03. Communicating with the community

Overview

Communicating during an epidemic can be difficult. Disease outbreaks, especially new ones, can cause uncertainty, fear and anxiety that can result in circulation of rumours, disinformation and misinformation. People may not trust the authorities, the health system or organizations including the Red Cross Red Crescent. They may not listen or may not believe the information they receive from people or organizations they do not trust. People may also be overcome with grief for those who are sick or who have died.

Sometimes, communities have strong beliefs that are different from the preventive and protective social measures promoted by the authorities and healthcare providers. They may believe strongly in their own cultural practices, traditional medicine, or other methods that might not prove effective against the disease. They may not accept certain treatments (including medicines and vaccines).

In many countries messages take the form of directives and one-way-communication. However, community engagement and participation have played a critical role in successful disease control and elimination campaigns in many countries

During a disease outbreak, trusted communication with the community is vital. To build trust, two-way communication is important. “Two-way” means volunteers should both give messages to AND receive messages from the community. Community members must feel respected and listened to and should have the opportunity to share their beliefs, fears and concerns. To accept volunteers’ messages, community members must be able to trust you and have confidence in what you say. Once you understand the beliefs, fears and concerns of community members, you can provide them with truthful and accurate messages.

Providing health messages that are consistent, clear and easy to understand also helps to build trust. Giving accurate information to the community is critical, especially when it is necessary to persuade people to adopt safe practices (which might be different from what they would normally do). Some changes in behaviour that may be promoted are things such as:

• Accepting vaccinations or other medical treatments
• Washing hands with soap at crucial times
• Wearing personal protective equipment
• Burying loved ones in ways that are different from what they would normally do (safe and dignified burials)
• Practising social distancing
• Wearing insect repellent or sleeping under bed nets
• Agreeing to be isolated from others to avoid infecting them
• Preparing food and water differently (often by cleaning, boiling or cooking thoroughly)
• And other recommended public health measures

What to do and how to do it

Communicating in an epidemic

• Engage and involve community leaders and community members
  • Find out where the community obtains its information: Who do they trust to give them health information (for example: health authorities, community or religious leaders, doctors, traditional healers)
  • Work with communities to identify, choose and plan appropriate solutions for stopping the spread of disease
  • Talk to members of the community about their ideas, fears, beliefs and actions
    • Try to understand how much they know about the disease and its transmission
    • Try to understand beliefs and practices that might impact the spread of the epidemic
    • Try to understand what motivates or helps them to change behaviours
    • Try to understand what stops them from changing their behaviour

• Use different methods of communication
  • Use two-way communication when possible
    • When you understand the community’s beliefs, fears and concerns, try to address these in your own messages
  • Sometimes, one-way communication methods are used to spread health messages to large numbers of people quickly
    • One-way communication methods should always be accompanied by two-way communication methods to ensure the community perspectives are known and listened to
  • People learn and retain information differently. It is important to use different methods
    • Communities are composed of different people and groups who may have different communication preferences or needs.
      • Think about how to target different groups, especially those who are hidden, stigmatized or considered “different” because of their religion, sexual orientation, age, disability, illness, or for any other reason:
        • Think about where you will go to reach them
        • Find out if they trust the same or different sources than other groups within the community
        • Discover if they have different access needs, such as language translation 
    • When choosing methods of communication, consider what people prefer, trust and can access easily
      • Think about the characteristics of your target groups (for example, do they have access to media, such as radio or television? Can they read if they receive pamphlets of information? Are they accustomed to getting information from social media? Etc.)
      • Think about the resources you have access to (for example: do you have access to poster printing? Is there an appropriate location within the community where you can offer to answer questions or give out information? Etc.)
      • Consider the content of your message(s) and think about the most appropriate way to share that content in the specific context (for example: targeting men and women separately)

• Communication should be:
  • Simple and short. People should be able to understand messages easily and be able to remember and repeat them accurately and without difficulty.
  • Trusted. Delivered by people the community trusts, by a method the community trusts (for example: radio, television, posters, town-hall discussions, etc.).
  • Accurate and specific. Always provide correct and precise information. Messages should be consistent and should not be cause for confusion. If messages must change (due to new and advancing information about the epidemic), be honest and clear about what has changed and why.
  • Focused on action. Messages should be action-oriented and should advise members of the community about what they can do to protect themselves and others.
  • Feasible and realistic. Make sure that people have the capacity and resources to carry out the actionable advice you give.
  • Context-specific. Information should reflect the needs and situation of the specific community. In all your messages, take account of social and cultural factors that might encourage community members to adopt safer behaviours (such as accepting vaccines) or prevent them from doing so.

Different ways of communicating

There are many, many ways to communicate with communities. The following one and two-way methods of communication are some examples you might consider. Methods can (and should) be combined to ensure accessibility to as many community members as possible.

• One-way communication methods
  • Video, films, television commercials
  • Songs, poems, drama, role-play or theatre
  • Community announcements such as: loud-speaker announcements, SMS mass messaging, social media messages, radio broadcasts
  • Posters, billboards
• Two-way communication methods
• Door-to-door visits
• Meeting with key informants such as: community or religious leaders; traditional healers or midwives; teachers; elders, etc.
• Community discussions encouraging participatory methods such as: three pile sorting, voting charts, mapping, polling, barrier analysis, community planning

Pay attention to rumours

Rumours can cause panic and fear or can promote unsafe practices. Under the influence of the rumours, communities can lose trust in the health authorities, and they may lose belief in the ability to stop the epidemic. Rumours sometimes cause people to reject interventions that could prevent the spread of disease. Volunteers must:

• Listen for rumours or incorrect information.
  • Note when and where a rumour was heard and report it to your volunteer supervisor or National Society focal point immediately
• Correct the rumour
  • Give the community clear, simple facts about the disease
  • Reiterate and explain clearly what they can do to protect themselves and others