Umeå University researcher presents report on Ebola epidemic in Sierra Leone

A researcher at Umeå University has carried out a project to identify messages required for the community in Sierra Leone to stop the spread of Ebola. A report has recently been presented to the country's government with the results.

"This is an important project which, in keeping with the local culture and traditions, aims to identify appropriate and effective messages that will help stop the spread of Ebola. Part of this includes trying to overcome the obstacles that often lead to families taking care of patients themselves, or using the services of traditional healers, instead of seeking qualified medical care," says John Kinsman, Associate Professor in Global Health at the Department of Public Health and Clinical Medicine, division of Epidemiology and Global Health at Umeå University.

Even if the Ebola epidemic in Sierra Leone has slowed substantially, approximately ten people per week are still newly infected by the disease in the country. The need for information about how to protect oneself against Ebola, how to react if exposed to possible infection, as well as how to act if symptoms of infection arise remains critical.

In order to identify the challenges and to find solutions to spread information, the project, entitled "Development of a Social Marketing Strategy to Promote Ebola Treatment-seeking Behaviour in Sierra Leone", has involved carrying out interviews with ordinary people, health workers, traditional healers, and a variety of local leaders in the capital Freetown and the population in one rural area. The project also involved an extensive workshop with the aim to find feasible solutions to the problem of spreading contagion.

John Kinsman tells of strong traditions in Sierra Leone that are difficult to break, and which themselves increase the spread of disease. One example is how many families choose not to seek qualified medical care when a relative gets infected, but instead take care of their own sick and dying family members, usually with the support of local traditional healers. There are also examples of burial traditions where the grieving wash their deceased and then mix the water used with soil that they later rub onto their own bodies.

"These traditions are deeply rooted in the community and unfortunately they can facilitate the spread of Ebola infection. With the extremely cruel experiences deriving from colonialism in mind, it would be inappropriate to arrive as 'the white man' and simply decide on a resolution to the problem. This project has taken another route by listening to people's concerns about Ebola and the response to Ebola, and thereby identifying acceptable and hopefully effective ways of informing the population about how to reduce the spread of disease," says John Kinsman.

The report uses informative efforts directed at the local community within the following areas as a starting point in stopping the spread of Ebola:

• Improved handling of the dead as well as routines for burials
• Reducing the population's fear of ambulance care; something often experienced as insecure, unprofessional and dangerous
• Reducing the fear of health care professionals, who are not always fully trusted
• Reducing the fear of chlorine, which has been used as a detergent when cleaning ambulances that have transported Ebola patients as well as when handling dead patients, and which has been blamed by many in the community for killing patients
• Reducing the stigmatization in society of people working with Ebola patients
• Facilitating early diagnosis and treatment of Ebola patients
• Actions that Ebola patients can take on their own in order to protect their family whilst still being at home
• Reducing denial among Ebola patients about being infected, something that often leads to further spreading of disease and delayed medical care
• Reducing unnecessary calls and prank calls about Ebola to emergency phone numbers. Approximately 85 per cent of the daily phone calls to the emergency number are defined as 'prank'.