Canadian Journal of Communication Vol 44 (2019) 191–210  ©2019 Canadian Journal of Communication Corporation http://doi.org/10.22230/cjc.2019v44n2a3341


Visualizing Ebola: Hazmat Suit Imagery, the Press, and the Production of Biosecurity

Neil A. Gerlach, Carleton University

Neil A. Gerlach is an Associate Professor in the Department of Sociology and Anthropology at Carleton University, Ottawa. Email: neil.gerlach@carleton.ca.


ABSTRACT 

Background Examining press coverage of the Ebola outbreak in West Africa in 2014, this article analyzes the work of the hazmat suit as a visual signifier of disease.

Analysis  Hazmat imagery from Africa operated to make the disease visible, both “othering” it and contributing to fantasies of containment. In American imagery, the suit became a figure of biosecurity and reassurance, while also connoting the prospect of American “diseaseability.”

Conclusion and implications  African hazmat imagery reinforced pre-existing schema for understanding Ebola within a news category while American imagery straddled the boundary between the geography of disease fear and the imagined immunological community, potentially destabilizing press narratives of reassurance.

Keywords  Hazmat suit; Ebola; Press coverage; Geography of disease; Biosecurity; Photojournalism

RÉSUMÉ

Contexte   Par l’intermédiaire de la couverture journalistique de l’épidémie Ébola en Afrique de l’Ouest en 2014, cet article analyse les combinaisons Hazmat en tant que signifiants visuels de maladie. 

Analyse  La combinaison Hazmat a servi de métonymie pour représenter la maladie en Afrique, la rendant « autre » et contribuant à l’espoir qu’elle puisse être limitable. Au États-Unis, la combinaison a symbolisé biosécurité et rassurance tout en soulevant l’idée que cette épidémie pourrait atteindre les États-Unis.

Conclusion et implications  Pour la compréhension d’Ébola, l’imagerie Hazmat provenant de l’Afrique renforce certains schémas préexistants correspondant à des cadres journalistiques particuliers. En même temps, l’imaginaire américain brouille la frontière entre la peur d’une maladie franchissant ses confins géographiques et la confiance en la communauté immunologique, brouillage potentiellement déstabilisateur pour les médias se voulant rassurants envers leurs publics.

Mots clés  Combinaison Hazmat; Ébola; Couverture médiatique; Géographie de la maladie; Biosécurité; Photojournalisme


The July/August 2018 issue of The Atlantic contained a lengthy story entitled “When the Next Plague Hits,” with a subtitle that stated, “The epidemics of the early 21st century revealed a world unprepared, even as the risk of pandemics continues to multiply. Much worse is coming. Is Donald Trump ready?” (Yong, 2018, pp. 58–59). For the purposes of this article, the significant part of the story is the fact that the first page is illustrated with a photograph of two people in hazmat suits practising pandemic protocols on a mannequin. Such imagery recalls the relatively recent images of hazmat-suited figures in press coverage of the Ebola outbreak in West Africa in 2014–2015, which in turn recalls similar imagery during the SARS outbreak of 2003 and the avian flu scare of the early 2000s. The centrality of the hazmat suit in contemporary disease imagery is not surprising given the dangers posed by many modern infectious diseases, but rather than taking the image for granted, this article seeks to explore it further by asking the following questions. What is the function of the iconic hazmat figure within journalistic disease imagery? What is its work within the tensions created by contradictory press narratives of fear and reassurance? How does the hazmat suit, as an element of the visual culture of disease, operate within larger social discourses about the relationship between geographies of disease and imagined communities? The 2014 Ebola outbreak in West Africa provides a particularly apt case study for these questions because of the way the virus travelled from Africa to the United States, demonstrating the different functions of the hazmat suit in different contexts.

The article analyzes the Ebola 2014 coverage provided by four major American news sites and argues that at one level, hazmat suit imagery intervenes between a journalistic discourse of “diseaseability”—the sense of being constantly surrounded by, and vulnerable to, disease—and a discourse of reassurance, by both locating diseaseability elsewhere within a geography of disease fear and simultaneously signifying biosecurity at home. At another level, however, the hazmat suit makes the disease visible and operates to disrupt notions of biosecurity within the “imagined immunological community” of the United States and the global North more generally. In this way, hazmat imagery contributes to a sense of ubiquitous disease threat that is a part of contemporary globalized societies. Through this analysis, the article seeks to contribute to the understudied field of photojournalism and disease by examining how photojournalistic disease imagery fits into the discursive formation of biosecurity.

Themes in Ebola press coverage and the visual culture of disease

Analyses of the 2014 Ebola outbreak in Guinea, Liberia, and Sierra Leone differed from coverage of the 1995 Ebola outbreaks in Zaire and the Congo in a number of ways. Scholarly studies of the earlier outbreaks focused on the ways in which Western press coverage initially adopted a panicky frame but quickly moved to one of reassurance through “othering the disease, the victims, and Africa to effectively contain the crisis” (Joffe & Haarhoff, 2002; Ungar, 1998). Analyses of the 2014–2015 West African outbreak have a different set of priorities, emphasizing the place of Ebola in global politics and global health regimes within a context of post-9/11 biosecurity fears. For example, Sudeepa Abeysinghe (2016) analyzed the frame of border control in newspaper coverage of Ebola in the United States, the United Kingdom, and Australia. She found that the theme of the ineffectiveness of borders in controlling disease spread is commonplace. The disease becomes a political resource for accusations of government mismanagement and a tool for political parties to define competing positions on border control, national security, immigration, and management of existing immigrant populations. The focus on borders transforms the press issue from a problem of a distant outbreak to a domestic concern.

Ebola and its victims continue to be othered in the press coverage in a number of ways. Dita Trcková (2015) conducted a metaphor analysis of American newspaper reporting to determine whether or not the portrayals of victims allow for reflexively identifying with them. She found that the metaphoric representations portrayed the infected as either an impersonal aggregate of victims without agency or wrongdoers who were agents in the spread of the disease. In either case, victims were distanced from Western audiences. João Nunes (2016) examined the issue of othering at the global institutional level by focusing on the historical pattern of neglect of Ebola in Africa within global health governance mechanisms. He argues that this neglect is systematically structured into the global health system due to the problem-setting/problem-solving processes that govern the system. In the case of Ebola, neglect is a product of anxiety over certain kinds of groups and bodies, the abject nature of the disease, and its media appearance as spectacle and crisis rather than long-term problem. The result is an ongoing definition of Ebola as something to be made invisible and dealt with as a short-term problem.

At the level of visual representations of disease, the opposite may be true. Kirsten Ostherr (2005) asserts that public health discourse is concerned with making the invisible visible and manageable.

[I]nvisible pathogens produce widespread anxieties about global contagion, and in both cases [post–World War II public health campaigns and fears about current global outbreaks] the anxiety is displaced through a proliferation of images of contamination. This form of representational inoculation—if one can see the contaminant, one can avoid infection—defines the discourse of world health, with its efforts to map and thereby contain disease-ridden areas of the globe. This discourse compulsively attempts to visually represent invisible contagions in order to fix the location of the ever-elusive pathogen. (p. 2)

Ostherr goes on to argue that visual representations play a central role within the discourse of world health as educational tools, vehicles for ideological dissemination, and metaphors for the spread of disease through the pathways of globalization. Disease imagery is meant to “inoculate” the public against disease fear by rendering disease visible, knowable, and manageable (p. 2).

Researchers like Ostherr and others who focus on the visual culture of disease in public health campaigns (Bashford, 2004; Cooter & Stein, 2010; Ostherr, 2002, 2005; Serlin, 2010), on representations of disease and diseased bodies in art and medical imagery (Clarke, 2010; Gilman, 1988; van Dijck, 2006) and on representations of disease in popular culture and online sites (Cohen & Shafer, 2004; Marchessault & Sawchuk, 2000; Oudshoorn & Somers, 2007) highlight the extent to which visual health information is a central feature of subjective engagement in modern life. The role of the visual culture of disease in photojournalism, however, remains an understudied field. Instead, scholarship has concentrated on the photojournalism of war and the place of iconic photographs in political processes. Much of this research is useful in elucidating the issues involved in photographic meaning making within press coverage more generally. John Taylor (2000) summarizes central issues involved in the academic downplaying of the importance of photojournalism by pointing out that it is often used for sensationalism, it employs stock images that lack specific meaning, and editors often choose images that will not be deemed offensive and therefore do not challenge the viewer to engage with the story. Michael Griffin (2004) adds to these critiques, arguing that journalistic photographs are significant not for their ability to describe events but rather for their role in evoking pre-existing interpretive schema that link the viewer’s memory to familiar news categories. They symbolize generalities and provide mythical frames for interpretation.

Others assert a more critical role for photojournalism. For example, in her study of the Abu-Ghraib prison torture photographs from the American war in Iraq, Kari Andén-Papadopoulos (2008) questions the assertion that news images are simply illustrations of the text. She points out that the relationship between visuals and news narratives is often one of tension (p. 6) and argues that the perspective that images are simply markers or cues for the narrative comes out of the limitations of using content analysis in analyzing images. Photographs are signs with their own complex means of signifying through photographic conventions of framing, gaze, lighting, context, and camera position, and social conventions of visual codes of dress, style, architecture, objects, and body language. Consequently, “[P]hotographs to a certain extent ‘speak’ a language of their own. They are complexly coded cultural artifacts that to some extent ‘place’ us in specific viewing positions and convince us to see matters in a certain way” (p. 9). Given their own specific mode of communication, one must consider the possibility that visual images may have the ability to challenge and reframe the accompanying textual narrative.

Difference, borders, and biosecurity

Analyses of press disease coverage highlight representations of the shaky global health regime, a “disease world view” of the globalization process, the ongoing colonialist narratives in relation to Africa, and the use of disease as a political resource within the domestic politics of the global North. All of these issues relate to the problems produced when attempting to order “difference” within a globalized world where commodities and people move relatively freely. Mary Douglas (1966) provided insights into how societies approach this issue when she argued that every culture establishes symbolic ordering systems to deal with difference. These systems are binary classifications based on hygiene/order/purity versus dirt/disorder/impurity. “Thus we find that certain moral values are upheld and certain social rules defined by beliefs in dangerous contagion …” (p. 3). Through these symbolic classifications, we create ontological order and security. This is one of the functions of the outbreak narrative described by Priscilla Wald (2008).1 It falls within Douglas’ (1966) description of mythological systems consisting of “[i]deas about separating, purifying, demarcating and punishing transgressors [that] have as their main function to impose system on an inherently untidy experience” (p. 4).

However, that order is disturbed when things are out of place and arguably, the contemporary global context is defined by the inability to neatly restrict people, viruses, commodities, and ideas to their “proper” places. The result is a high level of ontological insecurity characterized by a perception of the global context as “a churning cauldron of crisis” where potential threats perpetually loom in the background (Massumi, 2011, p. 20). Sudeepa Abeysinghe and Kevin White (2011) link this notion of perpetual threat to disease by arguing that many people view globalization through the lens of a “disease world view” (p. 315). It is this sense of threat that news agencies attempt to contain through processes of othering.

Nevertheless, the threat of disease outbreaks never fully disappears from public consciousness, thanks to recurring “incidents” of disease. Carlo Caduff (2015) demonstrates how those incidents are interpreted by journalists, scientists, and officials through acts of “divination” that cast the disease incident as a cipher of the perpetually emergent pandemic that is just around the corner (p. 21). It is the proliferation of these incidents that makes diseases narratable and produces them as sites for exploring the tension between fantasies of containment and stories about the relatively free flow of disease around the world (Albertini, 2008). This theme is further developed by Bruce Braun (2013) when he points out that the contemporary environment of life, on the global scale, is characterized by a situation in which human life, non-human life, and machines have become integrated into “bio-technical assemblages” (p. 49). Biological life flows through political, economic, and social interactions along with the technical systems of airplanes, factory farms, and labs. Non-human life is intimately woven into the fabric of human interaction and renders us all diseaseable.

A consequence of the threat of diseaseability is deep doubt about the ongoing relevance of the borders around our “imagined immunological communities”—our sense of the nation as having its own histories of disease and immunities that give it a unique immunological ecosystem (see Wald, 2008, p. 53). This fear invokes “geographies of disease fear”—a process of mapping out the disease “hot zones” of the world and othering them from regions in the global North (see Aaltola, 2012, p. 668). Biosecurity measures lie at the intersection of geographies of disease fear and imagined immunological communities, and they are an element of the fantasy of containment promoted by officials in the press. However, biosecurity, as a discursive formation aimed at managing public anxieties about the viability of borders, is undermined by a cultural sense of the ubiquitous threat posed by the bio-technical assemblages within which we all live. In press accounts, this tension works itself out through competing narratives of diseaseability and reassurance. It is within this press context, and wider cultural context, that hazmat suit images appear.

Studying hazmat imagery

To examine the use of hazmat suit imagery in news coverage, research was carried out on the online sites of four major American broadsheet newspapers: the New York Times, the Washington Post, the Wall Street Journal, and USA Today. These sources were chosen because they are all among the top 10 circulating newspapers in the United States and, unlike others on that list, are readily available through the Factiva news database. Between October 3 and October 7, 2016, a Factiva search was conducted of these four news sources for the period January 1 to December 31, 2014, using the search term “Ebola.” Factiva generated a list of 8,262 sources, broken down into categories such as outbreaks/epidemics, medical conditions, domestic politics, columns, health, et cetera. The first of these categories was chosen because it was the largest, with 4,292 articles. One-tenth of this number (429) was randomly selected as the final sample.

Factiva is a text-only service, necessitating research into the online versions of the articles to find images. All of the online articles had both images and text. This research resulted in 122 articles with images of hazmat suits, approximately 28 percent of the sample, including photo journal articles that had a number of hazmat images. The combined number of photographs from the articles was 156.2 Other common images from the coverage were disease maps, microscopic images of the Ebola virus, fruit bats and monkeys as carriers of the disease, crowds of people in the streets of the affected cities, emergency vehicles, portraits of doctors and nurses, police and military personnel engaged in crowd control, and government and health officials. Many of these photographs and graphics included images of hazmat-suited figures as well.

The images were coded according to social conventions present in the images. Photographic conventions of framing, gaze, lighting, and camera position are important elements of meaning making but, due to space limitations, are a matter for another article. Social factors included visual elements related to setting, identities, and activities, including contextual factors suggestive of place (signifiers of Africa, signifiers of the United States); characteristics of the people in the background (crowds, civilians, authorities, adults, children, patients, health care personnel); activities performed by the hazmat-suited figures’ activities of the people in the background; centrality of the hazmat suit; and characteristics of the people in the suit (if visible).

With these categories in mind, the elements in the photographs were examined in detail to determine the categories of hazmat images, to determine whether or not there were any norms of representation, and to examine the ways in which those norms may have varied in the two contexts of Africa and the United States. Through this examination, it was hoped that analysis of the hazmat suit would reveal something about how it is involved in the construction of accounts of these different social worlds.

The analysis was limited to the images themselves, without examining the accompanying captions or headlines. The reason for this is, as Roland Barthes (1977) argued, when images are captioned, the text comes to “sublimate, patheticize or rationalize the image” (p. 25). News accounts attempt to privilege a particular meaning by anchoring it through captions and headlines. However, research shows that images are one of the main routes into news texts (Griffin, 2004; Knox, 2007; Smith, 2005; Zillman, Knobloch, & Yu, 2001), and it is important to observe what a casual newspaper viewer might see before being influenced by the text to address the question of whether or not the images communicate something different than the texts.

Hazmat imagery in Ebola press coverage

The hazmat suit as image or object has drawn very little academic attention. In their audience reception study of Ebola coverage in 1995, Joffe and Haarhof (2002) noted that respondents referred to the newspaper visual imagery, including hazmat suits, as science fictional. The authors argued that this symbolism has a positioning power in terms of detaching readers from the African situation, not only othering the disease and victims but also locating them in a world of make-believe. Polly Pallister-Wilkins (2016) identifies discourses around humanitarian agencies’ use of personal protective equipment such as hazmat suits, arguing that these objects play a mediating role, bringing normative and political questions into the world of objects. She asserts that one of the effects of hazmat imagery is to fetishize the suit as the thing that needs adjustment and fixing while wider structural factors of the Ebola epidemic remain unaddressed (p. 514). Bill Albertini (2008) characterizes the suit as an icon that is used in fiction and non-fiction to distinguish between the infected and the uninfected. It removes markers of identity and culture while encasing the body in technological complexity and authority. It is a “lifeboat” against infiltration by pathogens and dictates protocols of self-control that restrict movement of clumsy bodies to prevent accidents in contexts of complex technology, viruses, and security. As such, the hazmat suit is associated with anxiety about the accidental spread of deadly diseases (p. 454). It is a set of metaphors about alienating and othering, standing in for the disease itself and subject to fetishization as the solution to diseaseability.

All of these considerations about the hazmat suit are present in the imagery emerging from press coverage of Ebola in 2014. However, they work themselves out in particular ways within the context of the movement of the virus from Africa to the United States. In both cases, the hazmat suit bears the metaphoric burden of making Ebola a visible and affective presence at the local level. The appearance of the hazmat suit, often alongside the bodies of victims, marks the manifestation of the disease. In the United States and West Africa, however, the hazmat images have different purposes and do different kinds of work.

West Africa: The imagery of diseaseability

The primary basis for distinguishing press imagery of the Ebola outbreak of 2014 is geographic: images from West Africa, which comprise 63 percent of the 156 image sample (98 images), and images from the United States, comprising 37 percent (58 images). There are important distinctions among the news sites in terms of what is covered and how it is covered. For example, imagery from USA Today focuses almost exclusively on the story in the United States, with very few images from the African situation. In contrast, the New York Times, the Washington Post, and the Wall Street Journal feature a large number of photographs from Africa and many of them are the same, purchased from news agencies. The same is true of all four news sites for their coverage of the United States—the range of photographs was narrow, with many of them purchased from the same news agencies. Also, the New York Times and the Washington Post drew heavily on infographics from the Centers for Disease Control and Prevention to demonstrate the operation of hazmat suits. Among all four news sites, there were similar patterns of pictorial coverage.

Within the set of African images, common norms of photographic representation occur. Of primary importance is what Griffin (2004) refers to as the “frontstage” nature of the photographs (p. 385), focusing on spontaneous ongoing events happening on the ground at the time of the crisis. “Backstage” images, in comparison, are removed from the crisis zone: stock images that show behind-the-scenes preparations, portraits of medical officials and personnel, and photos of stockpiles of equipment. There are very few backstage images of prominent doctors, local officials, WHO officials, and Western leaders in the African stories. Instead, the photographs centre on local people working and suffering through the day-to-day struggle to survive, with hazmat suits a common feature of that context. Common imagery within the West African photographs involves street scenes around the houses of those who are infected or who have died. Scenes in clinics or in airports and other transportation centres are much less common. Frontstage street scenes tend to emphasize the poverty of the situation with crowds, garbage in the streets, small houses, protest scenes, and occasionally bodies left on sidewalks. Only very basic medical technology is visible, including inexpensive hazmat suits, thermometers, needles, and pump action disinfectant canisters, plus canvas and plastic tents, and pickup trucks for transporting the deceased to gravesites.

Within this West African imagery, three prevalent types of hazmat-related representations emerge: retrieving and burying the dead, decontamination, and donning the hazmat suit. It is important to note that there are other types of images, including clinic scenes, images of children with workers in hazmat suits, photos that show airport screening, and some backstage photos of quantities of personal protection equipment. Quite often, these activities, people, and objects overlap, but the most prevalent elements present in the photographs are the three discussed below.

Retrieving and burying the dead

The most common hazmat image in the West African photographs, present in 63 of the 98 African images studied (64%), involves workers removing bodies from homes and streets or burying bodies. This is not surprising considering that during the course of the outbreak, over 27,000 people were infected and more than 11,000 died (Centers for Disease Control and Prevention, consulted on July 23, 2018). Figure 1 is a typical example of a retrieval image, capturing the tragedy and drama of contagion.

Figure 1

Photographs in this category share certain features. The workers in the hazmat suits are foregrounded and are the active figures. They are the only ones wearing hazmat suits, distinguishing them from other people in the photograph. Images of body retrieval generally include the house from which the body is being removed as well as the surrounding neighbourhood. Sometimes mourning relatives are nearby. Almost always, a crowd is present in the scene along with weeping family members, but images also show children left alone and anonymous burials with no relatives or friends present. Overall, these images present the real human drama side of the coverage. It is emotional, frontstage, and often gritty. The disease becomes visible through dead bodies and hazmat suits.

Decontamination

The second most common photographic imagery from Africa, present in 12 of the African images (12%), involves scenes of decontamination. The decontamination activities occur in a number of contexts, most commonly the decontamination of dead bodies either in homes or on the street. There are also numerous scenes of figures in hazmat suits spraying chemicals on each other to minimize the risk of infection from the exterior of the suit itself. Buildings, the ground, and other surfaces are also subject to decontamination and together, all of these varieties of decontamination reinforce the sense of a completely diseased environment in which everyone and everything is diseaseable. Figure 2 is a typical example of a decontamination image.

Figure 2

In Figure 2, a hazmat-suited figure is spraying the ground next to a group of children having a meal. A number of images contain children, often in areas being decontaminated, or they are shown being carried away by hazmat-suited figures. The presence of the hazmat-suited figure and the disinfectant makes visible the surrounding disease. It is an attempt to impose order on the “untidy experience” of disease as theorized by Douglas (1966, p. 4), while making the disease visible and manageable in the form of the hazmat-suited figure (Ostherr, 2005).

Donning the hazmat suit

The third most common image, present in 10 of the African images (10%), is donning the hazmat suit. These photographs show people being trained in how to put on the suits or workers donning the suits for another gruelling day of body disposal and decontamination. Figure 3 is one such example.

Figure 3

Often in these images, workers are already wearing the body covering but their heads and faces are uncovered to some extent, removing the typical anonymity of hazmat imagery and both humanizing and valorizing workers while simultaneously identifying them as African. Generally, donning the suit takes place within the plastic walls of clinic tents where the workers are surrounded by plastic bags, rubber boots, hazmat suit items, and beds for exhausted and overheated workers. There is always a mirror present for checking that all of the potential openings in the suit have been sealed. The focus is very much on the suit as protective covering—the only thing standing between vulnerable bodies and a virulent disease. The suit is, as Pallister-Wilkins (2016) argues, fetishized as a type of armour, a protection against the accidental spread of the disease.

Through the mobilization of these sets of hazmat suit imagery, the work of the suit in press coverage of the West African Ebola outbreak takes on particular functions. Scenes of body retrieval and burial draw upon pre-existing schema for understanding disease in developing countries. Such images were common in the previous major Ebola outbreak in 1995 and have been a part of developing world disease reporting for decades. Familiar signifiers are present in the photographs, including non-white victims and crowds, rundown buildings, and tropical vegetation. Health workers in hazmat suits insert a Western technoscientific element into the scenes, contrasting with the squalor of the context and also working to make the disease visible by showing examples of how it is being managed. Through these elements of representation, the press coverage reinforces the geography of disease fear that defines Africa in general as a hot zone and distances the disease from North American audiences.

At the same time, the photographs work together to portray West Africa as highly diseaseable. The primary sense generated through images of body retrieval and burial, decontamination, and donning the hazmat suit is that the figures in the suits are perpetually surrounded by disease. This protective technology is the only thing distinguishing them from the diseased crowds that are often present. Even the suits themselves become diseased and have to be decontaminated. Ritualized images of donning the suit valorize the health workers and reinforce the diseaseability of the situation, since this is the only way the workers can survive dealing with the thousands of dead bodies they encounter. Consequently, West African news photographs reinforce the sense of biosecurity that viewers in the global North have come to expect. Africa is confirmed as a diseased place, as evidenced by the prevalence of the hazmat suit. However, the geography of disease fear is maintained, and the Western viewer is safely removed from the tragedy and threat of Ebola.

The United States: The imagery of preparedness

When viewing the West African imagery as a whole, the sense of the situation is anything but preparedness. The pictures show an unmitigated disaster and it is hard to imagine how it will be brought under control without a massive outside intervention as dead bodies, misery, poverty, and disease parade before the viewer on a daily basis. This is a pre-existing schema about dangerous diseases and the hazmat suit fits into it by helping to make the disease visible, but distant. Imagery from the United States is quite different, due in part to the fact that there was only one death from Ebola in the United States during the 2014 outbreak. The difference is also due, however, to the nature of the imagery present in the news site coverage of the time. U.S. Ebola imagery in the four news sites focused on two main types of images: decontamination and demonstrating the suit. However, another type of image, the medical emergency, was the third most common type, involving hazmat suits, emergency vehicles, and people on stretchers or climbing into ambulances. This type of image worked to counter the reassurance that the other varieties of images produced.

Decontamination

Beginning in early October 2014, photographs of hazmat suits on the streets of the United States began to circulate in the news. This was part of the massive press response to the admittance of Thomas Eric Duncan to the Texas Health Presbyterian Hospital on September 28, the resulting infection of two nurses, and his death on October 8. Duncan had come from Liberia to Dallas to visit relatives, but unknown to him or anyone else, he was already infected with Ebola. Much journalistic speculation had occurred prior to this event about what would happen if Ebola reached the United States, with health officials, acting as primary definers of the issue in the press, reassuring the public that the U.S. biosecurity and healthcare systems would be able to stop the disease before it became an outbreak (e.g., Bernstein & Dennis, 2014; Hartocollis, 2014; McKay, 2014). Once Ebola appeared in the United States, however, the press framed the whole incident as a failure of the U.S. biosecurity system (e.g., Armour, 2014; Kollipara, 2014: Shear & Landler, 2014).

It was within this context that the initial U.S. hazmat images circulated in the press with 32 of the 58  images studied (55%) showing suited figures wheeling biocontainment and disinfectant canisters into the Dallas hospital and out of the homes of Duncan’s relatives and the infected nurses. Figure 4 is a common type of photograph of hazmat disinfection in the context of Dallas, and it appeared on all four news sites.

Figure 4

A figure in a white hazmat suit is disinfecting the ground in the yard of one of the infected persons, with the disinfection technology quite visible. Given that there were only three infections involved in this case with only one death in a hospital, there was no imagery of dead bodies. This is a frontstage photograph showing on-the-ground activity around a potentially infected site, but the calm nature of the activity is very different from the images of crowds, victims, and bodies visible in the African photographs.

Demonstrating the suit

The second most common type of hazmat image in the press coverage of Ebola in the United States involves putting the suit on display and demonstrating its protective capacities, present in 21 of the U.S. images (36%). The purpose of this performance of the suit is quite different from West African images of healthcare workers donning the suit. Those photographs were frontstage images about showing the workers in action and directed the viewer’s attention to their courage within their diseased environment. Photographs and infographs from the United States are not about the workers but rather are backstage photos highlighting the technology of the hazmat suit. They are not about making the virus visible but instead function to reassure the viewer that the technology is in place to prevent the virus from spreading. Figure 5 is a typical example. In this photograph, health workers pose to show off the suit rather than the activities of the medical staff. They stand in a hygienic room near high-tech diagnosis and monitoring equipment.

Figure 5

Along with photographs displaying the suit, news sites published, or provided online links to, a number of detailed infographics, provided primarily by the U.S. Centers for Disease Control and Prevention (CDC), demonstrating how to put on and remove the hazmat suit and emphasizing the various safety features built into the technology. Figure 6 is a typical example.

Figure 6

The level of detail suggests that these images are intended primarily for practitioners rather than for the general public and raises the question of what the non-medical viewer is supposed to read in the image. Like the medical staff displaying the suit, the message appears to be a demonstration of the efficacy and safety of the suit, emphasizing its importance as the front-line technology for combatting Ebola and other infectious diseases. What is important about these images is the fact of their existence rather than their content. They are presented to reassure audiences that biosecurity technology is in place, it is sophisticated, and health workers know how to use it.

Medical emergency

A third type of image that appeared in the press coverage of Ebola in the United States showed emergency vehicles with workers in hazmat suits loading and unloading patients into ambulances, present in five of the images (9%). Figure 7 is an example.

Figure 7

Some of the individuals in these images were medical personnel who had worked in Africa, had contracted Ebola, and were being brought back to the United States for treatment. Others were individuals who had come into contact with members of Thomas Eric Duncan’s family or were the two nurses who had treated Duncan. Although there were very few individuals considered at risk of Ebola infection, a few photographs of hazmat-suited figures transporting them to hospitals were circulated many times over, giving the appearance of a number of people who had contracted the disease in the United States.

While the hazmat suit in the West African photographs is primarily involved in a narrative of diseaseability, within the context of the United States the story changes to one of preparedness. Images displaying the suit and presenting information generated by public health authorities on its safety features demonstrate that the American biosecurity system is effective and operating. Despite the blow to public confidence caused by the entry of the Ebola virus into the U.S., these images suggest the public could rest assured that the system would deal with any problems. Hazmat suit infographics present information on both safely donning the suit and, more importantly, safely removing it after it becomes contaminated. They identify and name the various elements of the suit, and also provide information on the different levels of suits available. Other infographics place images of hazmat suits alongside pictures of ambulances, police, airport security, and hospital workers, associating the hazmat suit with the biosecurity system as a whole and converting the issue of disease vulnerability into a technical issue of preparedness through technology and technique. However, the imagery of hazmat-suited workers transporting Americans in emergency vehicles shows the biosecurity system in action domestically, returns the hazmat suit to the frontstage, and raises questions about the system’s ability to exclude the Ebola virus from the United States.

Discussion

Within the press coverage of West Africa and the United States, the hazmat suit has different functions. In the context of Guinea, Liberia, and Sierra Leone, the suit is part of the frontstage imagery, serving to make Ebola visible to viewers. It marks out these West African nations as a hot zone in the midst of a hot crisis and, in the process, frames the outbreak as simultaneously a spectacle and a familiar scene. Reinforcing the fantasy of containment, the African photographs locate the disease within a region identified with the geography of disease fear that characterizes contemporary Western notions of epidemic and the risks of globalization. The photographs are clearly African images, with shantytown dwellings, tropical vegetation, crowds of dark-skinned people, and the absence of modern, Western-style healthcare facilities. The presence of hazmat suits not only makes the disease visible but also emphasizes the role of modern technology and Western aid as essential barriers to the disease. Everyone outside of the suit is either diseased or diseaseable, a notion that is emphasized by the oft-repeated scenes of decontamination of suits, bodies, streets, and buildings.

The African photographs also valorize the healthcare workers who are trying to manage the outbreak. They are regularly shown donning their hazmat suits like medieval knights donning their armour before going into battle. Often, they are photographed before putting on the headgear that will obscure their faces, thereby humanizing them and showing their courage, exhaustion, and fear. The human identity of the workers is important in the photographic narrative produced through the West African images because these photos are not only images of despair and disaster but also courage and determination in the face of seemingly overwhelming odds. As a symbol of both crisis and courage, the hazmat suit operates to bring normative and political questions into focus, specifically the need for humanitarian aid in Africa.

Taken together, the African imagery serves to reinforce press narratives about Africa and disease. The photographs show familiar scenes of death, crowds, poverty, and humanitarian aid—pre-existing schema for interpreting Ebola as a news category and as a mythical frame (Griffin, 2004). This is what Western viewers expect to see; the imagery contributes to a sense of order in a world where a disease world view and skepticism about the viability of borders around the imagined immunological community raise the spectre of disorder.

Beginning in early October 2014, images of hazmat suits in the United States started to appear in the press coverage. The political issue that these images reinforced pertained to the need for border protection in the United States. As research shows, border protection and the need to recuperate the American biosecurity system, after the appearance and feared spread of Ebola in Dallas, are important themes in the textual narratives of the Ebola press coverage (Abeysinghe, 2016). The imagined immunological community is at stake, and the presence of Ebola in the West becomes a traumatic incursion of the realities of global biotechnical assemblages into the symbolic order. Consequently, the presence of the hazmat suit in U.S. news imagery is less about making the disease visible than it is about making the biosecurity system visible through repeated scenes of decontaminating sites and demonstrating the suit. The hazmat suit becomes a symbol associated with re-establishing a sense of ontological order within the geography of disease fear.

Eventually, the textual narrative of the press turned toward reassurance, although it took longer than usual (Gerlach, 2016), and U.S. press imagery was always oriented toward reassurance through images of biosecurity in the form of the hazmat suit. However, long after the textual narrative was reassuring the American public that the biosecurity system was capable of handling the crisis, images of hazmat suits and people in the United States being taken away in ambulances by attendants in hazmat suits continued to circulate on news sites. Arguably, for anyone examining this story primarily through visual imagery, this had the effect of prolonging the sense of crisis and potentially contradicting the reassuring tone of the text. After a time, the continued presence of the hazmat suit in the press potentially produced a sense of American diseaseability, particularly in images of medical crisis. The suit began to make the disease visible in the United States even though the biosecurity system was supposed to have excluded it.

As an element of the visual culture of disease, the hazmat suit in Ebola press coverage operates simultaneously at a number of levels. As a central visual component of the journalistic coverage of disease stories, it represents the ongoing disease incidents that appear in the press and in popular culture. The hazmat suit also represents a technology within the biotechnical assemblages that mediate the flow of viruses around the globe. This is why it is an important visual signifier of the presence of disease and diseaseability. As an element of disease incident narratives and biotechnical assemblages, the hazmat suit is associated with the ubiquitous threat of disease that disrupts the discursive borders between geographies of disease fear and imagined immunological communities. Those discursive borders are structured by larger cultural narratives of purity/hygiene versus impurity/disease and are intended to produce a sense of ontological order and biosecurity. However, as demonstrated by press coverage of the 2014 Ebola outbreak, the hazmat suit is a multivalent symbol that can be employed on either side of that binary and, therefore, can be a disruptive figure as it moves through our disease stories.

Notes

  1. Wald (2008) outlines the characteristics of the “outbreak narrative” that underlies many of the disease stories in the press and popular culture. It follows a pattern of an initial identification of a vicious, anthropomorphized disease by disease detectives and heroic medical researchers and practitioners; its spread through global networks, carried by unwitting infected travellers or animals; and the desperate scientific effort to contain the disease and find a cure as the crisis mounts. Eventually the disease is brought under control by scientists and government officials. The balance between viruses and human society is restored along with the system of borders and national biosecurity regimes.
  2. Most of the images came from the New York Times and the Washington Post, which had photographers on the ground in West Africa. The distribution of images in the sample was as follows: New York Times—58; Washington Post—52; Wall Street Journal—40; USA Today—6.

Figure sources 

Berehulak, Daniel [Photographer] in Fink, Sheri. (2014, September 3). Cuts at W.H.O. hurt response to Ebola crisis. The New York Times. URL: http://www.nytimes.com/2014/09/04/world/africa/cuts-at-who-hurt-response-to-ebola-crisis.html [October 6, 2016].

Berkowitz, Bonnie, & Johnson, David [Illustrators] in N.A. (2014, October 20). Tougher armor recommended for the fight against Ebola. The Washington Post. URL: https://www.washingtonpost.com/apps/g/page/national/tougher-armor-recommended-for-the-fight-against-ebola/1395/ [October 5, 2016].

Jallanzo, Ahmed [Photographer] in Hinshaw, Drew, & Akingbule, Gbenga. (2014, August 7). Ebola virus inflicts deadly toll on African health workers. The Wall Street Journal. URL: https://www.wsj.com/articles/nigerian-health-minister-says-nurse-died-of-ebola-1407325187 [October 3, 2016].

Latif, Adrees [Photographer] in Tavernise, Sabrina, Hartocollis, Anemona, LaFraniere, Sharon, & Goodnough, Abby. (2014, October 25). As Ebola spread in Dallas, New York honed protocol. The New York Times. URL: http://www.nytimes.com/2014/10/26/us/new-york-ebola-response-polar-opposite-of-dallas.html?_r=0 [October 6, 2016].

Muller, Pete [Photographer] in Ohlheiser, Abby, & Phillip, Abby. (2014, August 29). The Ebola virus has spread to Senegal as the deadliest outbreak in history gets worse. The Washington Post. URL: https://www.washingtonpost.com/news/world/wp/2014/08/29/the-ebola-virus-has-spread-to-senegal-as-the-deadliest-outbreak-in-history-gets-worse [October 5, 2016].

Raedle, Joe [Photographer] in Fernandez, Manny, & Philipps, Dave. (2014, October 8). Death of Thomas Eric Duncan in Dallas fuels alarm over Ebola. The New York Times. URL: https://www.nytimes.com/2014/10/09/us/ebola-us-thomas-eric-duncan.html?_r=0 [October 6, 2016].

Smith, Larry W. [Photographer] in Fernandez, Manny. (2014, October 12). 2nd Ebola case in U.S. stokes fears of health care workers. The New York Times. URL: http://www.nytimes.com/2014/10/13/us/texas-health-worker-tests-positive-for-ebola.html [October 6, 2016].

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