Antiblackness and Global Health: Placing the 2014 - 15 Ebola Response in the Colonial Wake
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Antiblackness and global health: placing the 2014 - 15 Ebola response in the colonial wake Thesis submitted for the degree of Doctor of Philosophy University College London By Lioba Assaba Hirsch Department of Geography Institute for Global Health September 2019 1 I, Lioba Assaba Hirsch confirm that the work presented in this thesis is my own. Where information has been derived from other sources I confirm that this has been indicated in the thesis. Lioba Assaba Hirsch 2 Abstract This thesis draws on Black Studies to explore how antiblackness is entangled in the field of global health. Drawing on ‘the wake’, a theorisation of Black life in the aftermath of enslavement and colonialism articulated by Christina Sharpe, it argues that the British- led, international response to the Sierra Leonean Ebola epidemic (2014-16) worked through colonial infrastructures and colonial imaginations of Sierra Leone as a de- historicised landscape, unaffected by transatlantic antiblack violence. It enhances existing analyses of the response by showing that historical entanglements of care and antiblackness signal ‘the wake’ as an epistemic and geographical reality. In Sierra Leone this reality is largely normalised and was, despite its ubiquity, given little consideration in the international Ebola response. The thesis takes the form of a multi-sited, non-linear, geographical study of the international response. It shows that ‘the wake’ underlies the international Ebola response; that it can be traced in Freetown’s cityscape, in the mobilities connecting Sierra Leone and the UK, in British archives and in colonial and contemporary expert accounts. Methodologically the research draws on interviews with international health responders and members of the Sierra Leonean diaspora involved in the Ebola response, fieldwork in Sierra Leone and London, and archival research on British colonial disease control. The empirical chapters examine the response in relation to ‘the wake’ in terms of the following themes: material and atmospheric traces of colonialism and enslavement in and around Freetown; disease control-related aeromobilities; colonial and postcolonial expertise; and care and care practices. The thesis demonstrates the value of placing contemporary global health in ‘the wake’ in order to rethink where and how we study the colonial present. In conclusion, it shows how ideas from Black studies should inform further research on global health in terms of unpacking postcolonial silences, centering Black perspectives and highlighting the endurance of colonial infrastructures. 3 Acknowledgments This thesis is dedicated to my parents, who believed that a 9-year old girl was capable of one day going to university and fought my teachers and the local school system to make it happen; who knew that I could do this, even before I knew myself. I wish every Black and Brown child growing up in a white world could have parents like you. Special thanks go out to all my research participants. I know your time is precious and I appreciate you spending some of it on my research. Without you I would not have been able to do this PhD. Especially a million thanks to M. and M. who introduced me to a multitude of people and allowed me to learn. I also could not have written this thesis without the generous financial support of the Heinrich-Böll Foundation and UCL’s cross- disciplinary scholarship training. Short parts of this thesis in chapters two, three and nine previously appeared in an Area paper entitled ‘In the wake: Interpreting care and global health through Black geographies’, which I wrote and which was published in August 2019. I thank the anonymous reviewers for their support and constructive feedback, which helped me sharpen my argument. This thesis would not exist without my principal supervisor, Alan Ingram. You read and re-read far too many drafts of what would become this thesis. Your patient, critical and generous support made me a better writer and thinker and pushed me to be the best researcher I could be. Thank you. Also, to my secondary supervisor, Ben Page who supported me throughout this process with critical insights and humour and kindness. Thank you. I would also like to thank the Institute for Global Health and especially Professor Ilan Kelman and Professor Ibrahim Abubakar who welcomed me and allowed me to learn and immerse myself in the field of Global Health. Sarah and Hibo made me a part of the IGH PhD student community and brought Black Girl Magic to IGH. They also reminded me that we’ve already made it. You’re awesome. I was lucky enough to be accompanied in my PhD journey by wonderful and inspiring colleagues and friends. Special gratitude to Sarah who lured me to UCL and was my PhD fairy Godsister. Thank you for being wonderful and generous with your friendship and your advice. To Lo Marshall, without whose amazing friendship and critical awesomeness I would not be where I am now. You are brilliant and wonderful and kind. 4 I would have been much lonelier and sadder too without the friendship of Tania, Niranjana, Laura, Daniela, Jane, Hui-Chun and Gümeç; thank you for shared meals and shared emotions. Thanks to Kat for Oxford chats, your generosity of spirit and all you do in the world. I am lucky to have been surrounded by a group of such inspiring, intelligent and strong researchers. And to Sandra, whose strength, kindness and intelligence inspire me. A special thanks is due to Ruba, Jamie, Niranjana and Sarah who read parts of this thesis and helped me edit it. And to Mateusz Zatonski who introduced me to my first interviewee. Thanks to Hilary Wainwright and Jamie, Philip and Amai Schaerer-Udeh who made me feel like I had a family and a home away from home. To my beautiful siblings, Leander and Louisa, for your support and friendship during this thesis and in life. A special thanks also to the Geography EDI Committee whose members took on extra (unpaid) work to make the department a more inclusive and diverse place. Also and especially to Anson Mackay for his generous and kind support to all students and for his always open mind and always open door. To Maria Rodriguez, Miles Irving, Suse Keay, Ajay Chauhun and Maks Ivkins for their support and eternal friendliness and patience in dealing with us students and helping us navigate life and work at UCL. And also to the cleaners who created a nice and agreeable working environment. Thank you. On an international scene, thank you to the entire SLURC team in Freetown, especially Joseph Macarthy and Brima Koroma who welcomed me to Sierra Leone and facilitated my research. And to Adia Benton for supporting my research from afar at the beginning and towards the end and for spontaneously meeting with me, when in London with her daughter. Finally, to Aidan: You make everything easier and calm my overactive mind. Thank you for sharing your life with me. 5 Table of Contents Thesis submitted for the degree of Doctor of Philosophy 1 Abstract 3 Acknowledgments 4 Table of Contents 6 List of Figures 9 List of Acronyms 11 Impact Statement 12 1 Introduction 13 1.1 Preamble 13 1.2 Thesis Rationale 16 1.3 Antiblackness and health in the wake: conceptual framework and thesis contributions 18 1.4 The 2014-16 Ebola outbreak and response: The case of Sierra Leone 23 1.4.1 The Outbreak 24 1.4.2 The Response 25 1.5 Chapter outline 27 2 Theoretical framing 32 2.1 Situating Black Studies, situating In the wake 32 2.1.1 Antiblackness, Afro-pessimism and the aftermath 33 2.1.2 Black geographies 38 2.2 Other frameworks 40 2.2.1 Mobilities 40 2.2.2 Ontopolitics 42 2.3 Conclusion 43 3 Literature review 45 3.1 Introduction 45 3.2 Situating Sierra Leone 45 3.2.1 Overview 45 3.2.2 Crises, violence and the everyday 48 3.2.3 Conceptions of space and spatial practice: the road and remoteness 49 3.2.4 Remoteness: security through spatial practice 51 3.3.5 Physical and spiritual landscapes 53 3.3 Biopower and biopolitics 55 3.3.1 Overview 55 3.3.2 Foucault and Agamben 56 3.3.3 The plague town and the panopticon 59 3.3.4 Space and power 60 6 3.3.5 Limitations and critiques 62 3.3.6 Summary 65 3.4 The politics of (global) health 66 3.4.1 Overview 66 3.4.2 Biological citizenships and governmental technologies 67 3.4.3 Discursive and conceptual framings of global health 74 3.4.4 Ebola in global health 81 3.4.5 Summary 85 3.5 Conclusion 85 4 Non-linearity and care: researching antiblackness in global health 86 4.1 Introduction 86 4.2 Positionality and reflexivity 87 4.2.1 Researching while diasporic and Black: mobility privilege and intersectional vulnerabilities 87 4.2.2 Reflections on Black-inspired methodologies and decolonial sensibilities 90 4.3 Ethics and Risks 93 4.3.1 Navigating traumatic events 93 4.3.2 Studying up in a multi-sited research project 94 4.4 Data Gathering 96 4.4.1 British archives of colonial disease control 97 4.4.2 Interviews with members of the Sierra Leonean diaspora in Britain 99 4.4.3 Interviews with international medical responders 101 4.4.3 Fieldwork and ethnographic observation 102 4.4.4 Gathering of documents 104 4.5 Data analysis 104 4.6 Conclusion 107 5 ‘The wake’ and ‘the weather’: place, weather and disease control in (post-)colonial Freetown 108 5.1 Introduction 108 5.2 Spatial Remains 111 5.2.1 Naming and the creation of the postcolonial cityscape 111 5.2.2 Care and Colonial Remains 119 5.3 Atmospheric Antiblackness 129 5.3.1 Race, place, disease 130 5.3.2 The weather 135 5.3.3 Atmospheres of (colonial) haunting 139 5.4 Conclusion 143 6 Colonial mobilities and infrastructures : the