Post-Ebola, what work awaits anthropologists?

In Guinea — and throughout West Africa — families are accustomed to washing and kissing their dead goodbye before laying them to rest. It’s a common knowledge cultural practice now, particularly to aid organizations like the International Federation of Red Cross and Red Crescent Societies working with the Guinean Red Cross on safe burials across Ebola-affected Guinea. But more than a year ago, it was a mystery hampering their Ebola response operations. When aid workers tried to collect and transport community members’ dead for sterilization purposes, for example, the family members left behind felt mistrust, suspicion and the desire to fight back. This is largely because the organization’s approach has been “biological and scientific,” according to Deffo Modeste, a health officer at the organization who is currently using his anthropological background to find compromise between necessary safety measures and cultural practices. Modeste was originally deployed to act as field coordinator in IFRC’s Ebola response, but later got involved to help analyze the country’s funeral services and why the organization’s approach was being rejected at community level. Thanks to a closer examination of cultural practices, he said, IFRC is moving toward a community-led biosafety approach, which means their teams are involving communities in burial activities. Modeste hopes to continue working in an anthropological capacity for the organization and believes this epidemic has illuminated the importance of the sector, but he shares several of the issues many anthropology professionals face: A tendency for extremely short-term contracts, being invited only toward the end of a project and competing for work that often hinges on the manager’s affinity for anthropology. A community-inspired approach After carrying out focus group discussions with communities, conducting short observational studies and collecting ethnographic data on local funeral practices, IFRC rolled out a new approach in which communities choose their own representative to perform the traditional funeral service with body washers, Imams and other key community figures while working with specialized Red Cross volunteers for biosafety measures. These representatives are provided training and necessary protective equipment during the time of service, and also play an important role in ensuring the community doesn’t manipulate the body until Red Cross teams arrive to take care of the deceased and disinfect the house. The family of the deceased is also allowed in the mortuary room. Modeste finds this approach lessens some of the frustrations community members were feeling when left out of the process of burying their dead. The funeral process, however, is just one aspect of the response that requires socio-cultural understanding. Modeste is currently concluding another analysis on epidemiological context to support surveillance activities in lower Guinea. Unlike Liberia, which was declared Ebola free last week for the second time, and Sierra Leone, which has started its own countdown toward being Ebola free, Guinea is still struggling to contain the epidemic. Modeste doesn’t plan to stop there. He aims to be involved in designing culturally appropriate interventions for the organization outside Ebola as well. There’s only one crux: he’s not employed by the organization to perform anthropology work. Modeste was an HIV focal point for IFRC in Central Africa before he extended help to his colleagues in understanding the socio-cultural issues on the ground. His official title, though, remains emergency health delegate. But Modeste doesn’t seem overeager to return to it, and is hopeful the organization would be open to the idea of allowing him to retain his current work as an anthropologist for IFRC. “I had a very basic knowledge of the Red Cross operational model, of peoples and programs, and very little colleagues knew me as [an] anthropologist,” he told Devex. “Now, I have earned a lot of practical skills and experience; I have a very good knowledge of how anthropology can support the work of IFRC.” Now, he’d like to use these cross-cutting perspectives to support other program managers during the key steps of program development, implementation and evaluation, he told Devex. IFRC, he claims, is “very keen” in using anthropological experts in their work. But he is aware that the final decision lies with the organization.. “I’m hopeful,” he says. “But I have no clear idea now for the future.” Anthropologists as consultants The uncertainty Modeste feels isn’t unfounded. Based on his experience — and that of other anthropologists Devex spoke with — most organizations working in development prefer to hire consultants for this type of work on a short-term basis, and only when needed. The reasons can vary, but it is largely linked to anthropologists being involved — or tapped — mostly per program or project. And in a program cycle, their expertise may not always be wanted or seen as vital by the manager in charge. For example, an anthropologist may be asked to help form baseline research on a new project a donor or NGO is thinking of working on, or provide understanding as to why an organization’s project isn’t making an impact or in the scale it’s supposed to achieve, or help analyze the whole of a project and provide lessons learned. Juliet Bedford, a medical anthropologist who worked with UNMEER as its in-house anthropologist in the first three months of its mission, has been involved in these different stages through the organization Anthrologica, which she founded and now directs. Anthrologica is currently working on a nationwide formative study on birth registration in Angola, evidence from which is aimed at helping UNICEF — with which Anthrologica has a long-term partnership — shape its communication interventions. At other times, her team has been tapped in the middle of programs. She recalled working with Save the Children on a maternal health project in Ethiopia. The organization had invested a lot in developing maternal health and found that mothers accessed the clinics for antenatal and postnatal care — but not during delivery. “So we did a focused piece of work asking the question: ‘Why are the women engaging with antenatal and postnatal health services not delivering at the clinics?’ and provided operational recommendations that would hopefully encourage them to go,” she said. In Somaliland meanwhile, the Anthrologica team was called in later to evaluate how a European Commission-funded project aimed at building the capacity of nonstate actors in the health sector fared. These examples show the multiple entry points available for anthropologists interested in development and humanitarian work, but anthropologists would prefer to be involved throughout the project cycle. “I would always prefer it if we can come from the beginning,” Bedford said. “Some of the longer term partnerships we have give us the opportunity to be able to work more collaboratively with agencies … and review the trajectory of the program and how it’s going,” Bedford said. But in most anthropologists’ work, this isn’t a reality. At times, some of them find their input — or part of it — may not always be taken into consideration. At least this is how Lars Soeftestad, an applied anthropologist who now manages different development-related projects through his consulting firms, Supras Limited, based in Norway and Bulgaria, felt when he was working for the World Bank in the 1990s. For the bank’s fourth fisheries project in Bangladesh, he recalls having prepared a social assessment, only to find more emphasis was given to the project’s variables that are “easily quantified” during implementation, or that were deemed more important by the people involved in project implementation, such as fingerling production and overall fish outtake. “The final evaluation presented, in turn, an occasion for addressing issues that the social assessment focused upon, including equality, poverty and gender issues, and concluded with the obvious, namely that too little emphasis had been given to cultural and local social organizational aspects,” he said. He also recalled times when several people involved in a program would argue that inclusion of social and cultural issues would “complicate the project” and therefore be time consuming. “How important [anthropologists’] voice is to the extent to which they are listened to is a different story,” he said. “In the final analysis, while local people’s well-being are at the center, project outputs, outcomes and impact often show that macro-level economic arguments prevail.” New opportunities post-Ebola? At the height of the Ebola crisis, multiple online platforms composed of networks of anthropologists popped up to give support to the response. Bedford refers to one particular group, the Ebola Emergency Anthropology Initiative, as acting like a “virtual think tank” of over 200 anthropologists, social scientists and regional area experts, from whom they could crowd source information on issues they were working on. This and other platforms, like the U.K.-based Ebola Response Anthropology Platform, are still functioning to some extent today. “There are huge conversations about how these platforms will be sustained, if indeed they will be post-crisis,” Bedford shared. “But I think we have conclusively shown the role and value that anthropology can bring to bear, and we’re really getting to the nitty-gritty discussions about how that work will be going forward.” How best to integrate anthropologists’ expertise also figures prominently in current discussions within the High-Level Panel on Global Response to Health Crises the U.N. Secretary-General appointed in April, and at the Institute of Medicine at the National Academy of Science, where a commission was put together to look at global framework for risk in terms of future epidemics and pandemics. “It is very high up the agenda at the moment, debated and negotiated in different ways and different settings,” Bedford said. Ebola, Bedford said, has the potential to be a turning point in terms of the marketability of anthropologists in development, but it’s “not a sea change,” she said. “What I do think it’s done is give the discipline greater visibility in development and humanitarian emergencies, and it has also given us a good platform to show how we add value and how qualitative data can be used alongside some of the harder scientific or medical epidemiological data,” she added. Similar conversations took place during SARS and MERS outbreaks, according to Bedford, but the difference now is that “there has been some kind of coalescing around the Ebola response,” particularly given the emphasis on effective community engagement. Organizations, in her view, are also increasingly becoming more receptive to having social science and anthropology included in their disaster preparedness and response work, and she hopes there will be a more permanent platform for this type of engagement which would go beyond Ebola, even beyond health, to influence other policy decisions, like the current migration crisis in Europe. “This would better facilitate ongoing evidence-based preparedness work that would also incorporate surge capacity for future emergencies,” she said. “It’s a combination of having the right mechanisms in place to ensure that expertise can be transferred at the right time, in the right way and at multiple levels.” Soeftestad meanwhile finds more and more projects look for people with social and cultural expertise, although he finds these projects often specify economists or natural scientists and not specifically anthropologists. In one example he shared with Devex, a headhunting firm recently approached him asking if he knew someone who could undertake an environmental and social impact assessment for a hydropower project in the Democratic Republic of Congo. The job title, however, called for an environmental expert. Modeste, however, believes his recent work during the Ebola crisis has served as a huge turning point — at least for him and his career choices. He looks forward to contributing to strengthen debate around anthropology in disasters in Africa. Whether you’re a seasoned expert or budding development professional — check out more news, analysis and advice online to guide your career and professional development, and subscribe to Doing Good to receive top international development career and recruitment news every week.