Rather than solely analysing how social mobilisation brought an end to the Liberian Ebola outbreak, this book gives an overview of Liberia's (pre)war and Ebola history, Ebola's legacies, lessons learnt, and the unintended consequences of efforts to halt the virus. The outbreak was aggravated by inadequate health facilities, Ebola hoax rumours, widespread political distrust, cultural practices and a global top-down response that disrespected people's wishes and knowledge. The authors go on to contextualise Ebola in Liberia's wider historic context of war and underdevelopment and mention its global connections to natural resource exploitation and pressures from international financial institutions. Yet while Liberia's settler and war years are extensively explored, the post-war years are only briefly touched upon and a discussion of historic social mobilisation efforts – meaningful for the book's intended purpose – remain unexplored. Chapter 4 provides the book's most extensive account of social mobilisation: community's self-quarantining, surveillance efforts, and acceptance of safe burials were efficient while government-imposed quarantines were detrimental. The rapid spread of Ebola in slum areas revealed Liberia's poor infrastructure and socioeconomic inequalities. The authors conclude that local behaviours were rational rather than ‘exotic’ and that international responses will not be able to halt viral spreads unless they integrate communities and their contexts. Ebola's legacies include thousands of ‘Ebola orphans,’ undocumented babies born during the outbreak, survivors’ continued ostracism and health problems, and health workers’ PTSD. Similarly, efforts to halt Ebola brought about numerous unintended consequences: flight bans caused increases in food prices and health equipment shortages which in turn caused health workers’ deaths; disrupted health facilities made treatments and vaccines of other diseases unavailable causing malaria, HIV/AIDS and (pre)natal deaths and the potential spread of measles; prohibitions of large group gatherings collapsed Liberia's agricultural labour system (kuu), disrupted harvesting, and declined yield; teenage pregnancies rose as girls were forced into sexual exploitative labour due to losing their safety networks and government's closure of schools; and border closures led to female traders’ financial losses. To achieve health security and improve responses to future epidemics, the authors assemble various existing suggestions: to improve local health facilities, surveillance, and educational technologies to build knowledge; to speed up vaccines’ and treatments’ trial processes; to ensure international support in overwhelmed affected countries; to increase political trust; and to reform the WHO and increase its funding to ensure rapid responses.
Since the book is largely based on secondary sources, UN and WHO reports, Liberian and global newspaper articles; many academics might crave academic theories, a more in-depth analysis of social mobilisation efforts, and rigorous academic referencing. As a political ethnographer, I would have liked to read more about the authors’ personal social mobilisation experiences through their briefly mentioned Ebola response engagement in a Liberian community. In the emerging literature on Ebola, this is a convenient summary of the Ebola outbreak and its context, legacies and lessons learnt that will be useful for newcomers to Liberia and Ebola. Particularly policymakers, interested in learning about the far-reaching impacts of viral outbreaks and efforts to halt them, would benefit from this book's accessible style.