Reaching people, saving lives
UNICEF leads community engagement for the Ebola response. Trying to convince skeptical leaders that the virus exists and that they need to protect their families has become a dangerous but crucial part of containing the disease.
Giselle works in the communities to make sure families know about Ebola. She also helps plan when vaccination teams are coming so everyone can sign up to get protected. She plays an important role in a social response to enhance medical outcomes. Giselle says the key to her success is being patient and speaking in Kinande so everyone can understand, especially the mothers and children . “They listen better to our message because they are used to us,” Giselle laughs. “When we go to church or schools, they know us and we all understand each other."
Stage 4 in a six step process is the injection of the Ebola vaccine. Good communication is key to making sure everyone understands what’s happening at a community vaccination. Coordinators explain all the steps to residents and everyone takes turns going through the process. Giselle says the vaccination in cities like Beni have been relatively easy to coordinate and win local support. She says doing the vaccinations in rural areas gets extremely challenging.
Emmanuel is a member of the local committee that helps build alliances to stop Ebola in the remote town of Aloya. Resistance to the Ebola response has been persistent but Emmanuel says they're seeing progress in the communities where they work. He says once the conversations start, people are open to ways to protect themselves. He and his fellow committee members advocate for regular hand-washing and vaccination along with advice on avoiding contact. Community leaders who work closely with the committee are taking considerable risks as they can be victims of violent attacks by ‘Ebola deniers’.
Members of the local committee in Aloya head out on a round of sensitization with the megaphone playing pre-recorded messages about Ebola prevention. They do the rounds through neighborhoods and they stop and have discussions to answer questions along the way. This broadcasting method has been effective, combined with the saturation of radio information, the messages are getting through: vaccination rates are increasing and the Ebola cases are decreasing.
Kavugho’s neighborhood in Aloya had several Ebola cases and even some deaths. She says it was terrifying and they had to stay at home. Her mother Ngilongo thought Ebola was a demonic disease and believed rumors that it could jump through the air so she stopped going to market or church to keep her children safe. The local committee started visiting with information about the disease. Slowly she started to see that she could protect her children with the vaccination and simple prevention techniques like hand-washing.
Josephat handles the relationships with local radio stations in Mangina, the center of the Ebola outbreak. He’s from the community and knows the local radio scene in this part of Nord Kivu. He’s a critical conduit between the Ebola response and the general public. If there’s new information, it’s Jospephat who makes sure the radio stations all have reliable, fact-based reports to educate the public.
Josephat spends a lot of time inside sound booths in radio stations like Tele Espoir Radio in Mangina. He’s invited on air to share news about Ebola and helpful steps families can take to protect themselves. Sometimes the radio stations invite him on for extended talk back sessions where people call in with questions. “It’s good to hear the community concerns,” he says. “We have to get these people accurate information so they won’t be afraid, it’s what we do.”
Mwasi is 15 and lives in a neighborhood that has been hit hard by Ebola. At the peak of the outbreak earlier this year, she says there were several funerals a week but now it’s returning to normal. She says she hears the messages about Ebola on the radio and her father has gotten serious about protecting the family. He bought a special hand-washing station and he made sure they all got vaccinated. Mwasi says it’s good not to live with the fear and uncertainty. “It’s nice to know we’re safe,” she says. “We still hear the messages on the radio, but we don’t have to worry.”
Mwasi’s radio in her courtyard is what keeps her moving as she does the laundry, cooking and chores around the house. She says the messages about Ebola have been good for everyone to understand and know what to do..
Mbaesai is the technician at Tele Espoir Radio in Mangina. He keeps the signal broadcasting at all hours of the day. He programs a mix of music, recorded messages and handles the desk for the live shows. He says it means a lot to be involved in the Ebola response. “We use the radio to reach people,” he says. “Sometime with music, but now with messages to save lives.” He has a folder full of UNICEF messages that give people information about the risks of the disease and how to prevent it.
Posters printed in local languages are everywhere in Nord Kivu. The posters have been specially designed with pictograms to deliver a message to communities where sometimes more than half the population cannot read.
Cleoface is from Beni but he works at the Ebola Treatment Center in Katwa near Butembo. He often works with UNICEF teams to build support for Ebola treatment and vaccination in the communities. “All the scars on my face are from rocks that were thrown at me,” he says. “When you turn up to talk about Ebola, some people do not want you there and they let you know it.” The community engagement is a complex effort that requires careful coordination with health workers to communicate with families on sensitive operations like funerals or decontamination visits. “It’s hard work,” says Cleoface. “But we can see the results and that makes us proud.”
Community visits can be daunting when entering a neighborhood that is hostile to the Ebola response. Remote locations on hard to access roads can be the scene of flare ups of tensions with communities who are grieving loved ones or object to any health teams visiting their area. The local committees that UNICEF supports are equipped to handle this kind of community engagement and ensure that the messages get through to where they are needed most.
Esperance is from Kinshasa but she works as a clinical psychologist to help Ebola survivors in Butembo. She was taken hostage at a funeral for an Ebola victim whose family members hated her for delivering the results of the test. Armed with machetes and clubs, the crowd wanted to bury her alive in the grave with their loved one. After a tense four-hour stand off, the family agreed to let her go. Everyone in the response who works in the communities is aware of the hostility they face and the risks they are taking. For Esperance, it’s inspired her to do more. “It gives us strength to continue,” she says..”We saw the worst but we can still keep going ahead and it can work.”
Graveyards can be the site of tensions in the Ebola response. UNICEF and partners continue to deliver a message about the need to conduct all burials as safe burials by specially trained teams in decontamination suits. But many are resistant to variations from traditional burial rites and funerals without protection are still common.
Kasongo has signed up to be vaccinated against Ebola the next time the vaccination team comes to her neighborhood in Beni. She says that she doesn’t have any reservations about the vaccination and she’s eager to feel even more protected from Ebola.
With community visits and radio broadcasts, the message about Ebola has reached a saturation point in many places in Nord Kivu. People understand the messages and are practicing hand-washing and caution. But this part of Congo has many travelers and traders who carry goods to sell in cities across the region. These travelers are one of the last remaining risks for transmission of the disease because they haven’t received the same health messages and can more easily contract and spread the disease.
Obed is a nurse at the health center and an advisor on the local committee handling Ebola response in Aloya. He lost his 20 year old daughter to Ebola earlier this year and he’s still in mourning. “She didn’t follow the steps to protect herself,” he says. “I feel her loss everyday and I work to make sure others don’t die of this disease.” Obed is on the local committee to ensure there’s clear and accurate health information in all the discussions and broadcasts.
The most effective way to stop the spread of Ebola is with regular hand-washing so the message has gone everywhere in Nord Kivu. Every business, school or office has a hand washing station and thermometer checkpoint and there are dozens of roadblocks where hand-washing and temperature check are mandatory. This kind of vigilance had helped reduce the rate of new cases, but the hardest part will be to convince the remaining skeptics.
Kaumo is a student at a school in Beni that has been gripped by fear and suspicion about Ebola. Parents first wanted to keep children home when the outbreak started, but the school hosted discussions to calm parents and children and ensure everyone was on board with hand-washing and vaccination. When an Ebola survivor returned to Kaumo’s class, parents and children were afraid of contagion but UNICEF and partners helped the classmates understand that there was no risk from people who’ve recovered from the disease.