Fighting Ebola, and the Conspiracy Theories

Misinformation about politics may often seem silly - the immigration bill will give out free cars! - but the consequences of false beliefs in public health can be deadly.

In the developed world, myths about the risks of vaccines have enabled the resurgence of communicable diseases like measles and pertussis. And in developing countries, false beliefs have hindered efforts to fight HIV/AIDS and eradicate polio in countries like Nigeria and Pakistan.

The latest example of the dangers of health misinformation comes from Western Africa, where the response to an Ebola outbreak in four countries has been hampered by conspiracy theories about its causes and phony rumors about how to treat it. False beliefs may not be the biggest obstacle to containing the Ebola outbreak, but they make an awful situation worse.

People in the affected regions have become especially distrustful of doctors, with some suggesting the disease is a hoax. A resident of a heavily affected area in Liberia told The Wall Street Journal last week: "I've never seen anybody die of Ebola. I've only heard of it. So it's a rumor." These beliefs are often based on conspiracy theories that the disease was invented by national governments in search of international aid or political power.

When a crowd, angered at a sudden quarantine and the transfer of patients, overran a clinic in Monrovia, Liberia, on Aug. 16, the idea that Ebola was a hoax played a role. The intruders, some of whom yelled, "There's no Ebola," not only came into contact with infected patients (many of whom fled) but also looted the facility of equipment. The gear may have included contaminated materials that further spread the contagion.

The effects of Ebola myths apparently extend far beyond Monrovia. With so many people dying after leaving home to receive treatment, some residents have come to equate the effects of the disease with efforts to respond to it. Raphael Frankfurter, an aid worker in eastern Sierra Leone, described hearing one woman saying about the hospital in Kenema: "Ebola is a lie! They're sending people to Kenema to die!"

This kind of misinformation, along with fear of contagion, has led to some health workers' coming under attack, being blocked from entering affected areas or being spurned by their own communities. Workers have also encountered conspiracy theories that Ebola was brought to the region by Westerners.

In addition, false claims are circulating about how to treat the disease. The World Health Organization issued a statement warning people against unproven treatments or supposed preventive measures, such as drinking salt water, which has reportedly killed several people in Nigeria.

As we've seen in the case of vaccines, circulating correct information about the causes and treatment of Ebola - as the WHO and national governments are trying to do - has not been enough to erase these myths, particularly given the pace and scope of the outbreak and the lack of health facilities and workers in the region. A better approach (though harder to do quickly enough) is to work with trusted community leaders, as Dr. Marc Forget of Doctors Without Borders correctly emphasized.

"We need to go to the thousands of small villages and repeat the message," he said in an interview with CNN. "It has to be one-by-one contact that needs to be done through the chiefs, the local authorities, the youth. It is time-consuming and very difficult."

Such an approach has been used, for instance, in the fight against polio in Nigeria, where Muslim imams have been enlisted as advocates to help overcome local opposition.

In seeking to understand and address misconceptions about Ebola, it's especially important to avoid the victim-blaming impulse, which may be exacerbated by negative Western stereotypes about African culture, as Frankfurter notes. Anyone facing such a terrifying outbreak would be panicked, distrustful of outsiders bearing a potential death sentence, and eager for any shred of hope.

In particular, research suggests that conspiracy theories can be psychologically reassuring in situations like this - seeing conspiracies in randomness or attributing negative events to enemies can restore feelings of control when people encounter unpredictable threats. Until we can help people feel as if the situation is coming under control, we shouldn't be surprised if they try to regain psychological equilibrium however they can.