Community Engagement and Health promotion in Countries Affected by the Ebola Crisis in West Africa: A Study of Aspects of the Red Cross Response

Author: Dr.Uzma Alam

During the 2014, West Africa Ebola outbreak the International Federation of the Red Cross (IFRC) mobilized resources to support the communities via the National Red Cross Societies of Liberia, Guinea and Sierra Leone. The response included community-engagement and social mobilisation. In order to understand better some of the difficult issues around this unique public health response and to inform future responses, the IFRC commissioned ICHA to conduct research on the impact of community engagement and communication activities of the Red Cross across the three affected countries.

Data collection involved an in depth desk review, 54 key informant interviews and multiple community engagement exercises. A modified focused group discussion was used to gather qualitative data from communities. This methodology was designed to build trust with communities and create space for a genuine two way dialogue. Working with 72 frontline staff and volunteers from national Red Cross Societies and other agencies, 23 different community groups were engaged and the voices of close to 345 community members were heard. Findings show that cultural misunderstandings and poor messaging – with some ambiguous and incomplete messages - contributed to resistance from the communities. While this is in line with other published findings, this research also found that these errors resulted in keeping communities in a denial and anger phase for longer with serious negative consequences for the spread and impact of Ebola.

Additionally, we show that one-way communication dominated the response and there was little uptake of the messages. Things changed once two-way communication began. However, even when community-engagement was established key elements of a successful engagement approach were missed. We further show that one of the driving factors for poor community-engagement and poor messaging was the side-lining of local capacities as a consequence of asymmetries of power.  This research also helps address gaps in the literature in terms of the impact of Ebola on minority groups and the role of community lead initiatives. These findings are key as part of continued community-engagement post Ebola. Despite the challenges the Red Cross learned rapidly as the epidemic unfolded and made bold changes as and when needed. Their strength lied in their pre-existing relationship with governments and their volunteer base. In the end, in the view of many communities “the Red Cross are heroes of the epidemic and this cannot be forgotten."