Belief in the time of Covid-19: Understanding the making of meaning and trust to maximise public health responsiveness of faith communities in DRC

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In Democratic Republic of Congo(DRC), faith communities and their medical services are central to reducing contagion. They should be urgently deployed. Religious belief and traditional healing practices are part of the framework in which Congolese people understand disease and respond to it. Understanding the contextual response to Covid-19 is vital to reducing its spread. Faith Communities support over 50% of biomedical care in North-east DRC. They are vital, trusted providers of care. They bridge community and professional sectors, providing supportive networks, medical treatment, prayers for healing. They have led medical response and social restrictions to the recent outbreaks of Ebola (2,250 dead between 2018-2020) and measles (killed 6,500 since 2019). They have knowledge of disease management and are integral to developing community-led solutions to endemic cholera, HIV, malaria, meningitis, plague. Their resilience in the face of multiple losses and repeated disease give insight into communities' capacity for restoration. Yet faith-health beliefs in DRC do not always lead to positive disease control. Disease outbreaks, like Ebola, propel particular beliefs about life, death, sickness, healing, the seen and unseen that, when there is no cure or vaccine, can present appealing alternatives to physical distancing, closure of community organisations and alterations to rites of passage.We examine the application of belief in DRC where faith communities are leading the health-care response to Covid-19 and where the scientific and spiritual operate within the same conceptual framework. Recorded cases of Covid-19 are low in many African countries. This is, in part, related to a lack of diagnosis and testing. DRC had its first recorded case in Kinshasa on 10th March 2020. But until May only one institution in the country had testing capacity. Numbers have risen steadily, and been reported Ituri and Nord-Kivu. Covid-19 compounds the urgent medical and security concerns of the region. Yet Covid-19 also highlights good practice of disease management and resilience in a region that is familiar with epidemics. We ask how Covid-19 and the public health strategies for mitigation and management are being understood, delivered, and actioned. We aim to understand, predict and mitigate adverse public reactions to civil contingency measures. A public health response using trusted communities is the best chance of reducing the death toll whilst there is no cure or vaccine. However, the measures taken in High Income Countries may not be appropriate for LMICs, and they rarely consider discourses of religious faith. The Congolese members of the project team are already investigating meaning-making discourses around Covid-19 in Ituri and Nord-Kivu. They are identifying disease management knowledge, and communal beliefs that support and critique protection and prevention practices. Findings from this in-depth examination will be used to co-create public health messages that are trusted and trustworthy and allow effective, emergency mobilisation of volunteers in faith communities. Our study of contemporary religious belief examines the beliefs and moral capacity of faith communities and their medical services to maximise community-inspired action and ensure community ownership. It is a timely piece of work that has implications for disease prevention beyond Covid-19. It informs a debate on how to increase public health capacity in fragile states where national governments rarely support the structural transformation required.