The document discusses the Marburg virus outbreak in Uige, Angola, highlighting its high fatality rate, transmission methods, and the severe impact on the local population already suffering from poor health infrastructure. Cultural clashes between health workers and villagers disrupted traditional burial customs and led to fear and distrust, prompting efforts to improve communication and community involvement in health measures. To address these issues, health workers adopted more culturally sensitive approaches and provided educational resources to facilitate better understanding and cooperation.

1. Containing the Deadly
Marburg Virus
Maddie Frick

2. Marburg Virus
• Similar to Ebola
• Fatality rate of 24-88%
• No vaccine or cure
• Incubation period of 2 to 21 days
• Spreads from human-to-human through direct contact with bodily
fluids like blood or saliva
• Symptoms: fever, headache, rash, abdominal pain, and bleeding

3. Angola
• Small country in West Africa
• Country had minimal infrastructure from a devastating 27 year civil
war
•Country’s medical system lacked trained staff and proper equipment
• Life expectancy was 36 years
• Half the population was illiterate
• 70% lived below the poverty line
• 80% of the population was involved in subsistence farming

4. Angolan Burial Customs
• Body is laid out for a full day before being buried the following day
• Spend great amount of time with the body: ceremonial body washing
and kissing it goodbye
• Female member sits on the coffin
• They believe a neglected spirit might become vengeful, so they
handle the deceased with respect and care

5. Outbreak in Uige, Angola
• October 01, 2004-March 29, 2005: 117 of 124 initial cases of the virus
were fatal
• Source of outbreak was a hospital in Uige; patients and 13 nurses
died; people panicked and abandoned their posts
•Most deaths in Uige occurred in children under 5 years of age, but as
the outbreak grew more adults were affected
•By July 2005, the outbreak had been mostly contained after 329
deaths

6. Cultural Issues
• Health workers came into the surrounding villages in white protective
gear, unfriendly, wrap the decease, and take them away (interrupting
traditional burial customs)
• Apparently, the color white of their gear reminded the residents of
ghosts
• Workers did not pay attention to the different culture there; they only
focused on the quick containment of the disease

7. Cultural Issues Cont…
• Patients who died in the hospital were buried without any rites or
family present
• Families were not notified about a death nor were they told the cause
of death
• Village residents felt excluded from the management of the epidemic
and felt the “outsiders” were not listening to their concerns
• Fear, distrust, and grief turned to anger: some villagers threw rocks at
mobile units that entered the area in search of victims

8. Fixing the Situation
• Two medical anthropologists, a WHO Communications specialist, a
UNICEF team, and Angola Red Cross volunteers joined the social
mobilization teams
• 5 television spots were produced in Portuguese and 5 radio spots
were translated into 8 of the country’s most widely-spoken
indigenous languages
• Educational pamphlets were printed in Portuguese, French, and
Kikongo
• Daily messages were developed to combat rumors and
misinformation

9. Fixing the Situation pt. 2
• To reduce fears, health workers arrived at homes in street clothing
and then put on the protective gear in view of the family
• They also took the time to talk to families and formally recognized
their loss
• Burial customs were modified: bodies were placed in open bags for
viewing and family members could sprinkle the body with a mixture
of water and bleach
• Family members could also be present when the body was removed
from the home and could accompany the body to the burial site

10. Cross Cultural Communication Theory
• “Cross cultural communication can also refer to the attempts that are
made to exchange, negotiate and mediate cultural differences by
means of language, gestures and body language. It is how people
belonging to different cultures communicate with each other”
(Communication Theory, 2017).
• Avoid stereotypes and preconceptions
• Sources that lead to miscommunication: assumption of similarities,
language differences, misinterpretation of body language, and
tendency to evaluate

11. Discussion
• Even though the main issue here is culture, are there any other
wrongdoings that you can think of?
• In future outbreaks, how can international teams be better prepared
in communicating with their publics?
• What role did communication and PR play in this case study?
• Are there any other communication theories that could apply to this
situation?