5 minute inspiration: How to respond to epidemics with courage and hope

by 27th Mar 2020

Everything about the news on COVID-19 is scary. We don’t know yet what the long-term impacts will be. We don’t know how long it will last. What we do know, from decades of responding to epidemics in some of the poorest and most fragile contexts, is that hope is possible. The only way through is together.

Take the experience of one Ebola survivor who was part of CARE’s programmes:

“When I was discharged they (the community) did not drive me away. They talked to me fine and accepted me and encouraged me that made me get courage. They touched me, they came to greet me and prepared fine pepper soup for me.”

Between 2015 and 2019, CARE has run 57 projects that aimed to stop the spread of infectious disease epidemics — like ebola, cholera, and zika — in 20 countries around the world. These projects collectively worked with 9 million people directly and 16.7 million indirectly.

These responses prove that things can get better. We already have many of the tools it will take to help the world respond to and overcome COVID 19.

What did we accomplish?

People knew how to protect themselves

In Sierra Leone’s Emergency Ebola Response Project, people were 80% less likely to be wrong about the causes of Ebola, and 12% more likely to know how they could avoid contracting Ebola. In Ecuador and Peru’s Zika Response, up to 98% of people were using data from community-based health systems to protect themselves, and 89% of women in Ecuador were applying best practices to stay safe.

More people wash their hands

In Yemen’s Emergency Assistance for Vulnerable and Conflict-Affected Communities Project, families were 2.6 times more likely to wash their hands. In Sierra Leone’s Emergency Ebola Response Project, people were 30% more likely to wash their hands to avoid contracting the disease.

Families can eat better

In Sierra Leone’s Rapid Social Safety Net and Economic Recovery Project, 91% of people were satisfied with CARE’s Ebola response, and 84% of people are eating more meals a day.

Health systems got stronger

In Yemen’s Joint Response Project, 29,836 people received health services from trained health workers. In Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program, the national supply chains for critical drugs got stronger, so health centres are 5 times more likely to have medications for women coming in for pre-natal visits. They are also 58% more likely to have the supplies and equipment they need. In Ecuador and Peru’s Zika Response, 60% of local governments in Ecuador, and 95% of local governments in Peru, budgeted extra money for Zika prevention, monitoring, and response.

How did we get there?

Build emergency alert systems

All of the projects worked with national and local governments, and community leaders to share accurate information that would help people take action. This included T-shirts, posters, dramas, and radio shows, and call in numbers with local health centres so they could get immediate alerts about suspected cases.

Connect health centres to communities

Most projects worked with a network of local volunteers who functioned as go-betweens between centres and communities. They could share health tips with communities, and alert the health centres when communities needed extra support and attention. A key learning from Ecuador and Peru’s Zika Response was that projects should pay health volunteers for their time — both to ensure longer-term engagement and to give families some much-needed support in an emergency.

Do your homework

All of the projects conducted rapid assessments so they could adjust project plans based on the immediate needs.

Be efficient and flexible

Sierra Leone’s Rapid Social Safety Net and Economic Recovery Project originally spent over $70,000 on a mobile money transfer system that didn’t work for the communities we were serving. In the second phase, they saved $39,000 by going back to more traditional distributions in places without mobile coverage.

Focus on supply chains

In Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program, community volunteers conducted supply audits at health centres to track which centres were having trouble keeping enough medicine available to treat patients, and develop a plan to fix it.

Make data visible

Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program helped health centres track patient and supply data so they could track supply and demand patterns and order medicines. It also made it easier for health inspectors and communities to hold centres accountable.

Think about the whole portfolio

The most successful project teams used a combination of donors and projects so they could bring in money to fill in gaps from other programs and avoid duplicating effort.

Focus on gender

Many projects focused on gender, using tools like Rapid Gender Analysis, gender mainstreaming trainings for all staff, and CARE’s Gender Marker as a way to measure progress towards quality gender programming.

Emily Janoch

Emily Janoch is Senior Technical Advisor on Knowledge Management for the CARE USA Food and Nutrition Security team focusing on ways to better learn from and share practical experience on eradicating poverty through empowering women and girls. She focuses on learning from programming and using that learning to improve impact.

With four years of on-the-ground experience in West Africa, 10 years of development experience, and academic publications on community engagement and the human element in food security in Africa, Emily is especially interested in community-led development. She has experience in food security, nutrition, health, governance, and gender programming, and has a BA in International Studies from the University of Chicago, and a Masters' in Public Policy in International and Global Affairs from the Harvard Kennedy School.

Email: ejanoch@care.org