Since the Ebola epidemic began in Guinea last December, the virus has claimed close to 4 000 lives and infected more than 7 000 people, most of them in West Africa. Liberia, Sierra Leone and Guinea have been hardest hit, with lock-downs imposed and armed forces called on in an attempt to stop the spread of the epidemic.
In neighbouring Côte d’Ivoire, which has not been affected yet, bloggers are proactively using social media in a bid to keep Ebola at bay.
“It is important to have a good hygiene”, a young woman in a YouTube video explains,” so I let myself lather against Ebola now!” She takes a deep breath and presses her lips together. Next to her, a man lifts a large plastic bucket. In one fell, he pours the frothy content over her head. Soaking wet and laughing, she lets out a squeaky cry.
Edith Brou, a popular Ivorian blogger, started the “Mousser contre Ebola” (Lathering against Ebola) campaign to raise awareness about the virus. Inspired by the very successful Ice Bucket Challenge, she initiated a local version on YouTube: with soap instead of ice and hygiene items instead of monetary donations. The foam shower’s principle is simple: by accepting the challenge, you must give three soaps or hand sanitizers to friends. If a person rejects the nomination, he is ‘punished’ by having to distribute nine hygiene items to people around him.
Since the campaign started in mid-August, it has triggered a veritable wave of lather on social media under the hashtag “#MousserContreEbola”. In a swimming pool, a bathtub, or on a roof – more than 50 people already have taken up the challenge. On her website MoussercontreEbola, Brou collects videos and photos from participants and provides important information about the world’s worst Ebola epidemic.
Edith Brou, blogger and founder of the Lather against Ebola challenge. (Pic: Supplied)
Of course, she also received negative responses to the challenge, Brou says. Some people thought it “useless or ridiculous”. But as many people in the country do not believe that Ebola really exists, it is particularly important to raise awareness. Despite the government’s prohibition, some Ivorians still continue eating bush meat. Others trust in God to protect them or repress their fear from the virus with humour. Côte d’Ivoire really is very close to the danger, Brou says. “The virus can arrive at any time.”
Another Ivorian blogger, Florent Youzan, has created a free interactive map for the prevention of Ebola. On it, “proven cases” in Guinea and Liberia, two neighbouring counties that are severely affected by Ebola, are featured. An orange marker is in the middle of the map: “On Saturday, August 30 2014, a suspected case of Ebola struck fear into Yamoussoukro, the political capital of Côte d’Ivoire.”
Youzan’s map also tells users about sensitisation and prevention activities organised in the country. In the village Kandopleu, in the west of Côte d’Ivoire, the government simulated an Ebola case to practise for an emergency. The Red Cross sensitised the population in the regions near the borders with Guinea and Liberia.
Reggae Stop Ebola, a reggae-style song, has been doing the rounds on social networks for several weeks.
A young man dances in the streets of Abidjan and sings, “You get very high fever, fatigue, headaches, nausea, diarrhoea and vomiting. You cough heavily and you start bleeding. Watch out brother, this virus is dangerous!” Taking an official communication by the government, journalist and blogger Israël Guébo rewrote the text into simple, accessible French and incorporated reggae music for a catchy tune.
“Every citizen should contribute to sensitisation against Ebola”, he says. He sees music as a simple and efficient way to reach a wide range of many people. A mobile operator already offers Stop Ebola already as a ringtone. Alongside the official version in French, Guébo published versions of the song with German and English subtitles. His goal is to have the song heard across all bars, restaurants and taxis “to delay to a maximum” the arrival of the virus in Côte d’Ivoire.
Tanja Schreiner studied journalism and communication in Germany and France. She has lived in several African countries and currently works in Côte d’Ivoire. Connect with her on Twitter.
A woman walks past a billboard promoting male circumcision to combat Aids in the capital, Harare. (Pic: Reuters)
Seated on a bench in a clinic in Harare, Taenda Tavira (not his real name) waited patiently for his turn. As he entered the consultation room, the nurse asked: “How can I help you, young man?” Tavira didn’t know where to begin but he managed to point at his pants, mumbling something. Annoyed, the nurse snapped: “You are not the only one to be served, don’t waste my time.”
The young man gathered himself and with difficulty said he thought he had contracted a sexually transmitted disease. As he removed his pants in front of the nurse, she shouted: “I knew when you entered that something is wrong with you! Are you a man or a woman?” Stunned, Tavira pulled up his pants, walked out of the room and never went back.
This wasn’t the first time he was treated this way.
“I, like every other gay person, has to give in to a lot of insults and degrading inhuman utterances every day,” Tavira confides after relating the recent incident. He is open about his sexuality and the discrimination he faces at the hands of health personnel in Zimbabwe.
For Zimbabwe’s LGBTI community, disclosing one’s sexual orientation is a major barrier to getting accurate, appropriate and relevant medical treatment. Gays and Lesbians of Zimbabwe (Galz) is an organisation that works to protect the interests of this minority group in the country. Its programmes manager Samuel Matsikure highlighted that as Zimbabwe’s leadership has openly denounced homosexuality, discrimination and stigma against the LGBTI community goes unpunished and will take a long time to uproot.
President Robert Mugabe has made it clear that homosexuality will never find a place in Zimbabwe. “Homosexuality degrades human dignity. Its unnatural and there is no question of allowing these people to behave worse than pigs and dogs … If you see people parading themselves as lesbians and gays arrest them and hand them over to the police,” he said in a speech at a Harare book fair in 1995. More recently, he maintained that “gays have no human rights” and reportedly called for the arrest of gays and lesbians who don’t conceive children.
This state-endorsed homophobia has made it difficult for Galz to get HIV and Aids prevention messages out to its 2100 members and the LGBTI community at large, who face a backlash from government and society and receive no support from public health institutions. About 15% of Zimbabwe’s adult population is living with HIV and Aids. There is currently no data available on the LGBTI community specifically.
“The hostile environment the gay community is exposed to, especially at health facilities in the country, has impacted negatively on their rights to basic services such as health,” Matsikure said. “Some have been keeping sexually transmitted infections for six to eight months without seeking help.”
“Such discrimination and stigma at the highest level makes our lives difficult and we remain a secretive and isolated community always fearing for our lives,” Tavira added.
Zimbabwe’s Constitution promotes universal access to health, enabling every person, regardless of their sexual orientation, to be treated with respect and have access to healthcare and support. The every day reality, though, is very different.
In a bid to address this, Galz has engaged the Zimbabwean government, the National Aids Council (NAC) and Zimbabwe Doctors for Human Rights to educate them about the LGBTI community.
“We have held sensitisation workshops with stakeholders to root out ignorance and misinformation associated with the LGBTI community. Hostility, and beliefs systems deep rooted against the practise of same sex relationships in the country will need to be reversed,” said Matsikure.
While Zimbabwe’s Constitution stipulates healthcare for all, it also outlaws same sex marriages. The gay community continues to be marginalised, making the fight against HIV and Aids all the more difficult. “The intersectionality of HIV and Aids between the broader heterosexuals and LGBTI community is a reality. If we are to reduce or end new infections, end deaths from Aids, end stigma and discrimination in Zimbabwe no one should be left behind,” said Matsikure.
Sally Nyakanyanga is a freelance journalist and media trainer based in Zimbabwe.
Famine has been staved off for now by the efforts of many agencies and the biggest ever UN humanitarian operation in one country. (AFP)
Water bottle in hand and rucksack on back, his grey trousers rolled up to reveal spindly legs, 12-year-old Gatwech boarded the first flight of his life. His ear protectors dwarfed his head as he gazed wide-eyed through the window of the Russian-built UN helicopter that lifted into the sky, sweeping over lush plains and thick forests.
Gatwech crossed the invisible frontlines separating government and rebel forces in South Sudan’s civil war. Finally, the aircraft came in to land on a ringfenced field in the village of Akobo, deep in opposition territory, and the boy strained to look at the excited crowd waiting under trees. He was about to be reunited with his family for the first time after nine arduous months in a displacement camp.
His best friend beamed, his aunt sang and wept and spat as a blessing, and his uncle gave him a rather formal pat on the head. Gatwech was safe at last. But in the world’s newest and hungriest country, every gain is tentative and every haven fragile. Three days later, there was chaos outside the hospital in Akobo when a cattle thief was bound, chased and whipped by a lynch mob of soldiers, police and vigilantes, including rifle-toting children.
The febrile atmosphere is a sign that the rainy season is coming to an end in South Sudan, raising the prospect of renewed fighting. Aid is working here but diplomacy is not.
Famine has been staved off, at least for now, by the efforts of numerous agencies and the UN’s biggest ever humanitarian operation in one country. Yet bad-tempered peace talks between the warring parties have stalled, agreements have proved hollow and the international community has failed to apply the requisite pressure. The intransigence of two men, President Salva Kiir and rebel leader Riek Machar, is seen by many here as dragging the country towards the abyss.
Thousands have been killed and nearly two million have fled their homes since their war broke out last December. Oxfam and other agencies have warned that an expected upsurge in violence could wipe out recent gains in food security and push the number of severely hungry people up by a million in the first three months of 2015. Describing it as a shift from crisis to catastrophe, they say parts of the country could slide into man-made famine early next year.
A dangerous life
Children, who make up half the population, suffer the most. When the war started, Gatwech – not his real name – ran for his life after government forces attacked the town where his close family was staying. He was carrying a pair of shoes. “I thought my parents were also running,” he recalled, speaking Nuer through an interpreter. “But when I reached the UN camp, they were not there and I thought maybe they were killed. I was very afraid because I heard a lot of gunshots and artillery.”
Nearly 100 000 people are crammed into UN compounds across the country for their own protection, often in inhumane and unsanitary conditions. Gatwech found himself sleeping on a mat on the floor. “I didn’t have anything to do. It was boring. The day was very long,” he said. The boy, who hopes to become a doctor one day, also witnessed attacks on the camp from government troops. “It was a dangerous life. I saw a lot of dead bodies.”
But months later came the news that Gatwech’s parents had been located in Akobo by a family tracing and reunification programme coordinated by Save the Children. It is long, complicated and logistically difficult work: at present 5 660 children have been registered as missing in South Sudan and only 393 reunited with their families. “It’s a needle in a haystack,” one aid worker said.
When Gatwech landed in Akobo last week, his friend Isaac was there to greet him in a crowd of villagers and wandering cows. The 13-year-old said: “I was very happy. I missed him. We weren’t optimistic because we thought in the long run the only way he would come is when there is peace in South Sudan.”
And peace remains a distant prospect, with Kiir and Machar seemingly hellbent on a military solution. Kiir told the UN general assembly last month: “The conflict in South Sudan is purely a political struggle for power, not an ethnic conflict as reported.” Yet violence has broken out along ethnic lines in many parts of the country, pitting forces loyal to Kiir, a Dinka, against those of his former deputy Machar, a Nuer.
Economic self-interest is also fuelling the conflict. A report last month by the Enough Project noted: “The country’s competing privileged elites are sacrificing their own people’s lives to secure the political and economic benefits – including massive state-corroding corruption – derived from control of the state.”
Political and military leaders maintain “lavish homes” in Kenya, Uganda, Ethiopia, South Africa and Australia, the report continued. “Families of the leaders of South Sudan’s warring parties are living in neighbouring countries and their children are attending the finest schools available. Meanwhile, the education system back in South Sudan has collapsed.”
Ammunition sources
The Enough Project said the South Sudanese government had received $38-million in weapons and ammunition from China since the start of the civil war, while there is evidence that opposition forces may have been resupplied with ammunition by Sudan, from which the country gained independence in 2011.
Akobo, a remote cluster of tukuls, or mud huts, in Jonglei state, near the Ethiopian border, was the scene of an infamous massacre in 1983. Last December young Nuer men stormed a UN base looking for Dinka civilians sheltering inside and killed two Indian peacekeepers. Since then the village has been overwhelmed by displaced people, putting pressure on food, schools and hospitals, and driving market prices up. Mobile phone networks have been cut off by the government.
Akobo is now firmly controlled by the rebels, who include large chunks of what used to be the national army, and in the central market there is a sense of something approaching normality. But few expect it to last. Koang Rambang, the county commissioner, predicts famine and even genocide. “Akobo is the first town the government are targeting because they consider it a supply route and escape route for the community,” he said. “We’ll do our best to make sure citizens are aware of the threats they are facing.”
Talking into a satellite phone and flanked by soldiers wielding guns, Rambang is now firmly in Machar’s camp because, he says, it is the pragmatic choice. “People call us the rebels but this is the resistance movement to the onslaught, the killings by Salva Kiir. I have no interest in rebelling to go running in the bush for no reason. But if someone wants to kill me because I am Nuer, then I have no choice. I am ready for peaceful solution but if people choose to go forcefully, I am also ready for that.”
In predominantly Dinka areas of South Sudan there are similar accounts of brutal treatment at the hands of the Nuers and hostility towards Machar. In Akobo, it is the Dinka president who is deeply unpopular. Rambang said, “The communities have no trust in Salva Kiir’s leadership. The solution to this crisis is to have Kiir step aside and let some change happen. The other party might want Machar to step aside. I’m sure Machar will compromise because I have spoken to him several times.”
The war has caused a surge in child brides, according to Rambang, with families pushing girls as young as 13 into marriage so they will receive a cattle dowry. But the biggest crisis in Akobo, he says, is food security. Harvests, markets and trade routes have been disrupted. One in three children are acutely malnourished, with consequences including increased vulnerability to malaria and failure to attend school.
Outpatient centres
The village borders a river where children splash and play and climb trees, exotic blue-and-red birds swoop low and lone canoeists gently push through a surface almost as smooth as glass. It takes 45 minutes on a motorboat to reach the village of Dangjok. Here soldiers stand guard, bullet belts around their shoulders, the Nuer initiation pattern of six parallel horizontal scars on their foreheads. The local chief works at a desk in a gloomy corrugated shed where rocket-propelled grenades litter the floor and bats hang from the wood beams.
Save the Children and a local NGO, Nile Hope, are running an outpatient therapeutic centre where, in a modest building of mud walls and thatched roof, malnourished babies are registered, weighed, measured for height and arm circumference and given the peanut-based paste Plumpy’Nut or, in severe cases, referred to hospital for urgent treatment. Right now the preventative measure appears to be working, with hospital admissions down to single figures.
Nellie James, assistant nutrition coordinator at Nile Hope, said some mothers carry their children for two hours to be here. “None of them give up. These mothers are very strong and very determined. Here in Akobo people value children more. A mother can go two days without eating but the child has to eat.”
Among more than 30 mothers waiting their turn last week was Nyanhial Ruot, who fled the city of Malakal nine months ago. She was on the main street when government tanks opened fire. “Children were crying,” she recalled, wearing a rainbow coloured dress, sandals and yellow headscarf patterned with a red rose. “I’ve seen people dying in front of me. Most of them were mothers and children who were not able to run. We turned left and that’s why we’re alive. Those running in front were killed.”
Ruot, 25, and her family trekked for two months to reach Dangjok, but now her four-year-old daughter and two-year-old son are suffering vomiting and diarrhoea. “I’m worried about my children’s lives,” she said. “Before the crisis we got medicine in the market. Now there is none or the prices have gone up.”
A small paracetamol tablet has risen in price from 10 to 25 South Sudanese pounds (roughly $3 to $8), she complained. Food is also scarce. “We have planted some sorghum and maize but there is not enough for the children. In the dry season we collect fruits, grasses and leaves.”
That Ruot and hundreds of mothers like her are receiving help, and that South Sudan is not yet officially in famine is a notable victory for the aid agencies. Ultimately, however, it is only a sticking plaster. One in seven people are still at food crisis or emergency level and 50 000 children could die by the end of the year. All the good work could be undone if Kiir and Machar fail to make peace, or are not compelled to do so. The Enough Project has called for punitive measures including seizing the homes, bank accounts and shell companies of anyone undermining the peace process.
Tariq Reibl, head of Oxfam’s programme in South Sudan, said: “If famine comes to South Sudan it will come through the barrel of a gun. This is a man-made crisis, not one caused by the vagaries of the weather, and though humanitarian aid is vital it cannot fix a political problem.
“The international community is much better at saving lives than it is at helping solve the political problems that put lives in peril. Nine months of the softly-softly approach to peace negotiations has failed. If the international community really wants to avert a famine then it has to make bold diplomatic efforts to bring both sides to end the fighting.”
When an Internet message announcing a salt water solution for Ebola went viral in July, many Nigerians were quick to take heed. Twenty people were hospitalised and two died, reportedly from an excessive intake of salt.
Madam Franca was among those ready to believe in the power of salt water. “My niece, who happens to be a nurse, sent me an SMS that early morning, and I obeyed it,” Franca explained. “I had to do anything to stop Ebola from coming close to me. I bathed with salt water, morning and night for two good days, but I did not drink. I am hypertensive. I also sent all my family and close friends the SMS.”
Nigerians watched with growing unease as the Ebola outbreak spread through Guinea, Sierra Leone and Liberia. Few believed the creaking health infrastructure or the government’s managerial skills would be able to survive such a test. So when Ebola-positive Liberian Patrick Sawyer stepped off a plane in Lagos airport on 20 July, collapsed and died, social media exploded.
But it was not just the salt water claims and bogus pastors promising salvation that made the running: government agencies and proactive individuals also took to the internet to quickly debunk the rumours and offer proper advice. The authorities also threatened to arrest anyone spreading falsehoods, starting with the salt water “cure”. There was, after all, a plan in place.
A mass audience for messages
At 67 million users, Nigeria reportedly has the eighth largest Internet population in the world. It also had close to 166 million mobile subscribers as ofJune. (The country’s population is 175 million.)
With so many Nigerians online, portals like ebolalert.org set up by volunteer doctors, and the public/private ebolafacts.com initiative, have become important channels to provide accurate information to help people stay safe. They complement telephone hotlines and more traditional public health approaches.
The UN Children’s Fund (Unicef) has also taken a role in the communications work on Ebola, using the SMS portal UReport. UReport Nigeria is a free SMS platform designed as a community-based two-way information exchange mechanism. According to Unicef communications specialist Geoffrey Njoku, over 57 000 people received more than 3.6 million SMSes containing key messages about Ebola and how to stay protected over a six-week period.
Comfort and confidence
For some who have used the service, like Dr Adoara Igonoh, an Ebola survivor, the advice given offered reassurance and quelled fears. “I began to think about my mother,” Igonoh recalled. “She was under surveillance along with my other family members. I was worried. She had touched my sweat. I couldn’t get the thought out of my mind. Hours later on Twitter I came across a tweet from the WHO [World Health Organisation] saying that the sweat of an Ebola patient cannot transmit it at the late stage [after the incubation period]. That settled it for me. It calmed the storms that were raging within me concerning my parents.”
Nigeria has won praise from the international community for its response to the outbreak. While Ebola continues to burn in Liberia, Sierra Leone and Guinea, in Nigeria it appears to have been contained with only 21 confirmed cases and eight deaths – with the last case reported on 8 September and tracing having proven effective.
“A key issue in the fight against Ebola after the provision of the necessary human and technical infrastructure is information management,” said Tochuwu Akunyii, an online writer on public policy and international development. “In information management, the dissemination of accurate information is crucial; social media can be vital in this process.” Akunyii pays particular tribute to Nigerian youth and its use of forums and platforms like Twitter and Facebook.
Social media complemented traditional media
Nigerians who do not have access to the Internet and mobile phones have not been left out of the Ebola campaign. Traditional mediums like radio, flyers, posters, village meetings and announcements by town criers are all being used. Priority is given to local languages.
Comparing the traditional methods of campaigning to social media and SMS campaigns, Nwokedi Moses, better known as Big MO, a vernacular language broadcaster with Wazobia FM, said the two approaches worked well together. “The social media Ebola campaign was massive, but it complemented the traditional media. This is due to social media’s limited reach within rural areas.”
Local authorities have also taken the initiative. The Lagos State and Rivers State governments – the only two states where Ebola emerged – incorporated traditional awareness-raising campaigns like road shows, radio and TV jingles, distributing flyers, and educating the public on basic hygiene. Since Ebola first emerged, there has been a roaring trade in hand sanitizers and a corresponding collapse in the “bush meat” market.
As Nigeria gradually returns to normal, signalled by the slightly hesitant reopening of schools on 22 September, health campaigners are moving to tackle the new challenge of ending the stigmatisation of those who have recovered from Ebola – backed by a government warning threatening action against those that discriminate.
Lagos State Governor Babatunde Fashola recently met survivors to confirm that an Ebola-free certificate means what it says. Health Minister Onyebuchi Chukwu has declared survivors the “safest people to be around”, given their new immunity to the virus.
A woman passes a sign posted in an awareness campaign against the spread of Ebola in Freetown, Sierra Leone. (Pic: Reuters)
Upon landing at Kigali International Airport last month, I peered out the window and my eyes caught sight of an official clad in protective gear standing just under a sign that read ‘Arrivals: Ebola testing’. If I had ever been removed from what has been going on in my beloved Sierra Leone, it ended in this moment. Before my flight from Washington, I was informed that we would be screened upon arrival. And there it was. Even from the window of seat 16K, I could see the measures that had been put in place to protect the citizens of the country.
After disembarking the plane and entering the airport, we stood in a queue for about 10 minutes. I noticed a form that other passengers were filling out. I asked the young lady behind me if it was for everyone. She responded “Yes,” so I moved to the counter to complete mine. It asked: “In the past three weeks have you been in the following countries: Sierra Leone, Guinea, Liberia, Nigeria, Senegal?” At that moment I felt a sense of solidarity first with Sierra Leoneans near and far, because sadly this too has become one of our realities. I also felt isolation because my entry, identity and existence were being sanctioned and questioned by a customs form. A customs form at which other travellers would not cringe; they don’t have blood from Sierra Leone, Liberia and Guinea. Even if I don’t explain to you what happened next, you would still be able to surmise what would occur naturally as a Sierra Leonean-American woman with Sierra Leonean entry and departure stamps in her US passport. As I continued filling out the form, I checked “No” on the form because the truth was I hadn’t been to Sierra Leone in the past three weeks.
I calculated: three weeks equals 21 days. Twenty one is the magic number that many African countries and people all over the world will use to promote the stigmatisation of people from Ebola-hit countries, or with any relations to them. It’s the number that would decide your fate when attempting to enter another country. It takes up to 21 days for the deadly Ebola virus to manifest itself in symptoms after one has been exposed. The incubation period, they call it.
No, I haven’t been in Sierra Leone in the past 21 days. Not physically. But in the past 21 days, my thoughts have been there. My mind has raced incessantly and my heart has jumped at the numbers. My soul has cringed at flaws that have been illustrated by this epidemic in Sierra Leone. For more than 21 days, I have certainly felt helpless.
But this customs officer didn’t exactly know how I or other Sierra Leoneans have felt for the past few months. As he attempted to look for a clear page to add the Rwanda entry stamp, he came across my Sierra Leonean visa page. He glanced at my passport and the stamps for my entries to Sierra Leone, the most recent being December 2013 to January 2014. I watched his eyes widen slightly as he turned the pages and I anticipated the questioning. It took a while for him to gather his thoughts and ask the question. “Are you coming from the United States?” Obviously, I thought to myself. “When last have you traveled to Sierra Leone?” Didn’t you already see the stamps? “What was the last date you left Sierra Leone?” I responded “January 10, 2014. And when I left, this wasn’t a problem”.
Some countries have banned the entry of citizens and passengers arriving from Sierra Leone, Guinea and Liberia – nations that have been hit the hardest by the latest Ebola outbreak. I understand caution but paranoia and, consequently, stigmatisation, are not the cures to this disease. To see a Sierra Leonean visa in my passport evidently put the official on high alert. The realisation that I could somehow be considered a ‘risk’ – not just to this man but to his country – despite the evidence before him made me feel small.
He stared at me a bit longer, as if trying to gauge whether the words I uttered were the truth. Then he asked me for my point of contact. I gave him that information. He made the decision not to call or do whatever he had considering doing. I smiled because even in the face of this ugly stigma and the horror that we know as Ebola in Sierra Leone, I am still proudly a “Salone Titi.” I thanked him, retrieved my passport, and rolled my hand luggage to begin my experience as a Sierra Leonean-American woman in Rwanda.
Bintu Musa is a globetrotting educator and writer. She is currently lecturing at Rwanda Tourism University College as a Fulbright Scholar. She blogs at Bee’s Backseat.
