Ebola report

By Santigie Bayo Dumbuya, Founder/Programme Director, WYCF

Community Organisations Partner Together for Ebola Awareness

In January 2015, We Yone Child Foundation (WYCF) conducted an Ebola education programme in partnership with Fight For Peace (FFP), working with 10 community-­based organisations (CBOs), each operating in different slum communities in Freetown.     

Two members from each CBO – 20 people in total, participated in community education training with an Ebola specialist from Connaught Hospital. In 10 teams of two, they spent three weeks carrying out a house-­to-­house baseline assessment, Ebola education, and post-­ education assessment programme.

Communities Reached & CBO Participants  

The communities we reached included:

Kissy Shell Old Road
Dwazark George Brook
Kroo Bay Zone Two and One
Sumaila Town
Mabella
Susan's Bay
Cline Town
Mends Street
Lumley Crab Town
Aberdeen
Allen Town
Ascension Town
Fergusson Street
Kissy
Regent Road Lumley
New England Vill
Sorie Town

Participants came from these organisations:

Youth Arise!!
Conscience International
West Africa Youth Network
Forum of Sierra Leone Youth Network (FoSLYN)
Foundation for Democratic Initiative and Development (FDID-SL)
Youth Action International (YAI)
Concern for the Deprived Welfeaf Association (CoDWeIA)
Campaign for the Voiceless
Africa Youth for Peace and Development
Young Men's Christian Association (YMCA)
We Yone Child Foundation (WYCF)      

Results

Ebola Awareness, Attitudes, and Behaviours           

This programme reached 7,000 people in 17 different communities in Freetown.

The data collected demonstrates that people’s understanding of Ebola, its causes, symptoms and effects, is generally good in the communities reached. [Percentages stated in all following data reflect the total of all the people in the communities we reached out to.

Community members feel that they are capable of protecting themselves and their families from Ebola and that if another community member  or family member does catch the virus, they know  how to behave regarding emergency procedures.

  • 89% of responses in the baseline survey were correct compared to 90% in the post-­education survey.
  • 99% of people surveyed feel they are able to protect themselves against Ebola.
  • 88% of people in the baseline survey understood how Ebola is spread,  compared to 90% in the post-­educationsurvey.
  • 5% of people surveyed decided to change a particular part of their behavior in relation to Ebola protection and prevention due to the Ebola education training received.
  • 10% of those surveyed have been placed under household quarantine at some point between May 2014 and January 2015.

 

This data indicates that the Ebola education delivered by our programme had a marginal positive change on the level of understanding of Ebola, its causes, symptoms and effects, and appropriate behavior regarding these factors.

It is clear that 5-­10% of people in these communities require additional education and  training to raise them to an appropriate level of understanding on how Ebola is spread and what the appropriate behavior is to prevent the   spread of Ebola. It is crucial that  these  populations maintain a high state of awareness and diligence in order for the number of new Ebola cases to continue declining, and for Freetown in particular – and Sierra Leone in general, to eventually become Ebola-free.   

Role of Government and  Major NGOs           

The high level of understanding about Ebola in these communities may be tied to the largely positive perception the populations have of the government and large NGOs.

  • 85% of people surveyed rate the performance of the Sierra Leone government in relation to Ebola as 4 (very good) or 5 (excellent) out of 5.
  • Only 24% of people surveyed report a negative change in their level of trust of the Sierra Leone government as a result of their response to the Ebola crisis.
  • 85% of people surveyed rate the performance of the major NGOs in relation to Ebola as 4 (very good) or 5 (excellent) out of 5.

 

We acknowledge the limitations in the nature of these questions and the favourable answers – in particular, that the educators may have produced the answers based on the communities’ perception of them. Nonetheless, we acknowledge the central role of major institutions in fighting the Ebola crisis.

Traditional Medicine         

Based on the results of our investigation, we believe Ebola has had a vital effect on the reduction of the level of trust for traditional  methods of medicine in the populations surveyed.           

  • Before receiving training from our educators, 14% of people surveyed believed Ebola was spread by witchcraft or a curse.
  • After the training, this figure had dropped to 0%.
  • 5% of people surveyed reported that  they had, at some point during the Ebola crisis, resorted to traditional methods to protect themselves  against Ebola.
  • 69% of people surveyed report a negative change in their level of trust of traditional healers in their communities.

 

It is widely reported that traditional healers contributed disproportionately to the spreading of Ebola through unhygienic and ineffective medicinal practices.                  

To begin with, we have two types of bitter colar, one is vegetable and the other is rum (alcohol) made by the Indian traders living in Sierra Leone. The Indian alcohol – bitter colar, it is a liquid form, people drink it. So it was regarded as a medicine to cure an Ebola-affected person.

Salt and hot water were used to wash the body all over, not just a specific area of the body. And it was supported by prayers as well (in Christians and Muslim ways).

A good number of people believe in these traditional medicines and they still go to these people (herbalists) for help not only for Ebola, but for other issues such as spiritual power against enemies (witchcraft), and for fortune.

These herbalists are still highly regarded in the communities not just for Ebola, but also for other issues as stated above.

Secondary Impacts of Ebola

There are multiple indications that people – in particular, children, are suffering from the secondary impacts of the Ebola crisis.

  • 62% of people surveyed report a rise in the cost of living.  
  • 58% of people surveyed report a decline in the level of interaction with  community members in public places.
  • 90% of parents surveyed said their children are suffering more as a result of the Ebola crisis, than they did before the crisis.
  • 38% of people surveyed report a rise in the level of criminal activity in their communities since the start of the Ebola crisis.

 

The data indicates that there are socio-­economic needs within these communities that have    been exacerbated as a result of the Ebola crisis. We believe these areas require further assessment in order to prepare a needs-­based response by the organisations working in these communities.

Role of CBOs         

Crucially, this programme demonstrates  that CBOs can operate effectively together in the design, implementation and evaluation of coordinated training and assessment programmes.                       

Limitations to the Programme

  • Data collection: the limited experience in data collection among participants resulted in sections of data being unreliable or invalid. More training and experience in data collection should improve the quality and usability of data.
  • Short term: the rapid implementation of training and assessment of the communities means the data lacks a long-­term perspective.  A more effective and well-­resourced approach would aim to achieve a continuous assessment for a minimum of six months.
  • Not triangulated: due to the limited resources and expertise available during the project, we were not able to triangulate the data with multiple touch points from independent teams.
  • Response bias: due to the mixed perceptions of our community educators and the relatively crude structure of questions asked, readers should be aware that respondents may have offered answers they perceive to be desirable, rather than the answers that are the most honest.  We don’t believe this applies to all answers and have minimized this limitation by ignoring flawed parts of the data during our analysis.
  • Data entry: the data was entered and independently validated in Freetown and analysed by the team in London. The break in communications may have led to weaknesses in the data in ways that are difficult to track.

Programme Recommendations

WYCF feels confident that a few key recommendations can be made based on the results of the programme, despite the above limitations.

  1. WYCF, Fight For Peace, and the 10 CBOs involved should carry out a Post Disaster Needs Assessment  (PDNA) focusing on education and family welfare in order to understand the impacts of Ebola and to inform our work in the future in the communities reached. A needs assessment serves the additional purpose of tying in with the national action plan and assisting the CBOs to deliver relevant and needs-­based responses to their communities.
  2. This Post Disaster Needs Assessment (PDNA) should include a requirement for assessment teams to re­iterate key messages to the communities about Ebola protection and prevention.
  3. All participants should undergo data collection training in order to improve the quality of the assessment and the impartiality, objectiveness and usefulness of the data.

Call to Action

WYCF delivered this Ebola education programme on a budget of £3,500. We believe we can deliver a PDNA to a ‘good enough’ standard on a budget of £5,000.

The additional cost relates to the costs incurred from minimizing the limitations mentioned above.      

We request our funders, donors, and partners  to fund this programme now, in order that our work may be more effective in the future.