The Role of Family and Culture in Extreme Adversity: Psychosocial Response to the Ebola Virus Disease (EVD) Epidemic in Guinea, West Africa

  • Neda Faregh
  • Alexis Tounkara
  • Kemo Soumaoro


The need for psychiatric and psychological treatment of people affected by the 2014–2016 West African Ebola epidemic led to the development of international and nongovernmental programs aiming to prevent and treat the effects of the crisis on mental health. In this chapter, we examine the development, adaptation, and the practice of interventions aimed at addressing the mental health burden of impacted individuals and families in a humanitarian crisis context. The aim of this chapter is to review the “practice of aid” in the form of psychosocial interventions for survivors of the Ebola epidemic in Guinea from the pragmatic as well as the broader social, political, and historical contexts. The chapter emphasizes the role of culture and the need for adaptation of standards of care, situating the work against a backdrop of fear and uncertainty where the nascent community of Ebola survivors struggles to formulate itself, continuously evolving and adapting to accommodate the gaps formed in the fabric of family and society from loss by death or anathema. Viewing psychosocial interventions from this perspective reveals that in such contexts, the work of the humanitarian actor facing the constant threat of the crisis milieu while providing assistance to families suffering from the impact of the epidemic is far from technically neutral. All stakeholders are operating in reciprocal spheres of influence as they, individually and collectively, undertake the process of meaning-making along a continuum of shared values and the moral impetus, at home and abroad, that drive the humanitarian response to the needs and demands of those affected by extreme adversities, such as the 2014–2016 Ebola epidemic in West Africa.


Ebola epidemic Culture Cultural adaptation 


  1. Abramowitz, S. A., McLean, K. E., McKune, S. L., Bardosh, K. L., Fallah, M., Monger, J., … Omidian, P. A. (2015). Community-centered responses to Ebola in urban Liberia: The view from below. PLoS Neglected Tropical Diseases, 9(4), e0003706.CrossRefGoogle Scholar
  2. Ayalon, O. (2008). Beyond words–trauma-healing experience & methods in the wake of the tsunami disaster. Community Stress Prevention, 6, 32–40.Google Scholar
  3. Bava, S., Saul, J., Gow, K. M., & Celinski, M. J. (2013). Implementing collective approaches to massive trauma/loss in western contexts. In K. M. Gow & M. J. Celinski (Eds.), Mass trauma: Impact and recovery issues. New York, NY: Nova Science Publishers.Google Scholar
  4. Bedrosian, S. R., Young, C. E., Smith, L. A., Cox, J. D., Manning, C., Pechta, L., … Daniel, K. L. (2016). Lessons of risk communication and health promotion – West Africa and United States. Morbidity and Mortality Weekly Report, 65(3), 68–74.CrossRefGoogle Scholar
  5. Dawson, A. J. (2015). Ebola: What it tells us about medical ethics. Journal of Medical Ethics, 41(1), 107–110.CrossRefGoogle Scholar
  6. Elliott, C., & Greenberg, J. (2008). Communication in question: Competing perspectives on controversial issues in communication studies. Toronto, ON: Thomson Nelson.Google Scholar
  7. Erikson, K. (1976). Everything in its path: Destruction of Buffalo Creek. New York, NY: Simon and Schuster.Google Scholar
  8. Erikson, K. T. (1994). A new species of trouble: The human experience of modern disasters. New York, NY: W. W. Norton.Google Scholar
  9. Espinola, M., Shultz, J. M., Espinel, Z., Althouse, B. M., Cooper, J. L., Baingana, F., … Rechkemmer, A. (2016). Fear-related behaviors in situations of mass threat. Disaster Health, 3(4), 102–111.CrossRefGoogle Scholar
  10. Fidler, D. P. (2015). Epic failure of Ebola and Global Health Security. The Brown Journal of World Affairs, 21(2), 180.Google Scholar
  11. Greene, M. C., Jordans, M. J. D., Kohrt, B. A., Ventevogel, P., Kirmayer, L. J., Hassan, G., … Tol, W. A. (2017). Addressing culture and context in humanitarian response: Preparing desk reviews to inform mental health and psychosocial support. Conflict and Health, 11, 21.CrossRefGoogle Scholar
  12. Guidry, J. P. D., Jin, Y., Orr, C. A., Messner, M., & Meganck, S. (2017). Ebola on Instagram and Twitter: How health organizations address the health crisis in their social media engagement. Public Relations Review, 43(3), 477–486.CrossRefGoogle Scholar
  13. Honigsbaum, M. (2017). Between securitisation and neglect: Managing Ebola at the borders of global health. Medical History, 61(2), 270–294.CrossRefGoogle Scholar
  14. Joffe, H., & Haarhoff, G. (1982). Representations of far-flung illnesses: The case of Ebola in Britain. Social Science & Medicine, 54(6), 955–969.CrossRefGoogle Scholar
  15. Ki, M. (2014). What do we really fear? The epidemiological characteristics of Ebola and our preparedness. Epidemiology and Health, 36, e2014014.CrossRefGoogle Scholar
  16. Kpanake, L., Gossou, K., Sorum, P. C., & Mullet, E. (2016). Misconceptions about Ebola virus disease among lay people in Guinea: Lessons for community education. Journal of Public Health Policy, 37(2), 160–172.CrossRefGoogle Scholar
  17. Kudchodkar, S. B., Choi, H., Reuschel, E. L., Esquivel, R., Jin-Ah Kwon, J., Jeong, M., … Muthumani, K. (2018). Rapid response to an emerging infectious disease – lessons learned from development of a synthetic DNA vaccine targeting Zika virus. Microbes and Infection. Scholar
  18. Landry, J. T., Foreman, T., & Kekewich, M. (2015). Reconsidering the ethical permissibility of the use of unregistered interventions against Ebola virus disease. Cambridge Quarterly of Healthcare Ethics, 24(3), 366–369.CrossRefGoogle Scholar
  19. Nuriddin, A., Jalloh, M. F., Meyer, E., Bunnell, R., Bio, F. A., Jalloh, M. B., … Morgan, O. (2015). Trust, fear, stigma and disruptions: Community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone. BMJ Globalization and Health, 3(2), e000410.CrossRefGoogle Scholar
  20. Rosenfeld, L. B., Caye, J. S., Ayalon, O., & Lahad, M. (2005). When their world falls apart: Helping families and children manage the effects of disasters. Washington, DC: NASW Press.Google Scholar
  21. Royo-Bordonada, M. Á., & García López, F. J. (2016). Ethical considerations surrounding the response to Ebola: The Spanish experience. BMC Medical Ethics, 17(1), 49.CrossRefGoogle Scholar
  22. Saul, J. (2014). Collective trauma, collective healing: Promoting community resilience in the aftermath of a disaster. New York, NY: Routledge.Google Scholar
  23. Schol, L. G. C., Mollers, M., Swaan, C. M., Beaujean, D., Wong, A., & Timen, A. (2018). Knowledge, perceptions and media use of the Dutch general public and healthcare workers regarding Ebola, 2014. BMC Infectious Diseases, 18(1), 18.CrossRefGoogle Scholar
  24. Semalulu, T., Wong, G., Kobinger, G., & Huston, P. (2014). Why has the Ebola outbreak in West Africa been so challenging to control? Canada Communicable Disease Report, 40(14), 290–298.CrossRefGoogle Scholar
  25. Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2015). Public health interventions to prevent the international spread of Ebola virus disease. International Journal of Advanced Medical and Health Research, 2(2), 142–143.CrossRefGoogle Scholar
  26. Smith, M. J., & Silva, D. S. (2015). Ethics for pandemics beyond influenza: Ebola, drug-resistant tuberculosis, and anticipating future ethical challenges in pandemic preparedness and response. Monash Bioethics Review, 33(2), 130–147.CrossRefGoogle Scholar
  27. Southall, H. G., DeYoung, S. E., & Harris, C. A. (2017). Lack of cultural competency in international aid responses: The Ebola outbreak in Liberia. Frontiers in Public Health, 5, 5.CrossRefGoogle Scholar
  28. Wessells, M., & Strang, A. (2006). Religion as resource and risk : the double-edged sword for children in situations of armed conflict. In N. Boothby, A. Strang, & M. Wessels (Eds.), A world turned upside down: Social ecological approaches to children in war zones. Bloomfield, CT: Kumarian Press.Google Scholar
  29. Winters, M., Jalloh, M. F., Sengeh, P., Jalloh, M. B., Conteh, L., Bunnell, R., … Nordenstedt, H. (2018). Risk communication and Ebola-specific knowledge and behavior during 2014–2015 outbreak, Sierra Leone. Emerging Infectious Diseases, 24, 336.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Neda Faregh
    • 1
  • Alexis Tounkara
    • 2
  • Kemo Soumaoro
    • 3
  1. 1.Carleton UniversityMontrealCanada
  2. 2.Independent ConsultantConakryGuinea
  3. 3.Universite Gamal Abdel Nasser de ConakryConakryGuinea

Personalised recommendations