Abstract
This article considers the increasing centrality of biosecurity and epidemiological surveillance as key priorities for the Sierra Leonean health care system after the 2014–2016 Ebola outbreak. Amid this broad shift from conceiving of clinics as sites primarily for the provision of therapeutics to instead sites for disease surveillance and threat mitigation, paperwork regimes have proliferated within remote facilities that are out of stock of nearly all supplies and unable to address even the most basic of infectious diseases. Drawing on fieldwork in one such clinic in the region in which Ebola first emerged, I describe one nurse whose endless paperwork tasks seem to have transformed into a type of magical therapeutic practice, resonant with other forms of local text‐based healing. Thus, I reflect on the ways that the logics of the fetish—and the emergent ambiguities and perils therein—come to operate through paperwork for local healing practices and biosecuritization efforts alike.