FACILITATORS S GUIDE DEVELOPED BY FOCUS 1000 IN COLLABORATION WITH ISLAG AND CHRISTAG

TRAINING OF RELIGIOUS LEADERS ON EBOLA PREVENTION AND CONTROL FACILITATORS S GUIDE DEVELOPED BY FOCUS 1000 IN COLLABORATION WITH ISLAG AND CHRISTAG FUNDED BY DFID THROUGH SMAC 1

Contents 1. PRAYERS 5 mins.... 3 2. WELCOME AND INTRODUCTION 20 mins.... 3 3. BACKGROUND ON ISLAG AND CHRISTAG 10 mins.... 4 4. OVERVIEW OF THE EBOLA SITUATION IN SIERRA LEONE 20 mins.... 5 5. ISLAMIC EVIDENCE TO SUPPORT EBOLA PREVENTION and CONTROL 30 mins... 6 6. CHRISTIAN EVIDENCE TO SUPPORT EBOLA EVENTION and CONTROL 30 mins.... 8 7. GROUP WORK 20 mins... 11 8. GROUP PRESENTATION 30 mins.... 11 9. THE WAY FORWARD 20 mins.... 11 10. CONCLUSION AND CLOSING 15 mins.... 12 2

1. PRAYERS 5 mins Lead facilitator calls meeting to order and asks designated imam or pastor to lead in Islamic and Christian prayers depending on the composition of the congregation. Key Points Sierra Leone is a prayerful nation and enjoys religious freedom and religious tolerance between people of different faith. This is a big blessing. During this trying period that our nation is faced with the crisis of Ebola we need to call on God (Allah) to give us the wisdom, the strength, the resources and the determination to stop Ebola and save our nation from the calamities associated with this devastating disease. We all need to pray. But we also need to take the right action to prevent ourselves, our families, our loved ones and our communities from the Ebola Virus Disease within the shortest possible time. We must put our Faith into Action to end Ebola and put our country back on the path towards National Development. 2. WELCOME AND INTRODUCTION 20 mins. Lead facilitator introduces the Chairman of the occasion. The Chairman welcomes participants to the one-day training. He/she emphasizes that Islam/Christianity have a crucial role to play in the fight against Ebola. He/she asks participants to introduce themselves according to the mosques/churches they represent. He/she outlines the objectives of the training session as follows: To improve the knowledge and belief of religious leaders about the transmission, prevention and control of the Ebola Virus Disease To discuss the role of religious leaders in ensuring safe and dignified burials, early referral of suspected cases of Ebola and addressing the issue of respect for Ebola Survivors and Health Workers To engage religious leaders Muslims and Christians to mobilize their respective congregations to participate in the fight against Ebola 3

Key points Religious leaders are respected sources of information in their communities, so they can inform and educate their followers about simple ways to prevent the spread of Ebola especially practices associated with washing of dead bodies and touching of sick persons. The recent Knowledge, Attitude and Practice study on Ebola conducted by FOCUS 1000 with support from MOHS, UNICEF, CDC and CRS found out that mosques/churches were the second most popular trusted source of information on Ebola in Sierra Leone. The most popular was Radio. Three participants an imam/pastor, a women leader and a youth leader - have been invited from each mosque/church. They are expected to work as a team to educate other members of their congregation on ways to prevent and control the Ebola Virus Disease. 3. BACKGROUND ON ISLAG AND CHRISTAG 10 mins. Facilitator gives a short background of the Islamic Action Group (ISLAG) and the Christian Action Group (CHRISTAG) Key Points ISLAG and CHRISTAG were formed in 1987 with support from the Ministry of Health and UNICEF to undertake social mobilization activities to promote child immunization in Sierra Leone. The initiative was part of the Global Universal Child Immunization (UCI) Campaign aimed at 75% immunization of children against 6 vaccine preventable diseases by 1990. Child Immunization in Sierra Leone by 1986 was only 6% With involvement of ISLAG and CHRISTAG and other groups Sierra Leone was able to increase child immunization level to over 75% in 1990. This achievement was globally acclaimed by UNICEF and WHO at the World Summit for Children in New York in 1990. After the achievement of UCI in 1990, ISLAG and CHRISTAG extended their social mobilization activities to Basic Education, Water and Sanitation, Family Planning and HIV/AID Prevention. During the war, both ISLAG and CHRISTAG were actively involved in the peace negotiations between the government and the RUF. After the war, ISLAG and CHRISTAG agreed to consolidate their position into the Inter-Faith Council as an umbrella body responsible for coordination and advocacy on matters involving religious leaders. 4

ISLAG and CHRISTAG are now working together with support of FOCUS 1000 and funding from DFID through SMAC to Act against Ebola. 4. OVERVIEW OF THE EBOLA SITUATION IN SIERRA LEONE 20 mins. (i) Resource Person, from MOHS/FOCUS 1000, makes a short presentation (10 minutes) on the Ebola situation in Sierra Leone. He/she will cover the transmission, general prevention, safe and dignified burials, early referral of suspected cases of Ebola, respect for Ebola Survivors and Health Workers, and current statistics on the Ebola disease in Sierra Leone. (ii) After the presentation the facilitator opens the floor for questions. (iii) He/she invites the resource person to respond to the questions (iv) He/ she conclude the sessions highlighting the key points. 5

Key Points The Ebola Virus Disease is caused by a special virus a tiny organism that cannot be seen by the naked eyes. The disease can affect both wild animals and humans. It usually starts in animals such as bats, monkeys and chimpanzees, and later transfers to human beings when they eat these animals or come in contact with their blood or flesh. When once the disease has entered the human population it spreads through body contacts especially fluids such sweat, vomit, stool, blood, tears of infected persons. In Sierra Leone today, 7 out of every 10 infected persons got the disease by washing or touching dead bodies. This is why the main way to prevent transmission of Ebola is by avoiding the washing dead bodies and avoiding the touching suspected cases. People should call 117 if someone dies in their home or neighborhood or if someone is suspected of having Ebola in their family. People can prevent themselves and their families by: a. Avoiding touching and washing dead bodies b. Taking sick family members to the hospital and not caring for them at home c. If in the extreme case care is to be given at home, using approved and suitable gear and equipment such as PPEs As of today the situation is as follows: Total number of people infected in the country XXXXX Total number of people who have survived and released XXXXXX Total number of people who have died XXXXXXX So we can see that people can survive if they get to the treatment centers early. Do not hide any case of suspected case of Ebola in your family. 5. ISLAMIC EVIDENCE TO SUPPORT EBOLA PREVENTION and CONTROL 30 mins. This presentation will be done only for workshops with Islamic leaders. The resource person from ISLAG makes a short presentation (10 minutes) on the Islamic View Point on the Ebola Crisis. He/she will provide evidence taken from the Holy Quran and Hadith to illustrate what Islam says about the transmission, general prevention, safe and dignified burials, early referral of suspected cases of Ebola, and respect for Ebola Survivors and Health Workers. (i). After the presentation the facilitator opens the floor for questions. (ii). He/she invites the resource person to respond to the questions (iii). He/she concludes the sessions highlighting the key points. 6

Key Points Islam proclaims that epidemics are real and destructive. The Islamic history has confirmed the occurrence of an outbreak known as "Tha'oon Amwas in the 18th year of Hijra which took the lives of more than twenty thousand people. The Prophet (PBUH) said: there is no Adwa" i.e. No transfer of disease by itself. Bukhari: 5717- there must be a cause. In the case of Ebola, there is enough evidence to support most of the public health measures recommended for its prevention and control: a. Medical Care: Islam has commanded the sick to seek medical cure and make use of physical means that would help eradicate the disease. The Prophet (PBUH) said: " O you servants of Allah. Seek cure (from your illness) for Allah has not made a sickness without making medicine for it " Tirmidhi 2038. b. Burial Rites: It is the right of a dead Muslim to be washed and buried after offering janazat prayer on him/her. However, in an unusual situation such as in this Ebola epidemic where washing or touching the dead body could expose many lives into danger, the Quran has warned by saying: "And do not throw yourselves into destruction". Al-Baqarah: 195. In fact there have been cases in Islam in which bodies were not washed: Muslims who died in the battle field fighting for the course of Islam are called Martyr and Martyrs are buried with their clothes and blood with no washing and no janazat prayer. Similar the bodies of Muslims who die in fire accidents and by drowning are usually not washed before burial. Nevertheless burial teams must ensure they preserve dignity of the dead and bury the corpse accordingly. The Prophet (PBUH) has warned against any form of maltreatment of the dead by saying: "Do not abuse the dead for they have met the reward of that which they presented before out of good or bad deeds". Bukhari 1393. 7

c. Quarantine and Isolation: Islam has long ago recommended the quarantine and isolation of infected patients with epidemics from non-infected ones. The Prophet (PBUH) said: "Do not let the infected ones come into contact with the healthy ones". Bukhari 5771. d. Contact with body fluids: Islam confirms the spread of epidemics through body contact like hand shaking, hugging etc. it therefore forbids close contact with infected persons, in order to avoid transmission of the diseases that may endanger the life of individuals. It is reported in Sahih Muslim that a delegation from Thaqif came to the Prophet (PBUH) to seek his allegiance and there was a leper amongst them, the prophet (PBUH) sent to him saying: "We have accepted your allegiance". i.e. don t come to us. I cannot shake hands with you because leprosy is contagious and could transfer through body contact. Sahih Muslim: 2231 e. Hygiene and cleanliness: Hygiene and cleanliness is one of Islam's preventive measures from diseases, and so it is a command and part of faith, in fact Islam connects it with human nature: Al- Baqarah: 222. f. Hand washing: Islam commands regular washing of hands. In Sahih Muslim, the Prophet (PBUH) said: "If any one of you awakes from sleep, let him wash his hands before inserting them into the container three times, for he does not know where his hands slept". Sahih Muslim: 278. g. Bush meat: Islam has made clear distinction between lawful and unlawful meats in the Quran and Hadith. The Prophet (PBUH) on the day of Khaibar warned against eating the meat of domestic donkeys, wild animals with canines and birds with claws". Sahih Muslim: 1934. Abu Dawood: 3813. h. Respect for Ebola Survivors and Health Workers: Victims of epidemics must not be stigmatized, for what happened to them was destined to be, no one could have stopped it. They must therefore be treated with honour and respect and must not be discriminated in the societies and penalized for a crime they have not committed. They too must be thankful and grateful to Allah for having healed them from the disease and waved their sins and raised them to higher levels of faith. As for those who die of the epidemic, they are considered in Islam as Martyrs, for the Prophet (PBUH) said: "Epidemics is martyrdom for every Muslim". Bukhari: 5732. So we should not lose hope. Let us strengthen our faith in Allah and believe that working together we shall win the battle against Ebola. 6. CHRISTIAN EVIDENCE TO SUPPORT EBOLA PREVENTION and CONTROL 30 mins. 8

This presentation will be done only for workshops with Christian leaders. (i). A resource person from CHRISTAG makes a short presentation (10 minutes) on the Christian View Point on the Ebola Crisis. He/she will provide evidence taken from the Holy Bible to illustrate what the Holy Bible says about the transmission, general prevention, safe and dignified burials, early referral of suspected cases of Ebola, and respect for Ebola Survivors and Health Workers. (ii). After the presentation the facilitator opens the floor for questions. (iii). He/she invites the resource person to respond to the questions (iv). He/she concludes the sessions highlighting the key points. Key Points Christianity proclaims that epidemics are not new to mankind. Biblical references contain the words pestilence, ailment, plague, terrible disease which appear often in the Old Testament. Leprosy as a contagious disease appears several times both in the old and new testament. Then I will do this to you: I will bring upon you sudden terror, wasting diseases and fever that will destroy your sight and drain away your life. You will plant seed in vain, because your enemies willeat it. The Lord will strike you with wasting disease, with fever and inflammation, with scorching heat and drought, with blight and mildew, which will plague you until you perish. (Deuteronomy28:22 and Leviticus 26: 16) However, Christians believe that diseases can be prevented and cured. The Bible provides ample evidence to support the public health measures being recommended for the prevention and control of the current Ebola crisis in our country: a. Medical Care: Seeking medical attention or healing is approved in the Bible, particularly in the New Testament where various people sought healing from Jesus including the blind, the lame, lepers, etc. as they had faith that he would do it. This virtue was even passed on to his disciples. That element of trust and faith should be manifested in people so that when people are sick especially of Ebola they straight away should try to seek medical care. Lev. 13: 3 Acts of the Apostles, The Gospels, St. Paul s letters b. Burial Rites: Those who touch dead bodies of an infected person are unclean and may infect others according to the Bible. "Whoever touches the dead body of anyone will be unclean for seven days. He must purify himself with water on the third day and on the seventh day; then he will be clean. But if he does not purify himself on the third and seventh days, he will not be clean. Whoever touches the dead body of anyone and fails to purify himself defiles the Lord s 9

tabernacle. He will also be unclean if he touches something defiled by a corpse. (Numbers 5:1-5; 19:11-16) c. Quarantine and Isolation: Quarantine to prevent the spread of infectious diseases is permitted in the Bible. Infected persons were instructed to isolate themselves outside the camp until healed, and were to shave and wash thoroughly. The priests that administered their care were instructed to change their clothes and wash thoroughly after inspecting a victim. Quarantine in the Bible normally starts with seven days and if no sign of cure it will continue until there is sign of healing on the patient. The person with such an infectious disease must live alone; he must live outside the camp (Lev.13:45-46). d. Contact with body fluids: The Bible is clear that those with infectious skin diseases, discharges may infect others If a descendant of Aaron has an infectious skin disease of a bodily discharge, he may not eat the sacred offerings until he is cleansed. Any crawling thing that makes him unclean, or any person who makes him unclean, whatever the uncleanness may be. The one who touches any such thing will be unclean till evening. He must not eat any of the sacred offerings unless he has bathed himself with water. Or by anyone who has an emission of semen, or if he touches it. (Numbers 5:1-5; 19:11-16) e. Hand washing: In Christianity the use of hands is first for lying of hands to heal, bless ward off evil and extend a hand of peace. This suggests that those hands have to be clean. Christianity is clear that cleanliness is next to Godliness. A hygienic environment is the responsibility for all to deal with avoiding infectious diseases. Hand washing is also seen as a practical approach to reducing diseases. Water treatment, sanitation and safe disposal of faeces were illustrated as sure ways of preventing diseases. (Deuteronomy 23:12; Leviticus 11:1-47; 15:1-33; Numbers 19:3-22; Matthew 15:1-2; John 2:6; Psm26:6; and Chronicles 21:19;) f. Bush meat: The Bible clearly spells out those animals and birds that can be eaten. By all indication monkeys and birds do not qualify. Say to the Israelites: Of all the animals that live on land, these are the ones you may not eat: You may eat any animal that has a split hoof completely divided and that chew the cud. There are some that only chew the cud or only have a split hoof, but you must not eat them. (Lev.11:1-4; Deuteronomy 14:3-21) g. Respect for Ebola Survivors and Health Workers: The Bible has always condemned all forms of stigma: 1. The story of the two Tamar s in the Bible Tamar raped by her half-brother and Tamar who had to seduce her father-in-law in order to get a child. 2. The woman with the issue of blood. 3. The paralytic man healed by Jesus that was looked down on because of his illness. 4. The Parable of the Good Samaritan the man that was abandoned to die. 5. The story of the disciples sending away children from Jesus. 10

All these people had experienced stigma after facing a disgraceful encounter. (2 Samuel 13:1-22; Gen.38; Mark 5: 24-34; Galatians 6:17; Psalm139:16; Luke 10:25-37; and James 1:27) So let s have faith in God for He will surely save us from this calamity. 7. GROUP WORK 20 mins The facilitator divides participants into 5 small groups. (i). Each group is provided with a poster paper and marker. (i). Each group is asked to nominate a chairman and reporter, who will take down the key discussion points from the group and make a short presentation to the big group. (i). Each group is requested to work on one of the following topics: Safe and Dignified Burials Early referrals of suspected cases of Ebola Respect for Ebola Survivors and Health Workers General Preventive Measures against Ebola Spreading the Message in our mosques/churches and communities 8. GROUP PRESENTATION 30 mins. (i). The facilitator asks participants to end the group work and return to the big group meeting. (ii). He/she asks the reporters from each of the small groups to make a 5 mins presentation to the big group highlighting the key points that came out of their discussion. (iii). After the group presentations, the facilitator summarizes the key points from the discussions and concludes the session. 9. THE WAY FORWARD 20 mins. The Chairman thanks participants for their contributions in the group work and invites them to mention FIVE important actions they will take to: 11

Educate their family members, friends, church/mosques members and their communities. Ensure safe and dignified burials in their communities Ensure early referral of suspected cases of Ebola in their families and communities Prevent the spread of Ebola in their communities Monitor and report on their activities to their zonal coordinators The facilitators will distribute ISLAG or CHRISTAG flags for mosques and churches. They will also distribute the weekly monitoring forms to participants. 10. CONCLUSION AND CLOSING 15 mins. (i) The Chairman thanks participants for their contributions during the workshop. (ii). He/she reminds them about the objectives of the workshop and asks if all the objectives have been achieved. (iii). He/she summarizes the main leaning points and follow-up actions. (iv). He/she invites a participant to move the Vote of Thanks (v). He/she calls for closing prayers. 12

Annexes Time table Materials Leaflet on safe and dignified burials Key messages on Ebola Prevention, Safe and Dignified Burials, Early Medical Care and Stigmatization Summary presentation on the Ebola Situation in Sierra Leone Prototype Kutuba on Ebola Prevention and Control Prototype Sermon on Ebola Prevention and Control Leaflet on CHRISTAG and EBOLA Leaflet on ISLAG and EBOLA Weekly monitoring form CHRISTAG and ISLAG flags to be hang on churches and mosques for easy of identification and reminders 13