Tag Archives: Liberia

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.”

Monrovia, Liberia. Reported by Phil Sedlak.

Women’s Campaign International (WCI) is partnering with UNICEF and USAID on their Ebola Virus Disease (EVD) social mobilization prevention and response initiatives. With UNICEF, WCI is working in 15 counties in Liberia, and in early February, mobilizers from Grand Cape Mount, Montserado, Nimba and Bong Counties participated in training mobilization workshops. Participants were primarily women – about 90 percent. Several were teachers and educators, others were health mobilizers, and others small businesswomen.

When the mobilizers talk about their roles and what it will take to stop the virus from spreading, their commitment and dedication is apparent. They identify the barriers to them succeeding in their job. Not surprisingly, these barriers are about behavior.

Two mobilizers – Grace Nagbe from Gbarnga and Janet Benson from Ganta – participated in the mobilization trainings and were interviewed separately on what motivated them to be social mobilizers and what they see as the way to stop Ebola. An abbreviated summary of the interviews follows:

Grace Nagbe was a mobilizer with WCI prior to the Ebola outbreak, and she also has been a family planning health mobilizer. She is a WCI Field Assistant and will be coordinating the social mobilization in three counties. When comparing her past experience as a mobilizer to the Ebola work, she firmly noted that “none of those experiences have been like this…”

Grace Nagbe

WCI Field Assistant, Grace Nagbe, talks about the importance of communication and behavior change to stop Ebola.

Like so many in Liberia, Grace has lost friends and loved ones to the virus. She told the story of a good friend who was a nurse at Bong County hospital who became ill with the Ebola virus that she may have contracted from a pregnant patient. The patient, her newborn child, and Grace’s friend died. Grace was prompted to join WCI as a mobilizer because she felt so strongly about stopping the virus.

Ms. Nagbe is forthright in her opinions and her main complaint about the job is that “people are so stubborn… They don’t want to change.” She referred to the common belief among many in Liberia that Ebola is not real or that it is designed to make the “rich richer”. Grace emphatically said, “If we can get through to these stubborn people and convince them to take the right measures, we can stop Ebola in its path.”

Janet Benson is one of the WCI UNICEF Community Leads, whose job is to bring the message down to the communities and households. There is little doubt that she will succeed. WCI selected Janet Benson because of her strong commitment to how the Ebola prevention training should go and how she thought that community activists should do their job.

Janet Benson

Janet Benson, a WCI UNICEF Community Lead, is committed to bringing information to people in local communities to fight Ebola.

Ms. Benson told WCI that she wanted to “achieve things in her community.” She wants to influence leaders and community members to “shape up” and do things correctly to stop the progress of Ebola. In addition to “achieving things in her community,” she could also “teach other young people.”

She became interested in working on the Ebola mobilization, which only “arrived” in her community recently. She “learned about other peoples’ lives and how Ebola had infected them” and found out “what she could do” to help. That led her to WCI.

When asked about the future of Ebola in Liberia, she said that “a lot of what will happen is up to us [social mobilizers], the people who work in the communities.” We have to “carry the information to the people. Then they can do the right thing. They can finish this Ebola.”

“Ebola will finish because … we won’t give up. We are not quitters. Is truth,” she stated.

She went on to explain that “Now we have to work with school kids … They’re going to be harder because kids sometimes just do what they want, not what we think they should do. If we can get the parents to talk with the kids and get the kids to talk with the parents and if we can get the pastor of the local church involved – this guy has a lot of influence around the community – then we can beat Ebola.”

Ms. Benson and Ms. Nagbe are strong advocates to Stop Ebola in Liberia. They show the commitment and dedication the WCI social mobilizers bring to this initiative. And as Ms. Benton said, “we are not quitters. Is truth.”

Couldn’t have said it better.

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WCI Projects in Liberia

WCI Projects in Liberia

Women’s Campaign International’s (WCI) mission is to empower women to transform communities. Specializing in transitional and post-conflict contexts, active and serving leaders throughout the 15 counties in Liberia since 2008, WCI has a long-standing relationship with actors at the national and county levels.

The majority of WCI’s staff members are Liberian and are embedded locally throughout the country. They provide contextual perspectives on how local Liberians are responding to the outbreak, its stigma, and the misconceptions surrounding it. Equally important, there is a high-level of trust and understanding because they are from the community and are talking among their peers. The communicators also have long-standing relationships and connections to decision-makers and key stakeholders.

When the Ebola outbreak occurred in early 2014, WCI was asked by the government of Liberia to provide health education outreach on the Ebola Virus Disease (EVD) in communities where they were working. In September, the Ministry of Health and Social Welfare (MoHSW) authorized WCI to travel to 50 communities in nine counties in restricted regions to provide humanitarian support.

In November 2014, WCI was funded by USAID’s Ebola Community Action Platform (E-CAP) to facilitate community outreach, working closely with its partner, the National Rural Women’s Program (NRWP), to educate local communities about correct preventative and response behaviors to avoid the EVD. The NRWP are trusted local communicators and serve as champions on Ebola prevention and stigma reduction. Additionally, the ECAP Training also emphasizes recovery from the devastating social and psychological impacts of the virus. In its first round of trainings held in November, 12 women from three counties (Gbarpulu, Bomi and Grand Cape Mount) were trained in Monrovia. The remaining 24 mobilizers for the additional six counties (Bong, Margribi, Grand Gedeh, Nimba, Maryland and River Gee) were trained within a week. Among those trained was a survivor from the virus who shared her personal experience. She lost her mother to Ebola and her older sister also died. It was especially distressing because her sister refused to take any type of treatment because she believed the myths and rumors about the treatments and side effects.

ECAP-trained social mobilizerShe received care at the Gbarnga Ebola Treatment Unit (ETU), where she recovered and was immediately hired to work. Though this tragic story has a good ending, she has been a victim of stigma from the community, which has not accepted her since she had the virus. She did say at the training that people are beginning to slowly understand that she can be useful to her community.

“Whether or not they accept [me] life goes on and I thank God for everything. My only regret is that at eighteen years [of age], I am working and making good money and my mother is nowhere around to enjoy some of it.”

Though officials are reporting that Liberia is on the verge of containing the spread of Ebola, communities must remain vigilant to its threat. Localized efforts in community engagement and resilience building have proven to be one of the best approaches to educate the nation and eradicate the virus.

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