No abstract

Quarantine has been widely used during the Ebola outbreak in West Africa mainly to control transmission chains. This measure raises ethical issues that require documentation of the modalities of quarantine at the field level and its social effects for contact persons. In Senegal, 74 people were in contact with the Ebola case coming from Guinea in September 2014. Of these, 34 members of the case's household were contained together at home and monitored by officers. The remaining 40 health care workers from two facilities were dispersed in their family households and monitored by telephone or during doctors' visits. The study is based on in-depth interviews with 43 adult contacts about their experiences and perceptions, with additional observation for interpretation and contextualization.Containment at home was applied differently to contacts who lived with patient zero than to professional health care contacts. No coercion was used at first since all contacts adhered to surveillance, but some of them did not fully comply with movement restrictions. Contacts found biosafety precautions stigmatizing, especially during the first days when health workers and contacts were feeling an acute fear of contagion. The material support that was provided-food and money-was necessary since contacts could not work nor get resources, but it was too limited and delayed. The relational support they received was appreciated, as well as the protection from stigmatization by the police and follow-up workers. But the information delivered to contacts was insufficient, and some of them, including health workers, had little knowledge about EVD and Ebola transmission, which caused anxiety and emotional suffering. Some contacts experienced the loss of their jobs and loss of income; several could not easily or fully return to their previous living routines.Beyond its recommendations to enhance support measures, the study identifies the ethical stakes of quarantine in Senegal regarding informed consent and individual autonomy, non-maleficence and benevolence, and equity and adaptation to specific situations. Nevertheless, the balance between preventive benefits and individual inconveniences of quarantine should still be evaluated from a public health perspective.

In this paper, we chart the context in which contemporary legal debates around traditional healing in Senegal unfold, pointing in particular to the type of power–knowledge relations that are at stake in both the current legal status–quo, and legal changes proposed in 2017. We interrogate the struggles over legitimacy and recognition that are at play in these processes, and the ways in which different actors relate to both formal legal rules, and more fluid forms of legalities, in which imaginaries of the law, and negotiations with the law, translate into everyday practices. We underline how legal and scientific discourses are mobilised to draw the opportunities and boundaries offered to different healing agents, and to organise their respective authority. Traditional healers overlap with modern health practices, while retaining their own ontologies and claims to legitimacy while representatives of the biomedical professions insist that they should have some oversight over the regulation of all healers. As negotiations continue over the possibility for the state to regulate traditional healing, everyday legal choreographies define the relative roles, possibilities and precarity of different healing agents.