Before the first field teams leave for affected communities in the Democratic Republic of the Congo, Julienne Anoko a WHO risk communication and community engagement officer is awake, reading overnight updates: new alerts, suspected cases, community rumours, security concerns and signs of resistance.
The day begins at 5:30 a.m. By 6:30, Julienne is already shaping the messages that may determine whether a family reports symptoms, whether a household accepts disinfection, or whether a community agrees to a safe and dignified burial. “A typical day in my role starts early with preparation and coordination,” she said.
By 7:30 a.m., Julienne joins WHO’s morning stand-up meeting, where the different pillars of the Ebola response come together: surveillance, infection prevention and control, laboratory teams, coordination, protection from sexual exploitation and abuse, psychosocial support, human resources and case management. Her role is to bring the community into the room — sharing insights from the community—such as misinformation, resistance, or concerns—and help align engagement strategies with the latest outbreak data. This ensures that messaging is both accurate and responsive to community realities.
In an Ebola outbreak, a message that is technically correct is not always enough. It must also be trusted.
“My role is essentially to act as a bridge between the communities and the response teams,” she said, “ensuring that interventions are not only technically sound but also socially accepted and trusted.”
By mid-morning, the work moves from coordination rooms to courtyards, health zones and family compounds. Before entering an affected community, the first concern is safety. In areas affected by insecurity, she seeks clearance from WHO security teams. Only then does the visit proceed, usually with the medical doctor of the health zone, a community health worker and a local leader.
That order matters. Julienne does not arrive as an outsider with instructions, but through people the community already knows.
On arrival, the community health worker or leader introduces her and explains the purpose of the visit. She watches carefully: how people greet one another, who speaks first, whether the family is grieving, whether prayers are said before the discussion begins.
If a family has lost someone, she asks for the person’s name and uses it during the conversation.
Empathy, in this work, is not a soft skill. It is operational.
“When I arrive in a community, I always give the floor to the community health worker or community leader to introduce me,” she said. “I show empathy all the time and listen actively to the family.”
Julienne’s day is built around two-way communication. From 8:30 a.m. until mid-afternoon, the work may include community dialogues, meetings with youth groups, visits to households, support to contact tracers, or helping burial teams when families are fearful or resistant.
Sometimes she trains national counterparts and partners in risk communication and community engagement. Sometimes she takes urgent calls from field teams facing unexpected resistance.
And sometimes, she goes to the Ebola treatment centre to help families accept the painful necessity of safe and dignified burials.
The fears are rarely simple. In this outbreak, she said, some communities initially believed the illness was caused by poisoning, witchcraft or sorcery. Some believed Ebola was fake. Others suspected foreign interests, including Western countries or mining companies, of using disease as a plot to control local resources. One rumour described a “magic coffin” moving through communities and attacking people.
Behind that rumour was a real chain of grief. According to Julienne, a woman from Mongbwalu Health Zone in Ituri died in Uganda and her body was brought home in a damaged coffin.
The family changed the coffin and burned the old one. Soon after, relatives began falling ill and dying. In the community’s telling, the deaths were linked to the coffin.
It took two weeks of intensive social mobilization before attitudes began to shift. People started to accept that Ebola was real and that practical measures — handwashing, early reporting of symptoms and avoiding unsafe burials — could protect families.
One case still informs how Julienne approaches communities today, though it happened during a previous Ebola outbreak in North Kivu in 2019.
A woman who was nine months pregnant had died. Local custom required that the foetus be removed from the mother’s body and buried separately. But for the Ebola response team, the procedure carried serious biosecurity risks. The family refused the proposed safe burial and asked to take the body back to the village, where they intended to perform the ritual themselves.
Their fear was not abstract. They believed that if the custom was not followed, other pregnant women in the community could die as punishment from angry ancestors.
Julienne spent three days negotiating between the family and the response team. Drawing on knowledge of the local sociocultural context and experience as an anthropologist, she helped identify an alternative reparation ritual that would allow the family and community to honour their beliefs without exposing others to infection risk.
The family accepted. WHO supported the ritual, and the safe and dignified burial was carried out. Afterwards, the response team and the community marked the ritual together.
For Julienne, the lesson from North Kivu remains central to the current Ebola response: communities do not abandon deeply held beliefs because responders arrive with technical instructions. Trust is built when public health measures are explained, negotiated and adapted in ways that protect life while respecting grief, culture and dignity.
Such work requires more than public health messaging. It requires translation between systems of meaning: biomedical risk, ancestral obligation, grief, dignity, fear and survival.
To explain an Ebola treatment centre, contact tracing or safe burial, the Julienne first gathers answers from technical teams.
What care is provided? Is it free? What food is given? Do doctors speak local languages? Can families visit? What does contact tracing involve? When does it end?
She then prepares questions and answers before families ask them. The goal is to show that their fears have already been heard.
“The family understands that I share their worries, and they trust me,” she said. “Most of the time, they ask for my phone number to continue to ask me questions.”
The emotional burden is heavy. The hardest moments come when Julienne offers condolences and families begin to cry. The deaths of pregnant women, babies and children are especially difficult.
“A pregnant woman should not lose her life to give life,” she said. “It’s not natural for parents to bury their children.”
Yet she tries not to cry in front of families. “I believe that they are suffering more than me,” she said. “I just support them in the bereavement.” There are also moments when one conversation changes the course of a response.
On 5 June, Julienne visited a family whose daughter had died on 28 May and had been classified as a probable Ebola case. While laboratory results were pending, the response team needed the family to accept home disinfection, investigation, contact listing and contact tracing. The family refused, insisting first on laboratory proof.
She listened for more than an hour. Then came an explanation of why early preventive measures mattered. Psychological support was offered.
Eventually, the family accepted disinfection and psychosocial support. When results later confirmed infection, she returned with a psychologist.
The family accepted all public health measures and appointed a family member as a focal point for contact tracing and early detection of symptoms.
By 3:30 p.m., the field day gives way to documentation. Julienne compiles community feedback, rumours, concerns and behavioural trends to inform priorities for the next day. From 5:00 p.m. to 7:30 p.m., there is a national strategic coordination meeting to review the dynamics of the response and plan risk communication and community engagement interventions.
The day does not end there. Between 8:00 p.m. and 10:30 p.m., she writes the daily report, compiling updates from all three affected provinces for WHO’s surveillance and data management teams.
The rhythm is relentless: listen, explain, negotiate, document, coordinate, return. But when asked what stays after a long day, she does not speak first of exhaustion.
“What stays with me is the feeling of accomplished duty,” Julienne said. “What stays with me is that I am useful and I help save lives.”
In an Ebola outbreak, some lifesaving work happens inside laboratories, ambulances and treatment centres. Some happens at the threshold of a home, where a frightened family decides whether to open the door.
For Julienne, that is where the day begins — and where before dawn, it will begin again.
