Why would people living in a region afflicted with an outbreak of the deadly Ebola virus burn down clinics and attack healthcare workers who are trying to contain the disease? That’s what I wondered when I read a recent article reporting that this was happening in the Congo.
I believe we can gain insights into this dynamic through an understanding of organizational wisdom. Better yet, such understanding points to solutions.
Organizational wisdom recap
As I have discussed previously, there are three themes of wisdom:
- Values guide wise action
- Knowledge is required, but insufficient for wise action.
- Wisdom is action-oriented. Action requires us to exercise our power.
How does this framework help us understand people are attacking Ebola clinics?
The article quoted one of the aid workers as saying, “The [government’s] response has often treated patients as a biosecurity risk, rather than as a patient with a choice about how they should manage their own illness.”
We can find at least two values in conflict from the above statement. On the one hand, we have the value of individual autonomy over one’s own body. On the other, we see the value of protecting the public from this dangerous disease. Both values are essential to a healthy society, but the spread of Ebola puts them in conflict.
The article also lists a variety of ways people in these affected areas understand Ebola, including:
- It is spread by the government to eliminate specific ethnic groups
- It is spread by white people to harvest people’s organs
- It is a sham spread by the government to prevent people from voting
I have previously discussed the different forms rationality can take. The above are examples of “embedded rationalities” (that is, knowledge of the world is embedded within a social setting). For people who live under a repressive regime, such interpretations of the disease may have a more visceral reality than esoteric concepts of viruses and vaccines.
The article quotes a resident of an affected town describing how the care workers entered the area. “The response started badly. They came here with police escorts to be protected. That wouldn’t have been necessary if they had employed [local people] to work with them.”
That is, the coercive arm of the state spear-headed the entry of care workers into affected areas. Given the conflicting rationalities and values I described above, one could easily imagine how residents might view such an entrance as one more act of oppression.
Most readers, I suspect, will believe attacking healthcare clinics aimed at stopping the spread of Ebola is wrong. That said, through understanding the values in conflict, the rationality informing people’s understanding, and the power dynamics at play, perhaps we can gain more insight into why they are being attacked. We may not agree with these attacks, but we can understand what is driving them. Through that understanding, we can chart a path forward.
Many people would agree that autonomy over your own body is a significant value. They might also agree that public safety in the face of a virulent disease is also essential. Is this truly an either/or situation? Can we protect the public while respecting the individual? Through dialogue with leaders of affected communities, as well as with the infected and their families, a balance can be struck.
The attacks on clinics tell us the beliefs held by these communities are backed with coercive force. These beliefs, therefore, cannot be ignored. Fortunately, we have successful examples of care workers bridging this divide. The secret seems to be engaging in dialogue with members of the community, respecting their forms of knowledge, and collaborating on how to manage the healthcare workers’ intervention.
The above two solutions empower the affected communities. Rather than imposing a solution, healthcare workers empower the community to collaborate in the creation of an effective response to the disease.
Looking closer to home
The problem I discussed in this post is not unique to rural Africa. Here in industrialized nations, we have radically different views on vaccines, climate change, and even the shape of the earth. The impact of these disagreements is significant.
Through the above, we see a heavy-handed approach stiffens resistance and stalls progress. Perhaps through understanding and respecting the interplay between values, rationality, and power, we can develop wise solutions to the problems besetting us.
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