The response team did not understand how we live here. They arrived in villages in biohazard suits, looking like members of armed groups and frightening the population. Without explanation, they would demand to take the patient away…The team did not build a dialogue, taking into account local cultural values. In Butembo, the rumours were that the Ebola response teams were the origin of the outbreak, rather than the solution. Priests worked hard to change this false belief.
Monsignor Sikuli Paluku Melchisédech, Catholic Bishop of Beni-Butembo (September 2019)
Local faith-based organisations (FBOs) and faith leaders played important roles in the Ebola response in DRC. Unfortunately, however, the international and national response was slow to recognise their contribution. Funding and decision-making on the response centred on UN and host government leadership and scaling up the medical response, without adequate attention to community engagement. All this played out in a context of violent conflict between the central government, local political actors and armed groups in affected areas, which spread and shaped rumours about the virus and the response. As a consequence, opportunities to address the fears people had about Ebola and the response to it were missed. Backlash against the Ebola response grew and, tragically, lives were lost – both frontline aid workers and community members who did not receive the information and support they needed from sources they trusted. As such, the Ebola response in DRC illustrates wider challenges in efforts to localise humanitarian action and meaningfully engage communities in a crisis response.
The contribution of FBOs and faith leaders to the response
It is hard to overstate the importance of faith and the roles played by faith institutions across DRC; an estimated 60% of educational facilities are managed by faith groups, and Catholic health structures (‘Bureau Diocésain des auvres Médicales’) manage 40% of the health system. As a consequence, faith groups were involved in the Ebola response from the outset. Catholic health facilities reported cases of people dying from a sickness involving bleeding in Mabalako in May 2018, but a strike in the public health system meant that cases were officially registered only in July, with the formal crisis declaration coming in August.
Faith groups were involved in the Ebola response from the outset:
- Preaching by example – for example, religious leaders played important roles in countering rumours and misinformation. Over 70 religious leaders had themselves publicly vaccinated in Mususa district to demonstrate by example that rumours against the vaccine were false. The Catholic bishops’ ‘Ebola Free Families Campaign’ mobilised grassroots women’s and youth groups in parishes to meet in neighbours’ homes and talk through misunderstandings surrounding Ebola, the vaccine and the wider response, as well as address the stigma faced by Ebola survivors. Muslim and Eglise de Reveil leaders undertook similar activities.
- Modifying religious practices – behaviour change is a critical part of community engagement in an Ebola response. To that end, faith groups developed and disseminated guidance through parishes and other prayer structures on washing hands before distributing communion and after conducting offertory collections, ‘taking communion by hand, and no longer directly in the mouth’ and establishing chlorinated water points at places of worship. Priests were trained at diocese level, and passed this training on to parishes (Shirika) and community groups.
- Religious institutions as centres for refuge and assistance – building on other basic forms of assistance provided at religious institutions, faith groups established reception areas and areas where people could be referred on to Ebola treatment facilities, provided hygiene facilities such as handwashing kits, supported monitoring of case contacts through food distribution and psychological assistance, and established early warning groups in schools.
- Playing an intermediary role between the wider response and communities – as the backlash grew against the response by the government and international agencies, religious leaders played crucial intermediary and advocacy roles. Local communities resented the disparity between the international resources poured into addressing a health crisis with international ramifications, and the inadequate action taken to tackle national, regional and global drivers of the violence they face every day. Faith leaders have called on the government and international agencies to develop, implement and support community resilience plans to integrate recovery from Ebola alongside wider plans to address intersecting humanitarian, governance and conflict risks in affected areas. Local FBOs and religious leaders in those communities can contribute to work on conflict and governance issues, but efforts on this front must be based on a careful analysis of conflict dynamics, the risks faced by local faith actors and the various ways different actors – government, UN, INGO, FBO – are perceived by local communities and armed actors.
Challenges in engaging with the response
In every strategic meeting on the crisis, faith-based organisations were mentioned as one of the major actors in the response. Unfortunately, this point was made without faith actors actually being invited to those same meetings.
National FBO manager, Eastern DRC, February 2020
Many of the challenges FBOs and faith leaders faced in engaging with the wider response in DRC had precedents in previous Ebola responses. A study by CAFOD and other FBOs of the 2014–2015 Ebola response in West Africa found that:
an essential element was the need to mobilise communities to change behaviour and in many cases neither health staff nor the government were well placed to do this. Instead, the local community itself was best placed to effect change, and faith leaders, as trusted and respected members of communities, played an important role as agents of social change.+CAFOD, Christian Aid, Tearfund and Islamic Relief, Keeping the Faith: The Role of Faith Leaders in the Ebola Response, 2015 (https://cafod.org.uk/News/Press-office/Press-releases/Faith-leaders-Ebola-virus).
In DRC, government and international staff deployed to the response did not come from the affected areas, did not speak local languages and brought with them practices that ran counter to local cultural norms (for instance regarding the feeding of patients and burial practices). One UN staffer, who had also been involved in the West Africa response, pointed to the lack of interest in learning from the response in Sierra Leone: ‘I was literally told “This is not West Africa. End of story.” Of course, nobody thinks you can cut-and-paste, but the UN failed to learn even the most basic lessons or apply them in DRC’.+Interview, February 2020.
Challenges with coordination and decision-making
A lot of this response was led by doctors, who are trained to hone in on a medical problem. The culture of standing back and looking at the bigger picture was not there.
INGO staffer, February 2020
The challenges FBOs and faith leaders faced in engaging with the Ebola response reflect in part wider challenges with the overall leadership and coordination of the response, which emphasised the medical dimension and neglected the importance of community engagement.
The initial response centred on bolstering health clinics at the epicentre of the crisis, which entailed deploying Ministry of Health (MoH), World Health Organization (WHO) and NGO staff to these areas. As one FBO staffer put it to us: ‘From the outset, it felt very much a command and control approach with a focus on the medical aspect, whereas attention to community sensitisation came much later’. The then Minister of Health centralised control of the response in the central line ministry and increased MoH staff in Kinshasa, and WHO staff were deployed from across West Africa: for one FBO staffer, ‘Those of us working at the local level felt disconnected from decisionmaking, out of the inner circle involved, and marginalised from the response’. Lack of engagement with FBOs reflected a wider scepticism at the MoH about the role of civil society, especially in Eastern DRC. One UN official observed that:
WHO could have done more to encourage the MoH to value and support the contribution of civil society, including FBOs. This problem was obviously all the more acute because the crisis had broke out in opposition-controlled areas in Eastern DRC. What’s more, when staff are deployed from Kinshasa on $150 per-diems, there’s a real disincentive to localising the response.
While IFRC and UNICEF tried to gather the views of local communities, ‘These were largely ignored by the leadership of the response’.+Interview, February 2020.
To help local FBOs and faith leaders reflect on their response and engage with others, international FBOs – including CAFOD, Tearfund, Trocaire, Misereor and Cordaid – supported their local partners to convene a series of workshops with FBOs and faith communities in Ebola-affected areas. Over 120 religious and community leaders gathered in four zones (Goma, Bukavu, Bunia and Butembo) between 28 August and 14 September 2019 to reflect on good practices and challenges in their work, and identify recommendations to inform the wider response.+Faith groups attending the roundtables included the Awakening Churches of the Congo (ERC); the Adventist Church; the Neo-Apostolic Church; the Kimbanguist Church; the Union of Independent Churches of the Congo (UEIC); the Church of Christ in Congo (ECC); the Catholic Church; the Anglican Church; the Islamic Community of the Congo (COMICO); the Salvation Army; and the Orthodox Church. Steps were taken to include diverse faith communities and enable Ecumenical and inter-faith exchange, including Muslim and indigenous faiths.
These roundtables also recognised the need for faith actors to get their own house in order, including by strengthening provincial coordination among faith groups. FBOs and faith leaders had an established inter-faith working-group in Kinshasa, including sub-groups on health and other issues, but there is no such structure in Goma or in other cities and cooperation at sub-national level has been more ad hoc. Moves to roll out a community engagement structure at the local level (the Cellules d’Animation Communautaire (CAC)) have helped clarify guidance on, and scale up, community mobilisation, but this work only began more than a year after the crisis was declared. One informant asked ‘why create a projectised structure with a grant facility, rather than look at the structures which already exist in these places, which have legitimacy, and engage with and support those?’.+Interview, February 2020.
Participants also recognised the need for a more structured and consistent approach to the advice technical specialists give church leaders as new issues arise, and more practical and systematic engagement in the wider coordination of crisis response efforts in DRC. At the national level, this could involve reviewing how the Kinshasa inter-faith working group relates to the Humanitarian Coordinator, Humanitarian Country Team and the clusters in planning, funding and accountability efforts.
Challenges in funding and programme partnerships
It should be obvious that a response to Ebola requires engagement with priests, pastors and parishoners. If someone is sick, then it is through this kind of community structure, which has their trust and that of their family, that support can be provided. It also gives people a sense of control over what’s happening to them.
UN official, February 2020
FBOs and faith leaders faced significant difficulties accessing timely and adequate funding. This was in large part a result of the centralised approach of the government, donors and the UN, and inadequate progress on localisation. As one staff member from an FBO put it: ‘One UN official asked us, what do the Christian NGOs need funding for? You already have people on the ground everywhere. Shouldn’t they just be doing this anyway?’.+Interview, February 2020.
Under the wider coordination structure, leadership for community engagement lay with UNICEF and donor funding was largely channelled there. Some FBOs with pre-existing partnership cooperation agreements (PCAs) with UNICEF were able to negotiate funding; Norwegian Church Aid, for example, had ongoing programming on water/sanitation and gender-based violence, which tackled issues including hygiene and community sensitisation, and these programmes were adapted to address Ebola. For agencies without a PCA, UNICEF’s modalities for partnership and funding do not permit much leeway or amendments to programming, though UNICEF has recently undertaken to review its approach to partnerships and flexible, multi-year funding.
The organisational model of some FBOs, which centres on fundraising from private donors in their religious community, means they often have less well-established relationships with the UN agencies serving as the conduit for institutional donor funding. In contrast to the technical and sectoral ways that UN agencies demarcate their mandates, FBOs tend to emphasise a holistic, multi-sectoral approach. Bridging these gaps is key to enabling more timely and responsive ways to fund their work. There are precedents for innovative consortia in DRC that have supported cooperation between FBOs and other humanitarian actors; the Shifting the Power consortium, for example, has helped catalyse cooperation to develop a new country-level NGO funding mechanism linked to the START network.+For more information on Shifting the Power, see: https://startnetwork.org/resource/how-has-shifting-power-influenced-local-and-national-partners-response-emergencies. But the reality was that many FBOs and religious institutions resourced their Ebola response largely from their own funds.
We will still be here when this crisis is over, when there will still be much work to do in rebuilding communities devastated by Ebola. National and international bodies need to acknowledge, support and work alongside us.
Catholic Bishop of Goma, Willy Ngumbi
In DRC, faith is a central part of people’s lives, religious leaders are trusted and respected, and Church structures have a presence across the country, including in areas where others do not. As such, engaging with FBOs and religious leaders should be an integral part, not just of the Ebola response, but also longer-term humanitarian, development and conflict efforts. The consequences of not doing so were already known from previous Ebola responses, but those lessons were not learned or applied in DRC. Change will only come through wider, concerted action on localisation and participation by affected communities, both in DRC and within the wider humanitarian system. To ensure that local faith groups, and people in crisis-affected communities, can exercise their agency and voice in this, a more politically informed approach is needed by donors, UN agencies and INGOs. Short-term, inflexible grants, where FBOs are contracted to deliver on priorities set by others, will not build trust or encourage learning. On health, education, community engagement and a host of other issues, more effective cooperation between FBOs and others can only emerge through longer-term partnerships. A politically informed approach also entails recognising the complex ways in which different actors – government, UN, INGO, local civil society, faith actors – are perceived by affected communities in conflict settings across the country, and what this entails for their ability to work safely and effectively. Otherwise, ‘engaging faith leaders and communities’ will remain lip-service, while all the financial, institutional and other drivers continue to push in the other direction.
In sum, priorities of relevance to Ebola response, both in DRC but also globally, include:
- Recognise the importance of community engagement from the outset of an Ebola outbreak and other public health crises, and the contribution of faith actors, alongside medical interventions.
- Embed Ebola recovery into a wider strategy addressing the conflict and governance challenges faced by affected communities.
- Establish practical entry-points for FBOs to participate meaningfully in coordination and decision making on both Ebola response and recovery, and wider humanitarian, development and peace efforts at national and sub-national levels.
- Scale-up locally led funding, programming and partnership opportunities to build trust and practical cooperation between FBOs and other actors on emergency preparedness, response and resilience.
- Avoid instrumentalisation of faith leaders by international agencies looking to ‘win hearts and minds’ or gain access. Faith leaders should be engaged in a genuine dialogue, which would involve identifying shared or complementary agendas, as well as carefully mitigating risks entailed for all involved – faith groups, UN bodies, local authorities and others.
Bernard Balibuno is CAFOD DRC Country Representative. Emanuel Mbuna Badjonga is Emergency Director, Caritas Congo, and Howard Mollett is CAFOD’s Head of Humanitarian Policy.