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Malaria programme tackles COVID-19 in Sierra Leone - how vital information saves lives

2020-04-24T17:51:08+00:00

People have been - understandably – very frightened by the threat of the new coronavirus COVID-19 in Sierra Leone. The country’s experience with Ebola in 2014-15 still feels very recent and its healthcare system is fragile; when the first cases of COVID-19 were announced, mis-trust and mis-information were rife, and our audiences were hungry for calm, accurate information they could trust.

Our popular Krio-language radio show, Tawa Fo Welbodi - which means ‘determined for health’— broadcasts weekly on partner radio stations around the country and is uniquely placed to help in this crisis.

Madiama is a listener of Tawa Fo Welbodi. Photo: Comic Relief

In special editions of these shows, we have focused on the novel coronavirus and provided audiences with information about what it is, how it is spread, how to protect yourself, what symptoms are, and what to do if you or someone you know develop those symptoms.

Our challenge now is to meet audiences’ needs for information about the novel coronavirus, while continuing our important focus on malaria prevention - debunking myths and increasing awareness about malaria. Half the world is still at risk from this deadly disease, which is both preventable and treatable. There were more than 200 million new cases of the disease in 2018, and a child still dies of malaria every two minutes.

Adapt, adjust and continue

As the COVID-19 pandemic dominates headlines and thoughts, we are rapidly adapting to this new context. Our radio programmes continue to emphasise the importance of early testing and early treatment for malaria, and we are providing clear, detailed information about the symptoms of malaria versus the symptoms of COVID-19. We’re also providing guidance about when to report to hospital for malaria testing, and when to self-isolate and call the emergency line.

We also know, from our research and our experience during and after the Ebola crisis, that people tend to fear and stay away from hospitals at times such as this, and may turn instead to traditional medicine. Our programmes inform audiences about measures in place at malaria treatment centres to ensure patients’ safety and protection, and remind audiences about the dangers of relying on traditional medicines instead of modern treatments for malaria. We also give updates on planned national programmes, like the next distribution of insecticide treated nets.

Our Facebook page is the most-liked page in Sierra Leone with over 500,000 followers; we are using this to post regular content from �� Media Action's global response to COVID-19, including this animation about physical distancing and this interview on misinformation and how to identify it. We are also sharing infographics on symptoms and creating our own animations for our audiences about prevention methods.

Watch this video, produced by Comic Relief and GSK, about our Tawa Fo Welbodi project (filmed autumn 2019)

And we are sharing real stories, like this family who are taking malaria prevention more seriously than ever, to continue to emphasise the importance of protecting ourselves against malaria, especially while the country is experiencing another public health emergency.

"While you are protecting yourself from COVID-19 you should also protect yourself from malaria… it kills fast" says Vandi Magona demonstrating the steps he takes to protect his family from malaria.

Dispelling fear and mistrust

We work hard to feature local voices, such as medical experts, local leaders or well-known entertainers, that people recognise and trust to help dispel fear. For this World Malaria Day, we will share a short video on our Facebook page from popular comedian Kindo Amani, who reminds audiences that it’s still important to work to prevent malaria and to seek early treatment.

And we continue to remind our audiences who is most at risk from malaria. Antenatal visits - where pregnant women receive intermittent preventative treatment - are as important as ever, as are vaccinations for children. We inform our audiences about the continued importance of these and how people can safely access them now.

These are unprecedented times, but we will continue to produce radio and social media content that people will engage with and most importantly trust about COVID-19 and about malaria – to ensure people know how to best protect themselves and their families.

Mary Morgan is Head of Production for �� Media Action, Sierra Leone

Learn more about our global response to COVID-19 here
Tawa Fo Welbodi is supported by Comic Relief and GSK, you can find out more about the project here.

Speaking up for Ebola survivors in Sierra Leone

2017-08-07T14:40:57+00:00

Abass became a voice for Ebola survivors across Sierra Leone. Allieu Sesay tells his ongoing story.

Holding his baby daughter in his arms, today Abass looks like any other proud father. But when we first met three years ago, at the peak of the Ebola epidemic in Sierra Leone, it seemed hard to imagine this day would come.

Then I was spending nearly every day making radio programmes to share life-saving information to stop the virus spreading. Abass was volunteering at a health centre in Freetown. As an Ebola survivor he had some immunity to the virus and wanted to help other patients.

When Abass told me his story – I was appalled. His wife Fatima had lost both parents to Ebola and most of her extended family. Their six-month-old baby had died in the epidemic.

Like most survivors, he was suffering serious health complications and most painful of all – discrimination and isolation from society.

I asked him to speak on our radio programme to represent survivors, showing listeners their point of view and their daily struggles.

How media fought Ebola

When the World Health Organisation (WHO) declared the Ebola outbreak an international public health emergency, we were already challenging misinformation and confusion in our discussion programmes, public service announcements and by training journalists across the country. We created “Kick Ebola”, a radio magazine programme and later Mr Plan Plan – a radio drama in local languages.

Radio programmes could reach large numbers of people, help them understand how to protect themselves and highlight how traditional practices – like caring for the sick or washing the bodies for traditional burials were killing people.

But increasingly it became important for ordinary people like Abass to say what they were going through - to have a voice – and most importantly for others to listen.

On-air counselling

Abass agreed to talk to a counsellor on air, helping others understand the devastating consequences of the stigma he faced. To help change perceptions we also invited a doctor to explain that you cannot catch Ebola by touching a survivor.

Through his bold statements and courage, he became an advocate for the needs of survivors. "Anyone who survived Ebola was a miracle at that time," he says, "but it was not easy for me and other people."

After the outbreak was declared over, and the government announced plans to restore essential services, we created a successor programme Wi Di Pipul (We The People). We reported on the country’s health, education and social care sectors, giving people information about their rights and entitlements. Read more about the impact of the programme here.

In Abass’s case, this meant getting the surgery he needed to address his health complications caused by Ebola, "I was unable to urinate and I was afraid of problems with my kidney," he said. He also helped keep up the pressure for the government to deliver on other promises – including providing free healthcare for survivors and pregnant women.

The road to recovery

Three years since the declaration of a public state of emergency - my country is slowly recovering.

And three months ago Abass and his wife welcomed Huratu Patricia, the baby daughter they longed for. They were fortunate to benefit from the free healthcare for pregnant women.

The road ahead isn’t easy. Abass’s health problems continue and make it hard for him to find employment. He is one of more than 4,000 survivors suffering from post-Ebola syndrome. Symptoms include joint and muscle pain, blindness, and neurological problems. Many people are still stigmatised and rejected by their families and communities, and struggle to find a way back to how their lives were before the epidemic.

As Wi Di Pipul comes to an end this month. I’m proud of the work we’ve done to give people a voice but know it is more important than ever for survivors to continue to be heard.

We need to continue amplifying their needs and concerns to help them rebuild their lives and build a future for Huratu Patricia and her generation. Let’s talk about what will happen next.

Allieu Sesay is the Head of Production for �� Media Action in Sierra Leone

�� Media Action is not funded by the �� licence fee and depends on the generous support of donors. Help support our work.

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�� Media Action’s work in Sierra Leone

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Love in the time of Ebola

2015-11-03T16:45:53+00:00

It’s not a stretch of the imagination to consider the potential risk posed by global health threats to us all. We’ve just seen how Ebola impacted the region of West Africa and scared people much further afield. We also remember SARS, bird flu and others, and then there’s the prospect of bioterrorism. As the eminent epidemiologist Larry Brilliant says, outbreaks are inevitable but pandemics are optional. He asserts that the difference between an outbreak and a pandemic is the speed and effectiveness of the response.

Last week, a group of experts gathered at the Rockefeller Foundation’s historic Bellagio Center in northern Italy to talk about the distinct role that communication plays in response efforts to global health crises. I was privileged to be a part of this group that was asked to envisage a future where the international community can be better prepared for outbreaks.

It’s an issue made all the more salient by the Ebola crisis. Media and communications provided life-saving information and a place for at-risk communities to interact with health and government officials, but it also helped to perpetuate rumour and misinformation, fuelling risk which spreads the virus.

Why is communication often overlooked in an emergency response? It can encourage positive behaviours to mitigate risks, provide locally relevant information when emergencies arise, and provide a platform for greater accountability in service provision.

Time and again we see that the first initiatives are to move in with treatment facilities, medical personnel and equipment. Communicating with the affected and at-risk communities is often an afterthought.

This may be because being seen to respond is as important as responding. It’s easier to demonstrate that something is being done when you can count the number of doctors deployed or protective gloves distributed. However, the perilous journey from outbreak to pandemic is determined by more than just the availability of diagnostic and treatment facilities.

We saw with Ebola that families would ignore calls to seek treatment for symptoms or abstain from traditional burial practices, not because of the lack of health equipment or burial teams, but because of behavioural determinants that can’t be easily measured or shipped in a logo-stamped container; things like love, fear, judgement and faith.

For example, we understood that many who conducted unsafe traditional burial practices, such as washing a corpse, did so even though they knew it was risky; the alternative meant sending a loved one off without proper care, consigning them to an undesirable afterlife and possible negative consequences for those left behind.

Even in a health crisis as dire as Ebola, we need to be compelled to access health services on a rational and emotional level. The principles of supply and demand apply. This is also famously apparent in the global attempts to eradicate polio. A vaccine is readily available, but getting people to accept the vaccination is the last – and highest – hurdle.

Here’s where communications has a critical role to play. Well researched and designed social and behaviour change communication, along with amplifying trusted voices from the affected communities, can help to address the barriers and facilitators to desired behaviour. One of the main conclusions coming out of the Ebola crisis is that community engagement helped stem the spread of the virus.

The Bellagio group agreed that to prepare better for future public health crises, communication should be integrated into global resilience and response strategies.

A perceived barrier in this is that some who determine global response priorities and budgets still require convincing that communication inputs are essential.

Our shortcoming as a field is that we need to improve the evidence base that shows investing in communications actually helps prevent further human suffering and fatalities. Luckily, �� Media Action has something to contribute here. We recently published a research report, Humanitarian broadcasting in emergencies, which examines the state of the evidence in emergency communications and presents case studies covering responses to the Ebola epidemic, the earthquakes in Nepal this year and other emergencies.

Conducting robust research in a crisis is part of the challenge, marked by a lack of access to affected communities or baseline data, and time and resource constraints. There are also clear ethical considerations: it wouldn't be acceptable to set up a counterfactual or control group that would not receive aid.

As a result we need to be creative and try new approaches. �� Media Action experimented with SMS polls to measure the impact of our Ebola radio programmes in West Africa at a time when randomly selected household surveys would have been unsafe and inappropriate. These polls revealed that radio helped inform and influence preventive health practices and showed that listeners valued hearing solutions from local voices across the region.

My hope is that those who are working on the reform of the international community's response to global health emergencies see communication as aid. I thank the Rockefeller Foundation for making the issue of communications in resilience and response a priority and hope that our combined efforts help prevent the next pandemic.

Research report: Humanitarian broadcasting in emergencies

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Ebola: audience research by mobile phone

2015-04-14T15:22:49+00:00

As we tentatively celebrate the recovery of Beatrice Yardolo, the last known Ebola patient to be discharged from a treatment centre in Liberia, �� Media Action continues working on programmes and training across the region to ensure Ebola is minimised.

Radio programmes like Kick Ebola from Liberia have played a crucial role in stemming the outbreak. But how could we measure this when the normal methods of audience research – face to face interactions with listeners – were off limits?

Human to human exchanges

The Ebola virus outbreak was at its peak when the first episodes aired. Programmes like Kick Ebola from Liberia encouraged people to avoid close physical contact – since Ebola is passed on through bodily fluids. Our usual research methods were therefore potential risk factors for contracting and spreading a highly infectious disease.

Finding solutions

In the face of this challenge, we opted to use a mobile phone survey to reach our audience in Liberia. The first round of data showed Kick Ebola from Liberia reached 85% of those surveyed. While we accepted this methodology meant we could only reach those Liberians with access to a mobile phone (estimated to be 42%), it would still provide very useful data in challenging times. Over 80% respondents found Kick Ebola from Liberia highly relevant, trustworthy and a platform to voice their concerns with 91% taking life-saving action, such as avoiding physical contact and washing hands.

Learning and ongoing conversations

As Kick Ebola from Liberia continues, we anticipate further rounds of mobile surveying along with carefully considered focus group discussions.

We’ve learnt a lot, and importantly, we’ve gained vital mobile phone survey experience, a research method to deploy in situations when human contact needs to be minimised.

Related links

More on �� Media Action Ebola work
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By bike, by bus and by boat: Our Ebola radio show’s incredible bi-weekly journey across Sierra Leone.

2015-02-26T11:23:13+00:00

Cars travel on a road just outside of Freetown, Sierra Leone

What do a priest, a boat, a bus and a bike have in common? Despite sounding like the start of a bad joke this is in fact an important part of our strategy for circulating and transmitting our life-saving Ebola information radio programmes to stations across Sierra Leone.

Brown paper packages

While most �� programmes are sent down ISDN lines or shared via storage systems backed by huge servers or cloud-based systems, we dispatch our programmes on CDs in brown paper packages.

Internet connections are too slow, too unreliable and in the smallest and most remote radio stations – non-existent. Our partner stations stretch from the island of Sherbro in the south of Sierra Leone to the rural borders of Guinea and Liberia and no single commercial courier covers the whole country. And even if it did Ebola-related travel restrictions make it logistical headache to deliver the programme safely and on time.

Though Sierra Leone has successfully emerged from the decade-long civil war and is developing its infrastructure tricky transport links and pot-holed dirt roads muddied by heavy rains mean a long and arduous journey for anything sent by post.

Canoes used for fishing

Under these difficult circumstances, ingenious ways are found on a bi-weekly basis to deliver radio shows to partner stations using every means of transport available. Our creative selection of options includes rickety motor bikes, cantankerous commercial buses, ancient jeeps supplied by a friendly NGO – and for one radio station based on an island - canoes normally used for fishing.

Father Mansaray

One marathon journey to distribute our Ebola-response radio programme Kick Ebola from Sierra Leone starts out at a lorry station in the capital, Freetown; the CD is then passed to a priest named Father Mansaray in the bustling city of Magburaka; the package then hitches a ride on a bus from the once Ebola-quarantined city of Makeni and ends up at Radio Bintumani in the far reaches of northern Sierra Leone. In total, the radio show travels over 450km over two to three days – every single week.

We encounter all sorts of obstacles. We’ve missed connections for buses which leave only every couple of days; during heavy rains, packages have been lost after delivery cars literally sank into sticky mud; and last month, we were prevented from driving into an Ebola-quarantined town by authorities. But by hook or by crook, we’ve still managed to deliver the programmes – albeit (and understandably) – sometimes a few days late.

It’s not just Ebola awareness programmes that embark on the bi-weekly tour of Sierra Leone. Through radio, �� Media Action in Sierra Leone is helping address women’s legal rights, re-build farming skills damaged by years of civil war; encourage debate and accountability before elections; and we have facilitated journalistic coverage of the Sierra Leone-based trial of former Liberian president, Charles Taylor.

So what do a priest, a boat, a bus and a bike have in common? It’s actually no laughing matter. Against the odds, they are all helping us to get life-changing radio programmes out to communities across Sierra Leone.

Related links

A dramatic approach to Ebola

2014-12-29T11:27:58+00:00

I recently spent a week away from my home in Bradford, in the north of England, working with a team in London on scripts for a new �� Media Action radio drama for West Africa called Mr Plan-Plan and the Pepo-oh. Our focus is Ebola and our aim is to use familiar characters and situations to help people feel confident about getting early treatment for Ebola Virus Disease (known as just “Ebola”) and ensuring safe burials when someone dies.

It was an international effort – I’m Liberian, and I worked alongside colleagues from Guinea and Sierra Leone, and a creative team from India helped us with storylines. The scripts were produced in both French and Liberian English in order to reach as many people in the region as possible.

These new mini-dramas bring together three strands in my own life: I’ve studied nutrition and public health, I’m a nurse and midwife by profession, and I’ve also been broadcasting health related programmes for sub-Saharan Africa for some years in my show Calls to My Sister.

Calls to My Sister is based on the telephone conversations I really have with my own sister in Liberia where, in addition to chatting, I share advice about nutrition and hygiene. I realised this kind of information could be helpful for others, and so turned our conversations into scripted dialogue that I record with another actor. Our weekly show is sent to radio stations across West Africa. One time I was talking to my real sister on the phone when she suddenly stopped talking and held her radio to the receiver. I could hear Calls to My Sister in the background!

I know how well drama works – it enables you to bring up topics that might be taboo and the listener isn’t being “told” what to do. So I was delighted to be invited to take part in this new �� Media Action project on Ebola response. Radio is terribly important in sub-Saharan Africa. Young people do increasingly have mobile phones but radio is how people get their information and news.

Before I got the call to help out I was getting very frustrated that I wasn’t doing enough to help tackle the problem back home (with a Guinean ancestry, a Sierra Leone name and a Liberian nationality, I’m rooted in the region). There is sometimes friction between the need to stop the spread of Ebola and observing age-old customs. For instance I heard that members of an official burial team [a team recruited by local officials to dispose of the bodies of people suspected of dying of Ebola] in Guinea had been attacked by the relatives of the deceased.

The people grieving didn’t understand what the team needed to do in order to ensure Ebola was not transmitted to anyone else. The bodily fluids of someone who has died as a result of Ebola are very infectious – but not to be able to spend time with the corpse and to touch it goes against local tradition. Without access to information people just don’t understand what to do or why to do it.

Liberia was only just starting to recover from the civil war when Ebola struck. I’m glad to be able to play a small part in helping the country beat this latest threat and to take part in these new Ebola response dramas as both an actress and scriptwriter. I thank God that my real sister and her family are ok so far and I pray that with the help of these programmes and good practices they, and many more, will stay well.

Listen to a Mr Plan-Plan and the Pepo-oh episode on Soundcloud.
Read another post about Mr Plan-Plan and the Pepo-oh on the �� Media Action Blog.
Go back to the �� Media Action website.
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A man with a plan: using drama to tackle Ebola

2014-12-19T09:57:27+00:00

In the three countries most affected by Ebola, information and communication play an important role in curtailing its spread. There is a lot of information out there, from posters displaying symptoms, to celebrity-featured public service announcements and Ebola songs. In the early phases of the crisis, communication focused on the fact that Ebola is real was important when denial was a barrier. Now, there is a much needed emphasis on providing two-way communication and highlighting survival stories to address misinformation, hopelessness, fear and stigma.

But what other gaps exist in people’s knowledge or what else can communication do? How can communication motivate people to take action? Besides advising people on hand washing, much of the communication to date hasn’t been action-oriented, especially for those who haven’t directly been affected by Ebola. We wanted to change that. It was important to us that what we communicate is practical and actionable.

Much of the communication to date has focused on what not to do: don’t come into contact with sick people’s bodily fluids, don’t wash the bodies of your deceased loved ones and so on. It’s difficult to see what action you can take if you aren’t currently facing that exact situation. What should I do if no one in my family is sick, besides washing my hands constantly whenever I’m in public? Is there anything else I can do to prevent the spread of Ebola to protect myself and my family?

Ebola has created an emergency-like situation for communities at higher risk. In the event of an emergency, what are we always told to do? Whether we are airline passengers or live near an earthquake fault line, we are told to be prepared. To be aware of what we can do should something go wrong. To have a plan. Having an emergency plan helps people deal with difficult decisions that have to be made in the heat of the moment, decisions that are often made in the presence of fear and panic.

Our task was to build a convincing case for "having a plan" that could stop the spread of Ebola. Experts currently agree that at this time, communication efforts need to focus on two broad goals: promote the need to seek treatment as soon as an individual experiences Ebola-like symptoms and practice safe funeral and burial rituals. We want to encourage our audiences to have an emergency plan for their family where they know what to do should a loved one fall ill or die. We know these are difficult and often taboo discussions. Having a plan, we hope, will encourage families to feel more prepared and in control in these scary and uncertain times.

We decided to use the power of drama, because drama can portray the conflicts and challenges people are confronting when faced with Ebola. This was the genesis of Mr Plan-Plan, our main character. Mr Plan-Plan is an itinerant trader, a wise fool, who champions "having a plan". He presents stories of what he sees around him: families torn over what to do when someone falls sick, friends misunderstanding each other, relationships being threatened, emotions boiling over, communities fighting to hold on to tradition and rituals. In Mr Plan-Plan and The People, a series of six mini dramas, we see how a plan helps people navigate their way through Ebola.

Mr Plan-Plan and The People has been produced in three languages: French (Guinea), Liberian English (Liberia) and Krio (Sierra Leone) and will be aired over our network of partner radio stations across the three countries over the Christmas and New Year period. This is a particularly salient time given Sierra Leone has cancelled holiday celebrations to avoid further spread of Ebola. The drama is part of a �� Media Action initiative to use media to reduce the spread of Ebola in Guinea, Liberia and Sierra Leone and to prepare ten neighbouring countries with training on media and communications.

The work is funded by the Paul G Allen Foundation.

Go back to the �� Media Action website.

Listen to the Mr Plan-Plan radio trail.

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Fighting Ebola: now it’s personal

2014-12-15T16:41:32+00:00

I have a strong bond with my mother and we are often in contact. She lives in the city of Makeni, northern Sierra Leone and I live in the capital, Freetown, a two hour drive away.

When she called me in September, in tears, I knew something was very wrong. “My family is being wiped out,” she told me, barely able to get her words out. Since August - in just a matter of weeks - 16 of our family members living in the town of Port Loko had died. They lived very close to one other in a densely populated area.

There were rumours of witchcraft. People were saying a “witch plane” had crashed and this had led to the deaths. A “witch plane” is quite difficult to explain but people think it is basically a form of supernatural “flight” that only those involved in witchcraft can see. Many people, including my mother, believed this is why my family had died.

I was frightened and depressed by my mother’s phone call. For the past six months, I’ve been producing radio programmes to give people information about the Ebola virus and encourage them to follow healthy behaviour related to prevention and treatment.

I strongly suspected my uncles, aunts and cousins had died of Ebola. It took me all my powers of persuasion to convince my mother not to visit her family, not to go to a burial or to touch any dead bodies, until I found out more.

Conflicting information

What I discovered upon contacting old friends, medical people and fellow journalists in Port Loko, shocked me. Even enlightened, educated people were talking about witchcraft, saying my family was cursed.

What really happened is as follows. My cousin, a woman in her early twenties, went into hospital in August and was later discharged. She died days later. Her mother who had cared for her during her illness also fell sick and died; her aunts who had washed her body died. Everyone who had come into contact with her died one after another. We later heard the nurse who had treated my cousin at the hospital was also dead.

I couldn’t – and still can’t - shake off the feeling that people were dying because of ignorance. People in Port Loko had heard of Ebola but the information they were getting was conflicting and often highly politicised. They just didn't know who to trust.

So I tried to change this. Before the Ebola outbreak, I had worked as a community radio mentor in Port Loko so I knew the local dynamics. I set about making a public service announcement (PSA) that would get through to people.

Finding the right person to deliver the PSA was crucial and I chose someone who could speak the local dialect whom people would respect. We then broadcast it through partner radio stations.

Helping to save lives

The words in the PSA were simple: “Please don’t fool yourself; the officials can help us – if people get sick, please report them to local health officials.” It was powerful because it was delivered with passion.

People called to thank me, saying the PSA was helping to save lives. The manager of Radio Bankasoka, Port Loko’s community radio station was in Freetown recently and made a special visit to our office to say that people were sending in SMS’s and calling in to find out more.

This experience has convinced me that it’s not just about giving information, but how it is given and who is doing the talking. I also know that advice needs to be repeated and reinforced.

I take my own advice. I tell my mother she must call me when she hears of someone displaying Ebola symptoms. That way, I can remind her that Ebola is a disease – and there are ways in which she can help to protect herself and others. However strong her instinct is to help, I tell her, she shouldn’t rush in blindly to help but she should listen to health advice, take precautions and encourage people to seek treatment.