A NADEL outreach worker at an Ebola checkpoint takes the temperature of each person entering the Tombali regional hospital. Though there have been no cases of Ebola in Guinea-Bissau, Tombali is considered very vulnerable. Photo: Jane Hahn / Oxfam America

Community outreach workers have helped transform worry into action on Ebola prevention.

The nurse behind the Ebola checkpoint at the hospital and I did double-takes when we saw each other last week, and she called out, “amiga!”

I was heading into the regional hospital in Catio, Guinea-Bissau, to talk to staff about how things have been going since my last visit a year ago, but I hadn’t dared hope I would run into nurse Maria Cardoso.

In November of 2014, I joined Cardoso as she traveled door to door in nearby villages, sharing information about how to prevent Ebola and cholera. She is grumpy and kind and funny, but serious in her mission:  if Ebola slips in across the country’s porous land and maritime borders, lives will depend on the information she and her colleagues have shared.

Cardoso is a member of the Association of Women Workers—Association des Femmes Travailleuses—a  group funded and trained by Oxfam partner NADEL that organizes nurses in the villages of Tombali region to protect public health. Before Ebola arrived in West Africa, Femmes Travailleuses and NADEL joined forces to stop the deadly annual outbreaks of cholera that occur here.

Correction: outbreaks that used to occur here.

For the past two years, there has been no cholera in Guinea-Bissau, almost certainly because these groups have helped communities raise the bar on hygiene and awareness.

When Ebola began to spread through neighboring countries, the organizations—working in close coordination with the government—adapted the content of their messages but used the same powerful and personal method of sharing information.

Asked about what’s new since I saw her last, Cardoso said, “We’ve seen changes in people’s habits. Now, many illnesses that used to come from the villages aren’t appearing any more. I don’t think people will forget that washing hands keeps their families healthy.”

Though the Ebola risks remain high, everyone I meet in the villages says NADEL and Femmes Travailleuses have helped them cope. A woman who lives in a community where Cardoso works summed up the consensus: “Now, we have less fear of Ebola because we know what to do in order not to catch it.”

After more than a year of focusing intensely on raising awareness at the grassroots level, Oxfam is shifting its attention from the here and now to longer-term solutions.  The government of Guinea-Bissau recognizes that it is not prepared to handle Ebola or any other deadly epidemic, but it is committed to upping its game. We’re going to support its initiatives to develop a new emergencies operations center, improve coordination and vigilance, and strengthen its emergency planning. So that if, for example, a dangerous disease breaks out in a remote village, health authorities can learn about it quickly and be ready to act at a moment’s notice.

Our goal: a safer, stronger country that rarely needs organizations like Oxfam to step in at times of emergency.

I said farewell to Maria Cardoso, wishing that we could meet again, but hoping we’d never need to.

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