This is one of a series of case studies showing how STEPS Centre projects have used methods and methodologies in particular settings.
Bats perform critical ecological roles, live very closely with humans and interact with livestock in new and changing ways that reflect shifting human demography and lifestyle patterns. They are not conventionally understood to be dangerous or to pose any risks to disease, yet these perceptions are shifting as natural scientists uncover new evidence of bats. At the same time, as diseases transmitted from wildlife are emerging as a key challenge to human health, bats are assuming increased importance in terms of uncovering new approaches to disease transmission and better understandings of how policies can best ensure both environmental and social gains.
This research focused on Ghana and aimed to examine the impact of scientific research and knowledge about emerging zoonotic disease, bats and human health in Ghana; and how this in turn informed policy. It approached this through an examination of academic research on bats, policy processes associated with zoonotic disease, media reports and health surveillance priorities.
Ghana hosts several sizeable bat colonies, which have become eco-tourism sites. Especially well known are the roosts at Buoyem, in the BrongAhafo Region; Shai Hills in the Greater Accra Region, Wli Falls in the Volta Region and at 37 Military Hospital in the capital, Accra. As this is one of Ghana’s most important hospitals, and it is located in the centre of Accra, at the intersection of several transit routes, Accra was the main focus of the research.
We began with the following two research questions:
- How have different actors’ framings of zoonotic spillover, associated risks and drivers shifted over time in interaction with growing scientific (and other) evidence?
- In what ways have these framings influenced policy around zoonotic health threats, bat conservation and small scale livestock surveillance?
Qualitative research – in the form of in-depth, open-ended interviewing – was undertaken in Accra, Ghana during May 2012 and October 2012. At this point in time, there was no definitive research evidence of disease spillover from bats to humans and no identified categories of ‘at risk’ people, although international researchers had alerted Ghanaian government officials that this possibility existed. In particular, scientific evidence showed that bats were associated with Lagos Bat Virus, Hendra, Nipah and Ebola. Key government representatives were concerned that widespread knowledge of the association between bats and Ebola would lead to panic and indiscriminate killing of the bats. This information was thus ‘confidential’ and not widely shared even within government.
Our research was done in collaboration with Ghanaian and international veterinary researchers who shared their scientific research with us. They also introduced us to key stakeholders and helped to ensure that key stakeholders were available for interview. This meant that, as researchers, we knew of this evidence and we knew that many key policy makers were not necessarily aware of the connections between bats and zoonotic disease spillover. This unusual situation of being privy to ‘confidential’ information gave us particular insights about knowledge, networks and about power relations.
Ethical approval was received from the Noguchi Institute of Public Health prior to the fieldwork beginning. Interviews were therefore undertaken in two rounds. In the first set of interviews, we spoke to key informants who were in some way connected to the research and who were ‘knowledgeable stakeholders’ in public health, wildlife conservation, veterinary services and biology. The second round of interviewing involved an expanded circle of stakeholders (from the tourism sector, traditional leaders, scientists, conservation NGOs and other government representatives who were less ‘knowledgeable’ about the ongoing scientific research on bats and zoonotic disease).
Broadening out and opening up
Our questions sought to broaden out understandings, by exploring the extent of different actors’ knowledge about bats and disease spillover as well as their diverse interpretations about the nature of this evidence, the degree of risk and the need to act. We sought, not to know whether there was adequate evidence that bats harboured diseases and posed a risk of zoonotic disease spillover or not, but rather to explore diverse viewpoints in relation to disease, risk and health policy. This line of questioning revealed the different disciplinary and sectoral perspectives on bats and on disease, and enabled us to better understand how people’s previous training and their different positions within government, or in other external organisations, influenced their perspectives, understandings of risk and possible pathways. This also helped to open up politics through highlighting alternative possibilities for dealing with the uncertainty around bats and zoonotic disease spillover.
During interviews, we asked stakeholders about their involvement with the media, their experiences of being cited in the media and their perceptions of media reporting. Although not initially planned, in turn, this led to a systematic search of the media to determine the sources of information on bats and zoonotic disease as well as how risk and uncertainty were being framed in both international and local sources.
Broadening even further
When we began the research, in June 2012, we had to be very careful about what we could ask as not everyone knew about the links between bats and disease. Ghana officials were worried about how people would react to the news that bats were potential carriers of the Ebola virus and wanted to avoid unconsidered attacks on the bats. As we undertook our interviews, questions of bat conservation and of the trade-offs between ecology and health emerged which we did not have answers to. In particular we wondered:
- In what ways have stakeholders’ awareness of bat conservation and the interconnectedness of ecology and health changed?
- What are the trade-offs between human health and bat conservation?
As we planned, in March 2013, to extend our research, a major outbreak of Ebola spread across West Africa with Guinea and Liberia badly affected. Ghana media reported on these outbreaks. In addition, one suspected Ebola death was reported from within Ghana. Although this was subsequently proved negative, the Ghana Health Ministry confirmed that bats, along with other animals such as infected chimpanzees, gorillas, forest antelope and porcupines, could transmit Ebola. People began to ask about the bats at 37 Military Hospital and the possible dangers. And so, as the situation develops, we are able to go back and do follow-up interviews with the same stakeholders, examining how their perspectives have changed and developing a greater understanding of the challenges and trade-offs associated with policy that seeks to embrace both ecology and human health dimensions.