Religion and Ebola: learning from experience

Marshall, Katherine; Smith, Sally

doi:10.1016/s0140-6736(15)61082-0

Cited by 52 publications

(40 citation statements)

References 4 publications

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“…Experience from both HIV and the Ebola crisis has made clear that community engagement in the design and delivery of health services is crucial, given the complex interrelationships between culture, traditional healthcare practices, and stigma and discrimination, all of which affect vulnerability to infection and uptake of health services [14]. In the case of Ebola, resistance occurred when traditional public health approaches were used to attempt to change long-standing burial practices that spread the disease.…”

Section: Discussionmentioning

confidence: 99%

Time for full inclusion of community actions in the response to AIDS

Collins

Greenall

Mallouris

et al. 2016

Journal of the International AIDS Society

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IntroductionCommunity action, including activism, advocacy and service delivery, has been crucially important in the global response to AIDS from the beginning of the epidemic and remains one of its defining features. This indispensable contribution has been increasingly acknowledged in strategic planning documents from UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, the World Bank, the World Health Organization and other organizations. A growing body of literature demonstrates that community-based services can have measurable impact, serve populations that are not accessing public health services and reach people at scale.DiscussionRecognition of the powerful potential role of community has not translated into full incorporation of community responses in programme planning or financing, and communities are still not fully understood as true assets within overall systems for health. The diverse community contributions remain seriously underappreciated and under-resourced in national responses.ConclusionsIt is time for a paradigm shift in how we think about, plan and finance community-based responses to HIV in order to achieve improved impact and move toward ending the epidemic. We must utilize the unique strengths of communities in creating resilient and sustainable systems for health. There are several priorities for immediate attention, including agreement on the need to nurture truly comprehensive systems for health that include public, private and community activities; re-examination of donor and national funding processes to ensure community is strategically included; improvement of data systems to capture the full spectrum of health services; and improved accountability frameworks for overall health systems. Health planning and financing approaches run by governments and donors should institutionalize consideration of how public, community and private health services can strategically contribute to meeting service needs and accomplishing public health targets.

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Section: Discussionmentioning

confidence: 99%

Time for full inclusion of community actions in the response to AIDS

Collins

Greenall

Mallouris

et al. 2016

Journal of the International AIDS Society

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“…Issues arise during the removal of bodies, filling body bags, safe burials, mass burials and even cremation. What these issues give rise to is not just the proposal of an unwelcomed burial or an invasive autopsy, it relates to the deceased and how the deceased are managed in different cultures (Manguvo and Mafuvadze 2015;Sajid 2016a;Sajid 2016b;Al-Saif et al 2016;Madadin et al 2014;Marshall and Smith 2015). This affects the capacity to undertake autopsy, sampling, or safe burials.…”

Section: Main Textmentioning

confidence: 99%

“…This could prevent the blaming of religion or belief systems as the cause of spreading diseases. The focus should be maintained on trying to gain a better understanding of how the international medical/ scientific world can engage with these communities more successfully (Sajid 2016a;Al-Saif et al 2016;Madadin et al 2014;Marshall and Smith 2015). Therefore, the first step is to find ways in which non-native healthcare practitioners can perform the necessary scientific work (e.g.…”

Section: Community Engagementmentioning

confidence: 99%

“…The term healer can also relate to diviners, traditional healers, spiritual healers, traditional doctors, witch doctors, sorcerers or medicine men/women, among others. These leaders or influential individuals usually hold extremely influential power within these communities (Manguvo and Mafuvadze 2015;Sajid 2016a;Sajid 2016b;Marshall and Smith 2015).…”

Section: Community Engagementmentioning

confidence: 99%

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Virtual autopsy and community engagement for outbreak response in Africa: traditional, religious and sociocultural perspectives

O’Sullivan

Sajid

Agusto

et al. 2018

Egypt J Forensic Sci

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Background: In response to outbreaks, the manner in which the medical field engages with the process of death is significantly important, not only in the pathological but also in the sociocultural aspect. Certain response-methodology used could be a critical catalyst for community resistance to post-mortem examinations (e.g. hiding corpses, violence), considering how the deceased are handled in different cultures. We reviewed the traditional, religious and sociocultural aspects of post-mortem response-methodology in Africa. With no means to take blood samples, innovative sampling techniques were developed and frequently adopted in post-mortem cases. However, this approach can be met with resistance. Main body: To avoid resistance, virtual autopsy (virtopsy) involving a non-invasive or minimally invasive imaging-guided biopsy (e.g. portable ultrasound guidance) is recommended as a proper entry point to negotiations around examination of the deceased. We outline how adapting virtopsy and community engagement strategies can have many benefits to communicable disease prevention or control, public health and communities in Africa and elsewhere. This paper provides a completely new perspective by applying imaging autopsy to field studies. These are usually hospital-based procedures. Many countries can train their response and military personnel on how to perform a safe straightforward virtopsy procedure in an outbreak situation. Just as relevant, Islam is now the fastest growing religion in the world-virtopsy might appease fears and increase the autopsy rate among large Muslim populations (in Africa and elsewhere).Conclusions: Virtopsy use and its application might have proved very useful in the recent outbreak of Ebola in 2014 and microcephaly associated with Zika virus. Use of virtopsy may have reduced the number of Ebola cases worldwide and enabled an earlier diagnosis linking Zika virus to microcephaly during the recent outbreak in Northeast Brazil. If the diagnosis was made earlier, additional cases of Ebola or Zika may have been prevented. The issue of invasive autopsy was in all likelihood one of the greatest factors that drove Ebola underground; it prevented communities from cooperating with non-native response teams and contributed to the excessive duration and length of the outbreak. Healers may unknowingly infect others (via scarification) and themselves (via contact with others). Adapting sociocultural engagement methods and conducting a virtopsy may be more acceptable, thereby ameliorating the spread of a deadly virus more efficiently.

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“…Religious institutions have provided "key social roles and contributions to resilience and peacebuilding during lengthy conflicts" in the current Ebola-affected countries, and it is likely that delays in appreciating "the vital roles of religious actors in addressing Ebola and supporting health systems" was detrimental to slowing the epidemic in its initial stages (Marshall and Smith 2015:1). Faith-based initiatives and organizations effectively responded to the epidemic by providing health care, training pastors, mobilizing volunteers, spreading health messages via text to congregations, and caring for orphans (Marshall and Smith 2015).…”

Section: Prevention Strategies: Science Tradition and Religionmentioning

confidence: 99%