Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa

Trust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies imped...

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Main Authors: Molly J Ryan, Tamara Giles-Vernick, Janice E Graham
Format: Article
Language:English
Published: BMJ Publishing Group 2019-02-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/4/1/e001272.full
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author Molly J Ryan
Tamara Giles-Vernick
Janice E Graham
author_facet Molly J Ryan
Tamara Giles-Vernick
Janice E Graham
author_sort Molly J Ryan
collection DOAJ
description Trust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic. Focusing on responder’s experiences of communities’ trust during the epidemic, this qualitative study identifies and explores social techniques for effective emergency response. The response required individuals with diverse knowledges and experiences. Responders’ included on-the-ground social mobilisers, health workers and clinicians, government officials, ambulance drivers, contact tracers and many more. We find that trust was fostered through open, transparent and reflexive communication that was adaptive and accountable to community-led response efforts and to real-time priorities. We expand on these findings to identify ‘technologies of trust’ that can be used to promote actively legitimate trustworthy relationships. Responders engaged the social technologies of openness (a willingness and genuine effort to incorporate multiple perspectives), reflexivity (flexibly responsive to context and ongoing dialogue) and accountability (taking responsibility for local contexts and consequences) to facilitate relations of trust. Technologies of trust contribute to the development of a framework of practical techniques to improve the acceptance and effectiveness of future emergency response strategies
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spelling doaj-art-6a677024a57b44729f2616e636b469ee2025-08-20T02:37:47ZengBMJ Publishing GroupBMJ Global Health2059-79082019-02-014110.1136/bmjgh-2018-001272Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West AfricaMolly J Ryan0Tamara Giles-Vernick1Janice E Graham21 Pediatrics (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, CanadaAnthropology & Ecology of Disease Emergence Unit/Global Health, Institut Pasteur, Paris, FranceDepartment of Pediatrics (Infectious Diseases), Dalhousie University, Halifax, Nova Scotia, CanadaTrust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic. Focusing on responder’s experiences of communities’ trust during the epidemic, this qualitative study identifies and explores social techniques for effective emergency response. The response required individuals with diverse knowledges and experiences. Responders’ included on-the-ground social mobilisers, health workers and clinicians, government officials, ambulance drivers, contact tracers and many more. We find that trust was fostered through open, transparent and reflexive communication that was adaptive and accountable to community-led response efforts and to real-time priorities. We expand on these findings to identify ‘technologies of trust’ that can be used to promote actively legitimate trustworthy relationships. Responders engaged the social technologies of openness (a willingness and genuine effort to incorporate multiple perspectives), reflexivity (flexibly responsive to context and ongoing dialogue) and accountability (taking responsibility for local contexts and consequences) to facilitate relations of trust. Technologies of trust contribute to the development of a framework of practical techniques to improve the acceptance and effectiveness of future emergency response strategieshttps://gh.bmj.com/content/4/1/e001272.full
spellingShingle Molly J Ryan
Tamara Giles-Vernick
Janice E Graham
Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
BMJ Global Health
title Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
title_full Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
title_fullStr Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
title_full_unstemmed Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
title_short Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014–2016 Ebola outbreak in West Africa
title_sort technologies of trust in epidemic response openness reflexivity and accountability during the 2014 2016 ebola outbreak in west africa
url https://gh.bmj.com/content/4/1/e001272.full
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AT janiceegraham technologiesoftrustinepidemicresponseopennessreflexivityandaccountabilityduringthe20142016ebolaoutbreakinwestafrica