As social distancing measures are implemented everywhere, there will inevitably be people who choose to not take action to slow the spread of infectious disease. It is tempting to dismiss these people as uninformed or dangerous, but history shows us that doing so is likely to make their resistance to social distancing more entrenched. Based on the historical and anthropological records from past outbreaks, the people who resist public health measures most strongly will be those who have historically been mistreated or mistrusted by government or public health institutions. An example of these dynamics at play can be found in the West African Ebola outbreak. The 2014 outbreak illustrates how understanding politics and marginalization is key to addressing the reasons people resist public health measures.
It is important to consider that these same groups are likely to be impoverished, part of a population that experiences discrimination or otherwise marginalized in some way. Yet rather than exploring or addressing these factors, institutions in power have often blamed these people for not following recommended measures, labeling them as ignorant or somehow culturally inferior. These actions may make marginalization worse and may initiate a cycle of worsening reactions, leading to escalations in which people may be arrested[RH1] or even attacked by military forces.
Anthropologists Annie Wilkinson and James Fairhead argue that in any epidemic, an understanding of local political dynamics will contribute to working constructively with communities at risk of infection. These lessons are relevant not just in West Africa but around the world, including in relatively wealthy countries such as the United States. Every country has populations that are politically marginalized and that may not trust mainstream public health institutions — and working with rather than against these people is critical for disease control.
They key take-aways for coronavirus control are, rather than rushing to judge those who are not following public health measures, we should take a breath, dial back our fear and self-righteousness, and make a real effort to understand the experience and concerns of others. Compassion and commitment to finding solutions that work for everyone are key to a response that brings us together, not tear us apart, and they are some of our most powerful tools in fighting this pandemic.
Source: Wilkinson, Annie and Fairhead, James. 2016. “Comparison of social resistance to Ebola response in Sierra Leone and Guinea suggests explanations lie in political configurations not culture.” Critical Global Health 27(1): 14–27.doi.org/10.1080/09581596.2016.1252034