The Ebola epidemic: a transformative moment for global health

Kennedy, Stephen B.; Nisbett, Richard A.

doi:10.2471/blt.14.151068

Cited by 19 publications

(13 citation statements)

References 3 publications

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“…Using cultural insiders and leaders to address people’s misperceptions and demonstrate accountability to the public can also enhance trust and encourage health system use [ 26 , 33 ]. A case study of community resistance from February 2015 in a village of the Guinean Forest region provides an example [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Fears and Misperceptions of the Ebola Response System during the 2014-2015 Outbreak in Sierra Leone

2016

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BackgroundFuture infectious disease epidemics are likely to disproportionately affect countries with weak health systems, exacerbating global vulnerability. To decrease the severity of epidemics in these settings, lessons can be drawn from the Ebola outbreak in West Africa. There is a dearth of literature on public perceptions of the public health response system that required citizens to report and treat Ebola cases. Epidemiological reports suggested that there were delays in diagnosis and treatment. The purpose of our study was to explore the barriers preventing Sierra Leoneans from trusting and using the Ebola response system during the height of the outbreak.MethodsUsing an experienced ethnographer, we conducted 30 semi-structured in-depth interviews in public spaces in Ebola-affected areas. Participants were at least age 18, spoke Krio, and reported no contact in the recent 21 days with an Ebola-infected person. We used inductive coding and noted emergent themes.FindingsMost participants feared that calling the national hotline for someone they believed had Ebola would result in that person’s death. Many stated that if they developed a fever they would assume it was not Ebola and self-medicate. Some thought the chlorine sprayed by ambulance workers was toxic. Although most knew there was a laboratory test for Ebola, some erroneously assumed the ubiquitous thermometers were the test and most did not understand the need to re-test in the presence of Ebola symptoms.ConclusionFears and misperceptions, related to lack of trust in the response system, may have delayed care-seeking during the Ebola outbreak in Sierra Leone. Protocols for future outbreak responses should incorporate dynamic, qualitative research to understand and address people’s perceptions. Strategies that enhance trust in the response system, such as community mobilization, may be particularly effective.

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Section: Discussionmentioning

confidence: 99%

Fears and Misperceptions of the Ebola Response System during the 2014-2015 Outbreak in Sierra Leone

2016

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“…Local cultural practices such as burials, church groups, and community-based organisations are part of the building of trust essential to combat an epidemic. 34 Empowered communities—with education, good health, adequate income, and health knowledge—are better able to diagnose and respond to their own crises. Equally important are effective top-down actions.…”

Section: Ebola: Lessons In Human Securitymentioning

confidence: 99%

Global health security: the wider lessons from the west African Ebola virus disease epidemic

Heymann

Chen

Takemi³

et al. 2015

The Lancet

449

352

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The Ebola virus disease outbreak in West Africa was unprecedented in both its scale and impact. Out of this human calamity has come renewed attention to global health security—its definition, meaning, and the practical implications for programmes and policy. For example, how does a government begin to strengthen its core public health capacities, as demanded by the International Health Regulations? What counts as a global health security concern? In the context of the governance of global health, including WHO reform, it will be important to distil lessons learned from the Ebola outbreak. The Lancet invited a group of respected global health practitioners to reflect on these lessons, to explore the idea of global health security, and to offer suggestions for next steps. Their contributions describe some of the major threats to individual and collective human health, as well as the values and recommendations that should be considered to counteract such threats in the future. Many different perspectives are proposed. Their common goal is a more sustainable and resilient society for human health and wellbeing.

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“…In the presence of this ‘intervention–culture’ disconnect, some authorities observed cultural backlash from community members with escalating levels of distrust and fear of relief responses to Ebola virus disease, including stigma associated with strict isolation procedures. Thus, lessons learned were the key intersections among the identification of cultural beliefs, appraisal of existing health systems, use of evidence-based practices by interdisciplinary teams, and household- and community-level participation [ 19 , 20 ]. Understanding the intertwining roles of these constructs may serve as a foundation to establish and strengthen cultural-based, standardized protocols for infection control during relief programmes, such as for Ebola virus disease.…”

Section: The Case Of the Ebola Virusmentioning

confidence: 99%

Addressing the role of medical students using community mobilization and social media in the Ebola response

et al. 2016

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Health professions education in the 21st century should incorporate both community mobilization and social media strategies. First, community mobilization facilitates change by educating community members with evidence-based, high-quality and up-to-date health information and empowering their active participation in target health initiatives. Second, advancements in technology and globalization foster the development of innovative communication technologies used as a key tool in the ‘roll out’ of community health initiatives during epidemics such as Ebola virus disease. In August 2014, medical students of Sierra Leone and Guinea used these dual health promotional strategies in the Kick Ebola Out campaign to educate community members about transmission of the Ebola virus and preventive measures, as well as to reduce perceptions related to stigma or fear of disease transmission. In this report, we describe how medical students, who are trained in basic and clinical sciences, evidence-based practices, and social determinants of health, can serve as human resources for health and facilitate dynamic communication strategies to educate and empower both medical students and community members for local or national health initiatives.

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The Ebola epidemic: a transformative moment for global health

Cited by 19 publications

References 3 publications

Fears and Misperceptions of the Ebola Response System during the 2014-2015 Outbreak in Sierra Leone

Fears and Misperceptions of the Ebola Response System during the 2014-2015 Outbreak in Sierra Leone

Global health security: the wider lessons from the west African Ebola virus disease epidemic

Addressing the role of medical students using community mobilization and social media in the Ebola response

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