Social Capital, its Uses and Contradictions, and its Relevance to the West African Ebola Crisis of 2013 – 2015

Social capital has been proposed as a useful concept for the understanding of epidemics of Emerging Infectious Diseases, such as the epidemic of Ebola Virus Disease (EVD) which occurred in West Africa in 2013 – 2015. This paper reviews some of the literature around the social capital concept, highlights the contested nature of that concept, and considers how the concept might be best applied to the study of the recent EVD crisis. It is argued that the emphasis in such studies must always be on the local meanings and concepts which establish the forms of social connection and networks which define social capital.

At the end of 2013, the first case in what would become the Ebola epidemic of 2013 – 2015 was identified, in the Guinean border town of Guéckédou (Kennedy and Nisbet 2015: 2). This was followed by a failure of both local governments and the ‘international community’ to intervene at an adequately early point against the burgeoning epidemic. Their failure allowed this outbreak of Ebola Virus Disease (EVD) to become the worst in recorded history, with a death toll numbering in several thousands in the affected countries, Guinea, Liberia, and Sierra Leone. Although the epidemic finally receded in mid-2015, its unprecedented scale, and its wider social cost, will require a great deal of research if it is to be fully understood. An emergent consensus has linked the scale of the outbreak to serious defects and deficiencies in the physical infrastructure, economies, health care and systems and political orders in the affected countries, defects and deficiencies that are rooted in the recent experience of protracted civil war (Sierra Leone, Liberia), or prolonged single-party rule and political crisis (Guinea). The consistent theme throughout the crisis was that of the inability of local authorities to properly effect and implement the public health measures, such as quarantines, that are necessary to the check and rollback epidemics. This inability was the result not only of deficiencies in the health care infrastructure (lack of doctors and other medical personnel, a paucity of ambulances, insufficient hospital places, etc.) but also due to widespread mistrust of government and the state among those communities most at risk of EVD. The issue of trust is significant here, because trust is at the heart of one of the key concepts of the past two decades – social capital. Defined as the amount of network connections which individuals and groups can draw on to gain access to resources, social capital has been seen as directly related to other social indicators relevant to health (Lomas 1998). Where high levels of connectedness and trust exist within a society – that is, where that society enjoys high levels of social capital – are directly related to low incidences of health problems and disease. Where levels of social capital or low or non-existent, on the other hand, health problems can be expected to be severe, and risk of susceptibility to epidemic diseases at both the individual and societal level can be expected to be high. Given the unprecedented scale of the EVD crisis in West Africa, and given that the disease spreads through social interaction in the kinds of social networks that are seen as one of the key defining features of social capital, and given also that social capital has become a key concept in public health and the understanding of epidemics, it seems reasonable to assume that many, if not most of the efforts to understand the West African Ebola crisis will make use of the social capital concept in some way.

The purpose of this paper is threefold. It is to review some of the literature on social capital, to highlight the contested and contestable nature of the concept, and to begin the task of thinking through how the social capital concept might be applicable or relevant to the case of the West African EVD crisis of 2013 - 2015. This is something that has direct relevance for policy questions, including those policy questions that arise in the wake of mass disasters such as that which struck the upper Guinea coast of West Africa in the last eighteen months. While it does seem to be the case that higher levels of social capital correlate with better public health, it also appears to be the case that not all forms of social capital are the same, and that the cultural systems which provide the means with which to forge social connections and accumulate social capital within any given population will vary from population to population, with consequences for the forms of social capital that appear in any given population. Different forms of social capital maybe correlated with different outcomes in, for example, degrees of susceptibility to viral epidemics. This is the second part of this paper’s purpose.