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We may not have seen COVID-19 before, but virus outbreaks are not new for much of the world.
Between 2014 and 2016, Ebola ravaged West Africa, infecting tens of thousands of people, including American health care workers serving in the region. Over two years, more than 11,000 people died. Last year, the virus broke out again, in the Democratic Republic of Congo – their tenth outbreak of Ebola in 40 years.
What we’ve seen in the fight against Ebola can directly inform how we combat coronavirus.
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The last person confirmed to have Ebola in the DRC was discharged from the hospital last month, on March 4. This month, after two full incubation periods of 42 days have ended, the end of the outbreak can be declared, according to the World Health Organization.
It’s important to note that an Ebola vaccine wasn’t approved by the Food and Drug Administration until December 2019. West Africa conquered the virus without one in 2016. The DRC will likely be Ebola-free very soon. This insight offers much-needed hope for those around the world facing the coronavirus spread. But it also emphasizes the vital importance of spreading awareness to rural communities in less-developed parts of the world.
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World Relief has been on the front lines of treating and containing the Ebola virus since the outbreak began in 2014. What we’ve learned, above all, is that to contain and end the spread of a deadly virus, a response approach must be two-pronged: We have to invest in community-focused behavioral change, and we have to invest in a medical response effort (both treatments and vaccines). Each approach is important in its own right, and they must happen alongside each other.
The Ebola virus is transmitted directly through physical contact with infected bodily fluids, and indirectly, by contact with previously contaminated surfaces and objects (as is coronavirus). As with coronavirus, people do not start developing signs and symptoms right away. And handwashing is one of the most important means of preventing the spread.
Vaccines and new treatments alone will not halt the spread of a virus unless networks of trust and understanding are built and reinforced.
We’ve worked with other humanitarian organizations and hundreds of churches throughout the DRC, South Sudan and West Africa to promote these messages; train primary case managers; provide prevention hygiene kits and vital health lessons in clinics and homes, and make sure that local churches and other facilities have handwashing stations. Through these efforts, World Relief has reached 50,000 people in the DRC and South Sudan in the past year and a half alone.
With the Ebola virus, harmful beliefs about the virus and its treatment sped up the spread. Ancestral funeral and burial rites, in which mourners bathed in or were anointed with water rinsed from corpses, largely contributed to the spread, according to the WHO. Some health care workers aided patients without proper protection.
Rural populations were skeptical of Western medicine and relied mainly on traditional healers. They were confused and terrified “by foreigners dressed in what looked like spacesuits, who took people to hospitals or barricaded tent-like wards from which few returned.”
We take it for granted that in the U.S., behavioral changes happen fast. For the most part, Americans quickly adopted new practices of social distancing, quarantining and improved hygiene. This was thanks to the high availability of media and government messages and reliable communication from the health care community. However, in many parts of the world, messages don’t spread as quickly, and people are highly skeptical of government leaders, law enforcement and medical practitioners. These are the communities we have to worry about now.
Containment and prevention efforts work the best when they work with a culture, not against it. This doesn’t mean accepting unhygienic practices, but it does mean working with the most highly trusted institutions in a region – in most cases, the churches – to get the proper messages out.
Church leaders know who the most vulnerable people in their community are. They can convince those who need it to seek treatment. They are reliable educators of best practices. This is why, with Ebola and now with coronavirus, World Relief is using our vast trust-centered Church Empowerment Zone networks to set the stage for messaging campaigns in these regions. We’re working with volunteers from churches and communities who are going door to door – and keeping an appropriate distance – to educate community members about this new disease.
Vaccines and new treatments alone will not halt the spread of a virus unless networks of trust and understanding are built and reinforced. As Dr. Emanuele Capobianco, IFRC’s (International Red Cross) Director of Health and Care, said about Ebola, “For the treatments to work, people need to trust them and the medical staff who administer them… It is a behavioral challenge, not a medical one.”
Even when treatment becomes available, we have to have the networks in place to convince local populations to seek these treatments. But as people become more informed and, more importantly, enforce the learned messaging in their communities, fear and mistrust melt away.
Many countries in Africa and elsewhere also face weak public health infrastructures, a shortage of health care workers, and higher population mobility across borders. West African countries, for example, have seven times higher population mobility than most other countries.
I have two important takeaways from my experience fighting Ebola:
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First, the challenges facing rural populations like those in Africa are not an African problem; they are a global problem. Until we are able to educate everyone, coronavirus will remain a threat. This is why I urge our government leaders and Americans – even amid our own economic crisis – to support the NGOs on the ground that are working to contain coronavirus in these areas.
And second, don’t lose hope. Let the strides we’ve made toward eliminating Ebola be a reason for celebration and encouragement in these difficult times. If amazing change can happen in the most disadvantaged countries, with a deadlier disease, and in the face of challenging cultural obstacles, we can conquer this new virus.