Anfaara Florence Wullo, Lawson Erica S, Luginaah Isaac
The Department of Gender, Sexuality and Women's Studies, Western University, London, Ontario, Canada.
The Department of Geography and Environment, Western University, London, Ontario, Canada.
Soc Sci Med. 2025 Jan;365:117609. doi: 10.1016/j.socscimed.2024.117609. Epub 2024 Dec 9.
Liberia, in the face of two consecutive health emergencies - the Ebola epidemic in 2014 and COVID in 2019 - offers a unique, comparative perspective on health crisis management within a fractured healthcare system. In dialogue with a feminist-informed political economy of health in the African context, this paper has two central objectives. First, it examines the strategies employed by community-based women's organisations - many of whom remain invested in peacebuilding after a 14-year civil war (1989-2003)) - to contain the Ebola and COVID-19 disease outbreaks. Second, it explores the implementation strategies under two political administrations, Sirleaf (Ebola) and Weah (COVID-19), at two distinct political moments. Results from five focus group discussions (n = 27) and seven in-depth interviews (n = 7) suggest that, while there was a relative collective effort from the Liberian government, grassroots women's organisations and community members to contain the Ebola epidemic response, the COVID-19 response witnessed an individualistic approach. Overall, participants suggested that lessons learned from the Ebola epidemic did not seem to be transferred to managing the COVID-19 pandemic in Liberia. The study suggests that while local-government-international partnerships are instrumental in ending health emergencies, grassroots community organisations require economic and social resources and sustained political will to effectively build and maintain various health infrastructures in post-conflict countries. This is relevant not just for managing disease outbreaks and health emergencies but also for entrenching public health services to support population health. Here, lessons from Ebola and COVID-19 rooted in everyday experiences of women's reproductive labour can provide an educational foundation for responding to future disease outbreaks in Liberia and other post-conflict contexts.
利比里亚在面对连续两次卫生紧急情况——2014年的埃博拉疫情和2019年的新冠疫情时，为在支离破碎的医疗体系中进行卫生危机管理提供了一个独特的、具有可比性的视角。结合非洲背景下基于女性主义的卫生政治经济学进行探讨，本文有两个核心目标。第一，研究社区妇女组织所采用的策略——其中许多组织在长达14年的内战（1989 - 2003年）后仍致力于建设和平——以遏制埃博拉和新冠疫情的爆发。第二，探讨在两个不同政治时期，在瑟利夫（应对埃博拉）和维阿（应对新冠疫情）两届政府管理下的实施策略。五次焦点小组讨论（n = 27）和七次深度访谈（n = 7）的结果表明，虽然利比里亚政府、基层妇女组织和社区成员为应对埃博拉疫情做出了相对集体性的努力，但在应对新冠疫情时却采取了个人主义的方法。总体而言，参与者表示，从埃博拉疫情中吸取的经验教训似乎并未被应用于利比里亚对新冠疫情的管理。该研究表明，虽然地方政府与国际伙伴关系对于结束卫生紧急情况至关重要，但基层社区组织需要经济和社会资源以及持续的政治意愿，才能在冲突后国家有效建设和维护各种卫生基础设施。这不仅与管理疾病爆发和卫生紧急情况相关，也与巩固公共卫生服务以支持民众健康相关。在此，源于女性生殖劳动日常经验的埃博拉和新冠疫情教训，可为利比里亚及其他冲突后环境应对未来疾病爆发提供教育基础。
