In a new Q&A series, we are profiling the experts who have worked tirelessly to stop the spread of the deadly Ebola virus in West Africa and are helping societies rebuild and strengthen health systems in the aftermath of the outbreak.

Kama Garrison is a senior public health advisor for USAID’s Neglected Tropical Disease Program. ​For the Ebola response effort, she has been working on social mobilization with other agencies and partners.

What is social and behavior change communication (SBCC) and what role has it played in the Ebola response?

SBCC is the use of communication strategies — mass media, community-level activities, face-to-face communication and technologies — to influence behaviors that affect people’s health.

Within the context of Ebola, SBCC is critical to ending the epidemic. Ebola is an easily preventable disease; changing a few key behaviors can stop the virus from spreading further. And while health facilities and health care workers are absolutely essential in responding to an Ebola outbreak, the behaviors of individuals, families and communities are key to stopping it entirely.

Kama Garrison holds up the silhouette of a hand, echoing the wall of handprints from Ebola survivors at the Bong County Treatment Unit in Liberia. / Ellie Van Houtte, USAID

Kama Garrison holds up the silhouette of a hand, echoing the wall of handprints from Ebola survivors at the Bong County Treatment Unit in Liberia. / Ellie Van Houtte, USAID

But SBCC isn’t just about telling people about Ebola, warning them to stop touching those who are sick or discouraging them from using traditional burial practices. It’s about carefully understanding a community’s cultural, religious and social beliefs so we can deliver meaningful, relevant and respectful messages and interventions.

Early on in the Ebola crisis, some fear-based messages made people feel powerless, hopeless and unable to act. Effective SBCC must be founded in the target population’s belief in their own ability to succeed; we seek to develop interventions that instill hope. Now, successful SBCC interventions have been developed to engage and better educate communities about Ebola.

Why is it critical to employ social and behavior change communication in a response like this?

Human behavior plays an important role in the spread of infectious diseases such as Ebola. Therefore, understanding the influence of behavior on the spread of disease can be the key to stopping disease transmission. Even if a new medical technology such as a vaccine is developed, people still have to trust that vaccine and choose to receive it – so addressing behavior is at the core of disease prevention and outbreak response.

But the motivations behind why people do what they do are complicated. People are complicated — our behaviors reflect our personal experiences, education, cultural/religious beliefs, community etc. SBCC seeks to understand these motivations. By using methods from psychology, anthropology, marketing and behavioral economics, we collect information and data about target populations to design suitable interventions that address the specific needs, beliefs and practices of the target populations.

Ebola survivors in Liberia leave their handprints on a wall of the Bong County Ebola Treatment Unit - the facility that saved their lives. / Adam Parr, USAID

Ebola survivors in Liberia leave their handprints on a wall of the Bong County Ebola Treatment Unit – the facility that saved their lives. / Adam Parr, USAID

What previous experiences with social and behavior change communication informed our Ebola response? How do you think those lessons that Ebola taught us will be relevant to future crisis responses?

In the past, I worked on SBCC and risk management for crises like the Avian Influenza and the 2009 H1N1/Swine Flu pandemic.

I’ve seen that large-scale outbreaks aren’t inevitable — that by working on preventative behaviors we can minimize the emergence of diseases and by strengthening response capacity, we can quickly contain them if they do emerge. But it isn’t easy. Food preferences, economics, and cultural and religious practices all contribute to the risks associated with emerging diseases. Those are difficult behaviors to address.

If prioritized, though, we can draw from proven solutions and make the necessary investments to prevent diseases such as Ebola from turning into regional or global epidemics.

What’s the next steps with these efforts?

The three affected countries aren’t out of the woods yet; there will be a continued focus on Ebola to end the epidemic in the region. Even after the end of this Ebola crisis, there will be a great need to rebuild trust in the health system so that children are immunized, women get appropriate maternal care, malaria is addressed, etc. SBCC is key to that trust building.

The Ebola outbreak has caused much pain and suffering.  However, in the midst of the crisis many heroic stories have emerged. What has touched you the most?

Ebola has created thousands of orphans — they are the ultimate tragedy of this crisis. In that tragedy, heroes emerge every day, from families that take in extended relatives to single individuals who adopt orphaned children. Those are the stories that touch me.

ABOUT THE AUTHOR

Clara Wagner was an intern for USAID’s Bureau of Legislative and Public Affairs working on content and public engagement.