Guest post from Katherine Marshall, Olivia Wilkinson and Dave Robinson
Ebola and COVID-19, two devastating infectious diseases that spread rapidly through populations, crossing boundaries of all sorts, put local, national, and international health systems to crucial tests. They also try religious communities, locally and globally. We are learning vital lessons from both experiences. First, religion and science must combine their strengths. For this, religious voices must be at the medical and public health crisis tables, and scientific voices at the religious ones. Second, both the distinctive strengths and potential limitations of each need to be understood and appreciated in planning and operationalizing responses at all levels, from global to local.
In the COVID-19 pandemic, a religious community played a central role in the initial outbreak in South Korea. Today worldwide, fierce debates about physical distancing and its implications for religious gatherings have catapulted religious topics onto agendas much earlier than during the Ebola crisis. But the Ebola experience provides invaluable lessons.
Ebola was virtually unknown to most West Africans in 2014 when a local outbreak suddenly erupted into a global health crisis. A frightening disease that kills many under the best of circumstances, Ebola struck countries (Guinea, Liberia, and Sierra Leone) with weak health systems, and with economies and societies ripped apart by war and other conflicts. Borders and schools were closed; farms essential to food supplies were severely disrupted. Basic social norms collapsed; teen pregnancies rose sharply. Throughout the world, fear spread faster than any biological pathogen, escalating into near-panic that the outbreak could become a global epidemic. A rapid and monumental international mobilization brought doctors, supplies, and experts of all kinds pouring into the region. Health care workers wore terrifying spacesuit-like outfits. The dead – eventually over 11,000 — were carried away and cremated or tossed in mass graves.
But in their own separate worlds, most local pastors and imams knew as little about the plague as their congregations did. They laid hands on people, with some calling the epidemic the wages of sin. Others, however unintentionally, fed the atmosphere of fear and distrust. Medical teams were attacked and killed in some places, especially where years of bitter conflict had deepened cultures of suspicion.
Despite understanding that working effectively with local communities was crucial, few public health experts initially thought to consult or even engage religious leaders, formal or informal, including traditional healers. Yet religious leaders not only were often more trusted locally than government officials or other leaders, they also ran many local hospitals and clinics. The accelerating nightmare forced public health leaders to alter their approach. Many people died after handling bodies, with one World Health Organization expert estimating that 20 percent of new infections occurred during burials. Terror and mistrust led people to dig up hastily buried bodies to provide traditional rituals. After hasty consultations between religious and public health leaders, a protocol for decent burials was worked out. Organizations reached out to pastors and imams, explaining the disease to them and enlisting their support. Religious communities were often the leaders in caring both for the sick and growing numbers of orphans. Anyone with open eyes saw that local religious communities were crucial partners.
Forging partnerships, however, was not simple. As is often true across the world, West African religious institutions are diverse and complex, with countless sometimes-competing and mutually-distrustful churches, mosques, and traditional healers. In addition, as the Ebola epidemic vividly demonstrated, the complexity extends to the wide range of vital roles religious communities play in many aspects of life. Health is one, but so is education, care of the most vulnerable, water, even energy.
So what lessons should we draw from the Ebola experience as we face a far more global and far more devastating health emergency today in responding to COVID-19?
First, understanding that the religious landscape is complex and dynamic is a prerequisite for a good response. This goes beyond understanding the varied natures of “religious” entities, and the many different and vital roles they play in communities. It is also crucial to understand who among religious actors is represented at national levels, who has existing connections with UN and other humanitarian actors, who does not have such connections and why, and how significant religious actors can be reached. This can include religions and denominations that are in minorities, that are less formally organized in structure, and informal leaders, for example among women and young people who are not represented in formal, hierarchical structures. Reaching traditional leaders and healers can present special challenges.
Second, effective partnerships with religious actors requires that they be “at the table”, and not only after emergencies have occurred. This, too, is complex, requiring respectful navigation and bridging of the common gulfs between languages of science and theology, and also efforts to ensure that the presence of actors is appropriately inclusive. Hearing voices of women and young people, is both challenging and important.
Third, interreligious partnerships and action can help – emergencies are often an opportunity for unprecedented collaboration – but this is not easy and demands constant attention and resources. Multiple channels of communication are needed; assuming that a single voice will reliably represent diverse perspectives is dangerous. Forging and supporting intra-religious collaboration between groups of one identified overall faith – “Christian” or “Muslim” or other – is often essential, but can vary in practice depending on the demographics of a country, and how groups have previously worked together.
Fourth, while governments and international institutions are beginning to appreciate both the power and complexity of religious institutions, “literacy” about faith communities is often severely limited, and even sincere efforts at outreach can be poorly executed, deepening rather than alleviating mutual suspicion, if not active hostility. Finding good “interpreters” is critical, both in crises, and for the longer term. Too often, brief emergency outreach to faith communities on key public health topics has been a norm and even then the communication is too often one-way, failing to ask the faith communities what information they themselves are seeking, or inviting their own recommendations for how responses can best address the needs in their communities.
The Ebola crisis offers a vivid example of how failures of public health initiatives to engage religious actors collaboratively can hinder crucial public health objectives. In contrast, effective partnerships with religious actors can lead to major improvements in achieving public health goals. Building bridges between development and faith, science and spiritual approaches is vital.
In the COVID-19 pandemic, the speed and effectiveness with which such bridges are erected will likely have enormous impact on how many people survive the pandemic. As we unite globally to solve the myriad scientific, technical, and logistic challenges that ending the pandemic will require, surely we can unite to bridge the worlds of science and religion, in service of their and our shared commitment to our fellow human beings.