The Effect of Community-Based Prevention and Care on Ebola Transmission in Sierra Leone

Pronyk, Paul; Rogers, Braeden; Lee, Sylvia; Bhatnagar, Aarunima; Wolman, Yaron; Monasch, Roeland; Hipgrave, David; Salama, Peter; Kucharski, Adam J.; Chopra, Mickey; Team, Unicef Sierra Leone Ebola Response

doi:10.2105/ajph.2015.303020

Cited by 34 publications

(36 citation statements)

References 14 publications

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“…Moreover, due to the temporal evolution of the figures of blame, as indicated in our study, real-time and on-going analysis of social media conversations are important to tailor online communication efforts to the users' perceptions. On one hand, this can allow for better calibrated communication campaigns that respond to the public's perception of risk (Smith 2006), and that address fears or distrust (Rousseau et al 2013;Sharfstein 2015) in ways that promote social cohesion and community mobilization (Laverack and Manoncourt 2016;Omaswa, Okware and Kiguli-Malwadde 2015;Pronyk et al 2016). On the other hand, it may also reassure community stakeholders who question official responses, by showing that their concerns are shared by the population.…”

Section: Resultsmentioning

confidence: 99%

Ebola and Localized Blame on Social Media: Analysis of Twitter and Facebook Conversations During the 2014–2015 Ebola Epidemic

Roy

Moreau

Rousseau

et al. 2019

Cult Med Psychiatry

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This study aimed to analyze main groups accused on social media of causing or spreading the 2014-2016 Ebola epidemic in West Africa. In this analysis, blame is construed as a vehicle of meaning through which the lay public makes sense of an epidemic, and through which certain classes of people become ''figures of blame''. Data was collected from Twitter and Facebook using key word extraction, then categorized thematically. Our findings indicate an overall proximate blame tendency: blame was typically cast on ''near-by'' figures, namely national governments, and less so on ''distant'' figures, such as generalized figures of otherness (''Africans'', global health authorities, global elites). Our results also suggest an evolution of online blame. In the early stage of the epidemic, blame directed at the affected populations was more prominent. However, during the peak of the outbreak, the increasingly perceived threat of inter-continental spread was accompanied by a progressively proximal blame tendency, directed at figures with whom the social media users had pre-existing biopolitical frustrations. Our study proposes that pro-active and on-going analysis of blame circulating in social media can usefully help to guide communications strategies, making them more responsive to public perceptions.

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Section: Resultsmentioning

confidence: 99%

Ebola and Localized Blame on Social Media: Analysis of Twitter and Facebook Conversations During the 2014–2015 Ebola Epidemic

Roy

Moreau

Rousseau

et al. 2019

Cult Med Psychiatry

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“…Blood samples were taken from those admitted. The aim was to have a laboratory-confirmed result within two days [2, 13]. Confirmed cases of Ebola were transferred by ambulance to an ETC.…”

Section: Resultsmentioning

confidence: 99%

Rural populations exposed to Ebola Virus Disease respond positively to localised case handling: evidence from Sierra Leone

Mokuwa

Maat

2019

Preprint

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13 At the height of the Ebola epidemic in Sierra Leone in November 2014, a new decentralized 14 approach to ending infection chains was adopted. This approach was based on building local, 15 small-scale Community Care Centres (CCC) intended to serve as triage units for safe handling of 16 patients waiting for test results, with subsequent transfer to Ebola Treatment Centers (ETC) for 17 those who tested positive for Ebola. This paper deals with local response to the CCC, and 18 explores, through qualitative analysis of focus group data sets, why communities see CCC in a 19 positive light. The responses of 562 focus group participants in seven villages with CCC and seven 20 neighbouring control villages without CCC are assessed. These data confirm that CCC are 21 compatible with community values concerning access to, and family care for, the sick. Mixed 22 reactions are reported in the case of "safe burial", a process that directly challenged ritual 23 activity seen as vital to maintaining good relations between socially-enclaved rural families. Land 24 acquisitions to build CCC prompted divided responses. This reflects problems about land 25 ownership unresolved since colonial times between communities and government. The study 2 26 provides insights into how gaps in understanding between international Ebola responders and 27 local communities can be bridged. 29Author Summary 30 Control of Ebola Virus Disease requires facilities where patients can be isolated and treated 31 safely, without risk to medical personnel or family members. In the 2014-15 Ebola epidemic in 32 Sierra Leone emphasis was at first placed on large field hospitals known as Ebola Treatment 33 Centers (ETC). These were often located far from areas where new cases were being discovered.34 Patients were distrustful of their purpose and slow to report, and the disease continued to 35 spread. Six months into the epidemic a new approach was tried, based on much smaller and 36 more rapidly constructed centres (Community Care Centres (CCC) located where new cases were 37 occurring. This paper examines community reactions to the CCC. There was a much greater sense 38 of community ownership of these small, localised centres, and reporting times improved.39 Families were able easily to visit and observe activities, even though restricted from crossing red 40 lines. The staff were often local and provided trustworthy information on the progress of 41 patients. Families were able to prepare home food for patients, and this was thought to improve 42 their morale and chances of survival. CCC were also appreciated for treating other disease, and 43 not only Ebola. Referral of patients to ETC was easier to accept when the outcome of an Ebola 44 blood test was known. There were some differences of opinion over "safe burial" procedures and 45 acquisition of sites for the CCC, but on balance CCC were well accepted by communities, and 46 were seen locally as a positive development in Ebola control. 47 48 54 Kenema, in September 2014, followed by other units in Bo,...

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“…The ethical deployment of non‐credentialled healthcare workers to augment critical services during a medical crisis does more than provide compassion. The work can even thwart disease transmission …”

Section: Discussionmentioning

confidence: 99%

“…The work can even thwart disease transmission. 17 Amidst the devastating toll, there are critical lessons in the ethical administration of response. It is incumbent upon us to reflect, to heed and to implement best practices.…”

Section: Discussionmentioning

confidence: 99%

Ethical aspects of collateral clinical services by non‐credentialed personnel in international medical crises

Schachter

2019

Internal Medicine Journal

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The study of global responses to medical crises in developing and under‐developed countries demands reflection about the ethical engagement of non‐credentialed medical personnel in the context of clinical care. The need for, and the desire to contribute by, people and organisations that lack demonstrable or readily transferable credentialed skills must be reconciled with the ethical administration of collateral clinical services. The urgent need for the provision of such services must neither preclude their use nor permit their use irrespective of salient ethical considerations. One way to explore these issues is to examine a recent exemplar of a non‐governmental organisation’s utilisation of non‐credentialed medical personnel during the Ebola outbreak in Sierra Leone. Although the group lacked clinical proficiency (apart from community health workers), it collaborated with experts in interment to train staff to bury those who had succumbed to the disease in respectful and hygienic individually marked graves. The group leveraged its cultural competency and in‐country presence to judiciously deploy staff, support the workers to combat social ostracism and offer vocational and other education to help them assimilate back into the workforce once the outbreak subsided. The non‐governmental organisation stepped up to do the work that others shunned. And to do it ethically and proficiently. I offer the work to show a compelling and innovative blueprint for ethical mobilisation of non‐credentialed healthcare personnel in a global medical crisis.

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The Effect of Community-Based Prevention and Care on Ebola Transmission in Sierra Leone

Abstract: Community-based approaches to prevention and care can reduce Ebola transmission.

Cited by 34 publications

References 14 publications

Ebola and Localized Blame on Social Media: Analysis of Twitter and Facebook Conversations During the 2014–2015 Ebola Epidemic

Ebola and Localized Blame on Social Media: Analysis of Twitter and Facebook Conversations During the 2014–2015 Ebola Epidemic

Rural populations exposed to Ebola Virus Disease respond positively to localised case handling: evidence from Sierra Leone

Ethical aspects of collateral clinical services by non‐credentialed personnel in international medical crises

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