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Agencies must win trust of locals to contain Marburg and Ebola outbreaks
Date:10/29/2007

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The MSF team in Uige enlisted the support of the Sobas traditional and official community leaders trusted by the people in trying to persuade families to accept hospital treatment for their loved ones. The team also developed a more proactive treatment approach involving IV fluids and naso-gastric feeding, both commonly-used interventions in hospital wards in Africa, and had the impression that this approach helped some patients to survive. Furthermore, the idea was that if people perceived that if greater effort was being made, they would be more likely to accept isolation and, indeed, the reputation of the Marburg ward improved after the proactive approach had been put in place.

The team also realised the importance of improving psychological support for everyone involved in the outbreak. Initially, only MSF personnel had been offered stress and fear management sessions, but these were extended to patients and relatives, who reported finding these helpful in allaying fear and anger, reducing patient stigmatisation and quelling rumours and panic within the community.

Matthias Borchert, a clinical lecturer at LSHTM, is one of the reports authors, having been seconded to MSF by LSHTM to contribute to the evaluation of the intervention. He comments: The experience in Uige clearly shows that biosafety and epidemiological efficacy alone are not sufficient to make an FHF intervention effective. Involving local authorities and respected influential individuals is an established principle of public health interventions in the community. Yet this principle is easily forgotten in the heat of an FHF outbreak. When MSF involved such authorities, community relations improved promptly and significantly, ameliorating case finding and outbreak control.

Co-author Paul Roddy, an epidemiologist based with MSF Spain, adds: Similar to previous outbreak response teams, the MSF team in Uige made errors, corrected them and underwent a learning
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Contact: Lindsay Wright
lindsay.wright@lshtm.ac.uk
020-792-72802
London School of Hygiene & Tropical Medicine
Source:Eurekalert

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