Health Care Workers were killed in the process of educating the public
about Ebola in Conakry, Guinea.
nypost.com/.../group-of-aid-workers-fighting-ebola-killed-by-african-vil...Sep 19, 2014 - CONAKRY,
Guinea — The team of health officials accompanied by
journalists ... them with knives and rocks and killing eight of
them, witnesses say. ...radio journalists who had been covering the awareness
campaigning.
Assignment:
Could this event have been prevented by applying lessons from the previous epidemics ?
What is your reaction about this news ?
Yes,it could have prevented this.
ReplyDeleteI have a mix reaction on this issue, actually it was a shocking news, and unheard that people you just wanted to help could be so nasty and ungrateful like that on other hand my fellow African peoples are not draft, there must be a misconception somewhere for that kind of animalistic behavior.
In my own opinions on this ugly incident, I will reserve my comments till end of my explanations.
According to American Health Educator Lawrence Green defines “Health education is any combination of learning opportunities designed to facilitate VOLUNTARY ADAPTATION of behavior which will improve or maintain health.” The use of word voluntary should be stressed and is significant for ethnical reason, it implies that health education should not impose or force people to do what they did not want to do. Instead, our efforts should help people to make decision and choices for themselves. If enforcement approach adopted by this team it could result to the above incident.
“One aid worker was recovering from a wound in the neck after a crowd grew hostile to a Red Cross team’s effort to encourage safe burial practices-one of the main reason for Ebola spread in the region”. This was a report from one of the reporters in Guinea .With reference to this; one could deduce that there are barriers for effective health education among the health workers and local people which could be as result of language barrier, traditions and belief system-these are practice that have been held for a long time from parents to children especially in case of befitting burial rites and processes which aids Ebola spread a which is difficult to crack unless one can provide a practical demonstration. In addition to this, communication cannot be effective unless it is seen or heard by its intended audience- a common cause of failure is preaching to the converted –the radio awareness campaign only reach people who have the radios and literates who can read newspaper especially in a place like Conakry (local area) which majority inhabited are farmers who might busy working at their farms when health education programs are broadcast.
” Spreading Public health messages has been extremely challenging in an environment with low health literacy and public trust officials” led to the villagers who mistakenly believed the visitors were actually spreading the fatal virus because “there was little understanding about the virus and public health officials have had a difficult time getting their messages across”. This was said by a reporter from Conakry, Guinea. A message will only be effective and/or attract attention so that people will make effort to listen/read it if message contents (health advice) presented are simple, culturally accepted, meets a felt need, easy to understand, realistic and appealing on hearing.
The issue of working with community should be stressed that community participation should also sought for ,that is the involvement of the local community stakeholders like their chiefs , youth leaders, market women leaders just but a few to be mentioned in the programs of health education would have yielded a positive results rather than violence in a case study.
Last but not the least, In Liberia, distrust in the government led some people to think Ebola is government scam to attract international aid. This is food for thought for Africans.
Now my question is who to blame people or Government? Thank you
I dont think the people are to blame. They acted out of Ignorance and mistrust. I'm curious as to who you think is to blame!!!
DeleteIt was a shocking news to hear that community members could go on to attack and even kill some of the health workers that came to help them contain spread of a disease that could have wiped out the entire community.
ReplyDeleteI believe this could have been prevented if lessons from previous epidemics was applied. I believe the community entry was not adequate because this was a rural community that i believe has traditional authority and influential persons ie Chiefs, religious leaders, traditional/voodoo healers who could have been reached with the ebola message and they would have been encouraged to take a lead in passing out the right prevention messages. I also believe the involvement of a community member in the prevention activity was neglected
This would have gone a long way in reassuring the local community of sincerity of the health workers.
The health workers were also not mindful of being abreast of happenings in that community because they would have heard about the false knowledge/ rumour which was being spread and attempts to control it would have been put it in place as the act of the community was said to be on account of a false information that the health workers were out to harvest the organs of their kith and kins which negates the African belief system which holds that a body not completely buried will not lay in peace.
This comment has been removed by the author.
ReplyDeleteIt is very unfortunate the health workers were killed in such a cruel way. Application of lessons from previous epidemics such as effective communication with the community members and the involvement of major stakeholders in the community could have prevented this incidence. Probably, the villagers did not have an indepth understanding of the present situation, or even the intentions of the health workers. This might have developed panic within the community, and weakened co-operation and support from them.
ReplyDeleteoke oluwatosin Dorcas
ReplyDeleteThat is so unfair! The people of Guinea have not done well at all! Why kill those who have come to make things better? Why shed innocent blood of the public health personnels? They should have even refused to listen to them rather than tempering with their lives.
It is possible such unfortunate incidence could have been prevented. One important lesson from the past is to properly consider the 'context' ( situation, belief, system of government) of any community before determining the appropriate method of channeling of the history public health responses. This paradigm actually came from the post-industrial era (1858-1965) experience in the history of public health, as regards preventable morbidity and mortality in the United States. Shattuck made attempt to establish state medicine (to promote health) but the people of America wanted independence as opposed to the common system of government Shattuck pushed for. This led to the failure of the establishment of state medicine in America at that time. Now, relating the past to this issue in Guinea, it is obvious that the context (belief) in the community was that strangers were the ones who brought that 'deadly' Ebola to their domain. Maybe the health professionals were not aware of this pervading belief among the Guineans, they could have developed preparedness plans for the challenges they could likely face.
The government responded, but my question is what specific measures did the government take and how will the government prevent future re-occurrence of the situation?
Why do you think its the governments duty to prevent a future reoccurence of such?
DeleteThis is rather a sad incident which was uncalled for. Lessons learnt from the past that could have been applied in this situation is proper community entrance. These health workers should have gone along side a community member or members who would have explained better to the people the purpose of their visit and this would have surely gained them better acceptance in the community. This on it's own is another lesson to be learnt, that when community members show resistance, health workers should not force their way in or try to still go in but rather go back and restrategize before trying again.
ReplyDeleteI dont think its proper for health workers to wait till community members show resistance before strategizing....my opinion.
DeleteNo. The above event could not have been prevented. Before reacting I will base my argument in the following discuss.
ReplyDeleteWhat is an Epidemic?
Epidemic is the outbreak of a contagious disease affecting an unusually large number of people or involving an extensive geographical area which may be short lived or last for years e.g cholera and HIV/AIDS.
Examples of epidemic
Bubonic plague 1347-1350
Spanish influenza 1918
Asian influenza 1957
Hong Kong influenza 1968
SARS 2003
Swine flu (H1N1) 2009
Most recently Ebola.
Lessons from the Past
1. DORSCON (The Disease Outbreak Response System Condition): this is a colour coded framework to guide the response during pandemic.
2. The WHO provided an Influenza pandemic alert system with a scale ranging from 1(a low risk of flu pandemic) to phase 6(a full blown pandemic).
3. The International Health Regulations (2005) or "IHR (2005)" which has been in force since 15 June 2007 and reviewed in 2009.
4. - Vector quarantine
- Close monitoring to prevent or curtail genetic mutation of the virus in vectors
- Monitoring and reporting atypical conditions e.g atypical pneumonia (SARS)
My Reaction
Lessons from previous epidemics are based on Alert Response to detect the disease on time create awareness to members states, build capacity to curtail and contain the disease. Never in time past has it occurred that issues like having health practitioners beating up while helping during an epidemic outbreak emanated before.
The case in Guinea only revealed the level of ignorance concerning health issues in that part of the country. In Nigeria for example, awareness and public information was made available and that on time that every individual whether in schools, offices, churches, mosques, and villages knew what Ebola literally was and avoided it and accepted the modes of prevention made available by the health sector. Schools just resumed for the same reasons and the use of hand sanitizers was employed rather than IGNORE the information made available by the health sector.
please, what event could not be prevented? The spread of Ebola or the Killing of the Health Workers?
DeleteThis is a very sad and regerettable incident and an act of wickedness that should not have occured at all and its a threat to the public health of the nation.it was borne out of ignorance.I think that before entrance into a community to sensitize people about ebola, the pervading belief or mental model concerning ebola should have been ascertained and addressed to prevent this kind of event. Most peopla in that community belived either that the government was spreading ebola or that it does not exist, just like the beief in some northern parts of Nigeria that immunization causes infertility. If the government had sent few people to the stakeholders or rulers of the community to know thier thoughts or belief concerning ebola, then they would known before hand the particular issue to be tackled 1st by involving stakeholders.
ReplyDeleteThe attack was out of fear and ignorance, and it only began when the health workers started spraying the disinfectants. The villages believed the sprays were actually meant to infect them.
ReplyDeleteSo the key mistake still remains the fact that the "Community Entry" was poor. The stakeholders: Traditional rulers, Religious rulers etc would have been the first point of call. The people will most likely believe their Local leaders than strangers. And to think that this was the third attack on health workers in Southeastern guinea in this year alone, one would have thought they should have taken precautions.
Understanding the culture and belief of the community before planning any intervention is very important. Were the health workers expecting these people to understand and accept the existence of a new disease without carrying the stakeholders along? The mistake we keep making in this continent is that laws can be implemented and decisions concerning the health of the population can be made without involving them. This ugly event could really have been prevented if the health workers had entered the community through the right channel.
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteThe killing of health workers in Guinea is rather sad, unfortunate and tragic. It shows the level of ignorance, misconception and mistrust in the authorities after years of instability, conflict and corruption in Guinea.
ReplyDeleteThe Guineans believe that local and foreign health workers are part of a conspiracy that deliberately introduced the outbreak or invented it as a means of luring people to clinics to harvest their blood and organs.
This event probably could have been prevented if lesson from previous epidemics were applied.
Before entering a community it is of necessity to understand the culture and pervading beliefs of the people.It is highly essential to establish contact with stakeholders in the community who in turn would sensitize and mobilize the people in order to prevent resistance. Stakeholders can actually make suggestions on how to go about the proposed intervention.
A good example is the Marburg virus outbreak in Northern Angola in 2005, similar to Ebola , also spread by body fluids. The international health workers sent to Angola met with hostility and were also attacked.This resulted in the recruitment of tribal leaders, Roman Catholic church officials and musicians who helped to educate villagers who were hiding infected family members. A music groups wrote a song which was played on the local radio station to help inform people and persuade them to cooperate with foreign medical teams. The health workers also changed their tactics. Initially they wore their full body protective gear as soon as they stepped out of their vehicle before entering the crowd, they later made their way to doorsteps in regular clothes before pulling out their isolation suits. This strategies among other things led to the success story of containing Marbrg virus in Angola.
If the health workers in Guinea had taken a cue from the Marbug outbreak they probably wouldn't have been killed.
It is sad to hear about this killings. Getting killed for trying to help a community by the member of the community is pure inhumanity in itself. I feel previous killings of health workers from the past in recent time which include Maputo killings in Mozambique in 2008 & 2009, Killing of Polio vaccinators in Northern Nigeria in 2013 and previous killings in other regions of Guinea could have prevented this Wome killing. Proper community entry, as my colleagues have noted, which involve meeting with community leaders, youth leaders and spiritual leaders would have gone a long way to prevent this sad incident. Misconceptions of the community about EVD would have been known and corrected, suggestions of the community members noted and unanimous decision is made on how and when to carry out the initiative will be agreed. The role of Government, private sector, popular role-models in the country in creating public awareness and demonstration of the screening and disinfection procedure on television, radio, billboards, fliers and public toll free numbers to report any case or seek information , a major tool employed during the fight against SARS in affected Asian countries, would have gone a long way to allay any fear of infecting the community members and possibly prevent this occurrence. Conclusively, I feel a proper preparedness plan against fierce opposition like going with casually dressed security personnel to protect these health workers and prompt evacuation if the assault escalates. I hope lessons will be learnt from this killings to prevent future occurrences.
ReplyDeleteLessons from the past would have prevented this event as a more coordinated approach would have been adopted and implemented,health systems strengthening especially at the primary health care level would have been done and of course massive,thorough and continuous education and awareness campaign in all the parts of the Nation in all the different local languages. All these approaches combined would have been effective in preventing this kind of occurence.
ReplyDeleteThe event is both sad and unfortunate as well as regrettable. Sad because aid workers who were contributing their quota and doing their bit to enhance public health had to pay with their lives,unfortunate because this kind of barbaric act is happening in the 21st century and regrettable because it would have been prevented or altogether avoided if the government had taken crucial steps in the wake of the virus as well as provided adequate security for the aid workers.
It is pertinent to note that Guinea pre -Ebola was on the verge of recovery from years of corruption and political instability and as such there was large distrust,suspicion and disdain for government,government officials and foreigners as they believed them to be collaborators with the government.
It is also worthy of note that superstitious beliefs held sway in rural parts of Guinea such as the one in which the unfortunate event occurred and they blamed aid workers for being perpetrators of the virus but this was largely due to misinformation and a non responsive attitude from the government.
To forestall future occurence of this kind of event,Governments the world over have to -
*prepare a preparedness plan with active involvement of key stakeholders and representatives from the various parts of the nation
**strengthen surveillance and screening mechanisms at the borders and ports
**training and retraining of health workers
**development of community specific approaches to informing and educating the public
**establishing clear and coordinated coordination mechanisms
**provide security in difficult and violence- prone terrains
I will end with this quote from Glantz-''you can greatly minimise the outcome if you apply intelligent thought to it''
This unfortunate incident could have been prevented if a bottom-up approach was utilized in designing and planning the health education programme. Lessons from history should have for warned them about the possibility of rejection of medical intervention. This is particularly so because the key stakeholders were not carried along in design and delivery of such programme. An appropriate preventive measure could have been involvement of community leaders, religious leaders and other stakeholders in the design and delivery of the health education. They would have had better listenership while their words would be very strong and persuasive in convincing the community to believe and use the knowledge being passed by the health educators.
ReplyDeleteThis unfortunate incident could have been easily avoided if lessons from the past were applied in the implementation of the intervention. Going by the WHO definition of health as a state of COMPLETE WELLBEING AND NOT MERELY ABSENCE OF DISEASE, we can say that the Wome community was not socially healthy even before the outbreak of Ebola virus disease
ReplyDeleteFrom time immemorial, denial is the first reaction to any emerging or reemerging disease. Lack of trust in the government and its officials also come into play especially in communities where they feel neglected. All these should have been factored into the planning and implementation of the intervention also bearing in mind that a previous riot was recorded at Nzerekore close to Wume after rumours that medical personels who were disinfecting were contaminating the people.
Community engagement is key to successfully controlling outbreaks and this cannot be overemphasized
Nigeria and the whole world at large must extrapolate the lessons to prevent future tragedies of this type as it poses a great threat to public health.
May the souls of these valiant health workers rest in peace
Ajadi Ajibola183334
Amen!!!
DeleteThis comment has been removed by the author.
ReplyDeleteUmar Bolaji 188816
ReplyDeleteThe incident is quite unfortunate, in my opinion I think it all stem from the fact that the lack of education is still rampant in many African communities. The areas where outbreaks usually begin in Africa are areas where superstitious beliefs superceeds education. So the health authorities still have a lot to do regarding public health of the populace perhaps in the area of ‘rumor management’.
The ebola outbreak began in an area where like in many parts of west Africa burial practices are personal and rooted in tradition and religion. Usually washing dead body is a part burial plus other practices like hugging, kissing, drinking from water used in washing the body etc. are common in rural settings. These acts are essential in transmission and spread of this deadly disease rapidly. Coupled with the fact that in these localities, many people are not familiar with basic biologic concepts of disease transmission.
‘Ebola disease was so new to this part of the world and so terrifyingly lethal that many people fear all outsiders associated with ebola, even if they are coming to help,’’ said Meredith Stakem, a health and nutrition adviser for catholic relief services. The growing distrust of the health personnel by the locals began like ‘when u said ebola has no cure, then what are you spraying around?’, a rumor like inquisition that wherever Doctors without Border went, they spread diseases and cause deaths.
Public health practice should look more into such long standing myths, superstitions and beliefs and strategize towards preventing this kind of incident. If adequate and stratified information release and feedback effects from people were taken into consideration, perhaps we wouldn’t have lost those lives.