Postcolonial riskscapes: risk, trust, and the community-based response to Ebola virus disease in Liberia

The initial outbreak response to the 2014–2016 Ebola Virus Disease (EVD) in West Africa was met with resistance in Liberia. In part, this was because responders failed to account for how the country's colonial history and sociocultural circumstances influenced attitudes and perceptions of the population. We argue that understanding the relationship between the broader structural influences and the subjective aspects–the lived experience of people in the region–is crucial to developing more effective outbreak measures. In this light, we adopt and refine the concept of “riskscape” to highlight how the resistance to response teams shifted as the EVD outbreak unfolded. To illustrate our argument, we consider how the particular historical, cultural, and political forces constituted a “postcolonial riskscape”, influencing evolving perceptions of risk and trust in the context of the outbreak response in the West Point informal settlement located in Liberia's capital, Monrovia. As part of that discussion, we demonstrate how the adoption of a bottom-up community-based strategy by response officials, stimulated changes in the riskscape that helped pave the way for the adoption of an improved response strategy that resulted in a relatively swift decrease in EVD prevalence.