BackgroundFuture infectious disease epidemics are likely to disproportionately affect countries with weak health systems, exacerbating global vulnerability. To decrease the severity of epidemics in these settings, lessons can be drawn from the Ebola outbreak in West Africa. There is a dearth of literature on public perceptions of the public health response system that required citizens to report and treat Ebola cases. Epidemiological reports suggested that there were delays in diagnosis and treatment. The purpose of our study was to explore the barriers preventing Sierra Leoneans from trusting and using the Ebola response system during the height of the outbreak.MethodsUsing an experienced ethnographer, we conducted 30 semi-structured in-depth interviews in public spaces in Ebola-affected areas. Participants were at least age 18, spoke Krio, and reported no contact in the recent 21 days with an Ebola-infected person. We used inductive coding and noted emergent themes.FindingsMost participants feared that calling the national hotline for someone they believed had Ebola would result in that person’s death. Many stated that if they developed a fever they would assume it was not Ebola and self-medicate. Some thought the chlorine sprayed by ambulance workers was toxic. Although most knew there was a laboratory test for Ebola, some erroneously assumed the ubiquitous thermometers were the test and most did not understand the need to re-test in the presence of Ebola symptoms.ConclusionFears and misperceptions, related to lack of trust in the response system, may have delayed care-seeking during the Ebola outbreak in Sierra Leone. Protocols for future outbreak responses should incorporate dynamic, qualitative research to understand and address people’s perceptions. Strategies that enhance trust in the response system, such as community mobilization, may be particularly effective.

This article describes how the Convention on the Rights of the Child (CRC) and other international child rights instruments are implicated in the postwar reintegration of child excombatants in Sierra Leone. Data are based on 18 months of ethnographic fieldwork throughout Sierra Leone from 1999 to 2001. Various actors, including children, their families, communities, teachers, nongovernmental organization workers, and the state, use the CRC and the Western construction of childhood as "innocent" and "apolitical" for strategic purposes. Child rights discourse and practice eases the reintegration of child excombatants by buttressing "discourses of abdicated responsibility" in children's narrations of their war experiences, thereby facilitating forgiveness and acceptance. However, this model of innocent child is in conflict with an earlier model of youth as hardworking and humble. In the struggle to reintegrate child soldiers, a new model of youth emerges in Sierra Leone, a model informed by the global human rights regime but created in everyday practice at the intersection of the global and the local.

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The brutal, eleven-year long civil war in Sierra Leone has been understood by many scholarly observers as ‘a crisis of youth’. The national elections of 2007 were notable for an explosion of popular music by young people directly addressing some of the central issues of the election: corruption of the ruling party and lack of opportunities for youth advancement. Though produced by youth and understood locally as youth music, the sounds were inescapable in public transport, markets, and parties. The musical style is a combination of local idioms and West African hip-hop. The lyrics present a young people's moral universe in stark contrast to that of their elders. This paper addresses the themes of these election-focused songs as well as the emerging subaltern youth identity discernible in supposedly less political songs.

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