The Ebola epidemic began in West Africa in 2013, but really took hold the following year. Unlike COVID-19, when Ebola began, people weren’t seeing survivors. At the start of the epidemic, the mortality rate was 90%. It had a short incubation period, and spread rapidly.
And one of the primary reasons for the rapid spread of the disease was the deep-rooted mistrust of government, security forces and health workers. These are countries that had not long emerged from civil war and political crisis – the relationships within and between communities and with government institutions were still fragile. So responses to the Ebola epidemic ranged from disbelief in the existence of the disease, to widespread conspiracy theories that the disease was manufactured by the state to weaken political opponents, or was being used to harvest organs. Every action or inaction was politicised or perceived differently.
Information that was shared with the population, either through governments or via social media, was often inconsistent, and this further compounded the feelings of mistrust towards government institutions, as well as humanitarian agencies.
This deep mistrust meant the virus was able to spread more rapidly, meaning that it quickly became more than a health crisis, with the epidemic leading to tensions and violence. Health workers were driven away from communities, government buildings and health centres were attacked and burial teams were stigmatised. Those trying to respond to the epidemic simply couldn’t reach communities.
The importance of trusted relationships
It quickly became clear that this was where local peacebuilders had an essential role to play. Since 2010 we’ve worked in partnership with national NGOs in the border regions of Côte d’Ivoire, Guinea, Liberia and Sierra Leone to establish a network of 18 locally-owned peacebuilding structures, called District Platforms for Dialogue (DPDs). These networks are comprised of trusted and respected community members – and they became a vital bridge between health workers, humanitarian organisations such as the Red Cross, and government institutions who were trying to prevent or respond to the epidemic.
In a crisis, the DPD members are often the first people communities turn to. Their greatest capital is trust. During the Ebola crisis they provided basic information such as information on the symptoms of the disease, and how people could protect themselves. It was however important to ensure their role was clear – they are not health professionals. First and foremost, their role was to provide an environment where health workers were able to support communities. It was vital to ensure that distinction, so that DPDs could retain their trusted relationships with community members.
These DPDs held dialogue sessions to discuss their communities’ concerns and potential solutions. During the Ebola crisis, thousands of people attended these meetings including health workers, government officials, and Ebola survivors. And because our NGO partners were working closely with communities and DPDs, they were able to take the concerns of local communities and share these at a regional and national level.
For our partners, this community peacebuilding work isn’t something that began, or ended with Ebola. One of the important things to remember about an epidemic is that it is likely to come and go. Sierra Leone and Liberia both declared themselves Ebola-free, before seeing the disease return – and to some extent this weakened people’s belief in the existence of the disease and the responses to it.
Conflict-sensitive responses
Over time, we began to notice that the subject of dialogue sessions, and the issue that was causing most tension in communities, was the monopolisation of Ebola response resources – inevitably, support was focused on Ebola survivors and health workers. However, everyone was impacted by the epidemic. Markets were closed, economies collapsed, social and cultural norms were broken. In countries scarred by war, the securitised response to the epidemic and the wartime rhetoric, which we’re now seeing across the world, was a retraumatising experience for many. For our partners, the Ebola epidemic was in some ways psychologically more challenging, one partner told us “at least with war you can see the bullets.”
More and more the dialogue sessions run by DPDs focused on giving people who weren’t recognised as direct victims a space to talk about the collective suffering of the community and the nation. Strategies that respond to epidemics must be conflict-sensitive in their design and implementation. They must recognise the collective experiences of the whole population in order to avoid further divisions and deepening tensions.
During such a crisis, those most marginalised – both physically and socially – are likely to be disproportionally affected. In the borderland regions, where governance is weakest, mistrust was greatest. With fewer resources, and poorer communications, the disease was able to spread more rapidly. We also saw that as the usually fluid borders between countries were locked down, people were suddenly separated from families, livelihoods, and often the nearest health facility. At the height of the Ebola epidemic, it was estimated that 75 per cent of people contracting the disease were women. As the primary care givers to the sick, as nurses and as traders, women were more exposed to the virus and as such were often ostracised by their communities. Women’s voices can be lost during a crisis, as can those of young people, the displaced and other marginalised groups. Local peacebuilding can proactively seek the inclusion of these groups in the development of responses and advocate with and for them.
Opportunities for change
Despite the horrors of Ebola, we also saw positive change as a consequence. For some, it was an avenue for redemption – former child soldiers were often the ones volunteering in the Ebola response. We’ve also seen in Liberia that the success of the locally-led responses to the epidemic, has seen the country embrace this form of governance with increased decentralisation. Already, the DPDs that we worked with during the crisis are mobilising and preparing for COVID-19 and lessons from this work are being shared with our partners and the Youth Peace Platforms in Nigeria.
While communities around the world mobilise to tackle the virus, we are aware that this is an opportunity to build relationships and collaborate with others for a more holistic response. It’s a time when humanitarian agencies, peacebuilders and local communities can work together to ensure support in responding to the pandemic is conflict-sensitive, and can reach the people who need it most.