MONROVIA, Liberia — The Ebola virus spread rapidly in Liberia in the spring of 2014, yet efficient health communication strategies managed to greatly reduce the infection rate. For future global emergencies, the success of social and behavioral change communication with Ebola in Liberia should be used as an example for action.
After the initial cases on the Guinean border of Liberia, Ebola quickly reached the capital city of Monrovia. By September 2014, the healthcare system was completely overwhelmed by Ebola patients and the disease had claimed 1,000 lives.
Despite the expansion of Ebola treatment units, medical approaches alone were not restraining the virus. Ancient social customs — bathing the deceased and consuming bush meat — were perpetuating the epidemic. Quickly, the Liberian Ministry of Health realized that behavioral change communication was just as pivotal to emergency response as clinical intervention.
In a primary attempt, the Ministry of Health crafted the message, “Ebola Kills”, which simply intensified fear and confusion about the nature of the virus. In May 2015, Liberia was declared Ebola free, only to have a resurgence one month later. It further became clear that correct and contextual health communication was essential to continue combatting the disease.
Social and behavioral change communication tactics – carefully researched and extensively implemented – transformed the Ebola crisis in Liberia. Messages promoted sanitary burial, early symptom diagnosis and factual information dissemination about the virus, mobilizing village chiefs and religious leaders to be engaged in the preventative process.
Social and behavioral change communication, or SBCC, is a health communication method that aims to encourage healthy behavior by influencing social stigmas, attitudes and norms within the context of the community. It corrects misinformation, increases trust of healthcare workers and positively impacts the social dimension of health.
SBCC uses a variety of methods, ranging from small community meetings to mass media initiatives. In Liberia, USAID created a survey via SMS that rapidly gauged public understanding of the Ebola virus, mobilized door-to-door community outreach and produced short radio segments in 18 languages on 32 radio stations countrywide.
International organizations also used entertainment-education for social change. Entertainment narratives produce intense emotions in viewers, as the viewers tend to empathize and feel personally involved in the challenges that affect the characters. As this method of storytelling reaches a large audience, when entertainment-education deals with global health issues, it proves to be very effective in inspiring behavioral change.
Rural communities with low rates of literacy and access to electricity require alternative approaches. To address this fact, more traditional forms of folk communication are used instead such as street theater, songs and puppet shows, as those don’t depend on the ability to read pamphlets or watch television.
With SBCC, bus terminals and radio stations began to echo with health messaging, as communities began to actively fight the epidemic all over the country. Youth volunteers to the Liberian hip-hop star Takun J all used message-driven art to take Ebola prevention and social change into their own hands; what’s more, it worked.
Social mobilization and health communication were the primary reasons for the reduction of infections and deaths. By the time international resources were organized for Liberian aid, the number of Ebola cases had already been cut in half.
Based on the success of these communication strategies to fight Ebola in Liberia, according to the Johns Hopkins Center for Communications Programs, international organizations should consider SBCC as a fundamental component of emergency public health responses. For other global challenges such as hygiene, nutrition, HIV and malaria, SBCC could maximize the positive impact when used in combination with medical measures.
Epidemics become epidemic due to human behavior. In order to prevent further damage of a disease, governments need to amend social stigmas, risky traditions and cultural fears. Ebola in Liberia was addressed through the community promotion of social and behavioral change communication; a success that has transformed the emphasis on health communications in global crises.
– Larkin Smith