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Democratic Republic of the Congo: Community Mobilization: Essential for Stopping the Spread of Ebola

Source: Mercy Corps
Country: Democratic Republic of the Congo, Rwanda, South Sudan, Uganda

The Ebola crisis in eastern Democratic Republic of the Congo (DRC) is worsening, and it poses a serious threat to the ongoing humanitarian response on which nearly 13 million people depend for lifesaving aid. As of May 27, 2019, over 1,832 confirmed cases of Ebola have been identified in eastern DRC, and there have been 1,193 confirmed deaths. Substantial community resistance to the response in many communities remains a serious obstacle, as indicated by persistent reports of individuals refusing the vaccine and avoiding treatment centers. In addition, since March there have been nearly 30 violent attacks on Ebola treatment centers and hand washing stations, including the April 19 murder of a WHO doctor during an attack on a hospital in Butembo. As a result of these dynamics, efforts to slow the spread of new infections have been seriously hampered, and there is a severe risk that the disease will spread further south along the main road towards Goma.

The purpose of this brief is to provide donors, NGOs and technical agencies such as the WHO, UNICEF, and OCHA with a snapshot of what the evidence says about why and how to deploy community mobilization in public health emergencies, using a synthesis of the existing literature and a reflection on Mercy Corps’s evidence from a 2015 community mobilization campaign in Liberia. Taking stock of the evidence about what works for community mobilization in Ebola response is crucial at this point in the outbreak, as decisive investments in community mobilization will be necessary to effectively reduce resistance and increase trust and community ownership of the response.

READ:  Kenya: ECHO Factsheet – Kenya – October 2018

Key Implications

…*for Donors:* Direct funding in 24-month cycles should be targeted to agile partners who are already on the ground in eastern DRC and in at-risk areas of neighboring countries such as South Sudan, Rwanda, and Uganda.

…*for Technical Agencies (WHO, UNICEF, OCHA):* There should be a senior community engagement lead appointed at the highest strategic level to ensure that effective community ownership is being achieved across the response.

…*for NGOs:* Fostering community ownership in a conflict setting will require the commitment of substantial personnel and resources that allow for ongoing learning and adaptation to local perceptions and politics.

Overview and Context

While several previous Ebola outbreaks have taken place in fragile and post-conflict settings, this outbreak in North Kivu and Ituri is different in that it coincides with an active conflict zone with nearly 120 different armed groups that are fighting with each other and with the government. Battles between armed groups and acts of violence against civilians were common in the region before the start of the current Ebola outbreak. These types of violence have continued alongside the spread of the disease and the rise in attacks against the Ebola response. In the month of April 2019 alone, 9 battles between armed groups and 14 acts of violence against civilians were reported in or near the health zones where the outbreak is active.

The current outbreak is also different from other past outbreaks in that it has coincided with a highly disputed election campaign, which was marked by delays in voting, reports of electoral malfeasance that impacted the outcome, and a suspension of voting in areas affected by Ebola. The ongoing violence and contentious political environment have shaped community resistance by encouraging a lack of trust between communities, the government, and responders. Recently published research from the Harvard Humanitarian Initiative shows that in September 2018, 45.9% of surveyed individuals believed at least one incorrect rumor about Ebola, and 60% reported not trusting the government for Ebola response. The March 2019 Social Science in Humanitarian Response compilation of behavioral data confirms that many of the rumors that are based on political conspiracy theories, such as “The Ebola Virus disease was sent here by the Kabila government to take revenge on the people of the great North Kivu, because he understood that he is not welcome here.”

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