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8. American Perceptions of Africa during an Ebola Outbreak

Published onMar 28, 2020
8. American Perceptions of Africa during an Ebola Outbreak
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The cover of an August 2014 issue of Newsweek featured an image of a chimpanzee behind the words, “A Back Door for Ebola: Smuggled Bushmeat Could Spark a U.S. Epidemic.” There was virtually no chance that “smuggled bushmeat” would bring Ebola virus disease (EVD) to America. Far from presenting a legitimate public health concern, the authors of the story and the editorial decision to use chimpanzee imagery on the cover placed Newsweek squarely in the center of a long and ugly tradition of treating Africans as savage animals and the African continent as a dirty, diseased place to be feared. Reactions to the recent EVD outbreak in the United States highlight longstanding ethnocentric and xenophobic popular understandings of Africa.

The 2013–2016 EVD outbreak in West Africa was unique in many respects. It was by far the largest recorded outbreak of the disease, infecting at least 28,000 individuals and killing over 11,000.1 It was also the first time that EVD spread beyond the African continent, with a traveler, Thomas Eric Duncan, bringing the virus to the United States, where two of the hospital staff who cared for him—nurses Nina Pham and Amber Vinson—were infected. Likewise, during this epidemic, various health care professionals were treated for the virus in Europe and the United States. In the United States, hysteria characterized much of the public reaction to EVD’s spread across the Atlantic. Although EVD was never a threat to the general public, sales of hand sanitizer and cleaning products spiked,2 children relocating from nonaffected African countries were kept out of school,3 and politicians responded to public fears with threats of quarantining all health workers returning from the infection zone, regardless of their actual exposure to Ebola virus.4

In this chapter, we seek to explain the hysterical, irrational public response to EVD in the West, primarily in America. In chapters 2 and 6 of this volume, respectively, Patricia Henwood and Armand Sprecher examined the international response in terms of supporting interventions against EVD in West Africa. In chapter 3, Michael Connor Jr. described the EVD cases treated in the West, while Marjorie Kruvand discusses the activities of hospitals dealing with the diagnosis of EVD inside the United States in chapter 11. Our chapter puts the Newsweek cover story and similar episodes during the 2013–2016 outbreak in a broader context of how Africa is viewed in the West and how these perceptions can shape response to a public health epidemic. We use a “College 101” approach to chronicle the domestic American response to the 2013–2016 EVD outbreak, covering some of the basics: history, geography, psychology, and our own discipline, political science. We conclude with a discussion of the implications of xenophobic responses in the West to public health epidemics in Africa.

History: A Long Tradition of Categorizing Africans and Immigrants as Inferior and Diseased

The Europeans who colonized Africa in the late nineteenth century were members of a culture obsessed with classifying and categorizing the natural world. This quest built much of modern biology, but also led to unscientific justifications for the colonial project. One idea developed by Frederick Coombs expounded the then-popular theory of phrenology: that the size, shape, and other physical characteristics of a person’s skull determine one’s intelligence (among other traits).5 The notion that physical characteristics of the skull determined intelligence, capability, and skill was patently false, but Europeans like Coombs worked hard to find evidence for their claims, starting with the assumption that they—white, northern and Western Europeans—were the smartest and therefore the characteristics of their own skulls were evidence of superior traits.

It followed from this assumption that southern Europeans (who were not considered to be racially “white” at the time) and people of color were inherently less intelligent than northern and western Europeans with light-colored skin.6 Victorian phrenologists developed elaborate typologies supposedly showing that Africans had the most apelike—and therefore most “savage”—skull types. The Victorians thus concluded Africans were less intelligent than northern Europeans and in need of the “civilizing mission” that colonization was supposed to bring, thus justifying African subjugation under colonial rule.7

While Coombs’s book may be the best known of the works of Victorian phrenology, the racism that his conjectures embodied was deeply embedded in the culture of colonizing states. Most Westerners of the time believed that people of color were “savages,” desperately in need of the benefits of modernity, Christianity, and intelligence that the colonists believed they were well suited to bring to Africa.8

As societal norms tend to do, the racism embodied in the notion that African people’s skulls are more similar to those of other primates than those of Homo sapiens skulls made its way into popular culture. And it did so in a particularly insidious way: by portraying Africans as apelike savages. Images showing Africans as apelike were commonplace. In popular culture, people of African origin were portrayed in postcards, film, and literature as “savages” who were not as “civilized” as their colonizers.9 These stereotypes even extended to children’s books. A Belgian cartoon book, Tintin au Congo, is perhaps the most famous of these representations; there, the Congolese people whom the boy adventurer Tintin encounters are at times almost indistinguishable from the great apes of central Africa. Similarly, Africans with exaggerated lips and other features who maintain extended-limb, apelike postures are portrayed throughout the original texts of the Babar series.10

As historian Sarah Steinbock-Pratt notes, imagery of Africans as hypersexualized savages—cannibals, even—persisted in cinematic representations of Africa throughout the twentieth century.11 For example, early volumes of Tarzan of the Apes, a wildly popular book series, stereotyped Africans as cannibalistic threats to “civilized” society.12 This long history of white people associating Africans with primates—both savage, running wild in the jungle (never mind that most Africans live nowhere near a jungle or any of the great apes), and threatening any white people who approach—has not evolved much in the last century.

In American society, there has been a persistent association of immigrants and disease.13 The Immigration Act of 1891 explicitly excluded from entry to the United States all “persons suffering from a loathsome or dangerous contagious disease.”14 Even before the Immigration Act of 1891 passed, immigrants were often scapegoats for infectious disease. For example, in the 1870s, San Francisco’s Chinatown was considered a “laboratory of infection,” and whenever a major epidemic threatened the city, “health officials descended upon Chinatown with a vengeance.”15

Associating immigrants with disease has continued in the century since the US Immigration Act of 1891. In 1991 Haitian refugees who tested positive for HIV were “confined like prisoners” at the naval base at Guantanamo Bay—despite knowledge at least five years earlier that HIV was not transmitted via casual contact.16 Early narratives about AIDS in the United States often invoked Haitians as a major “at-risk” population and the pathway through which HIV made its way from Africa to North America; these beliefs stemmed from underlying racist, ethnocentric attitudes.17 Likewise, in the 2003 SARS epidemic, New York City’s Chinatown was identified as a site of contagion and risk despite never having a single case of SARS.18

International migration has historically been associated with transporting disease, and metaphors of plague and infection have been used to marginalize and exclude diaspora communities.19 The aforementioned American episodes of overreaction to public health threats linked in the public imagination to immigrants—particularly nonwhite immigrants—have their equivalents in Canada,20 Australia,21 and elsewhere in the Western world.22

Geography: Africa as Monolithic

Despite the vastness of the African continent, historical mapping norms, particularly the Mercator projection, make Africa appear to be about the same size as Greenland, which is actually about one-fourteenth the size of the African continent. Misunderstandings about the continent have been perpetrated by old maps alongside cultural and media norms that often refer to Africa as one entity rather than an 11.7 million-square-mile land mass comprised of 54 countries and more than 1.1 billion people who speak over 2,000 different languages. The combined landmasses of the United States (including Alaska), Europe, and China are all smaller than the African continent.23 The United States would fit into Africa three times.

When a dangerous disease like EVD breaks out, Americans who are used to referring to “Africa” as one entity will mistake just how big of a threat EVD actually is, who might have been exposed to it, and the likelihood of infection. One example of a failure to appreciate the size of Africa and the distance between different African countries was the response to a woman vomiting on a flight from New York to Los Angeles in October 2014. Tens of firefighters and paramedics, along with airport police, county health officials, and FBI agents were on the scene at LAX to greet the plane and vomiting passenger.24 Why the huge response? She had been to Africa. It turns out she had not been to one of the most affected countries in West Africa but had been to South Africa—and she had airsickness, not a viral hemorrhagic fever. The distance between Liberia, the westernmost point of the main outbreak zone, and South Africa is over 3,000 miles. Yet the knowledge that the woman had simply been on the African continent was enough to terrify the flight crew and first responders into the unreasonable and unwarranted assumption that she might actually have been infected with EVD.

Of 54 African countries, only three countries had widespread and intense transmission of EVD. The three countries most heavily affected in the 2013–2016 Ebola outbreak were Guinea, Liberia, and Sierra Leone; more than 99 percent of recorded cases were in these three countries.25 Although there were also cases in Senegal, Nigeria, and Mali, these outbreaks were classified as having “localized transmission,” and EVD was contained relatively quickly in these countries.26 Considering the case of the sick air passenger traveling from South Africa, as we see in the map in figure 8.1, South Africa is almost as far from the outbreak zone as you can get while still being in Africa.

<p>Figure 8.1 West African countries with Ebola cases in the 2013–2016 outbreak are identified, as are South Africa and Sudan, to show the great distance between these two countries and the center of the epidemic.</p>

Figure 8.1 West African countries with Ebola cases in the 2013–2016 outbreak are identified, as are South Africa and Sudan, to show the great distance between these two countries and the center of the epidemic.

The American traveling from South Africa was only one example of overreaction in the United States. A Brooklyn teenager who had traveled from Sudan was ill with flu-like symptoms when New York health authorities thought he might have been exposed to Ebola virus.27 The map shows how incredibly far away Sudan is from the outbreak zone—more than 2,500 miles. Moreover, air travel from one African country to another—especially outside of each region—is difficult, and most commercial airlines had canceled flights into and out of airports in the outbreak zone. Someone needing to travel from Liberia to Sudan would have to transit via another country—probably in Europe or the Middle East—to get there, and the expense and difficulty of such travel, coupled with enhanced screening procedures for passengers originating from the outbreak zone, made it extremely improbable that someone would be infected with EVD in a place like Sudan.

As if the loss of life weren’t enough, the negative effects of the lack of geographic knowledge about Africa in this crisis had and continue to have real and negative economic impacts for Africans whose countries and lives are untouched by EVD. Estimates of the economic damage caused by EVD in this outbreak are as high as $32.6 billion.28 But the outbreak wrought havoc on African economies beyond the three most heavily affected by EVD, and that damage was completely avoidable. For example, bookings for safaris in East and Southern Africa—including for the famed Great Migration in Kenya and Tanzania—plummeted due to the EVD outbreak. In a survey of 500 safari tour operators, a majority of respondents had a decrease in bookings and an increase in cancellations in the wake of the West African Ebola outbreak.29

Psychology: How We Think about a Place or a People Shapes How We Respond

Fearmongering narratives about EVD circulating in the popular media have had a serious effect on how people think about the disease. Although the risk of contracting EVD was near zero in the United States, there was great public concern about a potential EVD outbreak on American soil. Nationally representative public opinion polls found 39–52 percent of Americans—depending on the date of the poll—thought there would be a large EVD outbreak in the United States, and more than a quarter of Americans were concerned that they or someone in their immediate family would get sick with EVD in the year following their survey interview.30 These surveys, and others taken during the height of hysteria in the United States, show that Americans grossly overestimated their risk of infection.31

Beyond overestimation of risk, the Newsweek story and similar media reports suggested increased vulnerability to EVD in the United States. The potential for an American outbreak raised emotions like anxiety, fear, and disgust, and these emotions sometimes influence policy preferences and prejudice.32 Under increased anxiety, Americans usually increase their support for policies that fight contagion, often at the risk of curbing civil liberties.33 Additionally, contexts of increased vulnerability will likely amplify negative reactions to people heuristically associated with disease.34 In the case of the Newsweek story, the many African migrants living in the Bronx (and potentially elsewhere in the United States) accused of liking bushmeat are further marginalized. The negative reactions to increased vulnerability include having more xenophobic attitudes. A study conducted in the wake of an outbreak of avian influenza showed that germ aversion was associated with support of exclusionary immigration attitudes and that perceived threat of the avian flu outbreak was associated with support for health-based immigration criteria.35

The Newsweek story likely generated additional prejudice against African migrants, a population that already suffers from greater prejudice than other immigrant groups. In a study predating the Ebola outbreak, researchers found that simply manipulating the geographical origin of a hypothetical immigrant group—from Eastern Africa to Eastern Asia to Eastern Europe—yielded significant differences in attitudes in a study population toward the immigrant group.36 Relatedly, a recent review of public attitudes toward immigration points out how prejudice and ethnocentrism can engender support for more restrictive immigration attitudes.37

Political Science: Politicking during an Epidemic

The peak of Ebola panic occurred during the thick of a US political campaign period. In addition to lower-profile state and local races, midterm Congressional elections took place in November 2014, as did elections for the governorship of 36 states. Faced with a relatively uninformed and inexperienced public when it came to Ebola, the outbreak was ripe for political exploitation. One prominent example was retired physician and then-US representative from the state of Georgia Phil Gingrey, who wrote a letter to the Centers for Disease Control and Prevention director regarding his concerns that migrant children crossing into the United States from Mexico were likely carrying EVD—as well as other “deadly diseases” that are “not indigenous to this country.”38

Numerous American politicians took full advantage of the Ebola panic to fearmonger in hopes of boosting their and their parties’ electoral success. Roughly 20 percent of over 1,600 e-newsletter communications from members of Congress in the period before the elections called attention to Ebola, which was twice as much as was communicated about other popular issues like Obamacare and immigration; 82 percent of e-newsletter communications mentioning Ebola were from Republicans.39 Excluding references made in the media to President Barack Obama, Republicans also produced twice as much media coverage as Democrats in US news articles about EVD.40 Analysts saw politicizing the outbreak as part of the Republicans’ midterm elections strategy.41 Once the midterm elections were over, media coverage of EVD dropped dramatically.42

Public opinion polls conducted during the outbreak reflected these partisan patterns. Survey respondents in a nationally representative poll taken in September—before Thomas Eric Duncan was diagnosed with EVD—showed strong partisan differences in how the United States should respond to the outbreak in West Africa. Only 37 percent of Republicans thought the United States should send financial aid, compared to 49 percent of Democrats.43 There was a similar gap between Republicans and Democrats for sending medical supplies (78 percent vs. 91 percent), sending medical personnel to train and assist doctors (58 percent vs. 68 percent), sending troops to assist with enforcing quarantines (9 percent vs. 21 percent), and in investing more money in Ebola research (60 percent vs. 68 percent).44 After Thomas Eric Duncan’s diagnosis and the infections of nurses Nina Pham and Amber Vinson, the gap between partisan Americans’ opinions about the Ebola outbreak widened. In a mid-October 2014 poll, 72 percent of Republicans thought the United States wasn’t doing enough to contain the EVD outbreak, compared to only 48 percent of Democrats who felt the same way.45 The partisan divide was also sharp in attitudes about potential policy responses; for instance, more Republicans (74 percent) than Democrats (46 percent) felt the US government should ban all direct flights from Africa.46

Even when public opinion is a partisan mirror of political elites’ behavior and opinions, it is challenging to substantiate that politicians making public statements about Ebola influenced citizens’ opinions about Ebola, because it could be that politicians are simply advocating on behalf of the opinions of their constituents. However, there is some evidence that politicization of the EVD outbreak increased negative attitudes toward immigrants. In survey experiments conducted among Americans in November and December 2014, the politicization of EVD by political elites negatively affected public opinion on immigration. More specifically, a single statement criticizing the Obama administration’s response to Ebola increased anti-immigrant attitudes by six percentage points.47

Conclusion

Coombs, the Victorians, and the people who created appalling twentieth century popular culture relating to Africa were engaging in a practice called “othering.”48 Othering happens when an in-group (in this case, white northern Europeans) treats other groups of people (the out-group—here, Africans and other people of color) as though there is something wrong with them by identifying perceived “flaws” in the out-group’s appearance, practice, or norms. The “unhealthy” are often othered and stigmatized.49 Research conducted both under laboratory settings50 and during actual disease outbreaks51 shows an association between disease salience and negativity toward foreigners. Although individual characteristics such as perceived vulnerability to disease and ideological beliefs about group hierarchies facilitate perceptions of disease threat as located among out-groups, othering is also dependent on media context and pre-existing representations of out-groups.52 Thus, portrayals of Africa and Africans in the media—whether during an outbreak or beforehand—are critically important in shaping whether Africans will be othered during disease outbreaks.

Othering has real consequences. Othering is particularly harmful in the context of a health epidemic because it “hampers the containment of contagion during an infectious epidemic by compelling people to reject public health instructions.”53 Scholars have reported on the racist and ethnocentric othering of Africans in the time of AIDS.54 But othering during a public health scare is not directed only at Africans, as the SARS epidemic clearly illustrated.55 Likewise, international media othering of African events or issues is not limited to infectious disease outbreaks, but also occurs in reporting on conflict. Othering of Somalia in the early 1990s led to the misidentification and oversimplification of the conflict’s dynamics by global policy actors, which led to two decades of misguided and ineffective policy responses to the Somalia crisis.56 Newsweek’s use of a chimpanzee to represent a scientifically invalid story about an African disease is a classic case of othering. It suggests that African immigrants are to be feared, and that apes—and African immigrants who might eat them—could bring a deadly disease to the pristine shores of the United States of America.

The long history of associating immigrants and disease in America and the problematic impact that association has on attitudes toward immigrants should make us sensitive to the impact of the “othering” of African immigrants to the United States during the 2013–2016 EVD outbreak in West Africa. Fearmongering about infinitesimally small risks in a given context serves no purpose to the greater good of trying to curb disease transmission and relieve people’s suffering in another context.

Acknowledgments

Portions of this chapter were previously published as posts on The Monkey Cage, a blog about political science and politics at The Washington Post and as a brief commentary in a special symposium on Ebola published by PS: Political Science and Politics. We are grateful to Adia Benton, Ruxandra Paul, Ken Sherrill, two anonymous reviewers, and the editors of this volume for their comments.

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