One reason the Ebola outbreak got out of control in West Africa in the early days of the crisis was a lack of trust among community members, frontline health workers, and the broader health system, suggests new Johns Hopkins Bloomberg School of Public Health research. Had the citizens and their healthcare community developed a trusting relationship prior to the outbreak, important messages about the disease and how to stop its spread would likely have gotten through to people much sooner and slowed the march of Ebola, says Timothy Roberton, MPH, MA, DrPH candidate. Roberton will present his findings at the American Public Health Association’s Annual Meeting in New Orleans today.
Roberton visited Guinea in July, spending two weeks with the Guinea Red Cross, based in the town of Gueckedou. In an effort to understand the drivers of the outbreak, Roberton and colleagues interviewed 41 Red Cross staff and volunteers who had been mobilized to raise Ebola awareness and teach families how to protect themselves.
In many villages, messages about Ebola were successfully transmitted—how to identify its symptoms, for instance, and the importance of going to health facilities if symptoms appear, isolating the sick, not touching anyone who is sick, and not handling the bodies of the dead. Families adopted safe practices. But in some villages, the messages were resisted. Often, the Red Cross advice went against the way Guineans had lived for generations; it is customary in the dominant culture to clean the bodies of the dead, for example. Some villagers who were told not to touch the bodies or to place them into body bags before burial found those instructions abhorrent and thus disregarded them.
The success of future public health campaigns in places like West Africa, Roberton says, will require stronger and more trusting relationships between health workers and community members, so families will believe and accept future campaigns’ important health messages. Read more from the APHA’s online meeting program.
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