Communication and Coordination

Vulnerable Populations

The learning objective of this module is to provide you with a foundational understanding of vulnerable populations. 

At the end of this module, you should be able to:

 

·         Describe vulnerable populations

·         Explain what makes people vulnerable

·         Define stigma

·         Discuss ways to promote gender equity in preparedness and response initiatives.

 

The primary objective of public health is to protect human life. For some people, staying healthy and safe is more difficult than it is for others. These vulnerable populations require special attention.

 

The phrase vulnerable populations is very clinical, but essentially vulnerable populations are those people who face a higher risk of injury, disease, or death during an outbreak or emergency.

Vulnerable populations include:

 

·         Women;

·         Children;

·         Older people; and

·         People with disabilities.

 

You know people who are part of a vulnerable population. You may actually be among them. Or you will be among them if you live long enough.

 

Older people are considered a vulnerable population.

Vulnerable populations also include people who have difficulty communicating – because of language or other factors – AND those who have difficulty accessing medical care.

 

The Global Fund to Fight AIDS, Tuberculosis and Malaria defines vulnerable populations as:

 

“People whose situations or contexts make them especially vulnerable, or who experience inequality, prejudice, marginalization and limits on their social, economic, cultural and other rights.”

 

In general, women, children, the elderly and disabled people are more vulnerable in terms of adaptation and survival – in emergencies or disasters – when compared with adult men. (Sheikhbardsiri, Yarmohammadian, Rezaei, & Maracy, 2017)

 

What does that mean for emergency preparedness? There are extra considerations and steps to take to address the unique needs of vulnerable populations.

 

One of the most effective ways to educate and connect with vulnerable populations is to partner with organizations and people who already interact with them.

 

For example, faith-based communities – including traditional chiefs and respected community leaders – often provide support to pregnant women, children, the elderly and people with disabilities as part of their mission and everyday activities.

 

These communities and groups often have a built-in framework for supporting members of vulnerable populations.

 

Cultivating relationships with these groups should be part of any preparedness and planning activity. These partners are your allies in ensuring that the needs of vulnerable populations are addressed and respected.

 

Likewise, schools provide a built-in network of support for children – another vulnerable group. Schools are an important way to reach parents too, and support them in taking steps toward emergency preparedness and taking steps during a response.

 

Communication and coordination with these groups is important across every stage of preparedness and response.

 

During the 2014-2016 Ebola response, a community-based strategy of social mobilization and community engagement was effective in case detection and reducing the extent of Ebola transmission. (Li et al., 2016)

 

As part of your preparedness efforts to address vulnerable populations, ensure that your communications are two-way conversations – not just one-way directives from authorities.

 

Your message is not just, “Here’s what the Ministry of Health intends to do for vulnerable people in an emergency.” It’s a two-way conversation in which communities are an integral part of the discussion.

 

Communities need support to provide emergency planners with information about vulnerable populations in their midst, and share what they perceive are their most pressing needs.

 

Preparedness plans are then a collaborative effort rather than a list of imposed directives.

 

Building relationships with groups and organizations that support vulnerable people takes time and patience. It’s worth it.

 

Another vulnerable group is women. When you’re building your preparedness plan, target the actions you take based on gender analysis. These actions will be evolving during an emergency response, so it’s critical to allow for adaptation to your tactics.

 

The organization CARE International recommends these steps to promote gender equity in the context of emergency planning:("CARE Emergency Toolkit,")

 

·         Design services to meet the different needs of women, men, boys and girls;

·         Make sure that women, men, boys and girls have equal access to services;

·         Make sure that women, men, boys, and girls can participate equally in response activities; and

·         Ensure that the data FROM women is collected BY women.

 

From a planning standpoint, CARE recommends that organizations should:

(Smith, 2007)

·         Train women and men equally;

·         Consider women’s and men’s different needs and capacities in planning;

·         Implement programs to prevent gender-based violence; and

·         When you collect, analyze, and report data – break down the data by sex and age.

 

Gender-based violence is an umbrella term used to describe any harmful act perpetrated against a person’s will based on gender differences. It includes acts that inflict physical, sexual or mental harm or suffering – as well as the threat of such acts, coercion and other deprivations of liberty. (Glass et al., 2018)

 

During an emergency, violence against women is often exacerbated, particularly in conflict settings. (Vu et al., 2017)

 

Gender-based violence remains one of the most prevalent and persistent issues facing women.

Stigma is often an issue for vulnerable populations, particularly women and children.

 

Stigma is defined as an attribute or characteristic that is devalued in a particular social context. The act of stigmatization serves to reduce an individual from whole and usual to a tainted, discounted one. (Pachankis et al., 2018)

 

Many orphans and widows of Ebola survivors during the 2014-2016 Ebola outbreak suffered stigma and isolation.

 

Likewise, Ebola survivors frequently faced stigma when they were released from Ebola Treatment Units and returned to their communities. (Nuriddin et al., 2018)

 

In each case, these vulnerable populations were stigmatized based on circumstances beyond their control.

 

There are three characteristics of stigma:

 

·         The problem is something the person stigmatizing others believes he or she can control;

·         The problem is distinguishable, which is to say that not everyone has the problem; and

·         The problem provokes a reaction that places distance between people.

 

Risk communications play an important role in combatting stigma. Keep in mind:

 

·         Communications outreach should balance the REAL risk with the needless association one person or identifiable group.

 

·         Emergency responders must take an active role in dispelling misconceptions and correcting faulty assumptions.

 

For emergency planning and response, stigma must be counted among the factors impacting vulnerable populations.

 

The burden of caregiving also falls primarily on women in society. (Fawole, Bamiselu, Adewuyi, & Nguku, 2016)

 

Because they are often the ones caring for sick people, women are often at increased risk of infection. They are also at increased risk of being stigmatized in their communities because they’re caring for sick people.

 

It is therefore critical that preparedness and response initiatives recognize the value of women’s roles and lives.

 

Emergency preparedness must address issues of stigma associated with being close or caring for sick people, and seek to combat the social isolation that women often face. (Sastry & Dutta, 2017)

 

The ECOWAS Gender and Development Centre has a mission and mandate of supporting gender equity and equality in the region. It is an outstanding resource for strategies, principles and assistance to support women. You can learn more by visiting:

 

http://www.ccdg.ecowas.int/?lang=en

 

Thanks for joining us.

 

References:

CARE Emergency Toolkit. Retrieved from https://www.careemergencytoolkit.org/gender/3-gender-in-emergencies/7-gender-in-emergencies-dos-and-donts/

Fawole, O. I., Bamiselu, O. F., Adewuyi, P. A., & Nguku, P. M. (2016). Gender dimensions to the Ebola outbreak in Nigeria. Annals of African medicine, 15(1), 7-13. doi:10.4103/1596-3519.172554

Glass, N., Perrin, N., Clough, A., Desgroppes, A., Kaburu, F. N., Melton, J., . . . Marsh, M. (2018). Evaluating the communities care program: best practice for rigorous research to evaluate gender based violence prevention and response programs in humanitarian settings. Conflict and health, 12, 5-5. doi:10.1186/s13031-018-0138-0

Li, Z. J., Tu, W. X., Wang, X. C., Shi, G. Q., Yin, Z. D., Su, H. J., . . . Liang, X. F. (2016). A practical community-based response strategy to interrupt Ebola transmission in sierra Leone, 2014-2015. Infect Dis Poverty, 5(1), 74. doi:10.1186/s40249-016-0167-0

Nuriddin, A., Jalloh, M. F., Meyer, E., Bunnell, R., Bio, F. A., Jalloh, M. B., . . . Morgan, O. (2018). Trust, fear, stigma and disruptions: community perceptions and experiences during periods of low but ongoing transmission of Ebola virus disease in Sierra Leone, 2015. BMJ global health, 3(2), e000410-e000410. doi:10.1136/bmjgh-2017-000410

Pachankis, J. E., Hatzenbuehler, M. L., Wang, K., Burton, C. L., Crawford, F. W., Phelan, J. C., & Link, B. G. (2018). The Burden of Stigma on Health and Well-Being: A Taxonomy of Concealment, Course, Disruptiveness, Aesthetics, Origin, and Peril Across 93 Stigmas. Personality & social psychology bulletin, 44(4), 451-474. doi:10.1177/0146167217741313

Sastry, S., & Dutta, M. J. (2017). Health Communication in the Time of Ebola: A Culture-Centered Interrogation. J Health Commun, 22(sup1), 10-14. doi:10.1080/10810730.2016.1216205

Sheikhbardsiri, H., Yarmohammadian, M. H., Rezaei, F., & Maracy, M. R. (2017). Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review. World journal of emergency medicine, 8(4), 253-263. doi:10.5847/wjem.j.1920-8642.2017.04.002

Smith, R. A. (2007). Language of the Lost: An Explication of Stigma Communication. Communication Theory, 17(4), 462-485. doi:10.1111/j.1468-2885.2007.00307.x

Tool Kit on Gender Equality Results and Indicators. (2013). Retrieved from https://www.oecd.org/derec/adb/tool-kit-gender-equality-results-indicators.pdf

Vu, A., Wirtz, A. L., Bundgaard, S., Nair, A., Luttah, G., Ngugi, S., & Glass, N. (2017). Feasibility and acceptability of a universal screening and referral protocol for gender-based violence with women seeking care in health clinics in Dadaab refugee camps in Kenya. Glob Ment Health (Camb), 4, e21. doi:10.1017/gmh.2017.18

 

Graphic courtesy ("Tool Kit on Gender Equality Results and Indicators," 2013)