Jamaica has experienced two serious health emergencies in the last ten years: chikungunya in 2014/15 and Covid-19 from 2020. Research on those outbreaks -- conducted using interviews, observation, social media and newspaper sources and relevant secondary literature -- shows the need for public health practitioners to engage with anthropology for successful containment of disease spread. Jamaica's history as a slave colony, and its present as a country stratified by race and class and subject to the dictates of neo-imperialism, means that many citizens distrust both their national leaders and international powerbrokers, believing them to be the cause of their poverty and marginalisation. While this distrust manifests in many ways, this paper explores its expression in the context of public health emergencies. In both outbreaks, many Jamaicans rejected the Ministry of Health's claims about aetiology and treatment. A powerful discourse circulated, predominantly among Jamaica's poorer citizens, that the diseases were the result of yet another conspiracy of the international and national elite to eliminate, weaken, and/or control black people. Many therefore rejected official treatment recommendations. Jamaica's complex history of push and pull between dominant Eurocentric epistemology and resistance against the latter rooted in African-based epistemologies meant that other responses to government prescriptions were more complicated. Serious engagement with anthropology would have shown policy makers the complexity and roots of popular disengagement and responses to official recommendations. It would also have moved them away from the knowledge deficit model of public health messaging towards a contextualist approach that finds solutions by taking Jamaicans' opinions seriously. This paper shows the pitfalls of not recognising the sociopolitical, cultural and economic realities of the citizens governments are duty-bound to protect, and recommends ways for future public health emergencies to be managed in ways that promote the health of all Jamaicans.
