Health Communication in Guinea and Atlanta

Since July 2014, CDC has sent staff on almost 3,000 deployments to support the Ebola response in West Africa, the United States, and elsewhere around the world. Responders fill a variety of roles, from disease detectives, to laboratorians, to logisticians, to health communication experts. Allison Friedman, a CDC health communication specialist, deployed to Guinea in the summer of 2015 to provide communication support for CDC’s Health Promotion team.

“I wanted to play a role in this historic effort and offer any help my skills could offer,” she says. Allison spent three months in CDC’s Emergency Operations Center (EOC) before being deployed to West Africa. Being a French speaker with a background in behavioral science and health communication made Allison a perfect candidate for working at the community-level in Guinea.

Allison Friedman at a community education event around safe and dignified burials in Forecariah.

While in Guinea, Allison’s job was to work with response teams going into communities to interact face-to-face with them. Social mobilization teams teach communities about preventing and controlling Ebola through door-to-door campaigns, village meetings, and educational sessions. Anthropologists help response organizations by conducting rapid assessments of communities to better understand the cultural, social, and individual factors that influence community attitudes and behaviors related to Ebola prevention and control. Allison helped bridge the gap between the anthropology and social mobilization teams, offering technical assistance with rapid assessments and ensuring that findings were translated into meaningful communication strategies and tools for social mobilizers. Together, the teams spoke with community members about their needs, concerns, perceptions, and proposed solutions for improving the Ebola response. Communities also got a chance to ask and answer questions about Ebola and ways to protect their families, friends, and neighbors.

One of the biggest challenges that Allison noticed in speaking with communities was the conflict between key infection control practices and prevailing traditions and cultural norms. “There are strategies we know to be effective in stopping the spread of Ebola, but convincing people to set aside their deeply held beliefs and practices, like preparing a loved one’s body for burial in the traditional way, is a very difficult thing to do,” says Allison. “It was especially hard in communities without recent Ebola cases, where villagers didn’t see the need to continue with safe and dignified burials.”

An added challenge was gaining the trust of communities that are accustomed to seeking health care from known local healers and do not trust the government or foreign agencies. Communities were more open to accepting prevention and control measures once they received tailored information, reinforced by trusted community and religious leaders and supported by real-life testimonials from Ebola survivors in their areas.

A town under cerclage attend an educational session in Forecariah.

When she returned to the United States, Allison extended her time in the EOC to support efforts in Guinea from the health promotion team in Atlanta, GA. This gave her the opportunity to leverage CDC resources to create needed messages and tools for use in the field. The health promotion team here supports staff in West Africa with Ebola-related communication research, planning, development, and evaluation.

Although there were challenges working in Guinea, Allison says that she found it very rewarding to work with such kind, committed, and patient people on such an important cause.

“I feel deeply enriched by my experiences working with communities and committed partners in the field. I am humbled and awed by the strength of the Guinean people – particularly the Ebola-affected families who have endured losses beyond what most of us can imagine and who continue to face stigma, discrimination and challenges meeting basic needs.”

Finally, she says “I’d also like to give immense credit to my CDC colleagues who have and currently are deployed to West Africa, working tirelessly, with a focus on getting to zero. With their passion, commitment, and perseverance, we are closer than ever to reaching this goal.”