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Despite impressive advances in biomedical science, the resurgence of infectious diseases poses an emerging threat to global public health. These developments underscore the importance of considering the relationship between biological and social change. This dissertation uses the epicentre of the HIV epidemic in West Africa---Abidjan, Cote-d'Ivoire---as a case study to show how epidemics are "crystallizations" of local biological and social factors. The Abidjan epidemic is accounted for in terms of the city's sexual modernity, rather than the common view that migration and prostitution explain the proportions the epidemic took there early on. This view supports recent epidemiological work demonstrating the importance of networks rather than behaviour in determining the scope of HIV epidemics. This sexual modernity has a complex genealogy that stretches back through the modernisation drive of the postcolonial state to colonial practices of government, including colonial strategies for containing tropical diseases, which shaped how Africans engaged with the modern world. As a result, sexuality became an important strategy for self-fashioning. With the advent of the economic crisis of the 1980s, sexuality became increasingly permeable to economic relations. Likewise, with the crisis, the city's therapeutic economy, heavily weighted towards the consumption of biomedicines, shifted resort for illness from the public health sector to the informal economy. This may have led to inappropriate treatment of sexually transmitted infections and increased re-use of needles, fuelling the epidemic further. Contemporary efforts to address the epidemic demonstrate how "bio-social" crystallizations can further effect social and biological change. The interface between local groups and international organisations is a site where transnational discourses of "empowerment" of people with AIDS, predicated on a western model of "self-help," encounter the local reality of poverty and illn

The fight against epidemics/pandemics is one of man versus nature. Technological advances have not only improved existing methods for monitoring and controlling disease outbreaks, but have also provided new means for investigation, such as through modeling and simulation. This dissertation explores the relationship between social structure and disease dynamics. Social structures are modeled as graphs, and outbreaks are simulated based on a well-recognized standard, the susceptible-infectious-removed (SIR) paradigm. Two independent, but related, studies are presented. The first involves measuring the severity of outbreaks as social network parameters are altered. The second study investigates the efficacy of various vaccination policies based on social structure. Three disease-related centrality measures are introduced, contact, transmission, and spread centrality, which are related to previously established centrality measures degree, betweenness, and closeness, respectively. The results of experiments presented in this dissertation indicate that reducing the neighborhood size along with outside-of-neighborhood contacts diminishes the severity of disease outbreaks. Vaccination strategies can effectively reduce these parameters. Additionally, vaccination policies that target individuals with high centrality are generally shown to be slightly more effective than a random vaccination policy. These results combined with past and future studies will assist public health officials in their effort to minimize the effects of inevitable disease epidemics/pandemics.

This study articulates the phenomenon of living under a constant threat of Ebola haemorrhagic fever, including what people’s reactions towards individuals and families affected by the illness symbolizes as well as the meanings ascribed to Ebola. The study was conducted in Kibale district in Midwestern Uganda to aid understanding of the human aspects of Ebola which has continued to result in widespread fear and anxiety, thereby creating challenges for affected individuals, families and health care professionals. A phenomenological inquiry was undertaken using Wertz’s (1983, 2005, 2011) empirical psychological reflection approach for data analysis, after utilizing purposive, convenience and criterion sampling techniques to select twelve (12) adult survivors and caregivers who anticipated, experienced and survived the outbreak and were in good health and also willing to take part in the study. Data were generated using in-depth qualitative interviews and the interviews continued until data redundancy was reached. The interview proceedings were digitally audio-recorded in addition to taking field notes and these were transcribed verbatim. Data analysis occurred at idiographic and nomothetic levels according to the principles of Wertz’s empirical psychological reflection. Thematic analysis of the research data revealed seven (7) themes, namely:  Living under constant threat of Ebola  Nature of Ebola experience: unique and general meanings  Surviving Ebola: physical, psychological, social, spiritual and economic implications on survivors  Caring for Ebola patients: social and psychological implications  Public reaction toward persons affected by Ebola  Social-cultural beliefs and practices related to Ebola  Coping with and living in the aftermath of Ebola outbreaks Adaptation emerged as the single most encompassing and accommodating concept that united the various themes, categories and sub-categories. It further grounded survivors’, caregivers’ and community’s experience of anticipating, experiencing and coping with challenges associated with Ebola. The findings add substantial knowledge about how survivors and caregivers experience Ebola outbreaks. Important recommendations are made and guidelines that may be used to increase survivors’, caregivers’ as well as the community’s resilience to challenges of future Ebola outbreaks are suggested. / Health Studies / D. Lit. et Phil. (Health Science)

This study articulates the phenomenon of living under a constant threat of Ebola haemorrhagic fever, including what people’s reactions towards individuals and families affected by the illness symbolizes as well as the meanings ascribed to Ebola. The study was conducted in Kibale district in Midwestern Uganda to aid understanding of the human aspects of Ebola which has continued to result in widespread fear and anxiety, thereby creating challenges for affected individuals, families and health care professionals. A phenomenological inquiry was undertaken using Wertz’s (1983, 2005, 2011) empirical psychological reflection approach for data analysis, after utilizing purposive, convenience and criterion sampling techniques to select twelve (12) adult survivors and caregivers who anticipated, experienced and survived the outbreak and were in good health and also willing to take part in the study. Data were generated using in-depth qualitative interviews and the interviews continued until data redundancy was reached. The interview proceedings were digitally audio-recorded in addition to taking field notes and these were transcribed verbatim. Data analysis occurred at idiographic and nomothetic levels according to the principles of Wertz’s empirical psychological reflection. Thematic analysis of the research data revealed seven (7) themes, namely:  Living under constant threat of Ebola  Nature of Ebola experience: unique and general meanings  Surviving Ebola: physical, psychological, social, spiritual and economic implications on survivors  Caring for Ebola patients: social and psychological implications  Public reaction toward persons affected by Ebola  Social-cultural beliefs and practices related to Ebola  Coping with and living in the aftermath of Ebola outbreaks Adaptation emerged as the single most encompassing and accommodating concept that united the various themes, categories and sub-categories. It further grounded survivors’, caregivers’ and community’s experience of anticipating, experiencing and coping with challenges associated with Ebola. The findings add substantial knowledge about how survivors and caregivers experience Ebola outbreaks. Important recommendations are made and guidelines that may be used to increase survivors’, caregivers’ as well as the community’s resilience to challenges of future Ebola outbreaks are suggested. / Health Studies / D. Litt. et Phil. (Health Science)