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Archive for "Epidemic"

Communication &Ebola &Epidemic Bill Brieger | 26 Oct 2014

What the Press Tells Us about the Early Days of Liberia’s Ebola Outbreak

The mass media are assumed to play an important role in the national response to a crisis, and Ebola should be no exception. The first cases of the disease in Liberia appeared in March 2014 after victims crossed the border from its point of origin In Guinea. A search for Ebola-related articles from the early period, March to May, was undertaken in The Liberian Observer.

DSCN7963While to date over 1,000 articles and references on Ebola were found in The Liberian Observer, most of the news coverage has appeared from August to October. In particular there were few articles in March, a surge in April and then a tapering off in May and June, before Ebola gained more prominence in print from July onwards.

Generally the early news articles in the Observer report events and opinions surrounding Ebola rather than serve as direct avenues for behavior change communication (BCC). Articles on politics, science, religion, economics, social commentary and even cartoons focused indirectly or directly on key events in the development of the national response.

DSCN7881Because of upcoming elections politicians used the outbreak to criticize each other’s response to the problem. In the early days the economic concerns focused primarily on reduced revenues across national borders in the region. Religious leaders either tried to rally support for control through prayer and fasting or blamed the epidemic on sin.

A couple opinion pieces in April acknowledged that BCC was going on through the radio. Special events such as sporting and athletics adopted an Ebola prevention theme, and several local NGOs pledged support for community outreach and awareness creation. Senators even had a retreat to learn more about the disease so they could educate their constituents.

DSCN7922 aOn March 23rd Marday L Peters wrote in the Observer, As Deadly Virus Threatens Liberia, Where is the Outcry?” At least from the communications point of view, the situation improved in April.

A.M. Johnson, The Health Correspondent for the Observer reported about Health Promoters Network, Liberia (HPNL) on April 3rd, quite early in the outbreak. HPNL in expressing its support for Ministry of Health and Social Welfare efforts “urged everyone within our borders to adhere to those preventive measures such as do not eat animals that are found dead in the bush, and avoid contacts with fruit bats, monkeys, chimpanzees, antelopes and porcupines. Limit as much as possible direct contact with body fluids of infected persons or dead persons. Wash your hands with soap and water as frequently as possible.” HPNL called on other Liberian NGOs to join the cause of educating the public.

On April 20th, S. Vaanii Passewe, II mentioned in a commentary that, “… the airwaves were laden with the news of an outbreak of the deadly Ebola outbreak… Subsequent warnings from the Ministry of Health notably said that the populace should report suspected cases, refrain from coming into body contact with suspected Ebola patients, avoid shaking hands, do not have casual sex with strangers, etc. These weird precautionary measures heightened fear.”

Some actionable information was provided in regular news articles in April. For example in an article on April 25th The Observer talked about “Ending Ebola in Liberia, A Collective Approach Needed,” readers were told about the symptoms, the potential spread through fruit bats and the fact that there was no specific cure, but supportive care is needed.

Further study of more mass media outlets concerning Liberia’s Ebola control efforts is needed. We know that although an early start to educate the public was undertaken, a relative dearth of coverage in the Observer might also indicate a reduction in enthusiasm by the press, NGOs and government to sustain Ebola communication and action. For whatever reason, the epidemic spiked. Fortunately efforts are now back on track, but there is a long road ahead.

Epidemic &Health Systems Bill Brieger | 28 Aug 2010

Malaria – another challenge for Pakistan

who-syed-haider-pakistan-flood2.jpgLike other diseases, malaria takes advantage of natural and human disasters. Pakistan may be the latest example. UN Radio reports that, “Cases of suspected malaria are increasing in the flood-affected provinces of Sindh and Balochistan in Pakistan, according to the World Health Organization (WHO). The agency says malaria is adding to the already increasing trends of water and vector-borne diseases, especially in Sindh and Punjab provinces.”

While WHO is providing treatment kits with artemisinin-based combination therapy (ACT) medicines, a bigger challenge may be destruction of infrastructure, including health services. Jhpiego explains that, “In 2005, northern Pakistan was struck by a massive earthquake, destroying 80% of the structures in that region and reducing the quality of, and access to, primary health care services.” Similar problems are expected because of the floods.

After the 2005 quake, USAID funded Primary Healthcare Revitalization, Integration and Decentralization in Earthquake-affected areas  or the PRIDE Project for 2006-10, which involved improving primary health care services at 94 health care facilities.

Pakistan experiences both P. falciparum and P. vivax malaria. The Demographic and Health Survey reports that the transmission pattern is a combination of stable and unstable malaria with low to moderate endemicity, with epidemic breakouts in Punjab and Sindh provinces. “The disease is now emerging as a prominent health problem in Balochistan and the Federally Administered Tribal Areas (FATA).” That 2006-07 DHS showed very low utilization of insecticide-treated bednets and low uptake of malaria medicines by children and pregnant women.

Pakistan has received three rounds of malaria grants from the Global Fund. A combination of Global Fund and government support was trying to address the 30 most highly endemic districts in the country. Although the latest grant performance report gave Pakistan an ‘A2’ grade, other news reports paint a different picture.

According to IRIN, “Pakistan’s Roll Back Malaria (RBM) strategy is lagging far behind the international goal of reducing the disease worldwide by 50 percent by 2010, mainly because of a lack of skilled staff and a shortage of funding.” A health official explained that “existing surveillance system is the major challenge at the moment, since we do not have accurate data.” This information pre-dated the flooding, and consequently the health system is in even less of a position to respond to malaria challenges now.

Pakistan needs appropriate emergency response to a potential malaria epidemic, but eyes should also be focused on the longer term need for reconstruction and strengthening of the health system. Otherwise malaria cannot be eliminated.