Songs, radio shows, and door-to-door visits: how community awareness

13Jun 2018
The Guardian
Songs, radio shows, and door-to-door visits: how community awareness
  • Containing the outbreak isn’t simply down to the vaccine

RELATIVES ride in on motorbikes, bust three patients out of an Ebola treatment centre, and take them to a church to be prayed over by 50 people. Later, one dies at home, another in hospital, while the third lives but could have infected an untold number of people.

Infection prevention and control materials from WHO are brought to the General Reference Hospital in Mbandaka

It sounds like a scene from a Hollywood disaster movie, but it took place less than three weeks agoin Mbandaka, a city of 1.2 million people in the Democratic Republic of Congo. A huge effort is now underway here to raise awareness about the virus and prevent its spread.

The government and international NGOs are leading the charge, but some of the most effective work is done by the local community and Church leaders. In the Roman Catholic archdiocese of Mbandaka-Bikoro, for instance, sacramentssuch as baptisms and anointing ceremonies have been suspended to avert the risk of transmitting Ebola.

“Ebola is real,” stressed community leader Gabriel Selemani at an impromptu gathering near a marketplace. “Don’t play games with it, and don’t listen to rumours and lies being spread around that it is a fairy-tale, an international conspiracy, or as a result of witchcraft.”

In local schools in Mbandaka, teachers hammer home the message too, leading children through a special “Ebola, Go away!” songand making hand-washing and temperature-taking mandatory before class.

Talking to people on the city’s streets, it is evident that many take the dangers posed by the outbreak extremely seriously. But others disregard the risks, while some are in denial about the outbreak or say they believe news of it has been planted as some kind of Western plot.

Many still flock to traditional healers or witch doctors like Papa Nganga, believing Ebola to be a product of witchcraft.

“What I need right now is for the NGOs and the health ministry to stop spending money and bring me all the Ebola patients,” Nganga told IRIN. “My ancestors, who still live in this statue, are empowering me to heal anyone in two days.”

Contained? Perhaps, for now

News of Congo’s latest Ebola outbreak (this is its ninth since the first-ever case was discovered near the country’s Ebola River in 1976) emerged in early May in the northwestern province of Equateur.

Read more: Ebola outbreak in Congo – what you need to know

As of Thursday, 37 Ebola cases had been confirmed, all in Equateur, including 25 deaths, according to the World Health Organisation.

Three deaths in Mbandaka by 22 May – including the two in the motorcycle kidnapping/escape incident – led health experts to warn that the outbreak was on a “knife-edge” and could spawn a wider epidemic.

The latest confirmed infection, in a village in the remote Iboko area, was recorded on 30 May. Experts caution that because the index (first) case was never identified and it can take three weeks for symptoms to appear, it is too early to declare the outbreak contained.

The greatest fear remains: that an infected person could carry the disease to a major urban centre, like the capital, Kinshasa, or Bangui, the capital of neighbouring Central African Republic – both reachable via the largely unmonitored Congo River.

Read more: Fear, suspicion, and anger along Congo’s river of worry

This time around, a new weapon has been deployed in the fight against Ebola – a vaccine, administered to anyone who comes into contact with a confirmed case. Tested towards the end of the West Africa epidemic that claimed more than 11,000 lives from 2013-16, this is the first time a vaccine has been part of a concerted effort to contain an Ebola outbreak.

For the so-called ring vaccination campaign to work, every person who has come into physical contact with a suspected case must be identified, vaccinated, and then monitored for symptoms.

While WHO experts say ring vaccination and contact-tracing are key to stemming outbreaks, they are time-consuming, invasive, and hard to do effectively in rural areas with patchy phone networks like Bikoro and Iboko, where the outbreak is thought to have originated. A journey of just 20 kilometres in this region can take several hours, and the vaccine needs to be kept at an extremely low temperature.

But containing the outbreak also depends on the willingness of the local community to help – by raising the alarm when a case is suspected and by informing health workers promptly and accurately of everyone an infected person has been in contact with.

Winning over the sceptics

While most people are cooperating and health workers say all the immediate contacts of known cases in Mbandaka have now been vaccinated, rumoursand conspiracy theories have also taken root.

Hordes of health officials (WHO alone has sent 170 experts), aid workers, and journalists have descended on Mbandaka, often making disconcerting demands or asking difficult questions. Some locals are benefiting from an economic boom, but others have been hit by unexpected price hikes and many are wary of the foreign invasion.

“The so-called Ebola is nothing but a curse. Ebola is a white man’s invention to attempt to control Africa’s resources,” pastor Jean-Pierre Elumba told his riveted congregation, meeting near one of Mbandaka’s many river ports. “Brothers and sisters, whether this Ebola thing exists here in Equateur or not, the truth is that the solution of Ebola lies in repentance, not in washing hands...

“Does anyone know anyone suffering from Ebola in their neighbourhood? If you know someone, please bring them to me, I will pray for that person and they will be healed. Now, shake the hand of the person standing next to you.”