Abstract
Rumors and misperceptions were a persistent challenge in the response to the 2014-2016 Ebola Virus Disease (EVD) outbreak in West Africa. This study aimed to document organizational approaches to identifying and addressing rumors and provide practical recommendations for future outbreaks. We conducted semistructured interviews with 34 individuals who participated in the EVD response in Liberia and/or Sierra Leone. Interviews focused on the general organizational approach and organizational response to specific rumors. Interviews were recorded and transcribed verbatim. Most respondents reported that rumors were considered an organizational priority and their importance increased over time. Formal rumor identification systems using community-level reporters were described in Liberia and Sierra Leone as well as varied informal systems. A wide range of approaches was used to address rumors including Community Led Ebola Action, Community Led Total Sanitation, drama performances, Ebola Treatment Center/Unit-based approaches, radio, leveraging community leaders as an information source, and organization change. Interpersonal and community-led approaches were described most often. Staff whose professional roles did not involve rumor management reported informally addressing rumors with colleagues and beneficiaries. Rumors reflecting valid concerns with the EVD response, such as potential infection in health care facilities, were addressed through organizational change and improvement. Interpersonal and community-led approaches were considered effective by participants and hold promise for future outbreaks. Informal systems developed at Ebola Treatment Centers/Units highlighted how these facilities may be utilized as an information hub. Professionals who interact with beneficiaries, especially local staff, are likely to address rumors informally and organizations may benefit from considering local staff an asset in rumor management. Rumors alerted responders to issues in the EVD response, but this may not be the most efficient mechanism to receive and address concerns.
Highlights
Rumors and misperceptions were a persistent challenge in the response to the 2014–2016 Ebola Virus Disease (EVD) outbreak in West Africa
A coordinated response to the outbreak did not begin until approximately 6 months after the first human contact with the Ebola virus[3] and inadequate and inappropriate communication early in the outbreak proved counterproductive.[4,5,6]
Rumor identification systems using mobile phones and large networks of social mobilizers appeared to be effective for gathering rumors, but interviews seemed to indicate that there was limited awareness of these systems
Summary
Rumors and misperceptions were a persistent challenge in the response to the 2014–2016 Ebola Virus Disease (EVD) outbreak in West Africa. Misperceptions, and community resistance presented significant obstacles in controlling EVD spread.[4,5] Rumors, defined as “unverified and instrumentally relevant information statements in circulation that arise in contexts of ambiguity, danger, and potential threat,”[9] can be problematic, but are an expected and adaptive response to frightening and ambiguous situations.[10] Information is necessary for planned action and when it is unavailable or not trusted, people may come together to pool information in an attempt to develop a reasonable understanding of a situation.[9,10,11] Rumors are not traditionally viewed as an information source but do reflect fears, hopes, and concerns of the populations in which they circulate As such, they can be an invaluable resource for informing communication approaches and outbreak response
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