Dialogue and trust helping to dissolve Ebola stigma

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Whether it is traders refusing to sell them food for fear of touching contaminated coins, or religious leaders turning them away from mosques and churches, Ebola survivors risk being marginalised. But grassroots groups in Africa are helping to nurture reintegration

In Liberia, one of the countries worst hit by the outbreak, organisations called District Platforms for Dialogue (DPDs) have been incorporated into the national Ebola task force. Established by peacebuilding NGO Conciliation Resources in 2009 to help facilitate peace in the wake of successive civil wars, the DPDs have turned their attention to Ebola. They hold community meetings where it is emphasised that survivors have been cured.

Harold Aidoo, executive director at the Institute for Research and Democratic Development in Monrovia, explained how dialogue can help dissolve fear and mistrust.

“The discussions are facilitated by a DPD chairman who begins reminding community members of life before Ebola.  How people relied on each other as a community, how they farmed, prayed and ate together, and will often conclude by saying that their common enemy is the Ebola virus – not the people it infects.”

“The local communities would look to their traditional leaders for permission and guidance, which is why it was crucial to get them on board right from the beginning”

Leveraging the influence of ‘opinion leaders’ in Ebola-hit areas has been a key focus for NGOs and aid agencies. Figures such as the imam, village or town chief and women’s and youth leaders “hold great influence in shaping the mindset of the community,” Aidoo told the Guardian.

Miles further south, there is a similar story.

“We didn’t operate from the top down, but from the ground up,” said Barbara Simmons, dean for international education at William V.S. Tubman University in south eastern Liberia.

The university established its own Ebola task force with the aim of preventing the spread of the virus to the county of Maryland. All districts in Liberia have been affected, but the southernmost tip of the country remains almost Ebola-free.

As well as training hundreds of community health volunteers, the university screened awareness videos, sent SMS and email alerts, and has been conducting weekly Ebola briefings. Engaging local leaders has been key, said Simmons.

“Community outreach teams invited the people who could spread the prevention messages to be in the driver’s seat. Sensitive behavioural changes were needed, for example in regards to not touching the deceased to say farewell. The local communities would look to their traditional leaders for permission and guidance, which is why it was crucial to get them on board right from the beginning.”

Sensitivity and dialogue has had a role in the global response too. For example, a new World Health Organisation (WHO) directive sets out protocol for the safe and dignified burial of people who have died from Ebola.

“By building trust and respect between burial teams, bereaved families and religious groups, we are building trust and safety in the response itself,” said Dr Pierre Formenty, an Ebola expert at WHO.

“Introducing components such as inviting the family to be involved in digging the grave and offering options for dry ablution and shrouding will make a significant difference in curbing Ebola transmission.”

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