By Lisa Pattison, IFRC
“ABC: avoid body contact”, “No touch” and “Ebola is real” became mantras to chant and print across Sierra Leone as the country continues to battle the unprecedented Ebola outbreak. Catchy and simple, communities have latched onto these snappy sayings and, for the most part, live by them. Education through social mobilization led to behaviour change. Case rates tumbled.
Over 3,000 Red Cross volunteers engaged in the Ebola emergency response have been central to binding communities to the words that will protect them from Ebola. The Sierra Leone Red Cross Society and the International Federation of Red Cross and Red Crescent Societies (IFRC) have carried out psychosocial support, contact tracing, safe and dignified burials, case management and social mobilization in Ebola affected communities. All five interventions have contributed to reigning in the outbreak. But it is dangerous to think that Ebola is over. Complacency is as dangerous as the Ebola virus itself.
Pushing for zero cases
Life is returning to normal throughout Sierra Leone after emergency restrictions – prohibiting public gatherings, restricting hours of commercial activity and limiting travel in an effort to stem transmission – were lifted over a month ago. Now, market places are hives of activity. The narrow streets are packed with petty traders as pedestrians fight for their share of the pavement. “I am happy that I can sell my vegetables like before. With the restrictions my income was smaller and it was difficult to support my family,” says Aminata Kamara a vegetable trader in Freetown. But as a sense of normality settles, how is it possible to ensure people remain vigilant about Ebola and continue to adopt safe and dignified burial practices?
The messages and advice for preventing Ebola stay the same, but the way they are said needs to be constantly reinvented and repackaged so that they do not fall on deaf ears.
Two districts, Port Loko and Kambia, continue to record cases of Ebola and have come under the spotlight for targeted intervention. Under the Northern Push operation, there is an intensification of social mobilization and engagement of leaders at the chiefdom level to ensure that Ebola-related bylaws, such as a mandate to remain inside quarantine zones, are enforced.
The Red Cross is playing a key role in deploying an extra 700 volunteers across the two districts to go door-to-door, raising awareness about Ebola and its prevention among rural and urban households. Red Cross volunteers, as trusted and recognized voices within their communities, are uniquely positioned to be able to keep people on guard against Ebola, even as life around them apparently returns to normal. Until zero cases are reached, and even after, there is no room for complacency.
Remixing the Ebola message
Creativity and engagement are also key to keeping communities interested and involved in fighting Ebola. One initiative that the Red Cross has developed is Radio in a Box which sees mobile radio and drama groups touring the two districts. “The Radio in a Box initiative is literally taking a radio station to the communities. It is a box which contains a laptop, speakers, synthesizers and so on. So people who couldn’t normally get to a radio station have the opportunity to have their say,” explains Edward Renner, senior broadcast officer at the Sierra Leone Red Cross Society. The interactive plays and radio programme are broadcast on local radio, ensuring that neighbouring communities hear the opinions and solutions coming from their close neighbours.
Actors perform in front of the gathered community, complaining about the persistence of Ebola and showing their annoyance at the restrictions placed upon them. One actor grumbles: Why is there still Ebola in his community when the majority of the country has managed to rid itself of it? Instead of another actor listing the reasons, community members are encouraged to come forward and explain their thoughts. One spectator cites attending unsafe burials, while another young woman suggests not respecting a quarantine zone is the reason for the continued presence of Ebola. Through this engagement, the community acknowledges that it is their behaviour which is not conducive to eradicating Ebola.
The actors then ask the community what each individual can do to solve the problem. Once again community members step forward and make suggestions. Interactive drama is entertaining and it helps communities understand that they have the capacity to change their behaviour and stop Ebola. It becomes clear that Ebola is not an external curse or a problem and that it can be solved.
There are signs that the campaign is working in Kambia, which borders Guinea’s Ebola hotspot of Forecariah. The community has achieved more than 30 days without a new case of Ebola. Drama, music and other creative responses are proving essential in keeping the population vigilant. IFRC beneficiary communications delegate Alif Nurlambang explains, “Engaging communities is not about sounding like a broken record, but about being able to remix the message.”