Fevers, Feuds, and Diamonds: Ebola and the Ravages of History

Medical anthropologist Farmer (coauthor, Reimagining Global Health), cofounder of the international health-care organization Partners in Health, delivers an incisive and deeply informed account of the Ebola outbreak (“the largest in recorded history”) that engulfed West Africa in 2014. Placing the epidemic within the historical context of the transatlantic slave trade, European colonial rule, and more recent “diamond-fueled” civil wars, Farmer argues that the disastrous “control-over-care paradigm” used to combat Ebola had its roots in centuries of exploitation and neglect. He rejects explanations blaming the outbreak on “exotic practices and beliefs held to be common in this part of the world,” and characterizes Guinea, Liberia, and Sierra Leone, the three countries most severely afflicted, as “clinical deserts” where it was rational for people to be suspicious of authorities whose clear priority was to contain the disease rather than to provide adequate patient care (the mortality rate in some treatment centers was 50%). Farmer’s detailed synthesis of the history behind the crisis enlightens, but poignant profiles of victims, survivors, and physicians, including Dr. Humarr Khan, Sierra Leone’s “Ebola czar” who died from the illness, are the book’s greatest strength. This fierce and finely wrought chronicle offers essential perspective on fighting epidemics. (Nov.)