Tag Archives: social mobilization

©UNICEFMéxico/MauricioRamos

#TuVozCuenta con U-Report México

¿Se imaginan qué increíble sería si pudiéramos preguntarle a los jóvenes sobre sus intereses, opiniones y necesidades en los lugares donde viven, y que pudiéramos obtener y analizar esa información en tiempo real? Imagínense que estuviéramos diseñando un programa que ayudara a los jóvenes a conseguir empleo después de sus estudios. Bueno, pues para ello, no sólo requeriríamos información estadística y diagnósticos de la situación de la educación y el mercado laboral; sino que también necesitaríamos conversar con muchos jóvenes para entender sus aspiraciones e ideales, temores y angustias, entender los retos a los que se enfrentan y la presión que muchas veces sentimos. De esta forma, podríamos lograr empatía con sus experiencias, pensamientos y emociones; y así diseñar un programa que los entienda y apoye de la mejor forma posible.

©UNICEFMéxico/MauricioRamos

©UNICEFMéxico/MauricioRamos

Este proceso de consulta llevaría muchísimo tiempo, por lo que en muchas ocasiones, los programas se diseñan tomando sólo en cuenta la información de diagnósticos y estudios hechos por especialistas. Lamentablemente, por falta de tiempo, muy pocas veces se les pregunta a los jóvenes qué es lo que quieren, cómo lo quieren y por qué lo quieren así.

El pasado jueves 13 de agosto, como parte de las celebraciones del Día Internacional de la Juventud, compartimos con cientos de jóvenes la buena noticia de que U-Report había llegado a México. Con U-Report los jóvenes de más de 17 países en el mundo están utilizando la misma tecnología que usan para comunicarse entre amigos para participar con sus ideas y opiniones en el desarrollo de sus comunidades y de sus países.

©UNICEFMéxico/LuisCedeño

©UNICEFMéxico/LuisCedeño

U-Report permite a UNICEF, y a sus aliados en México, consultar en tiempo real a los jóvenes sobre lo que sucede en sus comunidades, los servicios que reciben, los temas públicos que son de su interés, sus necesidades y expectativas. Esta valiosa información se recibe, analiza y procesa en segundos, para generar un reporte que es entregado a las personas que están tomando las decisiones públicas que tienen efecto en la vida de todos los jóvenes mexicanos. De esta forma, U-Report ayuda a tomar decisiones más informadas, a diseñar servicios y programas públicos que tomen en cuenta la visión, opiniones e intereses de los jóvenes.

Ese jueves, el auditorio se llenó del entusiasmo de cientos de personas que participaron con novedosas ideas para enfrentar los retos en educación, salud, bienestar económico y convivencia social que viven los jóvenes en México. A partir de ese momento, cientos de jóvenes se hicieron U-Reporters y serán embajadores de este movimiento por el cual nuestra voz adquiere el súper poder de unirse a millones más para que sea escuchada fuerte y clara donde quiera que sea.

©UNICEFMéxico/LuisCedeño

©UNICEFMéxico/LuisCedeño

Jaime Archundia es Responsable de Innovación de UNICEF México

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No room for complacency as Sierra Leone approaches zero

Kadiatu Sankoh from the Sierra Leone Red Cross Society spreading Ebola prevention messages in Magburuka Town.

Kadiatu Sankoh from the Sierra Leone Red Cross Society spreading Ebola prevention messages in Magburuka Town. ©UNICEF Sierra Leone/2015/Kassaye

Kadiatu Sankoh, Sawunatu Kaikai, and Ousman Koroma make their way along the windy paths of Magburuka town in Tonkolili District spreading their lifesaving messages. The three social mobilizers from the Sierra Leone Red Cross Society, Real Women and SMAC (Social Mobilization Action Consortium) respectively, are on a vital mission to safeguard communities against Ebola.

Their direct and personal engagement is critical following the return of Ebola to Tonkolili District after 150 days without any reported cases. The entire neighbouring village of Massesebe was put under Ebola quarantine.

“Our work is important because we want to protect our people so that they cannot become victims to this virus,” said Kadiatu. “That is why we talk to them house-to-house. They are ok with the message because they too love their lives.”

There are only two confirmed Ebola patients remaining in Ebola Treatment Units, both are whom it’s hoped will be released soon, a major milestone for the country which has been fighting Ebola since May 2014 and seen at least 3,586 Ebola deaths. Reaching zero will not only be a triumph for the medical response, but also for the thousands of social mobilizers who continue to ensure that communities know what Ebola is, how it spreads, and what to do if they come across people with symptoms. Sustaining a resilient ‘zero’ will call on all their continued efforts through an active engagement with communities.

UNICEF has been supporting the Government of Sierra Leone and NGO partners to train and activate social mobilizers across the country. After covering the areas immediately surrounding Massesebe and two other communities that were placed under quarantine in Tonkolili District, they will move further afield, fanning out to ensure the entire district has been covered.

“Tonkolili District went for a long period without a case, then all of a sudden we had one case,” said Kassim Kamara, UNICEF Field Support Officer in Tonkolili. “We needed to revitalize the social mobilization activities quickly, so we gathered the partners together to continue to sensitize the community people, and especially to avoid complacency, because this is a lesson for all other districts having gone over 150 days: you need robust action.”

Fatou Kamara with her grandchildren outside her stall in Magburuka Town.

Fatou Kamara with her grandchildren outside her stall in Magburuka Town. ©UNICEF Sierra Leone/2015/Kassaye

There is no room for complacency. Magburuka is two miles away from the community that was under quarantine until a few days ago, and high-risk contacts remain in quarantine for another week. The man who came from Freetown with the virus would have had to pass through Magburuka to get to his family in Massesebe. Making sure everyone is aware of what’s going on and mindful of how to prevent catching Ebola is therefore essential to prevent the outbreak from spreading further.

Despite the midday heat ahead of the regular afternoon thunderstorms, the team continues making its way through the community, making sure they have not missed any households. More than a year into the outbreak, their discussions with villagers reflect the need to do more.

“Some people accept, but some of them still think that the sickness is not in the country,” said Kadiatu. “Some of them believe. Some of them don’t believe. We try to get them to believe by talking to them, telling them about the way some of our families became victims to this disease and died. So you can convince them through that. You know that the sickness is there. We talk to them peacefully. Try to tell them about the disease and how it affects us. When they understand, they will accept.”

Alhussein Tulla is canvassing a nearby neighbourhood and stops at the stall where Fatou Kamara has set up shop selling rice, beans and condiments.

“The message that the mobilizers brought to us is fine,” said Fatou. “I had heard about the outbreak in Massesebe village. I am not happy at all about the situation there. I don’t want to hear that Ebola is anywhere in Sierra Leone, let alone in the neighbouring village. We were really scared at the height of the Ebola crisis. I was not able to do any business. I did not go outside – I was always scared of people coming around and the possibility of getting sick. We are scared again now because it has come back to a village that is very close to us. We fear that it might come here, but we are praying that it will not.”

With the support of partners like DFID, the EU, Irish Aid, Japan and OFDA, UNICEF, in partnership with the Government of Sierra Leone, WHO and NGOs, continues to engage communities in Tonkolili and other districts that have faced recent Ebola outbreaks. House-to-house visits, community discussion, radio programmes, and other social mobilization activities are used to ensure that communities remain alert and vigilant, and that when zero Ebola cases is achieved, we remain at zero.

Indrias G. Kassaye is a Communications Specialist working with UNICEF Sierra Leone

(c) UNICEF Sierra Leone/Indrias Getachew Kassaye

This Neighbourhood Watch Group is determined to keep Ebola out

Traditional healers and members of the community from Kaffu Bullom Chiefdom, Port Loko District gather to discuss Ebola prevention and the role of traditional healers. (c) UNICEF Sierra Leone/Indrias Getachew Kassaye

Traditional healers and members of the community from Kaffu Bullom Chiefdom, Port Loko District gather to discuss Ebola prevention and the role of traditional healers. (c) UNICEF Sierra Leone/Indrias Getachew Kassaye

Arriving in Mamusa village in Port Loko, we are greeted by the rows of houses cordoned off by bright orange plastic fencing. For the past 21 days, 134 people who had come in contact with an Ebola victim have been quarantined in their homes. Today, the fences will come down.

“Not a single person ran away from here,” exclaims Pastor Albat Kamara jubilantly. Pastor Kamara is one of the members of the Mamusa Neighbourhood Watch Group which was established by the Red Cross with the support of UNICEF. The group was formed after a father and son from the community went missing following the death of the boy’s mother from Ebola. “We have a plan to establish Neighbourhood Watch Groups in all the hotspots,” explains Victor Khama, a Sierra Leonean UNICEF field support officer, who helped out the Mamusa group.

The death of the mother spurred Santana, a 27-year-old Ebola survivor fromMamusa, into action. He had received information about the whereabouts of the father and son and let the newly founded Neighbourhood Watch Group know about his plans to travel to a nearby community where the two high-risk Ebola contacts were reportedly hiding. When he arrived in the community, they were nowhere to be found. Santana left his number with the community members and asked them to contact him as soon as they had any further news.

Santana from the Mamusa Neighbourhood Watch Group

Santana from the Mamusa Neighbourhood Watch Group is determined to keep Ebola out of Mamusa. (c) UNICEF Sierra Leone

Nine days later, he received a call that the pair had been spotted. Santana returned to the village and found the father and his son scared, hungry and hiding in the bush. After long discussions, he managed to convince them to return to Mamusa. He called 117, the free Ebola hotline, and the two were driven back to the village to be quarantined. Today*, they will be amongst the 134 people to be released healthy from their quarantine.

UNICEF is working under the leadership of Sierra Leone district authorities in Port Loko as well as other partners, such as the World Health Organization, the Sierra Leone Red Cross, Restless Development, Oxfam, DFID and OFDA to establish over 300 Neighbourhood Watch groups in all the Ebola hotspots as well as in communities bordering Guinea. These community-led groups typically include the village head and religious leaders, as well as women and youth group representatives. Members receive an orientation on Ebola prevention, on recognizing the first signs of the disease, and on the actions they can take to keep their community safe. They then monitor the community for travellers and sick people by doing house-to-house visits. Since the Mamusa group was established, they have used 117 to report five suspected Ebola cases, none of which, fortunately, turned out to have contracted the virus.

After Pastor Kamara poses for the group picture with his Muslim counterpart, Imam Mohammed Conteh, and other Neighbourhood Watch group members, he approaches me and says: “You asked me why we formed our group and it is very simple. We formed it because we want to be part of the fight against Ebola and keep Ebola out of Mamusa. We want to do our part in this fight.”

Tommi Laulajainen is a Communications for Development advisor with UNICEF Sierra Leone

*The visit to Mamusa took place on 9 July 2015.

Members of UNICEF’s social mobilization team in Sikhourou village use illustrated booklets to educate residents about the symptoms of Ebola and how to avoid becoming infected. ©UNICEF Guinea/2015/Tim Irwin

In Guinea, responding to Ebola by addressing rumors and resistance

One of the most persistent rumors, Roger tells me, is that the smoke from the generators in the Ebola treatment centers is really the bodies of the infected being burned.

Roger Lamah is a Communications for Development specialist working for UNICEF in the Forecariah prefecture in Guinea, one of the few remaining Ebola hotspots in the country. Since arriving here in February, he and a team of what are known as social mobilizers have been working with rural, and often isolated communities, to teach them how to avoid becoming infected by the virus; how to recognize and respond to symptoms; and to rebut the rapidly shifting cycle of rumors that, at first glance, may seem bizarre but which upon closer inspection speak of real fears among people who lives have been upended by the epidemic.

Roger Lamah (in blue), a communications for development specialist for UNICEF in Guinea, gets his team ready for a door-to-door awareness exercise in the village of Sikhourou. ©UNICEF Guinea/2015/Tim Irwin

Roger Lamah (in blue), a Communications for Development specialist working for UNICEF in Guinea, gets his team ready for a door-to-door awareness exercise in the village of Sikhourou. ©UNICEF Guinea/2015/Tim Irwin

We are in the village of Sikhourou, a two-hour off-road journey from Forecariah, where its 420 residents have been put under a “cerclage” – effectively 21-days of close monitoring to avoid movements that may spread the virus. Three people have died in Sikhourou since the outbreak of Ebola more than a year ago and last week an elderly man was taken to a treatment center in Forecariah for observation after displaying symptoms of the disease.

“Rural communities around here used to be very hard to access,” Roger says, “because of often violent resistance to Ebola responders. We had to come up with solutions because without access you have nothing – no prevention, no surveillance, no tracing of contacts.”

The social mobilizers began by mapping the areas of resistance and by tracking the rumors that were circulating in order to respond to the communities’ fears. UNICEF-supported radio stations were created to broadcast programs on Ebola prevention and to respond to whatever rumors were then going around.

“We found there were three types of resistance – community, family and individual,“ Rogers says as he assembles his team for today’s door-to-door exercise during which residents will be reminded of the importance of good hygiene and be provided bars of soap.

“You can see by how we’re received here today that community and family resistance is much less of a problem. The challenge now is not to get into a village, it’s to overcome individual resistance that can lead to unsafe burial practices or the refusal to take a sick family member to a treatment center.”

Members of UNICEF’s social mobilization team in Sikhourou village use illustrated booklets to educate residents about the symptoms of Ebola and how to avoid becoming infected. ©UNICEF Guinea/2015/Tim Irwin

Members of UNICEF’s social mobilization team in Sikhourou village use illustrated booklets to educate residents about the symptoms of Ebola and how to avoid becoming infected. ©UNICEF Guinea/2015/Tim Irwin

A committee of village women has gathered under a tree to take part in a short motivational rally. Each is wearing a bright T-shirt with the words “Ebola is real” written in French on the front. Not so long ago this was not a view shared by many here. And even as awareness of the illness grew, many people believed it was the responders who were bringing Ebola to their communities.

Earning the trust and support of traditional and religious leaders was key to gaining wider access, Roger tells me. To address the rumors that the bodies of victims were being burned, villages leaders were invited to the treatment centers. Ebola survivors visited at-risk communities to share their experiences of overcoming the disease.

Sikhourou is already geographically isolated, with the nearest village more than a kilometer away. But the villagers will not be left on their own during the 21-day period. This is day two of the “cerclage” and food and other supplies have already been distributed by partner agencies. Latrines are being erected and even a generator is being unwrapped. UNICEF is also drilling a borehole so that the community here has easy access to clean water.

A home in the village of Sikhourou is disinfected.  ©UNICEF Guinea/2015/Tim Irwin

A home in the village of Sikhourou is disinfected. ©UNICEF Guinea/2015/Tim Irwin

“Do you want Ebola to leave?” Roger asks the group, his question translated from French into Susu. In unison the 40 plus woman, many with babies swaddled to their backs, yell back – “yes!”

“Ebola you are not wanted here,” one of the women shouts when it’s her turn at the microphone. On the backs of the T-shirts that everyone in the village now seems to be wearing as they gather for the screening of a video on Ebola, it says “I’m involved for my community”.

Working with communities, helping them protect themselves, listening to their concerns, and putting them at the forefront of the Ebola response has been central to reducing the number of new cases in Guinea.

“Over the past two days you have seen a lot of people and vehicles here, probably more than ever before,” Roger says as his team begins to pack up. “These people want to help you. They want to help you get rid of Ebola. They are not afraid.”

Tim Irwin is a Communications Specialist working with UNICEF’s Regional Office for West and Central Africa.

Andrew and Emma are two Ebola survivors volunteering in Kambia to educate and sensitize communities (c)UNICEF SL/2015/Laulajainen

Meet two Ebola survivors fighting the disease in Sierra Leone

Andrew and Emma are two Ebola survivors volunteering in Kambia to educate and sensitize communities (c)UNICEF SL/2015/Laulajainen

Andrew and Emma are two Ebola survivors volunteering in Kambia to educate and sensitize communities. (c)UNICEF SL/2015/Laulajainen

Sierra Leone has come a long way since the peak of Ebola cases, and so have Emma (23) and Andrew (26) in Kambia district. Epidemiologically and mentally they are survivors – determined to restart their lives so violently disrupted at the height of the Ebola outbreak in late 2014. Back then the country recorded hundreds of new cases a week.

I can see the determination in both their eyes when I ask them what the future will hold for them once Ebola is over. Emma’s dream is to study physiology at the University of Makeni. Andrew wants to start studying banking and finance in Freetown. Somehow I have this feeling that they will succeed and reach their dreams. Against all odds, they have already beaten one of the deadliest viruses in the world – what greater challenge will they face?

Emma and Andrew don’t see themselves as passive victims. For the past four months now, they have been volunteering in the fight against Ebola in Kambia, one of the three hotspot districts left in Sierra Leone. They are part of the community engagement and social mobilization teams which visit communities daily to sensitize people about Ebola and remind them to remain vigilant until the outbreak is permanently beaten.

Their motivation and commitment to help in any way they can is remarkable. “I am proud to work for my country even if I don’t get paid,” says Andrew, who lost all his eight brothers, his sister, and his mother in the outbreak.

“First people were afraid of me,” says Andrew, “as I told them that I had had Ebola but survived it. People stayed at a distance from me and did not want to talk to me. Some even ran away as they thought that I would infect them. Now, having done community engagement work for a couple of months, villagers have gradually understood that Ebola survivors cannot spread Ebola. In fact, they are no longer vulnerable to the disease.”

Emma says she owes her life to her mother. Back in October 2014, Emma was traveling home to Kambia from Freetown and she was feeling very sick. She arrived at her home with high fever, vomiting and suffering from severe diarrhoea. As soon as her mother saw her, she asked her not to come in for fear of getting everyone else in the family sick. Emma’s mother quickly called 117, the Ebola hotline. “I am happy she did [stopped me coming into the house] as I would have infected my entire family,” says Emma. The ambulance arrived and took Emma to the nearest Ebola Treatment Unit. If it had not been for her mother, Emma would have been yet another victim, amongst the thousands, of this terrible disease in Sierra Leone.

Andrew is now the Chairman of the Kambia Branch of the Sierra Leone Association of Ebola Survivors. As I listen to his story I truly feel the devastation and tragedy Ebola has brought to so many families and communities in Sierra Leone. Andrew was lucky but only because he sought treatment early on. Most of his family members were not.

I say goodbye to Emma and Andrew, and head to the evening briefing at the Kambia Ebola Command Centre. As I hear the good news of the day; no new cases in Kambia today, I am wondering how much of this success is thanks to Emma’s and Andrew’s tireless volunteer work in their own communities. My guess is that they are a big part of this story.

Tommi Laulajainen is a Communications for Development advisor with UNICEF Sierra Leone

On 3 October 2014, child and adult Ebola patients wait to be transferred from the town of Port Loko, capital of Port Loko District in Northern Province, to an Ebola treatment centre – in either the city of Kenema or the town of Kailahun – in Eastern Province. Kenema, Kaihalun and Port Loko Districts are all under quarantine. In an attempt to curb spread of the disease, almost half of Sierra Leone’s 6.34 million population is now under quarantine.

In early October 2014, Sierra Leone is among countries in West Africa affected by the worst outbreak of Ebola virus disease (EVD) in history. As of 16 September, UNICEF estimates that 8.5 million children and young people under the age of 20 live in areas affected by EVD in Guinea, Liberia and Sierra Leone, countries where disease transmission is widespread and intense. Of these, 2.5 million are under the age of 5. Preliminary UNICEF estimates (as of 30 September) also indicate that at least 3,700 children in the three countries have lost one or both parents to EVD since the start of the outbreak. By 1 October, 4,080 cases and 2,071 deaths had been confirmed in Guinea, Liberia, and Sierra Leone. UNICEF remains at the forefront of efforts to respond to and help curtail the outbreak, and is the lead agency for the United Nations on social mobilization in the Ebola response. In Sierra Leone – where 2,179 cases and 575 EVD deaths were confirmed by 1 October – UNICEF is supporting social mobilization efforts, including Ebola prevention messaging and outreach and the creation and distribution of awareness-raising materials. UNICEF assistance also includes psychosocial support for patients and their families, contact persons and community members affected by EVD; training for medical staff; and training for adults and children on EVD.

Surging efforts in Sierra Leone’s last remaining Ebola hotspots

Two times at military checkpoints on the 40-minute drive from Port Loko town to Kaffu Bullom chiefdom we are stopped and politely asked to descend from our vehicles. This is not a war zone, but it is a clear sign that the 21-day Ebola surge dubbed ‘Operation Northern Push’ has kicked off here in Sierra Leone’s Port Loko district, and also neighbouring Kambia. At each stop, we file through hand-washing stations and health screeners check our temperatures.

Kaffu Bullom chiefdom is in the heart of the current Ebola outbreak in the district of Port Loko with close to 30 cases in the past couple of weeks from one single chain of transmission. Sierra Leone has come a long way since the peak of the outbreak in November 2014, but still, the road to zero is proving rocky with a rise in weekly cases from a low of two cases in early May.

Almost all new cases have centred on the districts of Port Loko and Kambia (in between the capital Freetown and the border with Guinea). And so, UNICEF is working closely with the Government and partners like WHO, Restless Development, Oxfam and IFRC on what is hoped will be a final push to kick Ebola out of Sierra Leone once and for all. The district launch for the surge took place in Kaffu Bullom under the leadership of the Paramount Chief.

Pledging to end Ebola at the start of the surge in Port Loko district, Sierra Leone (c)UNICEF SL/2015/Laulajainen

Pledging to end Ebola at the start of the surge in Port Loko district, Sierra Leone (c)UNICEF SL/2015/Laulajainen

“As Paramount Chief of Kaffu Bulom I have called all the traditional healers and my section chiefs to join us here today to hear the important message about this last push to kick Ebola out of Sierra Leone and solicit their full support,” said Mr. Gbereh III. “Without the help of our community leaders we cannot win this battle. We need everyone to be part of this effort to end Ebola in Sierra Leone,” he added.

Traditional healers are one of the key influencer groups who have been reluctant to join the fight against Ebola, and some of the latest Ebola deaths have been from among their number. Community members frequently use the services of traditional healers in the chiefdoms where there are chains of transmission, which brings them into contact with a large number of sick people.

“Zero Ebola – Let’s End This Together” – one of the campaign tag lines – says it all. The only way Sierra Leone can get to zero is if community and religious leaders, traditional healers, and most importantly community members themselves all work together to end further infections. UNICEF has financed the recruitment of around 1,400 social mobilizers in Port Loko from partners, focusing on the priority chiefdoms.

While the social mobilization efforts are being dramatically strengthened, great strides will also be made to improve the conditions in the quarantine communities and homes to ensure families have all the services and psychosocial support they need during the 21-day quarantine period. Active surveillance, as well as the promotion of the free 117 hotline that logs alerts from community members and social mobilizers on suspected cases and secret burials, will also get a boost.

As we head back to Port Loko and stop at the same two checkpoints, walk to the hand washing station, get our temperature checked, I am thinking and hoping that these efforts will pay off so that we can celebrate an Ebola-free Salone (Sierra Leone) in the very near future.

Tommi Laulajainen is a Communications for Development advisor with UNICEF Sierra Leone

©UNICEFMéxico/MauricioRamos

Por los sueños de mi hija

Desde muy temprano en la mañana, Selena, de diez años, y sus dos hermanas pequeñas comienzan a hacerse cargo de las tareas de la casa. Junto con algunas amigas del vecindario se dirigen después a la escuela, y en la tarde ayudan a cultivar maíz en el pequeño terreno que su familia tiene en su comunidad Tzotzil de Chiapas. Su mamá también trabaja muy duro en el campo, pero lo que obtienen del cultivo de la tierra no es suficiente porque no cuentan con las herramientas adecuadas y el terreno ya no es tan fértil como antes. Ante esta situación, el papá de Selena tendrá que alejarse de su familia para conseguir sustento.

©UNICEFMéxico/MauricioRamos

©UNICEFMéxico/MauricioRamos

El papá de Selena hace planes para salir a buscar empleo que no encuentran en su comunidad, por ahora se está recuperando de una lesión y no puede trabajar como albañil, con lo que mantenía a su familia. “Aunque para mí es muy duro dejar a mi mujer y a mis hijas,” afirma inquieto, “pienso volver a salir en cuanto me recupere de la espalda, porque es la única forma que tengo de atender a mi familia y de mandar a la escuela a mis tres pequeñas”.

El papá de Selena sabe lo mucho que le gusta la escuela a su hija y recuerda que su gran sueño es ser doctora y ayudar a su comunidad.  Lo que más le preocupa es que su hija tendrá que tomar el autobús o vivir fuera para estudiar la secundaria.  Él preferiría no irse lejos de su familia, pero no hay otra opción, porque eso es lo que hace un papá para apoyar los sueños de su hija.

©UNICEFMéxico/MauricioRamos

©UNICEFMéxico/MauricioRamos

UNICEF apoya comunidades indígenas para que todos los niños y las niñas tengan educación de calidad y el día de mañana contribuyan al desarrollo de sus comunidades. Así muchos niños pueden seguir estudiando y estar cerca de sus familias, porque con tu apoyo ayudamos a cumplir sus sueños.

 

Amaia López, cooperante de UNICEF México

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(c) UNICEF Sierra Leone/Issa Davies

Ambulance ‘open days’ dispel fears in Sierra Leone

A member of the 'open day' team stands by the ambulance which has its doors open - revealing the equipment inside.

A member of the ‘open day’ team stands by the ambulance in Kabaya. (c) UNICEF Sierra Leone/Issa Davies

The rough and pot-holed mud roads in remote villages like Kabaya, Kambia district, have witnessed a rare sight in the past few months – the presence of modern ambulances.

On the day we’re there, the section chief of the village, Pa Sane Conteh, joins other elders and women to take a ride in the ambulance: “It is safe! It is safe!” he shouts as he happily disembarks after a seven-minute ride.

“We are no longer afraid of ambulances and I am encouraging anyone who falls sick not to be afraid of riding in an ambulance to the hospital anymore.”

To people in countries and communities used to such health services, ambulances are viewed as a lifeline for those in immediate need of a rapid medical response. But as we and our partners have seen, for people in these rural communities in one of Sierra Leone’s last Ebola hotspots, ambulances are frequently viewed with suspicion.

A person wearing a protective suit worn by those responding to Ebola cases demonstrates the suit to a crowd in the village.

A demonstration of the protective suits worn by those responding to Ebola cases. (c)UNICEF Sierra Leone/Issa Davies

One of the residents of Kabaya, Musa Kamara, says ambulances are often seen as “moving coffins.”

“People used to run away and hide their sick relatives as soon as they heard the sirens of an ambulance blaring in the distance.”

“They thought that an angel of death has come to take another member of their community away and sometimes, when they take people away we never see them again.”

I travelled to Kabaya and other villages in this region, close to the Guinea border, to follow a new initiative designed to respond to these concerns. It is based on the idea that instead of ambulances visiting communities only when cases are reported, it would be good to allow people the opportunity to experience them in a more relaxed context. This would give them the chance to look inside the vehicles, and to learn about the spacesuit-like protective suits, chlorine sprayers, and all other paraphernalia used by those involved in the fight against Ebola.

The ‘open days’ have already been held in Port Loko district and Western Area. In Kambia, UNICEF social mobilizers are part of the convoy and they brief communities on the work they do at each stop. The initiative in Kambia is led by the CDC Health Promotion Team, with funding from DFID, with the support of CAFOD (for the vehicles and fuel), and social mobilization partners.In addition to visiting Kabaya, this particular ambulance was set to visit 20 other communities in the district.

UNICEF C4D colleague Pa Ousman joins social mobilizers and community members in a demonstration to show that the chlorine sprays used in the Ebola response are safe. (c)UNICEF Sierra Leone/Issa Davies

UNICEF C4D colleague Pa Ousman joins social mobilizers and community members in a demonstration to show that the chlorine sprays used in the Ebola response are safe. (c)UNICEF Sierra Leone/Issa Davies

Corporal Bangura, an Ebola survivor who is the military driver of the ambulance, said that previously there had been misunderstandings.

“In the past, during the height of [Ebola] cases, we used to run our siren-blaring ambulances at very high speed in the communities,” he said.

By listening to communities, a number of new measures are being taken by the Government’s District Ebola Response Centre, including providing more timely information to families on where sick persons are taken, turning off sirens to reduce community fear, and increasing dialogue.

Andrew Sesay, an Ebola survivor and social mobilizer with the team explains how positive the ambulances are. He shares that he lost eight members of his family to Ebola because they refused to be taken to treatment centres in ambulances. But he survived because he called the 117 hotline and willingly went inside the ambulance that took him to the treatment centre.

Through community engagement, trust is being built up and vital health measures are gaining greater acceptance.

Issa Davies is a Communication Officer working for UNICEF Sierra Leone.

PAYNESVILLE, LIBERIA - Children under the age of 5 years old receive Measles and Polio vaccines along with Worm medicine at Duport Road Health Center on Friday, May 8 following the Measles & Polio Vaccines and Deworming Campaign event. The campaign, led by the Ministry of Health and Social Welfare, and supported by UNICEF, the Center for Disease Control and the World Health Organization, will take place countrywide from May 8-14 and reach more than 600,000 children. 

Alpha Sidabey, 3, receives the measles vaccine while at the Duport Road Health Center on Friday, May 8, the first day of the Measles and Polio Vaccines and Deworming Campaign.

The success of social mobilization and community engagement in Liberia

Supported by his mother, Alpha (3) looks on bravely as he receives the measles vaccination.

Supported by his mother, Alpha (3) looks on bravely as he receives the measles vaccination. (c)UNICEF Liberia/S.Grile

Social mobilization and community engagement are two phrases I hear quite frequently these days, in the office and the media, with both activities widely credited as helping turn the tide in stopping the spread of Ebola. UNICEF-supported social mobilization teams have for months been at the forefront of efforts to halt the transmission of Ebola in Liberia. Now, with the country having reached zero cases, their role has changed to that of raising awareness in the communities about the importance of accessing routine health services.

The rules of the game have certainly changed since Liberia reached zero cases of Ebola on May 9. The day before the announcement, the country launched a week-long integrated immunization campaign in response to a measles outbreak – a positive first sign of the restoration of routine services.

The campaign aimed to reach over 600,000 children who had previously been unable to access immunization services during the Ebola outbreak. Preliminary reports indicate that over 90% of children under 5 years of age received vaccines during the campaign and that community engagement was key to the success of the immunization drive.

I am not surprised by these results. When I travelled to Gbarnga in Bong County a few weeks ago, I joined a social mobilization team and witnessed, first hand, the impact they had on encouraging behaviour change and in helping to educate communities.

Talking to communities about the importance of vaccinating children and the prevention of childhood diseases that too frequently lead to the deaths of thousands of Liberian children every year is just one way I saw how community mobilizers are re-engaging with communities.

“Liberians know about vaccinations for diseases like measles and polio. Before they didn’t need convincing, but now it is different. Speaking to both children and their parents yields the best results”, explains Dutch Hamilton, UNICEF’s Community Mobilisation Coordinator in Gbarnga, Bong County (who we met in a previous blog).

It is shocking to think that in Liberia, one in four deaths of children under five are due to measles and pneumonia, both vaccine preventable diseases. During the height of the Ebola crisis, immunization rates dropped to a startlingly low 16%. For this reason, the high coverage achieved in the latest campaign is both encouraging and welcoming.

Three-year-old Stephanie receives the polio vaccine.

Three-year-old Stephanie receives the polio vaccine. (c) UNICEF Liberia/S.Grile

Dutch tells me how difficult it has been working in the current environment and highlights that fear and misinformation have been holding parents back from accessing essential health services.

“A large part of the job is now about rebuilding confidence between the communities and the health workers, as well as with the health system in general,” says Dutch.

UNICEF recruited more than 4,000 social mobilization personnel who were deployed across Liberia to raise awareness during the integrated immunization campaign. Other equally important elements to the campaign were message development and the use of multimedia to encourage behaviour change.

“Reinforcing these messages is an ongoing task and communities are receptive. Ensuring families understand the importance of protecting their children from preventable diseases through immunization remains a challenge,” says Dutch.

Admittedly, it worries me that after Liberia’s success in stopping the transmission of Ebola within its borders, the world’s spotlight will shift away from the country’s growing health needs. In reality, the international community’s support is crucial to the restoration of services and the strengthening of Liberia’s already crippled health system.

Dutch and his team, and the 4,400 other social mobilization workers recruited by UNICEF across the country are now gearing up for the next vaccination campaign for polio and Vitamin A, which will take place between 26-29 June. The rainy season has already begun and the teams’ efforts will be needed more than ever to meet UNICEF’s goal to reach every child. I am hopeful that the success of the last campaign can be repeated again and only time will tell if these positive results can be sustained in the future.

Alvina Lim is a Communication Officer working at UNICEF Liberia.

 

 

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One last surge against Ebola in Freetown?

Under the shade of a makeshift blue tarp, I sat with community members in Freetown’s Moa Wharf area.  Children were playing on a nearby staircase and the sound of their chatter mixed with the waves at the seafront. The social mobilization team for Freetown was on the ground, co-led with the government by UNICEF and including NGOs and UN partners like WHO. I was also there because after a few “zero” days in the Western Area, it was disappointing for everyone working on the Ebola response when two days earlier, there were three positive cases coming from this community.

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(c) UNICEF Sierra Leone/2015/Knight

As a result, the Western Area’s Social Mobilization Rapid Response Team (SMRRT) went out and did a quick assessment.  They concluded the following:

  • this is a transient boating community with various entry points,
  • there is a lack of social mobilization activities inside the community and high levels of complacency,
  • there are not a lot of recent Ebola-focused print materials or hand-washing stations present,
  • there are three religious centres which promote gathering and common use of praying mats and kettles,
  • there are five nearby markets that community members are utilising, and
  • the sanitation situation is really bad with no public toilets and most community members defecating in open spaces.

The SMRRT engaged key leaders (chiefs, task force members, and other community stakeholders) and they arranged the community meeting – to be attended by Chiefs, religious leaders, Ebola community taskforce members, landlords, the Harbour Master, District Surveillance Officers, social mobilizers, and community members. As I sat and waited for everyone to turn up, I noticed UNICEF’s ‘hotspot busters’ arrive; I smiled and complimented them on their new t-shirts which read “UNICEF Ebola Champion”. I made small talk with Hassan, who is a “hotspot buster” and he tells me he lives in this community.  He said Ebola was not new, but people like to hide when they are sick because they fear the authorities.

The community meeting started with prayers and in the normal Sierra Leonean custom, they were said by a priest and an imam.  As we said our amens and ameens, I smiled at the religious harmony that is one my favourite things about Sierra Leone.

Everyone was given the chance to speak, and while the majority of the meeting was in Krio, I understood most of what was being said.  The Chief (a woman) called her community to action and told them that they must be diligent in knowing the signs and symptoms of Ebola and they must call the local Ebola hotline, 117, to report sick people. Some members called for the complete destruction of the affected homes (now quarantined) and the District Ebola Coordinator (also a woman) spoke sternly, telling community members that the high-risk contacts would be provided the option to stay at an offsite voluntary quarantine facility, but that this did not mean that everyone should become complacent.  She called upon everyone to remain fierce in the fight against Ebola. One of the team, a UNICEF Field Support Officer, addressed the meeting by reminding the people  of some important messages – that hand-washing with soap is one of the best ways to prevent the transmission of Ebola (as well as many other illnesses), and that calling 117 at the earliest onset of any symptoms can save lives and protect their family and communities.

During the meeting, the community decided that there should be a three-week surge.  This would consist of active case finding (by district surveillance officers, contact tracers, and community task force members) as well as intensified social mobilization (by the active social mobilizers working for different organizations in this community). As the area was broken up into five different zones, and everyone placed into teams, I noticed that Hassan had been appointed as a team leader.  I gave him a thumbs-up and told him to stay safe.

After the meeting, my team took me deep into Moa Wharf and as we approached the quarantined homes, through the narrow pathways filled with community members milling around, we came upon some security officials who told us to step aside. We watched (and I held my breath!) as the 11 high-risk contacts were taken to the offsite voluntary quarantine facility.  I heard my colleagues saying in Krio ‘have courage’ and ‘you are helping us contain the Ebola virus, thank you!’ I stayed silent, overcome with emotion, realising how brave and how scared everyone in Moa Wharf must have been.

I left Moa Wharf with the team and we headed back to the Western Area District Ebola Response Centre (WA DERC), which is the nerve centre of the Ebola response for Freetown, and my base. There we debriefed and planned for the next steps.   Energised by the community meeting, everyone was committed to getting to zero and we are sure the Moa Wharf surge will help us to get there.

To date, Moa Wharf has resulted in 13 Ebola cases; social mobilizers have reached 3,566 households (7,613 males and 7,865 females); engaged 120 religious leaders; 36 societal head; 46 Chiefs, and 27 traditional healers.

Lucille Knight is a UNICEF Communication for Development Specialist and co-chairs the Western Area District Social Mobilization Pillar, which covers the Freetown area.