The community response to Ebola in Lofa County, Liberia

Lofa County in northern Liberia shares porous borders with both Sierra Leone and Guinea. In March 2014, the first cases of Ebola Virus Disease (EVD) appeared in Lofa County; within several months the county registered 724 cases, including 451 deaths. Key challenges included the limited knowledge of Ebola dangers and prevention among community members which led to stigma, fear and resistance, as well as the limited involvement of local leaders in the initial phase of the response.

In Barkedu Town in Lofa County, working in partnership with local authorities, religious leaders started a resilient and creative community response in July 2014, devising measures to stem the epidemic:

• The community set up an 18 member Ebola task force comprised of youth, women, and community leaders. They organized their own rapid response system, identifying the suspected cases, isolating families and individuals, quickly carrying out safe and dignified burials and dispelling rumors by going door to door and organizing community dialogues.
• To facilitate negotiation of safe burials, 11 young trusted community members volunteered to be on the burial team.
• The town opened an isolation center for EVD cases since health centers had been deserted by health care workers.
• The community traced and monitored all newcomers. When in quarantine, the population patrolled the borders and restricted access.
• Quarantined families were closely monitored and provided with the necessary support they needed (food and non-food items as well as psycho-social support).
• Traditional leaders suspended all secret society ceremonies to avoid secret burials.
• Religious leaders prepared specific sermons addressing questions and resistance.

Government and its partners aligned their responses with the community, encompassing multiple activities that enabled Lofa County to tackle the epidemic while creating momentum and buy-in from the community members at all levels, and setting a precedent for the rest of the response. This formal engagement with religious and traditional leaders was the first of its kind in Liberia’s EVD response and proved to be critical in the resolution of the crisis. With this community leadership and community-based approach, Lofa County contained the epidemic in September 2014, with no further cases seen beyond this date.