Section 8: Mobilize Community Resources and Conduct Community Education"

This section describes how to:

• Organize community resources to develop and provide information about prevention and control of VHF in the community.
  
  
• Identify key messages and communication channels.
  
  
• Evaluate communication activities and take action to improve them as needed.

When VHF is suspected:

• Make sure that the community knows about the VHF outbreak and how it is transmitted.
• Involve the community in identifying the source of the epidemic and controlling it.
• Reduce fear and rumours in the population.

To develop community education in an urgent situation:

• Describe the extent of the current health problem.
• Identify and mobilize key community members who will plan and lead the education efforts.
• Describe the target population and develop health messages.
• Plan and conduct activities to communicate messages.
• Conduct ongoing evaluation of the activities and make improvements as needed.

8.1 Identify Key Community Resources

Identify key community organizations who already know the community and have access to it. Describe their expertise and available resources that could be useful in responding to the outbreak. Consider organizations such as:

• Local governments
• Local non-governmental organizations (NGOs)
• Religious groups (missions, churches, mosques, temples)
• Businesses
• Schools
• Sports clubs and other recreational clubs
• Service organizations
• Volunteer organizations and community service groups.

For each organization, gather and record information about:

• The organization's expertise
• The representative or leader to be contacted
• Available human resources
• Available material resources (such as vehicles, office supplies, and communication equipment).

Record the information on a chart such as the one below. Use it for planning and refer to it when VHF cases occur.


Chart example:

8.2 Meet with Community Leaders and Assess the Current Situation

Invite representatives from each organization to a meeting.

Explain that the goal is to develop a Mobilization Committee that will help halt an outbreak. Together with the VHF Coordinator and health facility staff, the Mobilization Committee will:

• Plan and describe how communication will take place between the Mobilization Committee and the VHF Coordinator. The purpose is to keep the health staff informed about the outbreak status in the community.
• Make sure the community leaders understand:
  • The signs and symptoms of a VHF.
  • How the disease is spread.
  • Personal precautions to use to prevent contact with infectious material and body fluids.
  • The person to notify when a VHF is suspected (for example, station a Red Cross volunteer at the health facility to take reports from community members about unexplained deaths or suspected VHF cases).
  • The importance of handwashing, decontamination of surfaces, careful laundering of clothes, bedding, and other home infection control measures such as trying to keep the sick person in a separate corner of the house.
  • Careful decontamination of the bedding and room where the patient has died.
  • The need for limited contact between the sick person and other family and community members.
  • The need to follow up family or community members who have had contact with the sick person. The duration of the follow up will vary according to the incubation period for the VHF.
  • When to send a sick person to the hospital. The VHF Coordinator, community liaison person, or Red Cross volunteer can facilitate this move if the community has been adequately prepared. For example, they can assist in transporting the patient safely to the health facility, help disinfect the area where the patient was cared for at home.
  • How to care for VHF patients at home before they have been diagnosed and also after they have been released from the health facility.
  • What is expected of families when the patient is in the hospital.
  • Why burial practices may need to be changed during the outbreak.
• Deliver health messages using a variety of communication methods that will reach as many people as possible in the community.
• Conduct community surveillance including reporting deaths, conducting case finding activities and planning case follow-up.

Fig. 59. Meeting with community leaders

8.3 Describe the Target Population

To prepare a complete description of the target population, gather and present information about:

• Maps of the town
• The size of the population
• Major ethnic groups in the town
• Locations of any special populations such as refugees or squatter settlements where the risk of disease transmission may be particularly high
• How many people may be affected by the outbreak
• The populations at greatest risk.

Ask the members of the Mobilization Committee for any additional information they might have about the target population. For example, they may know about nearby villages and recent travel by the local population to other areas.

8.4 Describe Problems Contributing to Transmission Risk

Identify the likely transmission risks for this community.

For example, does the community know how disease is transmitted and how it can be prevented? Is it customary to visit the sick in their homes? During mourning, are individuals expected to lay hands on the body or touch the body to show their grief? Are there new skills to teach? Is bleach available?

8.5 Identify Changes or Actions Required

Specify the behaviour changes and actions that are required to solve the problems. For example, if traditional burial practices involve touching or washing the body, the community will need to adapt burial practices.

8.6 Identify Barriers to Carrying Out Recommended Changes or Actions.

Talk with members of the Mobilization Committee about what could prevent individuals from doing the recommended changes or actions. Discuss, for example, if individuals:

• Know about the relevant VHF precautions and how to follow them?
• Have the skills to do the recommended changes or actions?
• Have the correct resources to carry out the recommended changes or actions?
• Understand that some caretaking and burial practices must change during the outbreak even though they involve traditional beliefs or cultural practices?

8.7 Develop Specific Messages

Review the information collected by the Mobilization Committee. Select messages that match the specific risks for transmission of VHF. Consider how to solve the obstacles that might prevent individuals from taking the recommended precautions.

For example, the custom in the community may be to visit the sick when they are at home. Plan a message about limiting visitors. Also include information about how diseases are transmitted. This will help the community understand why they must change their customary practice. After selecting the messages, decide if some activities should take place before others.

For example, give basic information about VHF and its transmission before telling the community about not touching the body of a relative who has died.

In addition, the community may have heard rumours that everyone in the hospital is dying. To reduce fear and rumours, give information as soon as possible about VHF transmission. Discuss the precautions being taken in the hospital to protect the patients, the health facility staff, and the community.

8.8 Select Activities for Communicating Messages

List all available methods of communicating with the community. More than one method should be used to reach the maximum population with the necessary information. For instance, consider:

• Existing communication channels in the community (church, mosque, temples and other religious networks; traditional healers, personal communication)
• Door-to-door campaigns
• Radio messages
• Short-wave radio to reach outlying areas
• Banners and posters.

Contact the person responsible for each communication method. Ask for their support and availability.

8.9 Assign Tasks and Carry Out Activities

Look at the list of community resources prepared in Section 8.1. Determine who should undertake which activity. For example:

• Religious leaders will make announcements in their services. They can also prepare messages to deliver to small groups and in personal communications.
  
• The Red Cross will be trained to evacuate the bodies and safely perform burials.
  
• The Red Cross volunteers and student volunteers will be trained by a member of the health facility staff skilled in VHF Isolation Precautions. A training schedule will be set up and the Mobilization Committee will work out the information needed.
  
• The governor or village chief can make public announcements with a loudspeaker to tell people to stay calm, to listen to the information, and to attend information sessions.
• Student clubs will make banners to put across the road to give a specific message, design leaflets, pass out leaflets, and go door to door and answer questions.

Elicit ideas from the Mobilization Committee about possible problems and creative solutions. Describe the problems that have occurred in previous outbreaks or that might occur in a future outbreak. Explain that meetings with the group will continue throughout the outbreak and new problems will be discussed as they arise.

If funding and human resources are limited, set priorities. Select specific activities that will make the most impact. Work with the Mobilization Committee to coordinate and communicate with all the resources in the community. There may be ways to accomplish all the activities if groups can be mobilized and understand the need.

Use the community information sheet to organize the specific tasks and assign organizations to do them.

8.10 Evaluate Activities

Evaluation of the community education efforts should be ongoing. Keep records of activities accomplished, any problems, and their solutions. Use the evaluation results to make improvements. When problems occur, find out why and solve them. Develop new solutions to identified problems and implement these solutions.

For example, in the 1995 Ebola haemorrhagic fever outbreak in Kikwit, community education was a key element in halting the epidemic. However, no one predicted that survivors would not be accepted when they returned into the community. Community members believed survivors still carried the disease. A new education activity had to be developed so that the survivors and surviving children would not be abandoned.

8.11 Obtain Community Feedback

The Mobilization Committee should identify a representative from the community or from each area of the community (for example, a representative from each neighbourhood or quartier) to attend community meetings and obtain feedback from the community. Explain to the community the purpose of the Mobilization Committee. Describe the activities that have been planned or that are already being done. Reinforce the critical role of the community representatives in providing information from the Mobilization Committee to their own communities. Community representatives are also important sources of information about possible transmission risks and prevention activities.

Be alert to feedback from the community that can affect the outcome of the community education efforts. For example, are there areas where health messages do not reach community members?

8.12 Meet Regularly with the Mobilization Committee

Set up regular meetings with the Mobilization Committee. Keep them well informed of what is happening. Encourage and support them to help continue enthusiasm for the efforts. Provide new messages and information they need. Work together to identify new problems and plan solutions.

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This page last reviewed November 26, 2003

National Center for Infectious Diseases
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