Epidemics and community conflicts: the value of indigenous institutions in addressing development shocks in rural Sierra Leone

Esther Yei Mokuwa

Research output: Thesisinternal PhD, WU


This work looks at the effect of institutions on development in Sierra Leone.  Problems of underdevelopment have been linked to institutional failures.  This thesis examines that argument, in relation to agrarian challenges contributing to the civil war of 1991-2002 and epidemic of Ebola virus disease in 2014-15.

Chapter 2: The outbreak of Ebola Virus Disease in Upper West Africa 2014-15 is the largest ever recorded.  This chapter describes the epidemic in Sierra Leone, and explores some of the social factors responsible for spread of the virus. Molecular evidence suggests infection depended on human-to-human contact.  To understand the epidemic and how to stop it social analysis was necessary.  The chapter focuses on the spread of Ebola in rural areas, the least fully documented part of the epidemic.  Various forms of social networking in rural communities and their relevance for understanding pathways of transmission are described.  Particular attention is paid to the relationship between marriage, funerals and land tenure.  Funerals were identified as a high-risk factor for infection. 

Chapter 3: This chapter considers local responses to the introduction of a large-scale Ebola Treatment Centre in eastern Sierra Leone in 2014-15.  Our study used qualitative methods to gather responses from patients, members of the families of survivors and victims of the disease, social liaison workers, and members of the general public. Scepticism and resistance were widespread at the outset. Direct experience of the disease changed perceptions, however. Even relatives of deceased victims agreed that the centre was valuable.  However, we also present evidence of scepticism in the minds of members of the general public, who continued to consider that Ebola was a crisis manufactured for external benefit.  Our conclusions stress the importance of better connectivity between communities and Ebola facilities to facilitate experiential learning. There is also a need to address the wider cognitive shock caused by a well-funded Ebola health initiative arriving in communities with a long history of inadequate health care. Building trust requires Ebola Virus Disease to be re-contextualized within a framework of concern for the health of all citizens.

Chapter 4: This chapter discusses an institutional innovation intended to address some of the problems apparent in public response to large scale Ebola Treatment Centres apparent in chapter 3. These centres were distant from where new cases were emerging, and not well designed to allow families to maintain contact with patients.  This challenged local institutional values, rooted in ideas about mutual care for the sick and dead.  Families were slow to reveal Ebola cases to the authorities, and infection spread. A need to accommodate family-based enclave values was recognized and new smaller, decentralized facilities (Community Care Centres) were established.  As a result, families began to feel they were playing a meaningful part in the treatment of their patients, even though basic biosafety principles still had to be followed. Communities were also involved in providing land and in the building of the centres.  Responders stumbled over land tenure issues until local institutional perspectives on land ownership were accommodated. The chapter argues that it is not necessary or helpful to impose “formal” top-down institutions on Ebola response.  It may be better to try to work local institutional values into the development “mix”.

Chapter 5: This continues the theme of institutional clash, but now applies the argument to a new case.  The civil war in Sierra Leone (1991-2002) fought for diamonds, or was it a peasant insurgency motivated by agrarian grievances? The chapter argues the case for agrarian grievance, derived from an examination of the anthropological literature concerning land, labour and marriage.  The argument is tested using econometric tools applied to data from a randomised household survey undertaken in 178 villages surrounding the Gola Forest in eastern and southern Sierra Leone, the cradle of the war.  It is shown that peasant disputes over marriage mark out an institutional clash concerning inter-family labour, evidenced by cases presented in local courts and family moots.  Disputes mainly involve a village elder suing a young man with weak social protection.  Fines are exceptionally high.  Most fines are paid off in the form of farm labour.  The chapter reports that a temporal distribution of cases is strongly associated with two periods of peak labour demand on upland rice farms.  It is concluded that local requirements to maintain social cohesion through marriage clashed with the growing individualism of labouring youth, and contributed to conditions fostering insurgency. This agrarian hypothesis, in turn, helps account for the otherwise puzzlingly high levels of peasant-upon-peasant violence associated with the civil war in Sierra Leone.

Chapter 6:  Chapter 6 offers a reflection on issues of institutional conflict raised throughout the thesis. When the decade-long civil war ended in 2002 NGO motorbikes penetrated to all parts in the relief and rehabilitation effort. This encouraged ex-combatants to buy cheap Indian bikes to take up work as taxi riders.  Young women – a highly targeted group during the war – were prominent among their passengers. When interviewed, they explained that they wanted to trade in the villages but were unsure about local conditions after over a decade of conflict and chaos, so preferred ex-combatant riders who knew how to handle any potential security challenges.  The ex-fighters were no longer feared because they were now the providers of a valuable transport service. Some riders started to lodge in the villages, and even to build houses, marry and have children. A resident rider is especially valued for being able to ferry passengers for medical treatment at any time of the night. As a result, the institutional values of market and enclave began to co-exist more comfortably. This brings us to the overall conclusion of the thesis; in African development, it may be better to allow people to find their own way, using their own institutional styles of accommodation.

Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Wageningen University
  • Bulte, Erwin, Promotor
  • Maat, Harro, Co-promotor
  • Voors, Maarten, Co-promotor
Award date9 Dec 2020
Place of PublicationWageningen
Print ISBNs9789463955928
Publication statusPublished - 9 Dec 2020


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