Communication and advocacy pack
Case study
Combating cultural fears and
perceptions about cholera
On 12 January 2010 just before 5:00 pm, an earthquake measuring 7.3 on the
Richter scale struck Haiti for 35 seconds. It was the most powerful earthquake
to hit the country in 200 years.
The earthquake created an unprecedented situation, made worse by
the fact that it hit the country’s most populated area as well as its
economic and administrative centre. Later that year in October, an
outbreak of cholera was also confirmed in Haiti. The country had not
seen cholera for many decades so it was considered a ‘new’ disease to
the population. The cholera outbreak occurring as it did on top of the
devastating earthquake, brought a new wave of fear and stigmatization
due to beliefs and perceptions.
The Haiti Red Cross Society started psychosocial interventions to tackle
the psychological and social dimensions of the outbreak. This included
facilitating participatory group discussions, building trust to gain the
community’s acceptance of cholera treatment centres, conflict
mediation, providing individual psychosocial support to people who
have been infected, as well as counselling and supporting grieving
family members.
The communities had many different views about the disease, believing
it to be a supernatural phenomenon:
“It is a punishment from God. It is another divine sign that the end of the
world will come soon.”
Cholera, like any epidemic, is primarily addressed through prevention
campaigns and medical treatment. Psychosocial support interventions
can play an important role in the response to such epidemics. Using
basic psychosocial intervention techniques such as non-judgmental
active listening, group facilitation, psychological first aid and mediation
techniques, the staff and volunteers of the Red Cross psychosocial
teams were able to address beliefs, perceptions and emotions around
the cholera outbreak in the Haitian community. Through their closeness
to the communities and their understanding of these communities’
dynamics and perceptions, psychosocial workers were able to improve
trust and confidence between the population and humanitarian actors.
The psychosocial teams also supported anti-stigma and fear through
International Federation of Red Cross and Red Crescent Societies
2 I WDR press pack/Cholera case study / 2014 edition of the World Disasters Report
SMS campaigns and explored the issues through a live radio debate.
These interventions were of critical importance in a context where
distrust and suspicion affected the acceptance and work of
humanitarian agencies.
Reaching out to non-traditional actors
Due to rising fear and anger associated with the cholera outbreak,
people increasingly suspected that the disease may have been spread
by Hougan (Voodoo priests) and Vaudouizan (Voodoo believers),
contaminating water sources with “poud kolera” (magic powder). In
December 2010 at least 45 Voodoo priests were murdered by a
machete wielding mob after being blamed for causing the deadly
cholera outbreak.
Voodoo leaders contacted the Haiti Red Cross Society requesting for
training in the early detection of cholera infection and its prevention and
treatment. The training was carried out for members of the Voodoo
community and consequently, they became active in cholera prevention
efforts at a national level. Given the importance of the Voodoo religion
and its broad following in Haiti, it was crucial having this group of
trained individuals actively combating cholera in the communities.