N’Zerekore – On a sultry morning in early March in the small town of Gouécké in south-eastern Guinea, scores of concerned community and customary leaders gathered for a meeting with WHO’s local team of social anthropologists.

As Guinea’s latest Ebola epidemic continued to slowly spread to towns and villages in the N’zerekore Prefecture, which comprises Gouécké, frightening rumours about the removal of bodies had begun to circulate. Among other things, it was said that the bodies were being used in a lucrative organ trafficking trade, or that medical teams were extracting blood from the corpses for other nefarious purposes.

“During an epidemic, people are afraid. And when they are afraid, if they don't receive good, clear information, they are going to develop other mechanisms to interpret what is going on,” says Dr Julienne Anoko, the Focal Point for Risk Communication & Community Engagement with the World Health Organization (WHO) who has been assisting the response in Guinea. “Rumours are one such mechanism.”

Persisting fear around the Ebola virus, and the dangerous rumours that accompany it, has often been informed by memories of the 2014 – 2016 outbreak, which claimed more than 11 000 lives in Guinea, Sierra Leone and Liberia. The first case in Guinea’s current epidemic was detected on 14 February 2021. Twenty-three cases and 12 deaths have since been recorded.

As part of its efforts to stem the spread of rumours and false information during this latest outbreak, WHO and other partners including UNICEF and the International Federation of Red Cross (IFRC) recently launched a collaborative communications commission under the leadership of the regional directorate of health. “This allows us to mutualize our efforts in fighting rumours and misinformation and to make sure that together we can cover all domains in our response to these issues,” says Dr Anoko.

Among other things, WHO Guinea has been producing a weekly social listening report, which it shares with partners. Extensive community feedback data is also shared and discussed among partner organisations and the ministry of health. This has helped to target specific rumours and disseminate appropriate fact-based health messages through social media channels as well as local radio.

WHO Guinea has also been working with the African Infodemic Response Alliance (AIRA), which was launched by WHO’s Regional Office for Africa in December 2020. In conjunction with 14 partners including UNICEF, Gavi, the Vaccine Alliance, IFRC, UNESCO and external fact checking organizations, AIRA seeks to coordinate actions and pool resources in combating misinformation and promote verified information during health emergencies in the African Region. Viral Facts Africa, the public face of the Alliance, produces a range of fact checks, debunks, misinformation literacy and social media content towards that end.

A community approach

But in Guinea, where internet penetration is only at around 21.8% and just 15% of the population use social media according to a January 2021 report from Data Reportal, direct community engagement remains the most pertinent approach.

“When we meet with communities, they share with us whatever rumours are circulating on the ground, and we then organize community dialogue sessions or focus groups as necessary,” says Dr Anoko. “We always leave the door open so that the community can tell us whatever they want. We try to listen as much as possible rather than just coming in and telling people what to do.”

At the March community meeting in Gouécké, having listened to the community’s fears around the removal of bodies, WHO’s social anthropologists took time to carefully explain and illustrate what the process really entailed. “Sometimes it can be as simple as just showing people a physical object that we use, like a swab for example, so they can understand what it actually is and what it does,” Dr Anoko says.

According to Franck Gaba, Community Engagement and Accountability Coordinator at IFRC Guinea, this direct community approach has borne significant fruit. “Before, it was impossible for us or our partners to enter certain areas because there was so much fear and reticence. But now, we can get everywhere. This is a very visible sign of the progress that has been made, and it has literally saved lives.”

WHO and its partners have also endeavoured to involve local religious and community leaders in their efforts to combat rumours and false information. “We can’t be on the ground all the time, so it’s important to pass on the appropriate health messages to people who are credible and influential in their communities so that they can go back into those areas and denounce rumours themselves," says Dr Anoko.

Attacking rumours early

On 8 May, around 30 imams from across the region attended a meeting with WHO and its communications commission partners at the imposing Great Mosque near the centre of N’zerekore, the bustling capital of the eponymous prefecture. These imams were encouraged to share community feedback and ask questions about the epidemic.

“We have learnt a lot from these meetings, not only about Ebola, but also about COVID-19,” says Yaya Diallo, an Imam at a mosque in the Boma Sud district of the city. Now armed with accurate health information, when Diallo hears that potentially harmful rumours are circulating in his community, he actively counters them through his sermons or goes door to door to speak to people directly. “You have to attack these rumours early so that they don’t spread too far,” he says.

In the early stages of the epidemic, Diallo says there was a lot of false information circulating in his district about the Ebola vaccine. “With the support of WHO and other organizations, we have been able to ensure that people are properly informed and the situation has now changed significantly. Now, most people have accepted the vaccine.”

Since the start of the outbreak, more than 9500 people have been vaccinated against the virus, including over 2600 frontline health workers. “Without dealing with the rumours and the reticence, this would not have been the case,” says Sevie Loua, the Focal Point for Community-based Surveillance in N’zerekore’s provincial health department and president of the recently-launched communications commission.

“Through the work done, above all on the ground, more and more communities now understand what we are trying to do to end the epidemic. They have come to understand that we are there for their wellbeing, not to cause further harm,” she adds.

With no new confirmed cases since 2 April, on 8 May WHO began a 42-day countdown to declaring the Ebola outbreak over in Guinea. The robust community engagement mechanisms put in place during the outbreak should continue to play a pivotal role in any future health emergencies in the country.