29 March 2019

Fighting Ebola by Restoring Trust in Communities

As Ebola again makes headlines, Professor Vinh-Kim Nguyen, team leader for Médécins sans frontiers (MSF), and Joanne Liu, International President of MSF, offer insight on the recent rise in attacks against humanitarian aid in the Democratic Republic of Congo (DRC). 

At a time when Ebola is once again making headlines, this time in the Democratic Republic of the Congo (DRC), humanitarian workers in the field are witnessing increasing violence. In response, organisations like Médecins sans frontières (MSF) are adapting their techniques to better reach those in need of medical support. The subject has resonated within the Graduate Institute: first with an article by Vinh-Kim Nguyen, Professor of Anthropology and Sociology, appearing in The New England Journal of Medicine; and second, a film screening and debate, organised in partnership with Le Festival du film et forum international sur les droits humains de Genève (FIFDH) and MSF, and moderated by Ilona Kickbusch, Director of the Institute’s Global Health Centre. 

Reflecting on how medical staff should approach people affected by Ebola in his article, “An Epidemic of Suspicion – Ebola and Violence in the DRC”, Professor Nguyen, who is also a team leader for Médecins sans frontières (MSF), said, “I’ve come to realise that the most important part of my job is building trust with the communities we serve. […] Many attempts to engage with affected communities during Ebola epidemics have been tone-deaf: little effort has been made to understand the public’s concerns or to find out what they understand from the messages being conveyed to them.”

He noted that MSF’s efforts to genuinely engage with the community meant that rather than promoting routine messages of health promotion, they recruited “trusted community members” to better communicate with locals, who felt “Ebola is just a business.” Locals were concerned that interest in their health would “leave when Ebola does, but we will still be here, slowly dying from the diseases that have always killed us.”

During the film screening and debate of “Survivors”, which presents a portrait of Sierra Leone during their respective Ebola outbreak, Joanne Liu, MSF’s International President, was present for a panel discussion along with Arthur Pratt, the film’s director, and Annie Sparrow, Assistant Professor at the Icahn School of Medicine at Mount Sinai.  

Dr Liu, in a video interview, echoed many of the same concerns and observations as Professor Nguyen with regards to humanitarian aid in the DRC. 

“If we want to restore trust [in local communities], we need to step back a little bit, listen to what are their concerns, not preach to them, and bring some answers to the very, very basic, issue, which is access to healthcare, access to water and, in addition, respond to the Ebola epidemic”. 

Both Professor Nguyen and Dr Liu are from Montreal and, coincidentally, maintain clinical affiliations in neighbouring hospitals: CHU Sainte-Justine (paediatric) and Jewish General (adult) academic medical centres.

Read Professor Nguyen’s article in its entirety in The New England Journal of Medicine

Watch Joanne Liu’s interview at the Graduate Institute: