To end an Ebola epidemic, listening helps

Despite progress against the second-worst Ebola epidemic in history, responders in Congo are struggling to heed the fears of vulnerable communities and to build up trust.

A health promoter with the Swiss NGO Medair demonstrates to traditional healers how to use protective gloves when they examine patients, as part of an Ebola prevention campaign in North Kivu province, Congo.

For eight months, health workers in Congo have been battling the second-worst Ebola epidemic in history. Nearly 600 people have died. Compared with a massive outbreak of the virus five years ago in western Africa, this time responders in the Central African country have much better medical tools. They are far more coordinated.

Yet many are struggling to adopt a key lesson from the previous crisis: Before doing anything, listen to and address the fears of vulnerable communities.

During the 2014-16 epidemic, acute panic as well as high suspicion of officials hindered the response. The crisis claimed more than 11,000 lives. Now in many parts of Congo, the response starts with volunteers going into villages and welcoming people to talk about their concerns, their knowledge of Ebola, and their preferences in dealing with it.

These “social mobilizers” also try to connect with religious and community leaders to understand cultural traditions and spread useful messages.

In the previous crisis, one nonprofit group in Sierra Leone called Focus 1000 was particularly effective by working with local preachers. Sermons were prepared that included both practical information and messages of love to quell the fears of congregations. The effort helped lessen the stigma associated with Ebola, allowing better access for health workers.

Adopting a similar approach in Congo has been difficult in part because of decadeslong conflict in the east and the presence of some 100 armed groups. In recent months, dozens of health centers have been attacked. But in addition, responders have focused mainly on medical solutions, bringing some criticism.

“Building community acceptance and securing trust has not been given the same weight as treatment, and we are continuing to see the consequences – suspicion abounds and case numbers rise,” says Jean-Philippe Marcoux, country director for the Mercy Corps charity in Congo. “The only way around it is to establish dialogue, which takes time, resources, and with the right people that [communities] can trust.”

Such calls for more “social mobilization” need to be heeded. Fear of diseases like Ebola can be contained by building up trust and by listening to local people. Compassion can be a balm for anxiety. It can also open a door for cooperation to end an epidemic.

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