Helping Guinean communities fight Ebola
In May 2015, cases of Ebola began to appear in Tanene, Dubreka Prefecture, Guinea, an area that had previously been unaffected. To ensure the outbreak does not spread, WHO and partners have launched a surveillance campaign to find individuals who might be infected. Through household visits, a presence on prefecture streets and conversations with influential members of key community groups, surveillance teams are spreading the message about Ebola and providing support to families.
WHO and partners launch a surveillance campaign
In early June 2015, WHO along with key partners – the Ministry of Health of Guinea, US Centers for Disease Control, Red Cross Guinea and UNICEF – launched a campaign in Dubreka to look out for suspected Ebola cases. Throughout the month, teams of social mobilizers, surveillance workers and doctors are going from household to household in the prefecture talking to families and encouraging them to declare any illnesses or deaths.
Teams also discuss the risks Ebola poses and give information on important infection prevention measures. They are available throughout the communities to answer questions and respond to alerts.
Social mobilization training
Before the campaign started, surveillance workers were trained in social mobilization techniques and ways to identify suspect cases and provided with key messages for the response. The national coordinator of the Ebola response, Dr Sakoba, addressed the members of the surveillance campaign at the start of the training session.
The Ministry of Health will ensure free health care is provided for all cases of illness in the prefecture during the campaign period. It is hoped that this will encourage families to come forward with any health concerns. They will also provide families with soap and food during the 21-day surveillance period, so they can stay at home to monitor their loved ones.
Reinforcing positive messages
At the beginning of the campaign, a representative from a local women’s group addressed community members in the town of Tanene. During the community consultations, Dr Keita Sakoba – the coordinator from Guinea’s National Ebola Response Committee – and the campaign organizers invited a representative from each of the key groups (religious leaders, youth, women, workers’ union, etc.) to speak to the community.
They reinforced the key messages of the campaign – vigilance and information sharing – and encouraged the community to cooperate with Ebola teams.
Assessing community understanding
Marie-Claire Fwelo-Mwanza is a social mobilization expert who has worked with WHO for more than 20 years and been a part of at least 5 Ebola response operations in Africa. She is here to monitor surveillance activities and provide guidance and advice. Here she speaks to students about Ebola messages. They tell her what they have learned from the teams and what they will do if someone they know develops symptoms.
Some resistance continues
Community resistance to the Ebola response remains an issue in Guinea. Rumours still circulate and some of the population refuse to believe Ebola is real. WHO must continually adapt its approach to take into account community reactions and combat misinformation.
Unfortunately, in some cases community resistance turns into violence. This ambulance was burned after community members stopped the vehicle to remove a patient and take him home. The patient was later retrieved from his home and tested positive for Ebola.
Families open their doors to Ebola teams
The Ebola teams in Tanene brief Marie Claire on the community’s response to the campaign and she provides advice on effective ways to deal with issues they may face during the campaign. On the first day of the campaign, the teams found that many of the households had shut their doors or temporarily left home.
This happened because of a rumour that Ebola teams were coming to disinfect their houses and give them injections. Yet after those who were visited by the teams told their neighbours that the campaign had helped them, many families returned home and opened their doors.
Ability to listen is key
One of the most important skills is the ability to listen. In Tanene, Marie Claire goes from household to household with the Ebola teams to find out the concerns of the community. Here a father explains the issues facing his family and what he understands about the Ebola epidemic. He is determined to remain vigilant to protect his family from the virus and put an end to the outbreak in his prefecture.
Demonstrating hand hygiene
Families have set up hand washing stations in front of their houses to prevent the spread of the Ebola virus. The children understand the importance of hand hygiene and demonstrate to the Ebola teams how they wash their hands.
Monitoring and gathering information
Ebola teams take the temperature of each family member using a contactless thermometer. This gives them a chance to identify any individuals with fever or high temperature and send an alert so an investigation team could be sent to speak with the families, gather more information, and determine if additional testing or hospitalization is required.
In Tanene, the messages are really starting to sink in. People are listening to programmes about Ebola on community radio, signs and stickers are posted throughout the villages and important conversations are taking place on the streets.
Children are one of the keys to ensuring messages are successfully integrated into communities. Messages which they are taught at school or in discussions with Ebola teams are taken back to their families, some of whom cannot receive the messages directly. In Guinea, the youth often have a strong influence on discourse and beliefs within the community around issues such as Ebola. This young man writes in the dirt outside his home: "Stop Ebola".