Responding to Ebola by addressing rumors and resistance

One of the most persistent rumors, Roger tells me, is that the smoke from the generators in the Ebola treatment centers is really the bodies of the infected being burned.

Roger Lamah is a Communications for Development specialist working for UNICEF in the Forecariah prefecture in Guinea, one of the few remaining Ebola hotspots in the country. Since arriving here in February, he and a team of what are known as social mobilizers have been working with rural, and often isolated communities, to teach them how to avoid becoming infected by the virus; how to recognize and respond to symptoms; and to rebut the rapidly shifting cycle of rumors that, at first glance, may seem bizarre but which upon closer inspection speak of real fears among people who lives have been upended by the epidemic.

We are in the village of Sikhourou, a two-hour off-road journey from Forecariah, where its 420 residents have been put under a “cerclage” – effectively 21-days of close monitoring to avoid movements that may spread the virus. Three people have died in Sikhourou since the outbreak of Ebola more than a year ago and last week an elderly man was taken to a treatment center in Forecariah for observation after displaying symptoms of the disease.

“Rural communities around here used to be very hard to access,” Roger says, “because of often violent resistance to Ebola responders. We had to come up with solutions because without access you have nothing – no prevention, no surveillance, no tracing of contacts.”

The social mobilizers began by mapping the areas of resistance and by tracking the rumors that were circulating in order to respond to the communities’ fears. UNICEF-supported radio stations were created to broadcast programs on Ebola prevention and to respond to whatever rumors were then going around.

“We found there were three types of resistance – community, family and individual,“ Rogers says as he assembles his team for today’s door-to-door exercise during which residents will be reminded of the importance of good hygiene and be provided bars of soap.

“You can see by how we’re received here today that community and family resistance is much less of a problem. The challenge now is not to get into a village, it’s to overcome individual resistance that can lead to unsafe burial practices or the refusal to take a sick family member to a treatment center.”

Members of UNICEF’s social mobilization team in Sikhourou village use illustrated booklets to educate residents about the symptoms of Ebola and how to avoid becoming infected. ©UNICEF Guinea/2015/Tim Irwin
Members of UNICEF’s social mobilization team in Sikhourou village use illustrated booklets to educate residents about the symptoms of Ebola and how to avoid becoming infected. ©UNICEF Guinea/2015/Tim Irwin

A committee of village women has gathered under a tree to take part in a short motivational rally. Each is wearing a bright T-shirt with the words “Ebola is real” written in French on the front. Not so long ago this was not a view shared by many here. And even as awareness of the illness grew, many people believed it was the responders who were bringing Ebola to their communities.

Earning the trust and support of traditional and religious leaders was key to gaining wider access, Roger tells me. To address the rumors that the bodies of victims were being burned, villages leaders were invited to the treatment centers. Ebola survivors visited at-risk communities to share their experiences of overcoming the disease.

Sikhourou is already geographically isolated, with the nearest village more than a kilometer away. But the villagers will not be left on their own during the 21-day period. This is day two of the “cerclage” and food and other supplies have already been distributed by partner agencies. Latrines are being erected and even a generator is being unwrapped. UNICEF is also drilling a borehole so that the community here has easy access to clean water.

A home in the village of Sikhourou is disinfected. ©UNICEF Guinea/2015/Tim Irwin
A home in the village of Sikhourou is disinfected. ©UNICEF Guinea/2015/Tim Irwin

“Do you want Ebola to leave?” Roger asks the group, his question translated from French into Susu. In unison the 40 plus woman, many with babies swaddled to their backs, yell back – “yes!”

“Ebola you are not wanted here,” one of the women shouts when it’s her turn at the microphone. On the backs of the T-shirts that everyone in the village now seems to be wearing as they gather for the screening of a video on Ebola, it says “I’m involved for my community”.

Working with communities, helping them protect themselves, listening to their concerns, and putting them at the forefront of the Ebola response has been central to reducing the number of new cases in Guinea.

“Over the past two days you have seen a lot of people and vehicles here, probably more than ever before,” Roger says as his team begins to pack up. “These people want to help you. They want to help you get rid of Ebola. They are not afraid.”

Tim Irwin is a Communications Specialist working with UNICEF’s Regional Office for West and Central Africa.

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