36118 Guinea: Meaningful Messengers

Dana Pitts, MPH, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA

Background:  Guinea is battling more than the Ebola virus. Like its West African neighbors, it is fighting the fear Ebola creates in its communities. In September 2014, 8 aid workers educating about Ebola in Guinea were brutally killed. Community resistance to messaging is still responsible for many new cases, and behavior change remains a challenge. However, leaders in Guinea have had success in finding and using meaningful messengers to connect. It is connection – between Guinea and the US; between healthcare workers and religious leaders; between leaders and their communities – that is making a difference. In some cases, connections made long before the outbreak proved critical to building communication networks when Ebola struck.

Program background:  CDC worked with Embassy colleagues through the International Foundation for Electoral Systems to host a series of 7 “town hall” meetings to reach all 5 Conakry communes. This project developed Ebola “conversations” (Q and A sessions) with communities throughout Guinea. Meetings frequently lasted up to 4 hours; no one would leave until every question had been answered. Town-hall events concluded with the testimony of an Ebola survivor who stood before the crowd, urging everyone, "Go to the hospital if you suspect you are sick. You can survive."

Evaluation Methods and Results:  More than 1,000 people participated in Conakry’s town hall-style meetings. The program’s immediate success and popularity resulted in expansion using a system of Civic Education Centers in most of the prefectures, working directly with the Conseil regional des Organisations de la Societe Civile and partnering with CDC experts alongside trusted local voices. The US Department of State International Visitor Leadership Program (ILVP) was instrumental in identifying trusted leaders and endorsing new ones. The meetings directly impacted further outreach efforts. One of the main local speakers and ILVP alumni, Vice President of the National Civil Society Council, and respected Imam Dr. Elhadj Lamine Diallo subsequently was asked to record a series of radio spots which were then broadcast throughout Guinea. Marie Claire Tchecola, the Ebola survivor who was infected working as an Emergency Room nurse at Guinea’s largest hospital, also spoke, and was later selected as one of ten International Women of Courage for 2015. 

Conclusions:  Meaningful messengers – those who have already earned their communities’ trust – are the most likely to be heard, especially when fear and distrust surround an epidemic, or when people are asked to change culturally important rituals. Effective communication in an international crisis requires not only an evidence-based message strategy and organizational structures that can be managed and sustained by national actors, but also acute attention to national norms, values, and culture.

Implications for research and/or practice:  By setting up town hall meetings, CDC created a dynamic, flexible social mobilization campaign. The need for connection, on levels ranging from local to international, cannot be underestimated. It is critical to build new bridges, and to maintain the connections that have been built before, and during, the Ebola response so they can be leveraged immediately when important information must be disseminated.