In the hardest hit counties, the role of community leaders is key in preventing the marginalisation of survivors of the virus

The Ebola epidemic has caused more than just a health crisis in Liberia. In the border regions, intercommunal tensions have increased while survivors and victims’ families struggle to shed the stigma of the disease. Often marginalised by their own neighbourhoods, they find it difficult to reintegrate after being quarantined. But community programmes are raising awareness of how the virus is contracted, and reassuring communities that those cured will not infect others.

Some of the counties hardest hit by Ebola in Liberia include its border communities. Due to fears that the virus might spread further, borders between Liberia and its neighbouring countries have closed, as well as nearly all of their markets, despite the fact that cross-border trade and relationships are vital for border economies and building trust.

One of the main impacts of Ebola is the tension created within communities. When the Ebola epidemic became pronounced in August 2014, the District Platforms for Dialogue (DPDs) in Tewor district (bordering Sierra Leone), was incorporated into the district’s Ebola task force by the local government. The DPDs went house-to-house educating people in Vai – the local dialect.

As health workers began developing a better treatment for Ebola, those infected began to hope of survival. But survival often caused complete marginalisation of survivors and their families: the wider community wanted nothing to do with those under quarantine for fear of infection, as was the case with one family I worked with.

Maima Kiawu was a strong member of the DPDs, and a mother of seven children. Maima’s husband worked in Tubmanburg, 28 miles from Tewor, and came into contact with someone infected by the virus. Upon his return, he unknowingly infected his wife.

In less than 48 hours, he started showing symptoms and was rushed to hospital where he died on arrival. Maima and the children were quarantined for 21 days, but before these could elapse, Maima died along with her nine-month-old baby.

The surviving six children were stigmatised by the rest of the community. Old friends no longer wanted to see them, they could not go the mosque to pray, and community members forbade their children from associating with the orphans left behind. Even after they successfully completed another 21 days of quarantine and were declared Ebola-free, the community refused to interact with them for fear of contracting the disease. The children could not even buy anything from the market because no one would accept their money.

The children Maima Kiawu left behind are not the only ones shunned by their communities. Many Ebola survivors now experience this, creating bitterness between survivors, quarantined families, and the larger community.

But solutions are being found to reduce this stigma through meetings and forums, and by educating communities about the virus.

Community meetings are generally well attended but most importantly the DPDs ensure that key opinion leaders, such as the imam, town chief, and youth and women leaders, are part of the meetings as they hold great influence in shaping the mindset of the community.

Survivors and health workers are invited to join meetings. The discussions are facilitated by a DPD chairman who will begins reminding community members of life before Ebola; how people relied on each other as a community, how they farmed, prayed, and ate together, and will often conclude by saying that their common enemy is the Ebola virus – not the people it infects.

During the discussion, people share their experiences and details of what they are doing to prevent the spread in line with the health ministry directives. Some of the issues often discussed are: reporting of sick family members to community leaders and the district taskforce, providing food for quarantined families in a dignified way without risking oneself, providing washing buckets to homes that cannot afford them, stopping stigmatisation of quarantined families and individuals, and accepting survivors back into the community.

People are encouraged to join these meeting by community leaders, and the DPDs invite health workers to answer questions, educate participants on the symptoms and signs of Ebola, and instruct them on what to do when a family member exhibits these signs. They also provide reassurance that once a victim is cured, they no longer spread the virus, and that family and friends should not reject them.

Harold Aidoo is executive director the Institute for Research and Democratic Development in Monrovia, Liberia. The DPDs are a joint initiative established by Conciliation Resources and partners.

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