Emerging Vulnerabilities of Frontline Caregivers during Health Emergencies
Based on results of ethnographic study about social construction of trust, this article describes experiences of the Ebola Virus Disease epidemic. The author describes how, on the front line of the disease, response to an unpredictable epidemic in a country with limited resources such as Senegal, relies on the capacities of health workers not very visible, who have a precarious status, and who are not considered to be health personnel but who provide essential “ordinary” care on a daily basis through “tasks delegation”. The article describes the patient’s care itinerary, contact case identification modalities and the profile of the caregivers considered as “contacts”. The author describes their experiences, the social and financial effects of home assignment, which reinforces their double professional and social vulnerability as well as their suffering. Locked in a “health subsystem” at the entrance of the health pyramid, these invisible caregivers are the most exposed, the least protected or supported. In context of a country with a fragile health system, this analysis should contribute to a sociological understanding of the usual role of caregivers in the public health system and in epidemic situations, but also to understand contours of an “organized” and institutionalized invisibility that compromises epidemic responses.