GAME SETUP
Objective: Participants physically demonstrate disease transmission pathways across human, animal, and environment sectors.
Materials needed:
- Role cards (15-20 cards)
- Open space for movement
- Ball of yarn or string
- Flipchart to record pathways
Roles:
HUMAN SECTOR (6 cards)
- Doctor
- Child
- Market vendor
- Hunter/bushmeat consumer
- Farmer
- Urban resident
ANIMAL SECTOR (6 cards)
- Fruit bat
- Chicken (backyard poultry)
- Dog (pet/stray)
- Cow/goat (livestock)
- Rodent (rat in market)
- Monkey (urban wildlife)
ENVIRONMENT SECTOR (3 cards)
- Water source (well, borehole)
- Market (mixing point)
- Wetland/forest
ROUND 1: EBOLA TRANSMISSION
Facilitator narration:
“Ebola virus lives naturally in fruit bats. Let’s see how it reaches humans in Kampala.”
Step 1: Fruit bat (hold up card) → drops partially eaten fruit
Step 2: Monkey (urban forest near Makerere) → eats contaminated fruit → becomes infected
Step 3: Hunter → kills infected monkey for bushmeat
Step 4: Market vendor → sells bushmeat in Nakasero Market
Step 5: Urban resident → buys and prepares bushmeat → becomes infected
Step 6: Family members → care for sick person → become infected
Step 7: Doctor (Mulago Hospital) → treats patient without full PPE → becomes infected
Visual: Use yarn to connect each actor, showing transmission chain
Debrief questions:
- At which point could intervention stop transmission?
- What sectors need to be involved? (Wildlife, health, markets, community education)
- What RCCE messages would target each actor?
ROUND 2: RABIES TRANSMISSION
Step 1: Dog (unvaccinated) → bites child playing in street
Step 2: Child → doesn’t tell parents (afraid of punishment)
Step 3: 2 weeks later → child develops rabies symptoms → dies (rabies is 100% fatal once symptoms appear)
Intervention pathway (prevention):
Alternative scenario:
- Veterinarian → conducts dog vaccination campaign
- KCCA → dog population control
- Schools → teach children about rabies
- Parents → seek post-exposure prophylaxis immediately after bite
Debrief:
- Why did the child die? (Lack of knowledge + fear of punishment)
- What RCCE messages would have saved this child?
- “If a dog bites you, TELL AN ADULT immediately”
- “Rabies vaccine works ONLY if given before symptoms start”
- “Free rabies vaccine available at health centers”
- Who needs these messages? (Children, parents, teachers, dog owners)
ROUND 3: CHOLERA TRANSMISSION
Step 1: Heavy rain → floods latrine in Bwaise settlement
Step 2: Feces contaminates water source (well)
Step 3: Market vendor → fetches water → doesn’t boil it
Step 4: Prepares food with contaminated water
Step 5: Customers → eat contaminated food → develop cholera
Step 6: Customers → use public toilet → don’t wash hands
Step 7: Cycle repeats
Intervention pathway:
- Environment sector → drain standing water, repair latrines
- KCCA → provide chlorinated water
- Health sector → oral rehydration points
- RCCE → handwashing promotion, water boiling, safe food handling
Debrief:
- This is an ENVIRONMENT → HUMAN pathway (not animal)
- But One Health principles still apply (integrated approach)
- RCCE must address multiple behaviors (water treatment, handwashing, food safety)
KEY LEARNING POINTS
RCCE must target all interfaces, not just health facilities
Diseases cross sectors (human, animal, environment)—interventions must too
Multiple actors must receive tailored messages (not one-size-fits-all)
Prevention requires coordination across health, veterinary, environment, community