LTC4: Lessons in Crisis Communications and Response

In this BSC podcast, Professor Matt Andrews interviews Peter Harrington, who shares his lessons learned from leading crisis communications during the Ebola crisis in Liberia.

Read our Public Leadership through Crisis blog series

Transcript

Katya Gonzalez-Willette: Hello and welcome to Building State Capability at Harvard University's Podcast Series. In this BSC odcastp, Professor Matt Andrews interviews Peter Harrrington, who shares his lessons learned from leading crisis communications during the Ebola crisis in Liberia. 

Matt Andrews: I am with Peter Harington, Peter works for Oxford Policy Management, and he worked before this with us at Building State Capability and also with the Africa Governance Initiative of Tony Blair when they were helping out in Liberia with the Ebola epidemic there. Peter, welcome to this conversation. 

Peter Harrington: Thanks. Really nice to be with you. 

Matt: Let's ask our first open question so can you just explain to people who are listening -What is your experience? What did you do in Liberia and what kind of roles did you play during that epidemic? 

Peter: So in 2014, when the Ebola epidemic started to scale up in West Africa, by then I had actually, for about two years, I had left the Tony Blair Africa Governance Initiative (AGI). But I had spent from about 2010 to 2012 in Liberia with AGI working in various roles in the president's office for the Ministry of Information, on strategic communications, on other reform areas. And in 2014, when the Ebola crisis started to accelerate and escalate, AGI asked various alumni to come back, people who could hit the ground running and slot in easly who knew the content. And so I responded to that alongside various other people and arrived back in Liberia in the autumn of 2014. That was the time when the crisis was at its height, really in Liberia. The exponential growth in cases was threatening to overwhelm not just the health system, but the whole country. The state infrastructure was starting to buckle. But around about November time, the crisis kind of turned a corner and the curve in terms of numbers of cases started to go down. The role that I played while in Liberia was I mean, all of us were doing a variety of things. So AGI had a team of people, I think there was about five of us, some of whom had to stayed in the country, some of whom who did come back like me and AGI had basically found ways to help or ways to support in roles in different parts of the response system. So basically, a couple of people worked mainly on the president's office side and a couple of people worked on the side of what was called the Incident Management System (IMS), which was a new institution that had been set up to manage the crisis response. So the whole new structure and apparatus separate from the kind of existing institutional structure. And I supported the INS in a variety of ways. But the main thing I worked on was in the area that was known as social mobilization, which is really all about public communications, conveying information and particular behavior change communication. So mobilizing the public, the citizens of the country to engage, cooperate with the crisis response to change behavior and to help bring the crisis down. So that involves a lot of working between different agencies - the President's office, with the Ministry of Information, with the IMS, with various international partners who were there - trying to craft messages, find resources, bring some coordination and some coherence to the messages and the public information that was being provided throughout the crisis. 

Matt: Could you describe a little bit what the IMS looks like? What did it look like and how did it differ from a conventional government kind of organization? 

Peter: Yeah, I can. So I dont have an org chart. I was actually looking for an org chart of the IMS before this conversation, but of course I couldn't pick one out. The IMS was essentially a new structure. I believe it was created on the advice of the American CDC, which had arrived in Liberia a couple of months prior, and it advised that you, Liberia need to very quickly have a separate institution because this crisis is going to overwhelm your Health Ministry. Your Health Ministry won't have the capacity to run this. So you need to almost from scratch build a new apparatus. It had a sort of executive committee at the top. It was rocky, but it was quite flat. It was remarkably flat. And I think that links to some of the other conversations you've been having about that kind of Snowflake Structure where there were various different teams and cells of this new entity, this institution, that took responsibility of different aspects of the crisis. Everything from logistics, so moving people in materials around, coordinating with the military, to financial management - making sure that money kept flowing so the crisis response activities were properly resourced, to operating and managing the hard infrastructure of the response - setting up Ebola treatment units which were separate facilities for managing Ebola cases so that cases weren't being sent to hospital. Again, it was all about setting up a separate new parallel system so that the existing system didn't crumble. So there were cells that were responsible for that hard infracstructure, so managing ambulances, running a call center. There was a unit that was very soberingly called Dead Body Management, whose responsibility was to manage burials and to ensure that highly contagious fatalities were managed properly. And then there were what I would call the softer infrastructure sides of the response, so data gathering, information management and social mobilization, psychosocial teams who were looking at how do we make sure that the vulnerable groups are protected? How do we make sure that the kind of social aspects to this are looked after as well? And so that social mobilization, public information part of it, which I can talk about more about that kind of softer infrastructure side. But as I say, it had some hierarchy, you know, each of those teams had a leader and the leader reported to Tolbert Nyenswah. It was the czar put in charge of the IMS by the president, but it was remarkably flat as well. This was a Liberian structure staffed by Liberians. But the international partners were then plugged into different places in that IMS according to their expertise and their resources and their best area to provide support. 

Matt: So would it be right to say that Tolbert, who is leading this initiative and who was maybe, let's say, kind of in the nucleus of the snowflake, depended on all of the people in these different areas to be doing the jobs? And he had a coordinator who would connect up to him and come and tell him what was going on. And he was the decider in chief, let's say. But there were people who were developing the information coming up with the ideas, bringing them to him so that he had the points of decision, and then they were the ones who were acting - Is that kind of how it seemed to work?

Peter: That's right. But he was a decision maker, but him and his close team were also like a server on a network. So it's not just the apex of the pyramid, but a server where this sort of intersection where all these different parts and moving parts of the crisis kind of intersected and had to pass through. You know, that connection kind of hub perspective is really important. It's also really important to know that this was not the president herself taking this role. The president had delegated this role to a competent and capable leader, which I think was a really important aspect of how this is setup. 

Matt: That's great. Thank you, Peter. I think it sounds very much like the kind of snowflake model and there's always going to be some hierarchy because people have those roles, right. And the role of being the decider, the role of being the one who sets the tasks is going to be super important. So given that you worked in this, just an open question is what kind of lessons, and it sounds like one of the lessons might be - if you're the president, you need to remove yourself a little bit from the direct action and you need to have other people working -that sounds like an interesting lesson, but maybe give me three, four lessons that you have to offer from the experience for people who are playing different roles in this kind of response. 

Peter: Yeah, there are many, but I'll try and pick out a few. I think the first lesson probably for a national leader is the one we've just noted, which is you need to be very, very hands on and engage with this crisis, but you cannot do everything yourselves. And you need to find a leader, a crisis coordinator who can really kind of quarterback this process effectively and delegate the work to them. You can't delegate accountability, but you can delegate work. And the same goes for that crisis coordinator who can't delegate their accountability, but they can delegate work and they need to stay above certain things and be big decision maker. That point about retaining energy to protect that kind of decision making muscle which you have to use and overuse in the coming weeks. I think the second thing I'd say, which is a lesson that AGI drew out, but I think many people drew out, was - it's very important to have a very clear leader. I think we've seen in some countries in high profile cases where there's been more than one leader. You have to have a very, very clear, for everybody, who is actually calling the shots in the crisis coordination. So if you have two or three people, perhaps a Health Minister who is vying with a national czar, who's vying with the equivalent of the head of the CDC, it can get very difficult very quickly. The natural leader has a responsibility to make it very clear who is the quarterback and how others fit into that. A third thing I'd say is that the qualities of that person, it's more important that they are an effective leader and have crisis leadership qualities than that they are necessarily the most technical expert person in the country. I think the Tolbert Nyenswah was an exceptional leader. But he wasn't the most senior health official in the country. He'd actually been a deputy minister, so he was suddenly in a position of seniority over cabinet ministers, which could've made things very difficult. But he took that in his stride and managed that quite effectively. I think other very, very early out of the doors lessons - I think this has been said in many ways, in many places, but don't wait for overanalysis. You just have to start work and start putting teams to work. Start learning. This is a huge adaptive learning process. So you have to actually just get moving. For listeners or readers who are familiar with the Cynefin framework, we're in the chaotic kind of quadrant where you have to act and find kind of emergent solutions. We're not in a simple, complicated or even complex one, we're in a quite chaotic situation where the important thing is to actually get moving and to do things and then iterate as you go. Don't wait to overanalyze and come up with perfect solutions. We've spoken elsewhere about how important it is to really put resource into data and be able to gather data. It really is so essential in a public health epidemic to be able to have useful data that you can actually make yourselves and that has some degree of accuracy. You recognize you're never going to have perfect information. I think your discussion with Shruti Mehrotra emphasized that point. And I agree that you have to recognize that and acknowledge probably that you will never have perfect information. And I think that the last lesson that I'll just flag up here at this point is the importance of the messaging and the communication that you take on. You have to start communicating early and a lot and then keep doing it. So don't wait to be getting messages out to people. But there's a variety of really useful tools and elements and ingredients that can make your communication more or less effective. But you have to really, really make a priority of it, whether you are the head of state, the head of the overall crisis coordinator, whether you are a provincial leader or a person in a particular part of the structure - being able to convey clear messages and do it consistently is really important. So do not, absolutely do not neglect the communication side of it. 

Matt: You say that there's some tools that can make this easier. I wonder if you could share some ideas and some lessons. One example that I remember you explaining to me before was that the public health experts came with a long book or a long paper that they wanted you as the communications folks to get out to everybody. And you guys basically said, no, no, no. Those are words that people don't understand, there are things that are not clear to people, we need to boil this down to something. And I think your strategy was to boil it down to kind of a one page note with bullet points and very clear messages. Can you maybe tell us a little bit about that story and what you did there and then some of the tools or some of the rules of thumb or lessons from the road that you could share to make this a little bit easier for folks? 

Peter: Yeah. So in the Ebola case. So once I started to work on the social mobilization and messaging side of things, at the time, the Ministry of Information was giving daily and sometimes twice daily press conferences. These were conflicting with press conferences that were sometimes given by the Incident Management System, so the media were not not clear who the mouthpiece was and where the information from the government was coming from. The information between those different entities was badly coordinated. Sometimes the President's Office would speak as well. So there were different actors speaking. And there was also, you know, within the INS, there was a team within the kind of communications branch that was looking at messaging and materials. And it's importan to remember there were about 100 international organizations in the country at the time, all producing their own flyers, their own messaging, their own billboards. There were 10 different billboards up around and probably 20 international organizations wanted messaging with their logo on it. And it was hugely conflicting, hugely confusing. There was a hundred different messages being put out there and kind of thrown at the public. And if you throw 20 pencils at somebody and ask them to catch, they won't catch any of them. If you try one or two, then might catch them. So it's a very, very basic kind of idea of communication theory. This messaging and materials group had taken a comprehensive approach and had basically every time a new organization came up with messages, they just added to the folder. And by the time I got there, the folder was about, I think 60 pages long. This was the message guide for the national crisis response. It was 60 pages long. I mean, that's extreme. And that was not helpful, not constructive. And it wasn't a useful tool to anybody. What we did was based on very basic principles of risk communication, which is a body of work of theory andmethodology, it's a very well-established academic area, risk communication, which draws on psychology, and sociology, and communication theory, organizational theory and all sorts of disciplines. We just developed a very simple thing, which is basically a message map. I really recommend anyone who's grappling with the communication side of the COVID-19 crisis to, if you don't have a message map in your criss response, you really should think about forming one. A Message Map is basically saying what are the three to five number one messages that we want to get out and odd numbers work better than even numbers, don't ask me why. That's just human psychology. There's a lot of evidence for that. Three or five is good and you have that message and then you have the supporting evidence and the factual support that comes under that message. We basically took it, as he said, and we took a 60 page document and turned it into one page, one side of A4. So not two pages, one side. The power of a that was that a decision-maker could look at that and understand it in 30 seconds and it wasn't a lot of text. It wasn't a side of A4 with text. It was this side of A4 with probably 100 words on it. If that was five messages with each one with a couple of sub supporting points, one side of A4. So decision makers could understand it. A social mobilizer going door to door to persuade people to respect quarantine measures could use it and understand it was written in colloquial language. It was then translated into all of Liberia's local languages. It was tested very quickly with its very, very quick focus grouping over the course of about 48 hours to actually test the messages. The test, if this was in the right vernacular, if it was got, might be clear to people, but it was such a simple tool to use. It wasn't perfect, but it was an effective tool. The one thing I would say on this that is really, really important is that communications has to be connected, rooted in the science. It's not just about coming up with messaging out of thin air. These five messages will be boiled down, the whole book too, were based on very careful conversations with technical, medical, and epidemiological experts. We're going to say these are the five behavioral interventions that will stop this epidemic. So there's a lot of lessons in there about simplicity, messages that people can understand, messages that are rooted in the science and actually having simple tools that can easily be used and implemented by everybody across the response. 

Matt: That sounds awesome, Petre. One of the things that is interesting to me is the role of the volunteers. You had all of these just ordinary people who volunteered and you uses them as part of the communication campaign. How did you find them? How did you train them quickly and how did you decide to use them in that way? And why are local volunteers so important as part of a messaging campaign? 

Peter: Yeah, there was a lot of learning that happened when it comes to behavior change messaging in this context, and I think in all the countries that fight Ebola. I think there are, although COVID-19 is very different, I think some really relevant lessons for today's crisis. I think in the early stages of the crisis in West Africa, the Ebola crisis, messaging had been very top down. It had been billboards or NGOs, international NGOs, national leaders who were saying on the radio, "Ebola is here, it's real. You have to do these these things now." For various reasons public trust in Liberia was extremely low. A lot of people didn't believe Ebola was real, actually, though they believed it was a conspiracy. There was a huge amount of noncompliance and non-cooperation on a behavioral level which contributed massively the spread of the epidemic. Behavior is so important to these epidemics because it is a biological and a social phenomenon. So the kind of top down messaging hadn't worked because people weren't listening. And I think people weren't listening and the messages were confused, conflicting, abstract, in technical language. They weren't learning. So it's the quality of the messageand medium. Both of those things matter. So I've talked about improving the quality of the message, thinking about the medium now, this is the other big area of learning for how to really connect with people and get people to change their behavior. The national leaders, top down foreigners delivering the message that hadn't been an effective medium. What I think we started to learn, the kind of strategic pivot that we took in the autumn was actually, we've got to communicate through, if you like, chains of people so that people are hearing messages from someone that they trust and that they will actually listen to. So rather than just blasting, you know, jingles over the radio or putting up billboards. If somebody comes to your door who's part of your community or calls a meeting in your local church, some of this is culturally specific to Liberia. Right? Every country has to take the kind of principles here and apply it to their specific context. Some of this is specific to Liberia. But the principles here hold truth for people anywhere. If you hear these kinds of messages from someone who is important to you, that you listen to and respect, you are much more likely to change your behavior. And so these social mobilizers in the case of Liberia, Mercy Corps, were very involved and UNICEF were very involved, but also various bits of the Liberian government, were involved and Liberian civil society organizations were involved in finding, recruiting and training literally thousands of social mobilizers whose job was to take this simple message map and go door to door safely, go door to door to talk to people and persuade them. But we also worked through the church organizations so that it cascaded down through the existing social infrastructure of the country using those existing connections. Use those links and those relationships that are already there, don't try to bypass that. Now in a different country that will look different. in a country where people don't go to church. Fine. You know, the churches, you know, might not be the most important thing, but there's still there's existing social infrastructure or even in the country which is in lockdown that's still there. Part of it is through social media, but part of it is through word of mouth, peer to peer through families and other networks. Who delivers the message is much more likely to influence you. So, the quality of the message and that medium are both really essential and I think are really, really important in the current crisis. 

Matt: Peter, what I like about this a lot is also the idea of working with what you have there. There is always something there. It's a key message, I think, that we bring in all of our workers. You may not have all the resources. You may not be as developed as other countries. You may not have even have a plan that prepares you for this. Well, nobody does. So you need to work with what you have there. And I think in terms of the communications, one of the things I'm hearing is you're saying we communicate in society. Society does put messages out all the time, whether it's a church system, whether it is through a union based system, whatever it is. Every society has those mediums. And what we need to do is we need to work out what they are and we need to basically deploy them for this purpose right now, use what we have. And that means really scanning the environment, getting an understanding of how people communicate, where their trust is, etc. and using those mechanisms that everybody has. So, you know, you don't need to go and find the best practice from everywhere. You just need to get some of these ideas. And the principle is work with the communication mechanisms you have, work out what they look like and then channel this simple message map through those mechanisms. I think it's a really, really powerful message. Thank you. 

Peter: I would just add the same goes for other aspects of this - work with what you have. This Incident Management System was not flown in from Europe or America. It was staffed and made by Liberians. Yes, it was created from scratch for the specific purpose of fighting Ebola, and it was scaffolded and supported by international partners in all sorts of ways to provide a lot of support, but it was Liberians who were in the lead, and I think that's the other really, really big lesson that I would urge and emphasize to any leader tackling this crisis. That is, the government has to be in the lead for this. The government has to retain control of this crisis. And the response to the crisis. Yes, leverage support. Yes, make use of your international partners, if you if you have to them. If you need them. Yes, try and frame that as much as possible. But it absolutely should be the government that is in control. And it goes to that point to working with what you have. 

Matt: And I think it's also what you said earlier - You can't transfer accountability. You are the government. You are the people who your country relies on. That's your job. And I think that's an important message. A question about your experience and how you would think about how you manage politics in this and how do you create a message that brings people across political divides together in all of the countries we work in, in Liberia, everywhere there's opposition parties, there are counter-narratives. Those narratives are going to be about the crisis, but they are also are going to be about, you know, who should be in power, et cetera. And sometimes these things can raise themselves in very negative ways, in crises, in almost extremely competitive ways. In Ebola, one of the things I think that was part of the story was the way in which political parties kind of came together and the political narrative was put together. But I can't imagine that that was easy to do. What advice would you have for people who are dealing with this? And who are kind of saying, look, we've got multiple political voices. How do we bring those political voices together, at least around this crisis? And to compound it, how do we manage that on social media, where it's very easy for people to have multiple, multiple messages on social media and almost put things out in a very costless way. Right. You can just throw things out there. How would you manage getting political togetherness or at least managing a fractured polity in as best possible way in this crisis? 

Peter: There's no simple answer to this. And I think it relates to some of the things that you've been writing about in your series on the blog. It's about leadership.In a crisis situation, it doesn't work to be extremely partisan and kind of highly sensitive. And any dissent and criticism becomes a personal attack. So there's an almost personal leadership level to this, I think, which is very important. As difficult as a situation and as stressful and as challenging, and when the sort of stones get slung at you, I think for leaders, it's gonna be really, really difficult. I feel for any leader who's grappling with this right now, this is really difficult, really stressful. And I say to anybody who's standing on the outside watching and on the side of the pitch criticizing, it's really, really hard, you know, to have this grapple with this. And so there needs to be that kind of awareness on the on the side of the critics, but on the side of the people who are making decisions, they also have to understand that that criticism and the accountability is a part of this. And I think the only way to handle that is to engage with it. Well, the best way to handle it is, is to engage with it and to try and minimize the sort of partisanship and to actually try and bring people into the room if possible. I think if there is a national emergency which threatens the whole country, then should the leader of the opposition or the leader of your party actually sit in on your crisis management meetings and be part of that rather than shutting the door and shutting down and trying to sort of fight that fight and then feeling wounded by a critique, which is very understandable. Is there a way to actually engage with that adversary and make them part of the solution? It's easier said than done. What I'm saying is hard in practice, but I think engaging with stakeholders is so important. Again, it's a little bit based on a broader point. I heard yesterday the head of the W.H.O., Dr Tedros, using the expression, "Solving this crisis is everybody's business." Yeah, which was exactly the slogan, I  don't know if he got that slogan from Ebola, but that was the slogan in Liberia - "Stopping Ebola is everybody's business." And it is a really important message, that every single person in society has a role to play. And as the government, even as you, the head of state or head of something, you can't do this alone. The government can't do this alone either. It needs to be in the lead. But that idea of leadership, which is collaborative, which mobilizes others, almost applies at the whole society level. Government needs to think in that way as well. You have got to go and talk to businesses from day one, go and talk to your international partners and on day one, your civil society groups, your church groups, your unions, your opposition parties. It's really hard to find time to do this because you're trying to firefight and you're trying to kind of lay down train track in front of this runaway train. But the more you can bring people into the conversation and begin talking to them and listen to those concerns, the better your crisis response will be, the better your communications will be and the better your messaging will be received. And so that communication thing is two way. 

I think one of the things that I'm actually writing a blog around now is the importance of recognizing when you aren't hearing from other people, it's a problem, you have to organize your snowflakes so your snowflake is constantly talking to those people. It can't necessarily be you at the center of the snowflake in the nucleus doing all of that outreach. But you have to have people who are speaking to your citizens, mobilizing them, finding out what's going wrong and bringing that information. And one of the things that I'm also emphasizing is - I think in some governments, getting information in real time from citizens is not something that governments like to do all the time, because sometimes the citizens are shouting at them and I guess throwing brickbats at them and things like that. But in this case, you want to know now what's going on. You do not want to know it in three days, four days or five days, because if you hear it the, to use your metaphor, the train has already gone through. And so this needs to be a time where you are actively looking for information from the ground, where you are almost insistent on receiving it, and if you don't receive it, you're getting angry. It's different from the norm. We don't necessarily want there to be bad news, but there is bad news and we need to get it as quickly as possible so we can respond. Can I ask you, when you were on the ground there - I asked the same question to Shruti - I'm very interested in this idea of self-care for people who are making decisions and for people who are working. How did you manage in your communications team and with the people around you to just regulate the pressure on this so that you could make sure that you were still kind of managing also so that you could make sure that you guys were still making good decisions, etc. And you know, if the answer, as was with Shruti that I didn't do that very well. What lessons did you come out with from there? 

Peter: I chuckled when when I listened to your discussion with her, because I think everybody really struggled with this. And I didn't handle it as well as in hindsight I wish I had. I think when you're in the midst of a crisis response and you're a part of it and you know that lives are hanging on the speed of the response and effectiveness of the response, it's really hard to take a weekend or take it even a day. Actually, it's really, really hard just to switch off even for an evening, because you feel such a sense of responsibility to do everything you can. And so it's really, really hard to protect us. I think that it's easy to tell it to someone else and tell it to yourself. So within a team, within the people you're working with. Look out for each other. So even if we're all terrible at taking our own advice. So if you're looking at people around you and they're looking out for you, that can help and actually force a bit of downtime and just getting enough sleep. I started smoking heavily again when I was in Liberia, and I'd say to anyone, try to avoid that, avoid things which are going to be, you know, depleting your energy and kind of adding to your stress and kind of making it harder for your body to support the work that you're doing. And not just the work you're doing, but the emotional wear and tear of what you're doing. Emotional wear and tear is absolutely enormous, not just the exercise of decision making muscle, but everyone was really careworn by the end of it. 

Matt: You're carrying a burden. 

Peter: Yeah. And you're careworn because you really, really don't want to make a mistake or be too slow and get things wrong, which is a good thing. That's the important thing when people are trying to do the right thing and that comes from their own sense of motivation and and concern. But yeah, I think it's essential to try and look after the body, the physical body. I would really emphasize that as something I've learned in all sorts of areas, not just crises. If the physical body is okay and that means sleep and eating decent enough food to keep you going, then that provides that platform for weathering the emotional stress. So look after your physical body would be my main adice. And second piece of advice would be if you're bad at looking after yourself, then look out for your team members and get them to look out for you. 

Matt: That's great advice. Great advice. Peter, we've had a good amount of time in this. I want to thank you for the time that you've spent. I'm sure that we'll be having more conversations because there's more topics that I'm sure that we want to talk about. But just to kind of close off, do you have any parting words for people who are doing this right now? Just some some final quick words of advice just to offer? 

Peter: Yeah, I would say that what you're doing takes courage. So I salute anyone who's working hard at this and fighting this, because it does take courage. It takes energy to keep going and to take courage from the people around you and from your sense of purpose. I would say remember that this is a human crisis. There's lots of data, there's lots of analysis. There's lots of numbers, but always bear in mind that it's people at the heart of it. And people's behavior, people's foibles, people's anxieties, people's worries, people's fears. And particularly when it comes to communications, it's really important to hold and engage with those anxieties and that fear and to try to sooth them a little bit. The really important part of communication is about soothing those fears. There's a good sort of equation somewhere that information plus empathy plus hope equals good crisis communications. Information, so clear, truthful, regular information is really important, but you also need empathy that acknowledges people's feelings and that kind of human side of it and that hope, which is that collectively we are going to get through this if we work together. This is everybody's business. Everyone has a role to play. And if we do that, then we will come through it. Those are the things I would say and I would wish strength and courage to everyone who's who's working on this right now. 

Matt: Thank you, Peter. Thank you very much for your time. We really appreciate it. 

Peter: My pleasure. 

Katya: To learn more about the Building State Capability program's Public Leadership Through Crisis blog series, visit bsc.cid.harvard.edu/public-leadership-through-crisis. Thank you for listening.