Saturday 18 January 2020
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reliefweb - 1 month ago

Democratic Republic of the Congo: When trust means life or death

Source: International Federation of Red Cross And Red Crescent Societies Country: Democratic Republic of the Congo
Stopping Ebola virus disease is not just about providing information, vaccine and treatment. It’s about gaining the trust of people with good reason to be wary. Like many people in the city of Butembo, 25-year-old carpenter Machozi had not heard much about Ebola virus disease before November last year. Up to then, the epidemic had spared the city of roughly 1 million people in the north-eastern corner of the Democratic Republic of the Congo (DRC). He soon learned more than he ever wanted to know. After taking an infected person — one of the city’s first cases — to a health clinic on his motorcycle, he was quickly identified as a ‘contact’, someone who was in close proximity to a person with Ebola. Health workers tracked him down and asked him to come to the closest Ebola clinic for tests. As he waited for results, his dread increased. “I had heard many rumours about how those who left for the Ebola treatment centre died,” he said later. “So I fled the centre and went back home.” Hiding in a small studio next to his family home, he began to feel the symptoms. Headache. Fever. Vomiting. Machozi’s mother finally convinced him to return to the centre where he was ultimately cured. As harrowing as it is, Machozi’s story is not unusual. Amid the violence, political turmoil and insecurity of North Kivu province, a combination of fear, mistrust, rumours and some very hard truths — a majority of people infected with Ebola do not survive — have led many to resist treatment or other measures aimed at preventing the disease’s spread. “People are scared and they have very good reason to be,” says Gwendolen Eamer, senior officer for public health in emergencies for the IFRC. “Ebola is a very scary disease.” Save I had heard many rumours about how those who left for the Ebola treatment centre died. So I fled the centre and went back home. In the meantime, the conflict that grips North Kivu — involving multiple armed groups, government forces and United Nations peacekeepers — continues to result in civilian deaths, both in cities such as Beni and Butembo and in remote rural villages. “We live under one fear that adds to another,” says Euloge, a nurse at a private health centre in Beni. “In the east you face machetes and in the west, where we were supposed to flee, now there’s this disease.” The conflict has created a perfect storm for the spread of Ebola. The frequent attacks, often occurring directly in Ebola hotspots, result in sudden displacement of thousands of people. Meanwhile, the maps used by relief workers are marked with numerous ‘red zones’, places where medical and aid workers cannot go due to fighting. At various times since the outbreak began, major aid groups have suspended operations in North Kivu. To navigate this fractious climate, the International Red Cross and Red Crescent Movement (Movement) relies on four of its Fundamental Principles — neutrality, impartiality, humanity and independence — to assure people that it is there to help vulnerable people, not take sides in the fighting. For that reason, Movement personnel never travel with military or police protection, nor travel in or with United Nations or government aid convoys. Just as importantly, the Movement has been at the forefront of efforts to develop better systems — put into action largely by National Society volunteers — to better listen to, track, analyze and respond to community needs and concerns. Confronted by rumours While many people in the communities torn by conflict and Ebola know and trust the Red Cross, due to its long-time presence providing a wide range of services, many others distrust anyone associated with the Ebola response. At the same time, a host of common rumours and beliefs have taken hold in many communities: Ebola is a scam invented by international non-governmental organizations to make money. The disease is the result of witchcraft. The Ebola vaccine contains poison. Health workers steal organs from the dead. Ebola isn’t even real, it’s just fake news. This distrust has potentially fatal consequences. Some communities have rejected the help of volunteers who have come to bury deceased people — who remain highly infectious just after death — in a safe and dignified manner. Suspicion of aid workers has at times led to verbal abuse, threatening gestures, even violence against Red Cross workers. Why such a level of distrust? In North Kivu, Ebola has taken hold where health and education systems are either weak or non-existent and where people have suffered horribly due to relentless violence without much notice from the outside world. Suddenly, at the arrival of Ebola, hundreds of international aid workers show up, filling the hotels and driving four-wheel-drive jeeps. “People are asking ‘Why are all these people here?’,” says Eloisa Miranda, who coordinated the ICRC’s ground operations in North Kivu until February 2019. “And, ‘Why from one day to the next did everybody become interested in us when before this, there was no one — despite the fact that we had enormous needs?’.” At the same time, the response to Ebola can be incredibly scary. When someone is reported to have died from Ebola, family members are visited by safe and dignified burial teams made up of people covered head to toe in protective clothing. “You are coming into someone’s home dressed in something that looks like a space suit — it is a very emotional thing,” says Jamie LeSueur, who served as IFRC’s head of Ebola response operation in the DRC for much of 2019. As part of their work, the teams must disinfect the corpse, then put the deceased in a body bag and bury the body. This work is absolutely critical in the effort to stop Ebola, but if not done with sensitivity, people may reject it entirely. LeSueur says great pains are being taken to gain people’s acceptance by allowing family or even community involvement and observation. “We don’t go into a community and take a body,” he says. “We work with a community to make sure that they understand why we are there, what we are doing, why our teams are dressed that way and why we are doing this with the body of their loved one.”


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