19 in Sierra Leone comparative lessons of epidemics for society

Abstract

This case study focuses on two epidemic diseases in Sierra Leone. Ebola in 2014-15 drew international response, but was contained within the Upper West African region. Covid-19 reached Sierra Leone in April 2020 as part of a global pandemic. Comparing the two cases allows closer examination of historical context as a factor shaping medical emergencies. Ebola response references Sierra Leone’s history as a humanitarian project associated with the abolition slavery. The pandemic challenge of Covid-19 draws attention to Sierra Leone’s nodal position within a global diaspora shaped by Atlantic slavery and emancipation. Responders to Covid-19 draw on experience of Ebola but need also to consider the way the pandemic has articulated with diasporic calls for global social justice.

1. Sierra Leone: an Atlantic humanitarian project

Sierra Leone is a small country on the Upper West African coast located astride the ecological transition from tropical forest to savanna grassland. The large natural harbour formed by the estuary of the Rokel river, backed by the mountains of the Sierra Leonean peninsula, was an early focus for Atlantic maritime trade.

Portuguese merchants began acquiring tropical produce and slaves on the coast of Sierra Leone in the late 15^th century. They were soon joined in the slave trade by the English. The privateer John Hawkins first collected consignments of slaves from Sierra Leone, by purchase and by the sword (as he states) in the 1560s.¹

In the second half of the 17^th century an English trading monopoly, the Royal African Company, headed by the future King James II, became a dominant force in the slave trade from West Africa. Its major focus shifted towards the Gold Coast and the Bights of Benin and Biafra, leaving behind on the Sierra Leonean coast a number of freelancers intermarried with coastal ruling families.

After a brief surge in mid-18^th century the slave trade from Sierra Leone declined during the American Revolutionary and Napoleonic wars. This was a period in which British abolitionists focused on ending the Atlantic trade established a model colony for freed slaves on the northern slopes of the peninsula mountains. English slavers from the region, such as John Newton, provided some of the evidence from which the abolitionists built their case against the Atlantic slave trade.²

Sierra Leone, as a political project, began in 1787 as a private humanitarian venture but became a British Crown Colony in 1807. A Royal Navy anti-slavery squadron was based at Freetown to enforce the parliamentary act ending British involvement in the Atlantic slave trade. Thereafter the port city grew rapidly, as a result of the discharge of “recaptives” - enslaved Africans released from slaving ships apprehended on the high seas.³

As British naval power expanded through the 19^th century, driven both by Atlantic trade and competition for African colonies, the strategic role of Freetown’s vast natural harbour assumed additional significance, further enhanced by British involvement in two World Wars.

Fearing French colonial expansion, the British annexed the interior regions adjacent to colony in 1896, ending local political and economic rivalries that threatened supply lines to Freetown after the destruction of the last coastal slaving ports in the 1840s.

Over a four-hundred year perspective British involvement in Sierra Leone can be seen as part of a long-term project to extend mercantilist trading preferences begun by the Royal African Company in the 17^th century, but extensively re-moulded by abolitionist concerns at the beginning of the 19^th century.⁴

These at time uncomfortably intertwined international elements continued to shape the country into the post-colonial period. Economic failure in independent Sierra Leone in the 1980s led to a troublesome rebellion referencing some of the injustices associated with the era of the slave trade.⁵ A doctrine of armed humanitarian intervention espoused by the Blair government brought UK armed forces to Sierra Leone in 2000 to end the rebel war, but doing relatively little to resolve underlying social grievances.

Medical units of the British army were back in Sierra Leone in 2014 to help address a new international threat – an outbreak of deadly Ebola Virus Disease, surging out of control in Guinea, Liberia and Sierra Leone, in a new location remote from previously known centres of outbreaks of the disease in the forests of central Africa. Local and international forces combined to address the immediate threat, but scepticism about the cause of the epidemic was also frequently encountered.⁶

From April 2020 the country became affected by the global pandemic of Sars-Cov-2 – a virus causing a life-threatening lung disease, Covid-19. It was a popular expectation in Sierra Leone that international humanitarian help would again come flooding in. The expectation was soon dashed. The reality of a pandemic is that every country is busy addressing its own outbreak. Sierra Leone has had to face Covid-19 drawing on its own capacities. Prior experience of Ebola is a helpful precedent, but epidemic response has also become linked to an international debate seeking redress for the injustices of the Atlantic slave trade.

2. Epidemics and pandemics - how Ebola and Covid-19 compare

How and why Ebola Virus Disease (EVD) reached West Africa in December 2013 is still unclear. Up until 2014 there had been about 20 outbreaks of the Zaire species of Ebola Virus, often associated with hunting in the Congolian forests.⁷

Bats are frequently cited as the original vector. Fruit bats carry the virus without ill-effect, and form networks along the forest margins, from central to upper West Africa. The index case, a Guinean toddler from Meliandou, a village close to the Liberian and Sierra Leonean birders, is said to have played in or near a bat-infested tree. The story is disputed.⁸

Up until the Guinean government reported Ebola to WHO in December 2013 the presence of the virus in the forests of Upper West Africa had not been suspected. The Guinea outbreak quickly spread to both Liberia and Sierra Leone across international borders that divide families, and where many crossing points are uncontrolled. The first cases in Sierra Leone have been linked to the activities of a herbalist and a nurse both of whom treated patients from Guinea.

Tracing early cases shows that the disease moved along main road networks and branched off into the forested interior, not the other way round, suggesting that infection was human-to-human.⁹ Molecular analysis of early cases in Sierra Leone confirmed human transmission.¹⁰ Bats and hunting were out of the picture, though it took international responders a long time to adjust their health messages.

EVD causes vomiting, diarrhoea, fever (sweating) and sometimes bleeding. Infection takes place through contact with the body fluids of a person sick with Ebola. Nursing and cleaning the corpse for burial are major sources of infection.¹¹ International responders campaigned against home care and local burial practices, but it took them a long time to understand why family involvement in nursing and burial could not be so easily abandoned, despite the dangers posed by the disease. This required detailed social and cultural knowledge, and it took international responders some time to acquire that knowledge.

The way toward a better understanding of the epidemic as a social and cultural phenomenon was led by local groups of volunteers, who organised case finding, contact tracing and quarantine as an extension of community civil defence obligations familiar from the Civil War. Local action based on sound social knowledge and bio-secure case handling provided by international responders then began to reduce the Reproduction number for the disease (R) from an estimated 2.3 to below 1.0, and the epidemic eventually faded away.

Community capacity for Ebola control remains relevant experience for handling the new threat of Covid-19, but the two diseases are different, and local knowledge of infection control needs to be adapted.

Covid-19 is a respiratory disease, and the virus is concentrated in the upper respiratory tract, where it is easily expelled by coughing, shouting, singing, even heavy breathing. Infection results from contact with the virus on the air or through touching contaminated surfaces. From information that the disease was airborne and had deadly outcomes (something reinforced by TV news film of chaos and death in well-equipped hospitals in China, Europe and North America) the impression was created that the disease was more deadly than Ebola.

In a game run in two villages (one severely affected by Ebola and one where community civil had prevented any infection) to assess how people rated the risks of Ebola and Covid-19 we were surprised to find that a majority in both communities rated Ebola as less threatening than Covid-19.¹²

This is perhaps best explained by fear of the unknown. People had controlled Ebola by reducing contact with patients and reducing burial risks. Protection from airborne disease seemed more difficult. There was also scepticism about social distancing, given the often crowded character of homes and public places.

The first cases arrived from Europe in early April 2020, after which the country went into lockdown, closing its international borders, and greatly restricting movement between the 14 districts into which the country is divided. Schools were closed, and church and mosque services suspended.

Some cases occurred in the capital, Freetown, but the disease has not advanced through the rest of the country at the rate some expected. Undoubtedly, early lockdown helped slow spread. It is also clear that Covid-19 transmits more effectively indoors than in the open air.

Much of life in Sierra Leone is lived outside, or in open-sided meeting places known as bafa. The disease arrived in the hottest part of the dry season when most people would aim to be in shady, breezy outdoor places as much as possible, whether for work or leisure. Factories or indoor agro-production facilities are infrequent. Strong sunlight quickly kills the virus on surfaces out of doors.

It remains to be seen how the epidemic will develop. Reversing out of lockdown will not be easy. Although the country has good experience of case finding, contact tracing and quarantine from Ebola it lacks the localised test capacity to monitor and crack down on local outbreaks of Covid-19. Covid-19 presents particular diagnostic challenges, since infection is spread by pre-symptomatic and asymptomatic cases.

With Ebola, there was a three-day interval before a severely ill patient developed the highly infectious “wet” symptoms. Case numbers were never very high, though the prognosis for those unlucky enough to catch the disease was very poor (initially about 70 percent of cases were fatal). Localization of initial case handling and better community liaison reduced reporting times. Mobile laboratories and teams of international volunteer technicians reduced testing turn-round times to less than the crucial three-day interval before cases became highly infective.

None of this applies to Covid-19. There may eventually be many more cases of Covid-19 than there were of Ebola, and any available test capacity is likely to be swamped. Covid-19 cases are infective before they know they are ill. The laboratory capacity for rapid turn-round of tests is simply not available. Little was done by aid donors after the Ebola epidemic to consolidate in-country laboratory testing capacities. Equipment was sometimes supplied, but training and paying of technicians, especially in provincial locations, was beyond the capacity of a government hovering on the brink of post-Ebola bankruptcy, and kept afloat by the sometimes-quixotic investment enthusiasms of international aid donors.

The post-war and Ebola humanitarian supply lines are now greatly attenuated. In a pandemic every country has the disease, and help and mutuality are at a premium, as evidenced by unseemly international wrangling over shipments of scarce resources such as test reagents and supplies of personal protective equipment.

African countries are now having to face up to the need to develop their own responses to the pandemic. Some challenges are country and location specific, and international advice or equipment are not always relevant. Local research and innovation are as important as imported solutions. For Sierra Leone, earlier lessons learned about social responses to Ebola provide a useful starting point, but these responses now require to be re-worked to fit the challenge of Covid-19.

3. The role of social knowledge in Ebola and Covid-19 control

Covid-19 is a new disease, and science is seen as an important tool for coping and adaptation. African countries lag in science and technology-based health systems. As one of the world’s poorest countries Sierra Leone is seen as disadvantaged in addressing Covid-19 because its health system capacities are judged to be exceptionally weak. But this assumption is challenged by the experience of Ebola.

Ebola was also a new disease to Sierra Leone in 2014, and one for which there were no effective treatments, but the assumed weakness of local health systems was nothing like as big a handicap as had at first been supposed. With Ebola, everything had to be focused on preventing spread. The key to this was to develop an effective system for identifying and isolating cases, and tracing and quarantining contacts.

Systems for tracking and isolating cases rely on human resources and social knowledge. Sierra Leonean capacity to track and isolate Ebola cases can be contrasted with British experience over Covid-19 offers a significant negative example, in which hopes rested on new technology and reliance on human capacity was downgraded.

The British Prime Minister announced an ambition for a “world-beating” system of contact tracing for Covid-19. This claim seems to have centred on a smart phone application that would record the close social contacts of persons who later reported falling sick with the disease, so that previous contacts could be advised to self-isolate.

The attempt to develop the software has now been abandoned. The system for smart phones to record a potentially infective contact with a person later diagnosed with the disease has proved ineffective, and security concerns cannot be overcome. Attention has returned to the point where Sierra Leone started with Ebola - to local public health teams, with the necessary local social knowledge to follow cases by more “manual” means.

The lesson here is that there is no such thing as a “world beating” contact tracing system, because the activity depends on how well it fits the local social context.

This fitness for purpose was more readily achieved in Ebola-affected Sierra Leone by hiring local people to do the tracing on foot. Possession of local social knowledge was a key asset of Sierra Leone’s Ebola contact tracing teams. The best results came from teams of village-based volunteers recruited by local chiefs. Their work was more than a job. Members of these teams saw themselves as fighting to protect their own communities.

A research team based at Njala University working on pandemic preparedness measured this factor through an unintended experiment. The team was carrying out a base-line household survey of a rural case-study community and attempting to collect information on the lineages from which females in each household came.

This information was of epidemiological significance, since at death a woman’s body belongs to her patrilineage and will be buried in her own village by her brothers and not in the village of her husband, unless a lifelong series of obligations by the husband’s family has been completed. Burial was such an important factor in spread of Ebola that we wanted to estimate the likelihood of inter-village post-mortem body movements.

The field team comprised four experienced research assistants, two men, and two women. As the survey forms came in the likely accuracy of the information on women’s families was carefully scrutinised. All instances in which women had been assigned to their husband’s lineage were sent back for checking. Local rules on incest make it impossible for a man to marry a woman from his own lineage, since she is counted as his sister.

The mistakes (about 20 percent of the total set) were easily corrected, but it was then noticed that they had been made by only three of the four interviewers. All interviewers were trained and experienced, but only one was a local resident. He had been a primary school teacher in the village for many years and had queried mis-reported family names as they were given.

This makes clear the importance of prior social knowledge. The British issue over contact tracing is more likely to be solved by deploying local public health inspectors, who know their “patch”, and training others to follow in their footsteps. It is not a problem that can be resolved by computer programming. But the lesson will be learnt with difficulty by over-centralised governments that fear any decentralization to be a diminution of their political power.

More generally, local knowledge was a key asset in Ebola response. The human-based pattern of spread of the disease was more rapidly understood by local than by international responders. International responders focused attention on the dangers of eating bush meat and on establishing large bio-secure isolation units for case handling. Initially, these had no survivors, and were shunned by local communities as death camps.¹³ Local responders, on the other hand, more quickly recognised EVD as a family sickness, and argued the necessity of finding an enhanced role for families in epidemic response.

In Mende, the language most widely spoken in southern and eastern Sierra Leone, the disease was given the name bonda wote (literally, family turn round).¹⁴ This brought social factors under closer scrutiny as epidemiological variables, and response shifted towards reducing risks in nursing and burial.

Controversy over bio-secure case handling facilities was managed by a shift towards better family liaison, and through the introduction of smaller, more localised and family friendly handling facilities. “Safe burial” (often viewed initially by families as a scandalous dump-and-run exercise) was rendered more acceptable through the introduction of socially distanced ritual elements. Greater family involvement in burial provided a context within which one of the main epidemic risk factors was eventually controlled.¹⁵

What scope is there to adapt these lessons to management of Covid-19? Ebola and Covid-19 transmit differently. Home nursing and burials, although potential risk factors, are no longer the main activities requiring modification to increase biosafety.

Early in the pandemic it became apparent that Covid-19 was a disease of congregation, and particularly congregational settings where there was a packed audience and an abundance of loud talking or singing. Clubs, bars, choirs, sports matches and religious worship all came under suspicion.

The worst occasions of all in terms of infection spread were festivals that first congregated large numbers of people, and infection was intense, and then scattered them over large distances as infected people then travelled home. New Year festivities, winter after ski gatherings and Carnival have all been implicated in the wide and rapid spread of Covid-19 in China and Europe. There is relative safety in being out of doors, but one German study shows that infection risks from Carnival street parties were higher than infection risks in the home.¹⁶

Much of this information is highly contextual – there are no after ski parties or Carnival street celebrations in Sierra Leone. What then should the Sierra Leonean response be? Rapid lock down of everything from international travel to education has clearly slowed initial spread but is unsustainable. Rural markets, the life blood of local exchange and food security, have been closed, but this cannot be permanent, any more than school education can be halted indefinitely.

More precision is required, concerning the proportion to which various activities contribute to the infection rate for Covid-19. A key issue then becomes how this information is to be gathered.

Here we encounter a problem with the science widely cited as a key element in effective control. Not everything that matters can be precisely measured. Science is selectively weighted towards the measurable, sometimes separated from consideration of what is intrinsically important, as the discussion of the face covering issue below will attempt to show. For African countries like Sierra Leone to address this problem they have to pay more attention to social observation and historical information, and to find ways to make reliable inferences from such observations, especially when more precise modes of measurement are unattainable.

4. On the possibility (and impossibility) of social epidemiology

It is interesting to track the contribution made by epidemiology to the management of the Ebola epidemic in Sierra Leone. Initially, there was talk of getting the Reproduction number below 1.0, and some debate about why this mattered. There was also some epidemic modelling, which was wildly off because it failed to take full account of the family factors involved in spread.¹⁷ But the scientific discourse of epidemiology was quickly replaced by a robust local discourse.

It was obvious to all where there were new cases. A simple dashboard provided by the National Ebola Response Commission of daily cases by district was sufficient to make the situation clear to all. Transmission began in the east of the country in May 2014 but ended in the first affected areas by November. This was termed “getting to zero”. Localities that maintained themselves at zero were then designated “silent districts”. People strove to keep their districts or chiefdoms “silent”. Hearts sank whenever a new case emerged after a period of silence. Post-mortems were held to discover why this was the case, and passionate arguments ensued about whether cases imported from elsewhere should be counted against the local “clean sheet”.

The population was engaged around issues conducive to ending the epidemic, but in which epidemiological concepts played little or no part. Digging out hidden cases was seen as the motivating factor rather than a focus on controlling R. Communities strove to protect themselves by policing their neighbourhoods. Chiefs were quite prepared at times to turn away respected family members attempting to visit to check on welfare. Persons of “unknown status” spelt trouble.

For a time, epidemiologists listened to local voices explaining the risks posed by large burials or attempted treatments by local herbalists, and what might be done to limit these risks. Esoteric ethnographic facts concerning arcane burial procedures were traded on-line.¹⁸ Anthropologists raised once more the prospect of a cultural epidemiology, a project hitherto cold-shouldered by the medical profession.¹⁹

Epidemiological business-as-usual returned in the immediate aftermath of the epidemic, as modellers scrambled to access the medical records and apply standard numerical analytical techniques to sorting out causal patterns.

A review of several major papers eventuating from this activity suggests that little was achieved in explanatory terms beyond confirming that the Ebola epidemic was characterised by “heterogeneities”, a fine word but not much of an explanation.²⁰ To find out what lay behind these heterogeneities a different approach was needed, in which ethnographic and historical methods played a part.

The lesson has not been entirely lost on Covid-19. Response to the pandemic in Germany has led to important work by epidemiologists in reconstructing infection pathways at local level, combining testing with a range of social observational insights.²¹ German advisory panels on Covid-19 are said to include philosophers, historians and observational social scientists.

In Britain the pattern has been different. The government’s Scientific Advisory Group on Emergencies (SAGE) kept its membership secret for several months, and when it was finally revealed it seemed that observational social science played a less decisive part than the behavioural sciences deploying quasi-experimental methods of behaviour modification.²² Of historians and philosophers there was little or no sight.

It is as if social pathways for infection were already understood, and that what was most needed was emphasis on how to mitigate infective behaviour. Yet published case studies of (for example) the measured impact of religious worship in spreading Covid-19 are rather few and far between.

A bias against basic observation may perhaps be counted an artefact of how science works as an area of endeavour – in which measured results count as evidence, but inference based on observation often does not. This may explain a failure of a social epidemiology of infection control to flourish in the British context defined by Covid-19, despite its evident utility in the 2014-15 Ebola outbreak in West Africa, and the overlap of key personnel.²³

African countries such as Sierra Leone should think hard about the need to counteract this bias, because observational inference is what made the difference in changing perceptions of Ebola hazard among both responders and populations at risk and could yet make a crucial difference in adaptation to the hazards posed by Covid-19 in Africa.

This can be illustrated by what happened in Ngiyema (pseudonym) a Sierra Leonean village very badly affected in the first stages of the epidemic in May 2014. The virus spread through the funeral of a highly respected local nurse who had attempted to treat patients with an unknown disease that turned out to be Ebola. There were 89 cases and 69 deaths. But people became aware of a pattern in spread. The new cases occurred among people who had been closely caring for sick people, providing convincing local proof that the disease was spread by touch.²⁴

People then tried to protect themselves either by avoiding touching the sick, or improvising protection from plastic bags and the like. The disease died down. In scientific terms, documentation of this case will be treated as no more than anecdotal evidence. Nevertheless, it is hard not to conclude that observational inference provided the information needed to end infection in this village.

Perhaps where this methodological bias matters most for Covid-19 is in the vexed matter of face covering. It appears to be the case that face covering plays little part in protecting uninfected persons but could be very effective in preventing people already shedding virus from passing on the infection. You wear a face covering not to protect yourself, but to protect others.

It is hard, however, to imagine how this could be tested using the protocols of a double-blinded randomised field trial, the gold-standard of evidence in scientific publishing. Wearing a face covering is a highly visible act, so everybody knows who belongs to the treatment group. It is (or ought to be) impossible to get ethical approval for an experiment involving a control group exposed to the incessant coughing of carriers of Sars-Cov-2 virus.

Yet wearing face coverings is something that African countries such as Sierra Leone should mandate. It may be the only option for contexts in which crowding is unavoidable, but the activity impossible to do without, such as market attendance or use of public transport.

An excellent paper by Greenhalgh both reviews the circumstantial and natural experimental evidence that face masks protect – including the case of a passenger who flew from China to Canada wearing a face covering and tested positive for Covid-19 the next day, but without having infected a single passenger or member of the crew.²⁵ Greenhalgh also addresses and refutes several of the hypothetical arguments that have been advanced to suggest why wearing face coverings might have negative consequences.

The lesson of the Ebola epidemic in Sierra Leone is that a social epidemiology based on observation and inference is a viable and necessary tool of epidemic response and can be undertaken without huge investment in scientific infrastructure. It should be retained and re-applied to Covid-19.²⁶ If high-quality work of this sort is rejected by the methodological gatekeepers of “standard” science then it may be relevant to ask whether such rejection is an artefact of racially-biased European-African relations against which a vigilant counter-colonial discourse is still required.

5. What social science contributes to management of epidemics (as compared to what its practitioners think they contribute)

The assumptions of a standard model of scientific best practice are strongly evident in the mathematical modelling that plays such a prominent part in epidemiological analysis and is a major influence over policy. Models are useful, and African countries will be wise to take note of, or commission such analyses. But some scepticism is also in order. A model is only as good as its assumptions.

As noted, initial model predictions of growth of Ebola cases in the West African epidemic were very wide of the mark because they failed to take proper note of the family clustering effects.²⁷ Some social scientists take this as a message to fine tune these models via better informed assumptions concerning human behaviour, and this is indeed highly desirable. But this underestimates the fuller potential of a social science approach.

A feature of social science is that its knowledge building activity is part of the social world it attempts to observe. The consequences of this reflexivity are sometimes treated as problematic, as if confounding or contaminating a desired objectivity.²⁸ Behavioural social sciences often prefer to take a “nudge” perspective, seeking to influence behaviour without people becoming aware of the behavioural corrections they are making.²⁹

The realist philosophy of social science offers a different prospect.³⁰ Analysis can help focus and mobilise social response through incorporating the affected populations as democratically enrolled agents of the social research process. This can be summed up in the phrase “know your epidemic”.

Better knowledge of how an infectious disease spreads then supports local commitments to protect community members. Evidence from the Ebola epidemic in Sierra Leone in 2014-15 suggests that typically it took communities only about 6-8 weeks to figure out the nature of the infection challenges they faced, and to mobilise against them.³¹

Of course, this mobilization will never be perfect. There are always free-riders and people who evade quarantine rules. Nevertheless, the speed of local social learning surprised many external responders to the Ebola epidemic in Sierra Leone. The same surprise has been expressed in many countries affected by Covid-19. People understood more quickly than expected how the epidemic threat was configured, and the need for measures such as social distancing.

A great majority are then willing to take steps to protect themselves and their communities and become angered by manifest breaches. Social shaming serves to control free riders.

This is more than just a social response. It also depends on a degree of calculation of risk.

The game comparing risks of infection and death from Ebola and Covid-19 mentioned in Section 2 above was configured so that the combined risks were the same in both variants (high infection risk x lower risk of death for the Covid-19 proxy and low infection risk x high risk of death for the Ebola proxy).³² One fifth of all players spotted this and commented that there was no difference in the overall level of hazard. This supports claims that humans are good intuitive probabilists.³³ Effective risk assessments among those lacking formal school education provides a basis for an effective people’s science of practical epidemiology.

Ebola taught that African policy makers can rely on the good sense of the people. Pandemic response can be based on a continued application of that understanding. Support people to acquire the evidence they need and rely upon them to make sensible decisions. With encouragement African populations will learn their epidemic and adapt to its shifting challenges. This suggests that policy on Covid-19 in Africa can be usefully decentralised and opened to democratic decision-making.

6. Towards new post-pandemic global social mutualities

Covid-19 is the most serious global health challenge since the influenza pandemic of 1918-20. Because it presents a set of basic biological challenge across all countries, the disease creates a framework for international comparison concerning health and social justice. It provokes comparative questions about who is doing well, and who is doing badly, and why.

Differences in standardised performance indicators, notably measures of “excess deaths” (the numbers of deaths above the normal for that country and time of year) demand explanation of variations in national response. Differences of impact by race and class are also exposed. Lockdowns generate startling new facts – such as cleaner air in China, or a major reduction in the appallingly high South African murder rate, apparently related to bans on alcohol sales.

New questions are now posed for Sierra Leone. Is the rate of spread in Guinea Bissau to the west much higher because a population with no experience of Ebola is less prepared for lockdown and quarantine? Looking to the east, does Nigeria have a higher rate of infection because it is a more developed country, with higher levels of indoor activity based on better buildings, and more air conditioning? Will new outcomes start to emerge as time goes by? Perhaps rates in Sierra Leone will surge as people start to find lockdown and quarantine measures too harsh, or if they begin to judge that the threat of the disease has been exaggerated for political reasons?

Racial differences in impact of the disease are also grounds for comment. Through diaspora connections, there is awareness of the higher risks posed by Covid-19 to persons of colour in Britain and the United States of America. Many overseas-based members of Sierra Leonean families work in medical professions or in medical-related services (as hospital porters and cleaners, for example) and have already been badly impacted by the disease. Questions are inevitably posed about why the death rates are so high among persons of African descent. Some have already concluded that these death rates are the product of racial bias in protection offered by host countries to workers of immigrant origins.³⁴

Moral outrage over Covid-19 and racial injustice thereby become fused. Sierra Leone’s nodal position in an Atlantic world created by slavery and abolition is thereby brought back into focus. The pandemic cannot be thought of independently of larger and longer-term discourses concerning slavery and emancipation.

Heightened awareness of global pandemic comparison readily connects itself to current awareness of racially motivated police brutality in the United States, for example. The killing by police of the African American George Floyd in Minneapolis occasioned mass demonstrations by supporters of the Black Lives Matter movement across the world. These demonstrations have been undertaken in defiance of lockdown and create a counter-discourse to epidemic control. People have taken to the streets knowing the increased risks, on the basis that racist violence has pandemic features. They have felt impelled to make a stand, virus or no.

These protests are closely monitored in Sierra Leone and have begun to have significant impact on thinking about the epidemic. In one highly salient demonstration in the English city of Bristol protestors tipped the statue of the slave trader Edward Colston into the water of the docks where once his slave ships tied up before leaving for the West African coast. Colston was chief of operations for the Royal African Company in the 1680s, during which time it is estimated the company, a monopoly of the English royal family, was involved in shipping around 100,000 enslaved West Africans to the Caribbean, 20,000 of whom died during the Atlantic voyage.

The statue has long been a disputed artefact. It was erected in 1895, in acknowledgement of Colston’s charitable work, but making no mention of the source of his wealth, at the height of British colonial expansion in West Africa, and one year before the British took over the interior of Sierra Leone. It was the Royal African Company’s slave trading activities under Colston in the 1680s that brought Sierra Leone firmly into the British sphere of Atlantic commercial influence.

Sierra Leone today thus stands at a point of intersection of two counterpointed global systems – a worldwide nexus of pandemic infection and a diaspora of persons of sub-Saharan African descent who serve as living testimony to the consequences of global forced migration engineered over four centuries by agents such as Colston.

This intersection attracts a long-term local critique of capitalism within Africa as a “vampire” mode of wealth extraction. This critique colours local understanding of infectious diseases. Claims circulate that Ebola (and now Covid-19) are laboratory-made infections, serving clandestine economic purposes, typically involving Americans, British or Chinese agents. The slave trade was only the beginning of a global system to forge unearned wealth from the bodies of seized Africans. International humanitarian agencies are there not to help end infections but to make money from the extraction of blood and human organs.³⁵ Ebola and Covid-19 are viewed as tools for renewal of centuries old extractive malpractice.

The continued nag of this negative discourse undermines confidence in both response efforts and treatment. More generally, it nullifies the arguments of development agencies that enterprise is a key means to bring about beneficial societal transformation. The fears will not be assuaged until a darker secret connected to the Atlantic economy is addressed.

When Britain declared a protectorate over provincial Sierra Leone in 1896 the main purpose was to protect the port of Freetown from French colonial expansion. An uprising of interior chiefs against British rule in 1898 challenged the new British order. The chiefs resented new taxes to pay for the protectorate and sensed the British would deprive them of their slaves.³⁶

Because rebellion threatened the port, a hub for both the British navy and merchant shipping in the Atlantic at a time of major British colonial expansion in Africa, the revolt was swiftly and ruthlessly put down. If the British had any ambition to end slavery in the interior it was quietly dropped. A blind eye was turned to social injustices to consolidate good relations with new chiefs appointed by the colonial government to take the place of the rebels executed for their part in the revolt.

As a result, tolerance of farm slavery persisted for a further three decades. In 1926 a slave revolt in the Mabole Valley in BombaIi District in northern Sierra Leone finally brought to the notice of the League of Nations anti-slavery committee the evidence that slavery remained extant in a country founded as a home for freed slaves, despite a British self-proclaimed civilizing mission of three decades duration.³⁷

This was a major scandal, and the colonial government in Freetown was forced to act. A declaration of emancipation was hastily drafted, and slaves were finally freed on January 1^st 1928, though not directly informed. At that point it was estimated that as many as a quarter of all villagers in some parts of northern Sierra Leone had been living as slaves. Many would remain trapped in subsequent poverty.

Compensation was offered not to the slaves but to the slave owners, resulting in one of the colonial government’s first agricultural development initiatives – a work oxen ploughing scheme for the slave-owning landlords in what had been an important rice-producing zone. The scheme was revived by the British overseas aid programme in the 1980s, though one suspects without realising the historical connotations. The cadres of the Revolutionary United Front, perhaps with a greater sense of history than international aid officials, finished it off, and roasted the animals. One of their war slogans was “no more master, no more slave”.³⁸

Emancipation was a sham. It is not even clear that the slaves were even informed officially of their change of legal status. Like slaves of African descent across the Atlantic basin, they continued to farm for their own subsistence on land they did not own.³⁹ Or they headed for Freetown and the mining districts to join the ranks of the daily paid labouring classes.⁴⁰ Unemployment, uncertainty and a sense of lives being wasted for want of opportunity for improvement – persisted into the first decades of independence from Britain. And then something snapped. The civil war of the 1990s can be seen as a major eruption of tensions in a society that up to that point had not fully resolved vexed issues separating those benefitting from Atlantic slavery and those who bore the brunt of the social dislocation it caused.⁴¹

The conjunction of the Covid-19 pandemic and activity by the Black Lives Matter movement has resulted in re-energised debate on the complex legacies of Atlantic slavery. It is genuinely surprising to hear the number of voices of hope raised despite pandemic concerns. Evidently, global social mutuality is being urgently re-thought. Some would argue, however, that Sierra Leone needs still to resolve internal tensions over its own legacy of collaboration with Atlantic commerce in order to become more fully aligned with these larger demands for social reform.

7. Conclusion

Ebola in 2014-15 was mainly contained within three countries of the Upper West African coast. The crisis called forth considerable amounts of international aid, but mainly channelled along colonial and Cold War lines, with French, American and British military missions playing a significant part in Guinea, Liberia and Sierra Leone. Russian assistance to Guinea and Chinese assistance to Sierra Leone also served as reminders of forgotten Cold War alliances. Sierra Leone was once again a poster child for British humanitarianism, recapitulating its abolitionist origins. The 2020 pandemic of Covid-19 in Sierra Leone elicited no major boost in international aid but has instead served to throw into relief connections with Atlantic forced migration. The global protests associated with calls for inter-racial justice have no doubt been intensified by realization that Covid-19 poses a higher risk to diasporic populations of African descent. As a result, Sierra Leone fights Covid-19 with its own resources, drawing on lessons learned from Ebola, while at the same time being drawn into a wider re-examination of the legacies of Atlantic slavery. Its own deeply rooted history of social injustices, brutally exposed during the civil war of the 1990s, surfaces once more. It is a feature of epidemics and pandemics that they have an apparent capacity to resurrect aspects of global history some might prefer to forget.

Biography

Author bio: Paul Richards is an anthropologist who has carried out fieldwork on food security, armed conflict, and epidemics in West Africa (Nigeria, Sierra Leone, and Liberia) at various times since 1968. He was Professor of Technology and Agrarian Development at Wageningen University from 1993 to 2010 and is currently an honorary adjunct professor at Njala University in Sierra Leone. His recent books include Ebola: How a People’s Science Helped End an Epidemic (2016) and (with Perri 6) Mary Douglas: Understanding Social Thought and Human Conflict (2017). His current research concerns the collective dynamics of mental health.