One on One with USAID Health Advisors on the DRC Ebola Response

USAID Health Advisors Dr. Jolene Nakao, Sonia Walia, and Kathleen Myer each spent much of the last year and a half on USAID’s DRC Ebola response, providing technical guidance and working with UN and NGO partners. Photo credits: USAID

Q: What in particular made this response so challenging?

Dr. Jolene Nakao: This response was challenging in many different ways. Linguistically, there were multiple language barriers. Geographically, our teams had limited ability to travel to the areas that were hit hardest by the outbreak because of the ongoing violence that has plagued these communities for decades. There were also cultural barriers, as well as complicated dynamics between the communities in the affected regions and the Government of the DRC.

Dr Jolene Nakao, Public Health and Medical Technical Advisor is also a physician and epidemiologist. She deployed four times to the DRC. Photo credit: USAID

Sonia Walia: In the beginning, there was a lot of confusion about whether this was a health crisis or a humanitarian crisis, when in reality, it was both, and both sides needed to be addressed. This made it tough for some of our humanitarian partners to have their voices heard, especially the NGOs that had been working in these communities for 10 to 15 years that people trusted.

Kathleen Myer: Previous Ebola outbreaks in Congo occurred in the western, Lingala-speaking areas of the country. This outbreak occurred in the eastern part of the Congo, which is extremely different. The east has been politically marginalized for years and the population has no cultural or linguistic ties to the west. The response needed to acknowledge the humanitarian context and the unique vulnerabilities of these communities from the beginning.

The Ebola outbreak in the Democratic Republic of the Congo occurred in eastern DRC, primarily in North Kivu and Ituri Provinces, two areas that had already suffered from decades-long armed conflicts. Map credit: USAID

Q: What lessons do you think the humanitarian and health communities have learned from this response that they can take with them to their next response?

Dr. Jolene Nakao: The criticality of community engagement is the largest lesson, but it’s not a new one. Some have even said it is a lesson learned multiple times in the past, yet ignored. It is something that should run through and through everything we do as humanitarians, and in international aid at large. All humanitarian action needs to be led and driven by the affected communities. Empowerment cannot be just a development catch phrase. This response just reminds all of us of the centrality of this.

Sonia Walia: I urge early integration of humanitarians into a disease response within a humanitarian setting. Early community engagement, dialogue with local communities, accountability for affected populations, and adherence to humanitarian principles can make future responses more effective.

Sonia Walia, USAID Public Health and Nutrition Advisor, deployed to the DRC four times over the course of the Ebola response. Photo credit: USAID

Kathleen Myer: The lessons I want carried forward are this: Listen to communities fears and address those first. Use local languages for all essential communication and employ people from the affected communities. I hope this response solidified people’s understanding of the role communities can play in taking responsibility for their own response. If communities are equipped with accurate information and allowed to be part of response planning and implementation of activities, the public health response can actually work.

Kathleen Myer, Public Health & Nutrition Advisor meets with local partners in the DRC. Photo credit: USAID

Read more about USAID’s humanitarian efforts in the DRC.

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