Game or Song Attendance and Troubleshooting Story Ask about Current Practices the Meaning of Each Picture Box Activity Discuss Barriers Practice and Coaching Request Commitments 5–15 minutes 5–15 minutes 5 minutes 10 minutes 30 minutes 15–30 minutes 15 minutes 20 minutes 10 minutes 2–2½ hours Abbreviations and Acronyms CCC Community Care Center CG Care Group CGV Care Volunteer ETU Ebola Treatment Unit EVD Ebola Virus Disease ORS Oral Rehydration Solution PPE Personal Protective Equipment SRU Screen and Referral Unit
International HIV/AIDS Alliance. (2002). 100 Ways to Energize Groups: Games to Use in Workshops, Meetings and the Community. Available at www.aidsalliance.org. international. 2014. WiRED Rapid Response Training Module Ebola. World Health Organization. 2014. Ebola virus disease. Available at World Health Organization. 2014. Frequently Asked Questions on Ebola virus disease. Available at Posters/illustrations from the Center for Disease Control and Prevention: Poster numbers: CS251137B; CS251137-C, CS252823A, CS255720-D Posters adapted from UNICEF C4D Ebola materials: “Ebola virus: What to do if you have symptoms”; “Ebola prevention poster” World Health Organization. “Field situation: How to conduct safe and dignified burial of a patient who has died from suspected or confirmed Ebola virus disease.” Ministry of Health and Social Welfare Liberia, UNICEF, World Health Organization and partners. gCHV Training on Ebola Flipbook and IPC. September 2014 (DRAFT). Academy for Educational Development, International Center for Research on Women and International HIV/AIDS Alliance. Developed by Ross Kidd, Sue Clay and Chipo Chiiya. “Understanding and Challenging HIV Stigma: Toolkit for action”. Introduction and Module A. 2007. Say and Play: A tool for young children and those who care for them by Dr. Jonathan Brakarsh in association with Project Concern International – Zambia (2009). The Journey of Life: A community workshop to support children by Regional Psychosocial Support Initiative (REPSSI), the Community Information and Inspiration Team (CIIT) and Dr. Jonathan Brakarsh (2004). Illustrations by Stan Watt. Caritas. “New burials reflect religious concerns”. Available at Academy for Educational Development, International Center for Research on Women and International HIV/AIDS Alliance. Developed by Ross Kidd, Sue Clay and Chipo Chiiya. “Understanding and Challenging HIV Stigma: Toolkit for action”. Picture Booklet. 2007. Infant feeding and Ebola: Further Clarification of Guidance, available at
Lesson 2: How is spread? About Ebola and Transmission Caregivers will understand the following and act accordingly: What virus is and the signs and symptoms What happens to a person when they get sick with Where to get good information about Ebola in their community and what to do if they suspect Ebola in their household Materials: Attendance registers Care Group Volunteer flipchart Summary: Game: Body Writing Attendance and troubleshooting Share the story: Two Sisters get Ebola (Picture Box 2.1) Ask about current practices Share the meaning of each Picture Box in the flipchart: Ebola is Dangerous but Early Care Can Help You Survive (Picture Box 2.2) Ebola Spreads from Person to Person (Picture Box 2.3) It Takes 2–21 Days to get Ebola (Picture Box 2.4) How do you know it is What do you do next? (Picture Box 2.5) Activity: Hand washing song Discuss barriers Practice and coaching in pairs Request commitments 1. Game: Body Writing (10 minutes)
Did anyone (spouse, grandmother, or children) interfere or tell you not to follow your commitments? Tell the story of what happened? What factors (people, events, or chores) in your life made it difficult to keep your commitments? How were you able to overcome these problems? 8. The Promoter thanks all of the CGVs for their hard work and encourages them to continue. CGVs should have a sense of pride that they are protecting their communities from Ebola by reinforcing messages and commitments such as hand washing and prompt care seeking at a health facility when someone is sick. 9. The Promoter asks the group’s Activity Leader to discuss the needed items for next week’s activity (if any) and solicit volunteers. (Note: Extra materials are needed for Lesson Plan 3: basin, soap, and water.) When CGVs teach their neighbor mothers: The CGV takes attendance. The CGV asks about new births, pregnancies (if tracked), mother or child deaths, or illnesses in the families of the mothers attending and help refer those with danger signs of severe illness to the local health facility. In addition, the CGV needs to start asking new questions at each meeting with their neighbor mothers, including about any newly orphaned children and about the signs and symptoms of any illnesses that family members have (in order to identify illnesses that match the signs and symptoms of Ebola), but without alarming the family. The CGV asks the neighbor mothers to review the key practices from the last lesson. The CGV asks the neighbor mothers about their commitments from the last meeting and follow up with those that had difficulty trying out the new practices. The CGV asks the Activity Leader to discuss the needed items for next week’s activity (if any) and solicit volunteers. (Note: Extra materials are needed for Lesson Plan 3: basin, soap, and water.) 3. Story: Two Sisters get Ebola (Picture Box 2.1) (10 minutes) Read the story on Picture Box 2.1 in the flipchart. The text to the story also is included below.
After cooking dinner, Helena felt worse. When her son Zomo got home, she was very weak and vomiting. Zomo cleaned up her vomit. Zomo told her, “I you should go to the hospital. What if it’s Ebola?” But Helena was afraid to die at the hospital and did not go. The next day, Zomo went to school. He received a message that his mother had died. When Zomo went home, his father was hugging Helena’s body and crying. “On the they said we should call the government officials to bury someone who has symptoms like Mother had,” Zomo said. His father refused. He wanted to bury her at home, in the traditional way.
authorities immediately when someone has signs or symptoms of Ebola, and not touching a sick person. 9. The Promoter asks the group’s Activity Leader to discuss the needed items for next week’s activity (based on the Promoter’s conversation with her prior to this meeting) and solicit volunteers. When CGVs their neighbors: The CGV takes attendance. The CGV asks about new births, pregnancies (if this is kept on the form), mother and child deaths, and illnesses in the families of the mothers attending and helps refer those with danger signs of severe illness to the local health facility. If an Ebola outbreak has been declared in any parts of the county, the Promoter and CGVs need to start asking new questions at each meeting. The CGV asks neighbor mothers about any newly orphaned children and about the signs and symptoms of any illnesses that family members have to identify illnesses that match the signs and symptoms of Ebola, but without alarming the family. The Promoter will ask the CGVs to report out on any such illnesses. The CGV asks the mothers to review the key practices from the last lesson. The CGV asks the neighbor mothers about their commitments from the last meeting and follows up with those that had difficulty trying out new practices. The CGV asks the Activity Leader to discuss the needed items for next week’s activity and solicit volunteers. 3. Story: Bahaar’s and Sarifina’s Community Response to Ebola (Picture Box 4.1) (10 minutes) Note: This can be used with CGVs and community leaders, including traditional leaders, as a way to urge them to come up with a community response plan for Ebola if a plan does not exist. It can also be used with neighbor mothers to help build support for a community plan. Read the story in Picture Box 4.1 in the flipchart. The text to the story also is included below. Bahaar and Sarifina live in two neighboring communities, much like this one. Over the past few months they have been hearing a lot about a very serious disease called Ebola on the radio and from friends and family. Although they know Ebola is killing a lot of people, there have been no cases or deaths in either of their communities. There are no changes in Bahaar’s community and everyone is continuing with daily life the same as always believing that Ebola will not come to
EVD survivors have beaten the disease and are not contagious anymore. They are champions, and your community should be proud of its survivors! They have been through a terrible experience, and having them help others (e.g., by educating the community) will help them to get over what they have been through. The definition of stigma is “a mark of disgrace associated with a particular circumstance, quality, or person”. Stigma is a spoilt identity. To stigmatize is to label someone; to see them as inferior because of an attribute they have. Some examples of stigma and discrimination: Physical and social isolation from family, friends, and community Gossiping, name-calling, violence, and condemnation Loss of rights and decision-making power Self-stigma: when people blame and isolate themselves Stigma by association: the whole family is affected by stigma 7. the Meaning of Picture Box 8.4: Ebola and Stigma (5 minutes) Ask the participants to describe what they see in the pictures in Picture Box 8.4. Read the bold text on the back of the flipchart out loud. the meaning of each picture in Picture Box 8.4. What do you these pictures mean? stigmatizing survivors. People that have survived cannot transmit Ebola to you. As far as we know, people that survive Ebola cannot get the disease again for at least ten years. They can also be heroes in their community by helping others who have the disease. It is important for a person to continue to follow good Ebola prevention measures even when he or she is declared well. The survivor can be an example to his or her community. Good Ebola prevention measures include washing hands with soap, not touching, avoiding funerals, etc.
(The Volunteer should provide information that helps replace any harmful myths being repeated in the area, while trying not to mention/repeat those myths.) Prevention: What can you do now? are things you can do to keeping Ebola out of your body. Wash hands with soap at the four critical times (after defecation or handling a child’s feces, before preparing food, before feeding a child, and before eating) and after caring for anyone who is sick. Cook all food properly/thoroughly. Treat drinking water at its point of use (e.g., in the home), especially when using stored water. Properly dispose of feces: Use latrines, and put all child feces in latrines. When a latrine is not available, bury feces. (Note: Include guidance on “flying toilets”),, You CANNOT get Ebola walking by a person who has Ebola or by walking by an area where there are people who have Ebola. Ebola is not transmitted by breathing. 4. Creating a Family Transportation, Communication, Treatment, and Burial Plan for Ebola Each community should develop (now) an Ebola Readiness Plan that includes: How people will be transported to a health facility or ETU without getting contaminated by the virus. How people should communicate with family members and people with information on Ebola when cases are seen in your country. (Mention any current hot lines, phone trees, or SMS services on Ebola in your country.) Share ways with the family that they can get accurate emerging information about Ebola. Each family should also develop an Ebola Care Seeking Plan in case someone in your family gets sick, including: How family members will be transported to a health facility or ETU without getting contaminated by the virus (if no community plan is in place). How people should communicate with family members and people with information on Ebola (mention any current hot lines, phone trees or SMS services on Ebola) when cases are seen in your country – follow the community plan.