‘Worse than the War’: An ethnographic study of the impact of the Ebola crisis on life, sex, teenage pregnancy, and a community-driven intervention in rural Sierra Leone

The Ebola virus disease (EVD) epidemic and crisis of 2014-2016 dealt a devastating blow to the citizens of Guinea, Liberia, and Sierra Leone, the full impact of which is still being unearthed. The purpose of this research is to illuminate both the wider impacts of the Ebola crisis on people’s lived experiences, with an emphasis on children, and its more specific effects on issues related to teenage pregnancy and its prevention.

The research was conducted as part of an effort to learn how the Ebola crisis had affected and interacted with a community-driven intervention to reduce teenage pregnancy. The intervention, which had been developed and conducted by two clusters of three communities each in Moyamba and Bombali Districts, respectively, included elements such as: dramas created and performed by teenage girls and boys on consequences of pregnancy followed by discussions; parent-child discussions on puberty, sex, and pregnancy; creation of and transmission by teenagers of youth oriented messages about preventing teenage pregnancy; ongoing community dialogues and reflection about teenage pregnancy; and support from health workers and authorities.

The Ebola crisis interrupted the intervention and introduced a host of confounding variables and threats to children, including increases in teenage pregnancy. Realizing that it would be impossible to interpret the endline survey data in a meaningful way, the research team decided to conduct post-Ebola ethnography that would examine how the Ebola crisis had affected children’s well-being, teenage pregnancy and related issues, and the community driven intervention. 

The key findings are presented in three sections on general effects of the Ebola crisis, effects on teenage pregnancy and related issues, and effects on the community driven intervention. Four key recommendations close out the report.