Mobilizing the social infrastructure of informal settlements in infectious disease response – The case of Ebola Virus Disease in West Africa

Abstract

The growth of social precarity - particularly in the Global South - has meant that those living in informal settlements typically face a wide range of threats on a day-to-day basis due to the lack of basic welfare, social services and infrastructure, normally provided by the state. In the relative absence of formal infrastructures, people informally forge their own connections, capacities and opportunities so that they are able to access the social support they requirewhen needed. Recognizing this trend, this paper argues that there is a greater need for epidemic program planners to recognize and leverage the potential social infrastructure of informal communities and self-governance mechanisms during a disease epidemic. This need highlights the importance of tapping into already existing networks of social capital that can be readily mobilized during an epidemic to achieve a more rapid response. The empirical basis of our arguments draws primarily on qualitative research in informal settlements of Freetown, Sierra Leone and Monrovia, Liberia, following the 2014–16 Ebola Virus Disease (EVD) outbreaks. Our research reveals that distrust in government and inadequacies in the official response were identified as primary factors accounting for the severity of the EVD outbreaks in informal settlements. Overall, the research stresses the importance of adopting community-based approaches to infectious disease response that explicitly builds on context-specific knowledge pertaining to locally-based informal social arrangements, governance mechanisms and the local political history in which the informal settlement is embedded.