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Lessons in trust from Sierra Leone’s Covid-19 communications response

October 1, 2020

By Nina Meghji

Messaging at the start of the Ebola epidemic in Sierra Leone was problematic – a lack of trust in the government and authorities, widespread misinformation, impracticable advice and culturally irrelevant and insensitive information were among the factors that contributed to the spread of the virus. With the advent of Covid-19, a new approach to public health messaging is demonstrating how a diverse and multifaceted approach can help ensure public health messages are heard and understood by entire communities.

Learning from Ebola

The Government of Sierra Leone’s One Health National Emergency Risk Communication Strategic Plan, developed post-Ebola, acknowledges lessons learned from the crisis, in particular the role of community engagement: “People are more likely to believe and act upon messages delivered by people they know and trust… local leaders are pivotal in changing the course of events.” “Community influencers” – paramount chiefs, heads of communities, religious leaders – and other trusted members of the community are integral to the planning and dissemination of public health emergency messages, it says. Alongside a person-centred approach, the plan advocates early, effective coordination and delivery of messages – content has been developed in 12 languages, in addition to Krio, spoken widely in Sierra Leone – through diverse communication channels, including billboards and posters, social media and text messages.

Getting the right messages out there

The Head of Traditional Healers, Dr. Abdulai Tarawallie, in Sierra Leoneexpressed his commitment to combating the spread of Covid-19, in an interview with Mohamed Massaquoi for Sierra Leonean newspaper Concord Times. Dr. Tarawallie urged colleagues to adhere to government guidelines and refer sick people to hospital, rather than treating them themselves. deploying a “taskforce” to educate people across the country on transmission of the virus. This, he hoped would avoid a situation similar to Ebola during “which every traditional healer was doing what he wanted.”

Similar experience has informed international NGO Concern Worldwide’s work with traditional healers who, since Ebola, have emerged as “vocal health advocates in their communities, and are in the perfect position to convey the right messages about COVID-19.” Concern attributes its success to trust, built over time, between its staff and traditional healers, and the longstanding trust between traditional healers and members of the community. The organisation believes “the most valuable weapons in the fight against Ebola were information and trust” and “get[ting] the right messages out there.”

Information-sharing and communication is the foundation of the NGOMedia Matters for Women’s (MMW) work. The organisation harnesses the power of trusted communication networks through mobile technology and has connected women in rural areas with vital news and information about Covid-19 prevention throughout the outbreak. In addition to podcasts, ‘town criers’ and ‘youth advocates’ have delivered messages via megaphone, enabling women without access to the internet, radio or telephones to hear life-saving information. MMW’s Covid-19 outreach has included more than 115,000 women, children and men living in rural parts of the country.

Migrants as Messengers

Sierra Leone is one of seven West African countries participating in ‘Migrants as Messengers’ (MaM), a campaign by the International Organisation for Migration (IOM) that empowers young people to make informed decisions about migration through returned migrant volunteers. As part of the scheme, volunteers have broadcast messages about protection from Covid-19 via radio and through online videos. A song entitled ‘Coronavirus is real’, recorded by three aspiring musicians raises awareness of the virus in Krio and English.

Public figures have also used their positions to inform the wider community about Covid-19: Sierra Leonean author and UNICEF Ambassador Ishmael Beah features in an Covid-19 awareness-raising video on the agency’s Facebook page; and paralympian George Wyndham, in a full-time role with Sierra Leone’s Public Health National Emergency Operation Centre, has educated communities about the dangers of Covid-19, and preventative measures to mitigate them.

Community organizing

Operating from Sierra Leone’s informal settlements, the Federation of Urban and Rural Poor (FEDURP) and the Centre for Dialogue on Human Settlements and Poverty Alleviation (CODOHSAPA), are skilled community organisers effecting change in their own communities. CODOHSAPA and FEDURP have customised Ministry of Health and Sanitation (MoHS) messaging materials for their communities, engaged in face-to-face and online advocacy – via social media – and radio broadcasts, and developed a Covid-19 monitoring app. FEDURP is also working with Freetown City Council and community chiefs based in the settlements to help enforce compliance with state regulations. The Federation acknowledges “mixed messages [that] resulted in the emergence of myths and misconceptions in communities and the society generally about the Covid-19 virus” as a key challenge it has faced.

Political messages undermine public health

Mixed messaging and a lack of clarity has plagued the UK’s Covid-19 response. In an article published by British newspaper The Guardian journalist Haroon Siddique argues that “public trust in the government’s ability to handle the coronavirus crisis has been tested by a summer of mixed messages.” Efforts to build trust and communicate life-saving information can also be compromised when the focus is shifted away from health. In an article for the International Growth Centre, Sierra Leone-based economist and researcher Abou Bakarr Kamara expressed concern that “recent political tensions… ha[d] undermined the response effort” and that social media was “awash with inciting political messages, instead of COVID-19 prevention and awareness messages.”

In the UK, the British Prime Minister’s senior advisor, Dominic Cummings, who broke lockdown rules and retained his job, set in motion what researchers in an article published by The Lancet described as the “Cummings effect” – an event that “undermined confidence in the government to handle the pandemic.” Trust in the authorities, they believe, is crucial because it “underpins public attitudes and behaviours at a precarious time for public health.”

Public health researchers, Samuel Boland, Gillian McKay, Benjamin Black, and Susannah H Mayhew lauded Sierra Leone’s Ebola response in a blog for BMJ Opinion, for its “massive community engagement effort.” Their message to Britain: “The UK should consider community level interventions as not only financially viable, but also epidemiologically effective—and invest in and validate them accordingly.”  

Sierra Leone’s Covid-19 communications response illustrates multiple and diverse approaches to public health messaging, with trust and communities at the forefront. If the focus on health, rather than politics, can be maintained, there are valuable lessons for countries like the UK struggling to engage with populations.

SALCAB TAKING INTERNET CONNECTIVITY TO UNDERSERVED AREAS IN SIERRA LEONE

In 2019, the Government of Sierra Leone, through the Ministry of Finance, secured a loan of USD30 Million from the Exim bank of China for the implementation of phase 2 of the National Fiber Backbone project (NFB 2). NFB 2 will increase mobile and broadband penetration to underserved regions in Sierra Leone and also make data transportation cheaper and faster. The successful implementation of the project will also make the SALCAB terrestrial fiber network more resilient and provide better quality of service to internet service providers and consumers.

SALCAB is very proud to be the driver of a project of this magnitude that will lead to more accessible and affordable internet services. In collaboration with the Ministry of Information and Communications (MIC), SALCAB has designed a project that will support the digitization efforts of the Government. Huawei was contracted to serve as the technology implementation partner on the project.

On Friday, 25/09/2020, a joint team from SALCAB, MIC and Huawei, traveled to the provinces to inspect the work being done by Huawei and also officially launch the project. At the first stop at Moyamba Junction, the Managing Director of SALCAB, Ishmael Kebbay, commented that he was very pleased with the progress of the work done by the Huawei team. He explained to the community people that the completion of the project will enable them to have access to fast internet services in their communities. He further explained that the fiber cable will run from Moyamba Junction to 65km into Moyamba town. The Chairman of SALCAB, Sorie Fofana, mentioned that he was happy to see many indigens employed by Huawei to work on the project. He went on to say that these local workers are being taught not only how to dig and deploy the fiber cable but also how to use specialized equipment used in these types of projects. The Project Manager of Huawei, Nana Kwabena Kwadade, spoke about the competencies of Huawei in successfully implementing these types of projects. He added that his team will be very meticulous in executing health, safety and quality precautions throughout the different stages of the project. The Acting Director of Communications at MIC, Mohamed Moumini Jalloh, commented on the effective collaborations between SALCAB, MIC, Huawei and the community people. He reiterated that this project will serve to provide high speed internet connectivity to the unattended communities.

During a community engagement session organized in Kenema on Saturday, 26/09/2020, the Minister of Information and Communications, Mohamed Rahman Swaray, explained that the NFB 2 project was designed to support the President’s agenda of improving internet access in the country. He encouraged the community people to take ownership of the project and collaborate with the Huawei team as the project implementation is ongoing. He added that his Ministry is determined to ensure that every Sierra Leonean has access to high speed internet. As part of the Huawei team, the Huawei Country Representative, Steven Zhupeng, was also in attendance at the event in addition to the SALCAB and MIC representatives.

The delegation also inspected the work in progress along the Mano Junction-Daru axis. The technical implementation of the work involves digging the path where the fiber cables will be laid, deploying the fiber ducts, backfilling the path and finally blowing the fiber through the duct. The work along this axis is approximately 50% completed.