As Ebola virus disease sweeps through the Democratic Republic of the Congo (DRC) and the surrounding region, healthcare workers aren’t just battling a deadly virus strain with a mortality rate of up to 50%. Misinformation, rumors and skepticism unfortunately are also spreading rapidly across central Africa, putting the lives of community members, patients and healthcare workers in danger. Since the DRC declared the latest outbreak on May 15, Ebola treatment centers (ETCs) have seen protests, attacks by angry mobs and even arson—all prompted by fear and suspicion in the community.
The misinformation fueling these attacks includes whispers that Ebola isn’t a real disease but rather a hoax created by humanitarians who want to take people’s land or resources. When patients with Ebola go into an ETC and never reemerge because they’ve passed away and it’s unsafe for their bodies to be returned to their families, some people even spread rumors that they were killed for their organs.
Then there’s the stigma of being an Ebola patient.
“When we have patients with Ebola, we have to isolate them to make sure they get the proper treatment in a dignified way, but also to protect healthcare workers and community at large. That isolation creates stigma around patients: they were isolated by doctors, which means they are the problem,” says Senior Global Health Advisor Dr. Abdou Sebushishe, who is helping lead our response to the outbreak in the DRC. “This creates resistance for patients, and some of them even run away when we suggest isolation.”
Between misinformation and stigma, many people with Ebola symptoms won’t seek the treatment they need, remaining instead in their communities—where they are at greater risk of death and of spreading the virus to their family and friends.
The DRC is currently experiencing its 17th outbreak of Ebola since 1976. Though the virus is hardly novel, DRC is a large country, and for many communities in the Ituri, North Kivu and South Kivu provinces—where the virus is now spreading—Ebola is new. There has also been no continuity in risk communication and community education (RCCE) once previous outbreaks have ended. Most communities in the DRC rely on radio for their news, so if the radio doesn’t provide ongoing public health messages, people remain in the dark about the disease.
With the support of the US Department of State and other donors, International Medical Corps is working to combat the rumors and misinformation that surround the Ebola virus in the DRC through RCCE work. Community health workers (CHWs) are some of our best channels for spreading critical messages about Ebola.
“The CHW network is a structure that is very important in the DRC context because the CHWs are the people who are most trusted by community members,” says Dr. Abdou. “However, the CHW structure suffers from broad health-system weakness, so it’s not permanently supported to provide services or messaging related to health. CHWs are activated only when there is an issue, like right now.”
Because widespread fear of isolation is one of the more challenging issues we are facing right now, our teams work hard to create transparency around the construction of our ETCs. Before we begin building, we bring community leaders to the construction site and explain what will happen at the ETC, how long it will take to construct, how isolation works and what differentiates an ETC from a regular hospital.
Whenever possible, we bring these leaders back once we finish construction and walk them through the facility, explaining why patients can’t see their families and why it takes some people a long time to recover. (This isn’t always possible; for example, recently in Bunia we needed to admit patients to the ETC immediately after construction finished.)
We collect feedback from everyone who comes to visit, and have a community team that informs us of the rumors they hear. We use this information to adapt our messaging and quickly address misinformation. We also let community leaders know what we’re hearing and give them counter-messaging that they can use in their conversations with community members.
Finally, our team works closely with the Ministry of Health to disseminate Ebola-related messages via radio and social media. These messages are in the local language and framed with local cultures in mind.
And during this outbreak, Ebola survivors will be crucial to the battle against misinformation—as they have been in prior outbreaks.
“Where possible, we recruit people who have survived Ebola to give witness to community leaders about their experience—what symptoms they had, how they think they got Ebola, how they were managed in the treatment center, their experience in isolation, how it felt to see the clinicians covered entirely in PPE. This helps the community leaders to understand Ebola,” Dr. Abdou says. “Then we give the survivors a megaphone, and they go into their community and explain these things, because they are trusted by community members who will listen to them more than people coming in from outside.”
As the fight against Ebola rages on, the battle against misinformation will continue to require all hands on deck.
“We need the engagement of everyone on this,” says Dr. Abdou.
