Monthly Archives: March 2015

It starts with hand washing. The basic preventative measure to staying well from a wide array of infectious diseases is to correctly wash your hands with soap and water.

In grade schools all over the world, students learn songs that teach them how to wash their hands. In the United States, signs are posted in public bathrooms reminding us to wash our hands.

But, really, how many of us wash our hands thoroughly and correctly every time? And, if asked, how many of us could demonstrate the correct way to wash our hands?

It sometimes is very hard to understand that a behavior as simple as washing your hands with soap and water can combat an illness as deadly as the Ebola virus. But it can.

That’s why WCI’s social mobilizers are participating in refresher training on hand washing and taking that behavior to their communities.

Continuing the Hand Washing Behavior

During the height of the Ebola virus outbreak in Liberia, chloride-water solution stations were installed at public buildings and a number of households, and they were regularly used. People of all ages in both urban and rural communities were instructed on how to use the chloride solutions.  Among the first messages disseminated in response to the Ebola outbreak was to wash your hands with chloride-water This message was strongly supported by the government of Liberia’s Ministry of Health and disseminated through social mobilization activities like WCI under the Ebola-Community Activity Platform (E-CAP).

In Liberia, reported cases of the Ebola virus are diminishing, and the shift from chloride-water to soap and water is underway. Hand washing remains a critical long-term public health strategy for Ebola prevention, and it is important that people continue the behavior as the country moves forward.

Social Mobilization Training

Though we all think we know how to correctly wash our hands, it is important to have refresher training. WCI organized a refresher training session for its social mobilizers in Tubmanburg in Bomi County. The training was led by field officer Morris Taweh. In addition to the refresher on how to correctly hand wash, there was a discussion with the mobilizers on how to ensure the practice of hand washing continues in homes, schools, and public places, and throughout rural communities.

With the expense of chloride and reduced availability of subsidized sachets, the focus is on using soap and water. Iron Soap, a locally-made soap, is affordable and widely available.  Iron Soap can be shaved and used as a powder for cleaning or used in its original solid block form for hand-washing.

Mobilizers at the training session explained that it is just as important to promote hand washing with Iron Soap as it was to use chloride solution to keep Liberia Ebola-free in the future. They focused on how to reinforce effective hand-washing techniques and make sure people take their time and don’t rush through the steps. . “We need to figure out simple ways to remind people to do it and do it right,” one mobilizer said.

Training poster illustrating the steps for effective hand washing

Training poster illustrating the steps for effective hand washing.

At the training session, Morris shared the graphic instructions on how to correctly wash hands. Then, the mobilizers each demonstrated the correct hand-washing procedure and talked through each step so that they could help reinforce the behavior in their communities.

A mobilizer demonstrates hand-washing following instructions from the training chart.

A mobilizer demonstrates hand-washing following instructions from the training chart.

After finishing the demonstration, a number of the mobilizers suggested that the chart should be posted at hand-washing stations in schools and other public places as a good reminder of the steps.

WCI will continue to demonstrate hand washing  as a preventive action against Ebola infection as part of its community mobilization efforts. WCI plans to produce the graphic as a flyer to be distributed and posted in homes and schools and throughout the communities.

“Washing hands is a critical behavior for preventing the spread of the Ebola virus,” Morris reminded the group.  “Everyone knows it. Let’s make sure they remember to do it.”

Women’s Campaign International currently is an implementing partner with UNICEF and USAID’s Ebola-Community Action Platform (E-CAP) in Liberia.

In collaboration with UNICEF, Women’s Campaign International (WCI) is using its grassroots approach to tell rural communities about Ebola prevention in the remote southeast region of Liberia. Travel to southeast Liberia is a major challenge: it is difficult and expensive to reach this part of the country because it is very remote and the infrastructure is less developed.

WCI Program Manager Rebecca Martinez visited River Gee and Maryland Counties to conduct a one-day training with 28 communicators in Fish Town and Plebo. She joined the WCI regional field officer Dominic Dennis and gave this report back about her visit and her observations.

Rebecca flew in and then travelled four hours by motorbike to reach southeast Liberia.

Rebecca flew in and then travelled four hours by motorbike to reach southeast Liberia.

Challenges in the Southeast

River Gee and Maryland’s location has affected these communities’ assessments of the Ebola virus. The region has been fortunate in that there have been only a few cases of Ebola. However, this has contributed to a lack of belief that the disease is real. The mobilizers have said that one of their biggest challenges is convincing people to use preventative measures – such as hand washing with soap and water, not touching people, or following certain protocols at funerals – against something that they have heard of but not personally seen or experienced.

Regional community leaders explained that if people do not see Ebola, then it is not real. One mobilizer said that if Ebola came to River Gee, “plenty of people would die because belief is not there”.

These counties’ citizens follow very traditional burial practices. There also is a high level of fear and distrust of the Ebola Treatment Units (ETUs) and burial teams. There is a fear among the citizens of being stigmatized if they go to the ETU, so they have stayed away.

That is very different from others parts of Liberia. There have been positive reports of Liberians leaving the ETUs healthy, and people are beginning to believe that it is possible to survive the ETUs. This message still needs to be strengthened within the communities, and this has been a central part of WCI’s work in the region.

WCI’s Approach to Fight Ebola

Mobilizers reviewing training materials on Ebola prevention.

Mobilizers reviewing training materials on Ebola prevention.

The trainings in Fish Town and Plebo emphasized Ebola prevention practices and basic information about what the ETUs are and how they should be utilized. In addition to the classroom training, there were demonstrations and practice by the communicators on effective hand washing with soap and water and correct preparation of cleaning solution.

 

Though there have been few reported cases of Ebola in the southeast, there are rumors and misinformation about the virus, its treatment, and the ETUs. A portion of the training was spent clarifying incorrect information about Ebola, the ETUs, how people become sick, and how to respond if someone seems sick. Dennis and Rebecca spent considerable time explaining when someone should go to the ETU and what to expect when a patient goes there.

 

There is a lot of stigma surrounding the ETUs. People are afraid to go to them because they believe they will die there. One of the roles of the social mobilizers is to make the ETUs less threatening by explaining what type of health care the patients receive there and that they are there to help, not harm.

Successes 

The mobilizers told Rebecca about changes they see among their communities in Maryland and River Gee. The people are increasingly receptive to the government of Liberia’s message that “Ebola is Real”, and they understand that people that visit ETUs can and do survive.

For hand washing, Samaritan’s Purse previously distributed hand-washing supplies and installed hand-washing stations in front of almost every household and place of business in Maryland. Though behavior change requires more than knowing what to do, having the necessary supplies available makes it easier for people to adopt preventative practices.

WCI’s mobilizers are pleased with the progress they have seen and will continue their strong efforts to keep Ebola out of these communities where its prevalence has been low so far.

“Sailing forward to a brighter future for Liberia”.

“Sailing forward to a brighter future for Liberia”.

Additional comments from field officer Dominic Dennis

 “Since the Ebola outbreak in Liberia, many other NGOs have been trying to fight this deadly virus that causedmany people to lose their lives. Among those groups helping to stop the spread ofEbola, WCI has partnered with the Liberian Ministry ofGender and Development and, through funding from the USAID and privatedonors, they are implementing multiple programs to empower the National RuralWomen Program of Liberia. The National Rural Women Program has worked with more than 20,000 rural women and men for many years and since three months ago they have established a strongnetwork which stresses community engagement to fight against Ebola across Liberia, including in the southeast region. WCI empowers the national Rural Women by building their social mobilization through training them in the area of preventing the spread of Ebola in more than 85% of the communities in the southeast including Sinoe County.

WCI has trained eight mobilizers, forty-one communicators, eightcounty leads and forty community leads  in Sinoe, Grand Kru, Maryland,and River Gee Counties. Two assistants have been employed in the southeast.

In partnership with UNICEF, our organization is still carrying on thepreventive measures of the awareness of Ebola activities in thecommunities in the Southeast.Through E-CAP, the Rural Women have also been trained to use the iPhone to take pictures and to send reports using the U-Report.”

When a public health emergency like the Ebola outbreak occurs, sharing correct information and managing uncertainty at the local level are critical steps towards preventing the spread of the virus and reducing deaths.  Working closely with the government of Liberia, Women’s Campaign International (WCI) has used their established reach – 20,000 volunteers that are part of the National Rural Women’s Program in all 15 counties, including remote rural populations – and presence in the communities to conduct Ebola prevention and response.

             WCI’s Approach to Communication on the Ground

In a conversation with Wilfred Kokeh, WCI field officer for Lofa, Nimba, and Grand Gedeh Counties, in February in Kakata, he talked about how WCI has applied its social mobilization skills to support USAID, UNICEF, and the government of Liberia’s response to the Ebola virus.

WCI field officer Wilfred Kokeh (left) syncing phones with Rebecca Martinez, WCI Program Manager

WCI field officer Wilfred Kokeh (left) syncing phones with Rebecca Martinez, WCI Program Manager

Mr. Kokeh explained that WCI’s approach differs from most other NGOs in that it is “bottom-to-top” to effect change. The overriding goal of WCI is to help people help themselves by working within their own communities to help their neighbors learn how to work independently, and create sustainable livelihoods. WCI does this by being community-oriented and what activities it starts it eventually transfers to local authorities to continue.

For the Ebola outbreak, Mr. Kokeh said that WCI “knew how to respond [to the outbreak]” from their democracy work “going door-to-door in the community.” He went on to say that “they have been successful doing exactly that” and it has made a difference in Ebola.

WCI field officers from l to r Wyaette Willet Moore, Binda Freeman, Morris Taweh, and Wilfred Kokeh (not pictured: Dominic Dennis).

WCI field officers, from left to right: Wyaette Willet Moore, Binda Freeman, Morris Taweh, and Wilfred Kokeh (not pictured: Dominic Dennis).

When the first Ebola cases were reported in Lofa County in early 2014, it spread quickly throughout the communities. WCI was working in the community on civic participation in run up to the elections and in August 2014 was asked by the Ministry of Health and Social Welfare to apply its social mobilization skills to the Ebola hotspots to deliver public health messaging and logistics for the delivery of food and water.

Mr. Kokeh succinctly summed up why WCI was asked to perform this activity, [WCI] was’ “not recognized as experts in Ebola, but […] as experts in Liberia.”

WCI is a unique NGO because of its close ties and relationships to the communities where it works. Community members interviewed talked of how they “felt relief” when they saw that NGOs including WCI were part of the Ebola response, and they became worried when stories circulated that the NGOs were leaving.

Wyeatta Willet Moore, WCI field manager for Montserado and Grand Bassa Counties, reiterated this response from the communities: “like after the [civil] war – NGOs coming in gave us hope and a return to normalcy.”

WCI social mobilizer (right), Makoya  Komara, and communicator (left) Mamie Sendolo, Nimba County

WCI social mobilizer (right), Makoya Komara, and communicator (left) Mamie Sendolo, Nimba County.

             The Critical Role of Women in the Ebola Response

WCI is women-centric and its core principles are to elevate the role of women in society with an emphasis on the rural, low-literate, and poor. In its Ebola social mobilization gender plays a role. It is estimated 90 percent of their mobilizers and communicators are women; the mobilizers live in the communities where they are conducting the work; and they are trusted and respected members of their community – teachers, midwives, pastors, and business women.

WCI is a partner in the USAID Ebola-Community Action Platform (E-CAP) working in Liberia.

WCI has five field managers assigned to five regions in Liberia. Each field officer is responsible for approximately 40 mobilizers and 50 communicators. Wilfred Kokeh is the field manager for Lofa, Nimba and Grand Gedeh Counties that cover a geographic area of 1000 miles. Wyeatta Willet Moore is field manager of Montserado County that includes Monrovia and Grand Bassa County. Morris Taweh works in Bomi, Grand Cape Mount and Gborpolu; Binda Freeman oversees Bong, Magribi and River Cess Counties; and Dominic Dennis is field manager for Southeast Liberia – River Gee, Maryland, Sineo and Grand Kru Counties.