DR Congo + 2 more

Social Science in Epidemics: Ebola Virus Disease lessons learned

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In this ‘Social Science in Epidemics’ series, different aspects of past disease outbreaks are reviewed in order to identify social science ‘entry points’ for preparedness and response activities. This brief draws out some recommendations for Ebola response actors in North Kivu. It includes lessons learned primarily from (i) historical outbreaks in Congo; (ii) outbreaks in Uganda in 2000-01 and 2012; (iii) the 2014-2016 West African epidemic; (iv) the outbreak in Equateur Province in DRC (May- July 2018), and (v) the ongoing outbreak in North Kivu and Ituri Provinces in DRC (August 2018 - ongoing). The full report can be accessed here: https://opendocs.ids.ac.uk/opendocs/handle/123456789/14160.

Cross-pillar recommendations

Our evidence synthesis highlighted various cross-cutting trends that apply to all response pillars:

• Communicate openly, frequently and transparently by using trusted local media and interpersonal engagement to affected communities about the outbreak: who is affected and what the government, international and local partners are doing to protect the community. Acknowledge and empathise with frustrations and fears. Establish constructive dialogue that seeks mutual improvements and takes into account community feedback in response activities together with affected communities, neighbourhoods and families.

• Actively listen to the concerns of affected and at-risk communities. First-hand experiences of the response can be crucial: perceptions of “who is visited”, “who falls ill”, and other observations by communities may lead to inaccurate ideas and fears. To avoid misinformation, ensure transparency and constant two-way dialogue with communities. Compassionate communication across all pillars is key.

• Collect community feedback and act on solutions provided by affected people, whilst being honest about what government and response partners can do (e.g. compensation of belongings destroyed during decontamination) and the limitations they face (e.g. having insufficient funds to build ETC’s in each village).

• Work through existing health and other social service actors and local leaders that affected populations use and trust – medical doctors, nurses but also local healers, pharmacies, teachers, community leaders, women and youth groups, etc.
This will build confidence in the response, support reach of interventions and encourage timely utilisation of services.

• The response must identify vulnerable groups who are at risk of harm and may be left out of the response (widows, orphans, street children, people with disabilities, etc.) at an early stage and set up strategies to protect them.

• Voluntary compliance and decentralisation of activities to communities is more useful than coercion. In the past, forced compliance to follow protocols has resulted in increased community resistance and mistrust.