A qualitative analysis of newspaper response to the Ebola outbreak in west Africa.

Author:Tshiswaka, Daudet Ilunga
Position:Report
 
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Introduction

The 2014 outbreaks of Ebola in the West African countries of Sierra Leone, Guinea, and Liberia have prompted the media to inundate audiences around the world with reports about the impact of the disease (Househ, 2015). This epidemic, which began in March of 2014 and has since killed over 9,000 people, is the deadliest outbreak since the discovery of the virus in 1976 (CDC, 2014c; Househ, 2015). Compared to HIV, the 2014 Ebola virus strain may well become the next pandemic disease due to the speed of its transmission if containment does not occur in a timely manner (Keneally, 2014).

Amongst these news stories, reports about a present EVD outbreak in the Democratic Republic of Congo (DRC) were included as well. Consequently, media representations about Ebola outbreaks, whether in West African countries or in the DRC, have tended to lump them all into the same qualitative category, despite the fact that both the past and the present of EVD outbreaks in the DRC differ significantly from the Western African countries' current experiences.

Historically, investigators in 1976 simultaneously encountered the Ebola virus for the first time at two places in central Africa: the Democratic Republic of Congo (DRC) (formerly Zaire) and Sudan (Breman et al., 1978). The discoverers named it after a river in a village located in the DRC where the first cases were found (WHO, 1978). The 1976 outbreak caused a considerable number of casualties both in the DRC and Sudan, with a case fatality of 88% and 53%, respectively. In West African countries, the current outbreak has caused many more casualties with only a 50% case fatality on average (WHO, 2014a). Undoubtedly, the massive media coverage of the recent EVD outbreaks contributed to the increasing number of its reported casualties (Fritz, 2015; Househ, 2015).

In contrast, over the past half century, the DRC has experienced seven EVD outbreaks, all of them in various remote areas of the country and each with different case fatality rates (WHO, 1978). During the first EVD outbreak in the DRC in 1976, drastic preventative measures including quarantine, discontinuing all needle or syringe injections, the wearing of protective clothing and respiratory devices, and proper disposal of contaminated excreta and fomites were used to help contain the disease (WHO, 1978). As with previous outbreaks, the 2014 outbreak occurred in various villages, with case count of 66, a 74% case fatality rate, and a total of 49 deaths (CDC, 2014c). Official containment of the outbreak on 21 November 2014 occurred approximately three months after its initial announcement (CDC, 2014a).

Considering the DRC's long experience with EVD outbreaks over the years, the country has addressed considerable difficulties involved in trying to contain the disease. This includes inaccessibility to some areas of the country, the lack of a strong landline phone network, and a lack of infrastructures (Heymann et al., 1999).

Facing these difficulties during the 2014 outbreak, the DRC Health Ministry and the Congolese print media took a 'polemic' approach to the problem when reporting EVD and its consequences for the country (Matshi, 2014). For example despite the fact that researchers generally advise declaring EVD contained only after a 42-day gap period without any newly diagnosed cases since the last known one (Global Alert and Response, 2014; Lusimana, 2014), Congolese officials nonetheless declared the outbreak contained on 24 September 2014 (Matshi, 2014). Some four weeks later, on 21 November 2014, the WHO officially confirmed the DRC's EVD outbreak as contained, (WHO, 2014b, 2014c).

Given the lower prevalence and fatality statistics for EVD in the DRC during this last outbreak compared to the Western African countries' experience, the DRC's relatively more successful containment may be linked to the effectiveness of well-tailored preventative measures, including print media campaigns against the disease. The aim of this study is to explore the construction of an Ebola outbreak narrative in mainstream Congolese print media as part of that preventative or containment strategy.

Material and Methods

The current study conducts a thematic analysis of media representations of EVD in the DRC utilizing a qualitative interpretive-descriptive analysis pertinent to health-related and nursing inquiries (Thorne, Kirkham, & O'Flynn-Magee, 2008).

Sample and Data Collection

Limiting our selection of stories to the time period of the most intense media coverage of EVD outbreaks, i.e., from 26 August to 31 October 2014 (CDC, 2014a), two researchers analyzed print-media stories and articles from nationally or regionally distributed newspapers to create a database of keywords associated with the outbreak, e.g., Ebola, virus, Democratic Republic of the Congo.

Purposive sampling was used to aggregate newspapers articles. Criteria for selection were: inclusion of the article in 'Le Fouineur' (www.rd-congo.info), an online Congolese database, as a way to identify and aggregate traditional and online versions of newspaper stories published in the DRC. We also collected local print editions of newspapers. Articles originally in French were translated into English and then back-translated into French to reduce the introduction of discrepancies (Sperber, Devellis, & Boehlecke, 1994) and to ensure the functional equivalence of the translated articles (Brislin, 1970).

Further inclusion criteria--based on the analysis of newspaper content to establish reliability (Lynch & Peer, 2002)--associated with the sampling pool collection included: the article had to be a complete story (i.e. not a promotional reference for a full story contained elsewhere); the article had to be written in complete sentences with a central theme; the article could not be part of a paid advertisement; and the article had to be longer than two print-inches in length (Lynch & Peer, 2002).

Data Analysis

Similar to Burnett, Johnston, Corlett, and Kearney (2014), our study analyzed Congolese newspapers thematically and summarized the content in light of a previously validated newspaper coding form (Kitzinger, 1999) in order to increase the reliability for this type of analysis (Crabtree & Miller, 1992). By providing both a summary and in-depth interpretive findings from print media aimed at preventative efforts during the 2014 EVD outbreak in the DRC (Hunt, 2009), our study aims to shed light on the explanatory force of data as it relates to the comparatively low spread of EVD in the DRC.

First, relevant terms were extracted from qualified articles and coded to identify patterns of language that addressed the containment, eradication, or elimination of EVD in the DRC. Following Ritchie and Spencer (2002), we analyzed the articles' discourse by

* reading and re-reading the newspapers in order to familiarize ourselves with the contents

* identifying a thematic framework through conceptualization of the terms

* indexing the thematic framework

* mapping and then interpreting the data to define concepts, create typologies, and find associations

* and producing a final...

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