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Filtering by Tag: Melissa Leach

Briefing – Ebola: Myths, Realities and Structural Violence

Future Health Systems

Wilkinson A and Leach M (2015) Briefing – Ebola: Myths, Realities and Structural Violence, African Affairs, Jan 2015, 114 (454): 136-148 doi:10.1093/afraf/adu080


Ten months after the first infection, Margaret Chan, Director-General of the World Health Organization, described the Ebola epidemic in West Africa as the ‘most severe acute public health emergency in modern times’. The disaster, she said, represents a ‘crisis for international peace and security’ and threatens the ‘very survival of societies and governments in already very poor countries’. As of October 2014, the disease had killed 4,951 and infected 13,567. It has crippled families, health systems, livelihoods, food supplies and economies in its wake. These numbers are likely to be vastly underestimated. How did it get to this? Why has this outbreak been so much larger than previous ones? The scale of the disaster has been attributed to the weak health systems of affected countries, their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This answer, however, is woefully de-contextualized and de-politicized. This briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development.

New therapeutic landscapes in Africa: Parental categories and practices in seeking infant health in the Republic of Guinea

Future Health Systems

In considering African health care practice, it is usual to draw strong distinctions between biomedical and traditional practices, and between public and private health institutions. Whilst distinctions between traditional and biomedical, and between public and private medicine make sense from the vantage point of health professionals, we question how far these distinctions are pertinent in shaping health-seeking behaviour given experience of them. This paper argues that other distinctions are becoming far more important to African therapeutic landscapes to the ways that people evaluate the salience of different health providers to their problems.
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Health dynamics, innovation and the slow race to make technology work for the poor

Future Health Systems

The “race to universal fixes” for health anddevelopment problems is valuable. It is an important counter to innovation approaches aimed simply at a race to the top inthe global economy, assuming that health and poverty-relatedproblems will be solved by trickle down. Yet as this article argues, it risks missing the finishing line if a complementary– and slower – race is not pursued. This “slow race”emphasizes pathways to tackling ill-health and disease whichare specific to diverse and dynamic local contexts; createshybrids between local and external knowledge andperspectives for appropriate solutions; recognizes thattechnological fixes are not enough and that social, culturaland institutional dimensions are key, requiring a systemsapproach to health and innovation, and embraces uncertaintyand unpredictable change through adaptation and learning.
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