Triggering local communities to prevent Ebola
"Community ge di power for tap Ebola!"
This is the key message printed on the t-shirts worn by the youth community mobilisers working for the SMAC – Social Mobilisation Action Consortium formed by Restless Development, Goal, Focus 1000, and BBC Media Action.
Sierra Leone was hit by the Ebola outbreak back in March 2014, and with 7,897 cases it's now the country the worst hit country in West Africa. A recent study into how the current Ebola outbreak is spreading notes that "Socio-cultural factors have not only contributed significantly to Ebola spread, but have also complicated the implementation of control interventions."
Lack of knowledge, fear and stigmatisation can prevent understanding and responsible changes in behavior. For example:
- Lack of prior knowledge of the disease, and lack of trust in authorities, can lead communities to deny its existence and/or to associate it with witchcraft or conspiracy theories.
- The stigma carried by Ebola survivors and victims’ families can increase infection rates – in particular, families hide relatives and friends with Ebola to avoid being shunned by their own communities. Case isolation can be understood as a death sentence.
- The cultural tradition of washing and touching the dead body before burial greatly increases infection rates – particularly as those attending funerals can then transmit the infection to their families and other localities. The sick are often being kept at home and buried in secret, increasing the risk of more infections.
Against these challenges, we led together with the SMAC consortium on the larget community mobilisation ever in Sierra Leone, to reach over 3 million people with life-saving messages; over 1,500 youth have been trained around the country on the Community Led Ebola Action. The purpose is to trigger communities to feel the need to react, to protect themselves and to do it urgently with their own resources. The mobilisers have been trained in the key Ebola messages, in safety and protection and community mobilisation exercises.
They interact with the communities through activities such as:
i) Body mapping - the community maps the parts of the body which suffer when infected with Ebola Virus Disease (EVD);
ii) Burial Role Plan - the community recreates a burial situation where risks (i.e. cleaning the corps) are identified, and alternative actions are brought forward;
iii) Ebola Spread - The EVD transmission ways are highlighted by the community;
iv) Danger Discussio n- A discussion around all the dangers involved around sickness and death is triggered for the community to raise awareness and suggest action points for them;
v) Survivor Role Play - some communities host EVD survivors; some mobilisers are EVD survivors. Communities need to understand that survivors don’t represent a risk; they are an asset to them as they have been proved immune to recontracting EVD;
vi) PPE information (Personal Protection Equipment) Communities have feared the PPE since the beginning of the outbreak, jeopardizing the work of the medical workers. For the community PPE is strange, scary and they don’t understand the purpose of it, or the fact that a person is inside.
Based on this approach, communities welcome our mobilisers, and are actually seeking to know more about the EVD itself and how to stay safe. They have experienced Ebola within their communities and now they feel ready to receive external support.
Our mobilisers' biggest achievement is building trust on the national and international institutions leading the Ebola response. Before, EVD infected community members would not come back to their communities, creating fear and distrust. This was due a number of reasons amongst which an overwhelmed medical care system and the inadequacy of the initial health response in the country.
However, thanks to the intervention of international technical medical support and the funds from the USG, the UK, the German Government, the World Bank, and the European Commission amongst the top 5 donors, EVD infected people are now being rightly treated, they are recovering and coming back alive to their homes.
Restless Development has been capable of unifying high level strategic response with a bottom-up approach. Moreover, we are mobilising youth energy to address safety and protection in a culturally adapted way where communities are at the centre of the action.