The Case of Ebola in West Africa - Swedish Healthcare Workers' Experiences of Navigating Global Health Interventions

Sammanfattning: In this time of global health interventions, preventing borderless diseases, such as Ebola, is a question of implementing global health policies in different cultural contexts. Although these interventions are mediated by international organs, the healthcare workers on the ground are actually those who implement policies. From this starting point, this thesis investigates the extent to which Swedish healthcare workers, when combating the Ebola virus disease in West Africa, take into consideration the local context in their application of global health preventive measures. It does so by exploring healthcare workers’ experiences of navigating global health interventions, while negotiating culture. Qualitative semi-structured interviews were conducted with participants in the Swedish Civil Contingencies Agency’s medical mission, which aimed to combat Ebola in Liberia and Sierra Leone. To understand their experiences, Michael Lipsky’s ‘bottom-up’ theory and conceptualization of the street-level bureaucrat inspired this study’s theoretical foundation. Three themes were prevalent in the interview material: Navigating the field and establishing trust, Consolidating objectives and Negotiating culture. This thesis argues that constant flexibility and adjustment to the pre-existing challenges in the field are vital in the adaptation of health policies. Moreover, flexibility is dependent on the information transferred from the field. Without rapid information transferal, bureaucracies and their employees have false perceptions of the field, on which they articulate their objectives for partaking in the health interventions. It is further argued that these actors continuously have an internal negotiation of ‘Self’ in relation to ‘Other’ and the bureaucracy that they work for, while trying to navigate health interventions in a foreign context. In conclusion, the ‘one size fits all’ approach does not work and this mindset (re-)produces a dichotomy between ‘us’ and ‘them’ where a certain way of doing things is seen as predominant.