At the heart of the Ebola crisis: Africa's tribal culture

There's a horrifying article in the New York Post about a recent mass rape in South Sudan.  I won't publish all the gory details here. You can click on the link and read it for yourself.  Basically, one group wanted something, and when they couldn't get it, they took it from another group.  In its essence, that's the problem.  The women concerned were not regarded as human beings by their rapists, but as members of a group to be targeted.

This is yet another aspect of the biggest problem in Africa:  tribal identity and culture.  There is no concept whatsoever in African tradition that the individual matters.  It's all about the tribe.  You are born into a tribe, and that basically circumscribes most of your life.  You work for the good of the tribe;  you die (if necessary) for the good of the tribe (including older people walking out into the bush to starve if there isn't enough food, so that what's available will keep the youngsters - the future of the tribe - alive);  you identify so strongly with your tribe that all others are regarded with, at best, suspicion, if not fear and/or hatred.  You work to strengthen your tribe in every way possible, including by weakening all other tribes (this is why so many African civil servants will bend or break all the rules to accommodate their tribe, while applying them rigorously against the interests of others).  I could go on, but you get the idea.

This tribal attitude produces extreme (and often violent) xenophobia against outsiders.  In a major crisis situation, such as exists in the Congo right now, this can even extend to breakdown of society within a tribe.  One village may fear, resent or actively seek to destroy another village, even though they're both from the same tribe, because there simply isn't enough to go around;  so the first village wants to get it, and the easiest way to do so is to drive the second village into the ground.  Couple this with a level of education so abysmally low that shamans and witch-doctors have more influence than doctors, scientists or teachers, and you have a recipe for disaster.

Medical aid teams trying to contain the Ebola crisis are experiencing this at first hand in the Congo today.

Doctors and other experts currently or formerly working in the region described a landscape that is not quite a war zone but in which shooting can break out almost anywhere for unknown reasons.

“Yes, it’s stressful,” said Anthony Bonhommeau, director of operational development for ALIMA, the Alliance for International Medical Action. “You work in an Ebola unit all day, then you go back to the hotel and hear gunfire at night. We make it possible for our people to see psychologists and to get a break after three weeks.”

The violence has also cut short the work of veteran doctors from the Centers for Disease Control and Prevention, many of whom have extensive experience in Ebola epidemics. Two months ago, the State Department ordered all American government employees out of the region and confined them to the capital, Kinshasa, nearly 1,000 miles away.

. . .

Some residents refuse to believe that Ebola exists or dismiss it as a foreign plot to test new medicines on Africans. Many simply see it as a lesser threat than the constant ones: malaria, cholera, hunger and violence.

. . .

In addition, many villages have their own Mai Mai, a catchall word for self-defense militias. Some simply protect their home areas, but others go rogue, engaging in banditry like stealing cattle and robbing travelers.

Mai Mai may be farmers by day and fighters by night, “so when we go into a village to reach the population, we know the fighters may be there too,” said Dr. Axelle Ronsse, emergency coordinator for Doctors Without Borders.

Roving medical or burial teams have been beaten or stoned by villagers after rumors spread that they were stealing bodies for witchcraft or forcibly vaccinating children.

There's more at the link.

The Washington Post has more on the issue.

A quarter-century of vicious conflict, triggered by spillover from the Rwandan genocide in 1994, has been accompanied by deprivations of food, medicine and shelter that have shattered North Kivu’s society. Amid the widespread trauma and desperation, foreign companies have continued to extract the region’s extensive mineral wealth, often paying protection money to armed groups, stoking the conflict. The U.N. peacekeeping mission — established in 1999 and now the most expensive in the world — has been the target of violent protests over its perceived ineffectiveness. Suspicion of outsiders is common and rooted in history.

To protect themselves, many communities have taken up arms. The resulting militias, which vary greatly in size, are collectively known as Mai-Mai. Other groups, such as the Allied Democratic Forces (ADF), a Ugandan-origin extremist group infamous for its child soldiers, routinely skirmish with Congolese government forces and attack anyone they perceive to be collaborating with them. The brunt of their vengeance falls on civilians.

An effective Ebola response relies on persuading people in the affected area to cooperate with health workers, but the distrust sown by years of conflict makes that much more difficult. Yao, the WHO coordinator in Beni, said not a week goes by in which his teams are not attacked by skeptical locals.

“Even yesterday, one of our investigations teams’ car was destroyed and a team member’s house was burned,” said Yao, who is Ivorian Canadian.

. . .

Ebola is being transmitted in worryingly large numbers in Mai-Mai-controlled suburbs of Butembo. [Dr. Belizaire] spends days negotiating with the militias for access.

“New Mai-Mai groups keep calling us and making their demands; it’s like a new one every day,” she said. “But they are very hostile to outsiders coming in. In some cases, we’ve agreed to have them send community members to us so we can train them instead of the other way around.”

While many Mai-Mai groups are open to such arrangements, the ADF won’t engage. Local workers have taken to calling an ADF-controlled area between the towns of Mbau, Eringite and Kamango “le triangle de la mort” — the triangle of death. That’s where many are worried Ebola transmission is happening out of sight of the responders.

Again, more at the link.

At their root, the incidents and attitudes described in both articles can be traced back to tribalism.

• You aren't from around here?
• You speak a different language?
• You speak our language and are from our tribe, but not from our village?
• You have more than we do?
• You want us to do things we've never done before, and which violate our tribal customs?
• You want to treat us with medicines we don't understand?
• You say Ebola is a sickness, where our witch-doctors tell us it's a curse cast on us by our enemies?

Any or all of those things make you, the aid worker, an outsider, presumed to be an enemy until proven otherwise.  Unless and until you overcome those problems, you will never be trusted:  but the armed groups will make damned sure you don't get enough contact with the people to build that trust, because if you do, their domination of the locals will be threatened - and that might be a death sentence for them.  It's been that way for aeons.  Lose control, lose power, and you're probably going to lose your head, literally.  Therefore, as far as they're concerned . . . ain't gonna happen.

And that's why Ebola is uncontrolled in the Congo, and will probably become even more so.  It's not just the ongoing conflict in central Africa;  it's the tribal attitudes that have existed for centuries, which have hardened under the stress of the conflict, and are still at the root of the violence.  A Western medical approach stands almost no chance of overcoming those realities in many communities.  Some, yes . . . but not all;  and those that can't or won't listen are the breeding grounds from which Ebola will spread (and is spreading) to all the others.

Peter