Creating Technology for Social Change

#StopEbola: What Nigeria Got Right (liveblog)

This is a liveblog (not a transcription) of the talk “#StopEbola: What Nigeria Got Right” delivered February 17, 2015 by Aimee Corrigan at the Berkman Center for Internet and Society, Cambridge, MA.

Aimee Corrigan is the Co-Director of Nollywood Workshops, “a hub for filmmakers in Lagos, Nigeria that supports and delivers movie production and distribution, training, and research”. Nollywood Workshops uses entertainment for various social goals, and was involved in Nigeria’s response to ebola. Aimee is also developing a long-form documentary about Ebola in Nigeria.

In July 20, 2014, Nigerian-American Patrick Sawyer landed in Lagos, Nigeria; he was the “index case” of ebola for Nigeria. Lagos has a population equal to Guinea, Sierra Leone, and Liberia combined. There was the chance for an “apocalyptic urban outbreak” in lagos. Nigeria contained it, suffering only 20 cases and 8 deaths. The WHO called Nigeria’s response a “spectacular success story.” 

First Consultant Hospital, where Patrick Sawyer came decided to quarantine him, which resulted in several of the nurses and staff being victims of Ebola. The president Goodluck Jonathan and Lagos’ Governor Fashola earlier on

Nigeria converted their polio operations center into an ebola emergency operations center, leveraging existing logistics. This was augmented by capacity built on staff and volunteers who would go out and test.

Patrick Sawyer was a diplomat and he chose to land in Lagos, a cosmopolitan city, and was ushered to the best hospital in the city. He was elite and his care was elite, so there was no contact with the slums of Lagos where it might have spread.

Communication and Technology in Nigeria
Nigeria has one of the highest penetrations of mobile and internet in Africa: 170M people with 114M mobile subscriptions. Her background in entertainment means that she thinks about internet and mobile in terms of media distribution and commercialization. But in the case of ebola in Nigeria, we see the internet working as a utility.

Contact tracing from Patrick Sawyer, the index patient, resulted in 18,000 meetings and monitorings. They mapped these traces using mobile devices and mapped the mappers in near real-time, which was critical.

Case 1: EbolaAlert
Volunteer doctors founded the EbolaAlert initiative. It began with a twitter account to announce updates, which the government was able to fold into their comprehensive intervention.

They employed design thinking and lean methods of iterative prototyping to develop solutions to address Ebola. Information available about Ebola was too technical and too late to be relevant to average Nigerians. While Twitter was effective, they understood that many people were not online. They mapped where people weren’t online and sent out volunteers to meet with people and report back on their engagement in real-time.

They developed a full campaign in a week across Twitter, Facebook, community outreach, and 24/7 hotline, before government came in to support them. Aimee argues they deserve a huge amount of credit for not only promoting awareness about ebola but reducing fear, which reduces many knock-on effects of people going into hiding and not receiving proper care. They took the online to exchange the offline and then brought back online in an effective strategy.

Case 2: Lens on Ebola 
Nollywood Workshops partnered with others to create high quality PSAs that were distributed on Facebook, YouTube, and Twitter. And ran on 10 major TV stations, 4 radio stations, and on 100 public buses, translated into all of the major languages.

Desmond Elliot, a popular Nigerian celebrity, was part of the whole production process. He starred in the PSAs and used his personal FAcebook fan page to promote the content. He hosted a live Q&A online, which the CDC said it was the most meaningful social exchange they were able to have in Nigeria at the time.

Part of the campaign also targeted the stigmatization of ebola victims, which helped communities re-accept them. Using top actors they dramatized the PSAs into something that people would want to watch and would stick in their minds.

The funniest PSAs were the most effective, being spread the furthest. Their goal was to make the hotline 1-800-EBOLA-HEALTH ubiquitous.

Aimee argues that a key power of social media is in spreading hope to defeat stigma around diseases like ebola by amplifying stories of survival and how people have returned to society. For instance, one Facebook post showed a picture of an ebola survivor returning to his neighborhood barber for a haircut.

Question and Answer
Q: You talked about the importance of humor. Is humor different in Nigeria?
A: Nollywood style humor is very dialog-based. And in the PSA on hand washing, they used the tropes of gendered arguments where the man is complaining about the woman doing something like washing her hands all day. And he asks why, and she plays out the role of being always right by getting him to wash his hands.

Q: If you care about educating people about ebola, your scripts might be better oriented around why you are washing your hands after being on public transportation or in participating in the contact tracing.
A: They had one mandate and it was to manage fear: Keep Calm and Stop Ebola. The messages were crafted to communicate . You are right about the PSAs. The handwashing scenario was not the most hygienic and we could have responded with a follow-up video. If you do a more pedantic version of the video, you sacrifice some of their impact and spread. These felt like Nollywood style shorts that maintained the trust of the audience versus something that feels like a CDC announcement, even though they did work with the officials on the scripts.

Q: How is the media getting out to offline and remote areas?
A: They actually are now running the PSAs ahead of community screenings of popular films. And they may even put them into the DVD releases. The other part of their tag line was “share what you know,” maybe that’s through sharing the video or maybe its just sharing the facts. The social media was very good at tackling myths such as salt water as a cure. They even did their own contact tracing on the side for such myths by asking people where they heard about it, and then following up with that person and everyone to whom they spread the myth.

Q: What was your relationship with Facebook?
A: Facebook really helped. They offered the team a special ability to hit as many people as possible in Nigeria with their posts. Does that mean that they need an established future public health interventions? Perhaps, but I think this does need to be balanced with Facebook’s commercial interests in expanding users throughout Africa.

Q: Were you able to research the effectiveness of the Ebola responses?
A: Often in these cases, the people that are most expert at creating and sharing media are not the best on research. Getting it out as soon as possible meant we made some compromises on the research side of things.