(MissionNewswire) Don Bosco Fambul, located in Sierra Leone’s capital city, Freetown, is one of the country’s leading child-welfare organizations and has been on the forefront of efforts to help prevent Ebola in local communities and provide care for children left orphaned. Since 2010, the organization has provided a countrywide phone counseling service.

At one time, nearly half the calls focused on teen relationship issues. Since the outbreak of Ebola in 2014, the counseling line has turned into a widely used resource for Ebola prevention and support. The World Health Organization (WHO) has reported that there were more than 13,264 confirmed Ebola cases and 3,949 deaths from the virus in Sierra Leone alone.

“At the beginning of the Ebola epidemic, the children asked for information about symptoms and for protective measures,” says Brother Lothar Wagner, director of Don Bosco Fambul. “From September 2014 forward, we became a crisis intervention measure against the deadly disease.”

The organization began advertising its free hotline as a preventative defense against Ebola in May 2014 and youth were encouraged to call to access critical information about the virus. Since that time, more than 25,000 calls about Ebola have been answered and fielded. The data gathered as a result of the calls has helped the country’s national registration office identify Ebola hotspots and crisis regions. The head of Don Bosco Fambul’s telephone counseling department maintained permanent contact with the Ministry of Health and the Ministry for Social Affairs as well as the Ebola command center. In addition, food deliveries were organized to the quarantine zones identified by these calls.

Through the hotline, Don Bosco Fambul brought hope to the children and adolescents of one of the poorest country in the world during a terrible time of crisis. For Fatmata and Samuel, who lost their parents to Ebola, Don Bosco Fambul provided much needed refuge. Both had contracted Ebola but were treated and recovered. Relatives looted their home and neglected the children, leaving them languishing in a hospital in Port Loko until Fatmata recalled one of her teachers telling her of the Don Bosco Fambul hotline.

Once connected with the organization, Fatmata was provided immediate assistance from a Don Bosco Fambul social worker. The children were cared for at the Don Bosco Interim Care Center in Freetown and were both eventually reunited with relatives and returned back to school. Their parent’s home has been renovated and both receive supportive family services.

In order to help children like Fatmata and Samuel, Salesian missionaries at Don Bosco Fambul, with assistance from the Catholic non-governmental development organization, Manos Unidas of Spain, transformed a school into a home for 120 boys orphaned by Ebola. This unique care center for orphans on the Don Bosco Fambul campus meets the children’s basic needs while providing schooling and education on health and hygiene. Precautions around health and hygiene, including a focus on preventative measures, are extremely stringent since the orphans have all been in contact with people infected by Ebola.

“Because the Ebola virus has an incubation period of 21 days, sometimes it is thought initially that the children are not infected, and some have even come with false certifications of a clean bill of health but it may be just that the symptoms have not yet appeared,” says Father Jorge Crisafulli, Provincial of the Salesians in English-speaking West Africa. “All the boys who come to us, no matter where they come from, pass an initial period in quarantine cared for by nurses who have survived the virus. Their temperature is taken every three hours for the entire 21 days and any change is recorded immediately.”

Youth who do not have extended family to go to are able to stay long-term at Don Bosco Fambul, attend school and participate in activities such as music, dance and organized games. Counseling is also available to help them successfully transition into adulthood.

Paris, le 28 août 2015

Le dernier patient atteint du virus Ebola est sorti de l'hôpital de Makeni, la troisième ville de Sierra Leone, lundi 24 août. Si la nouvelle est réjouissante, les efforts actuels et l'implication des communautés doivent plus que jamais être maintenus pour empêcher l'apparition de nouveaux cas. Une fois sortie de l’épidémie, la Sierra Leone n’en restera pas moins affaiblie, structurellement et économiquement. Les défis à relever par les autorités et les communautés demeurent cruciaux pour pérenniser les mesures de prévention et reconstruire l’avenir des Sierra léonais.

Un délai supplémentaire de 90 jours sera probablement ajouté par le gouvernement à la période réglementaire des 42 jours sans nouveaux cas, afin de s'assurer avec certitude que l'épidémie est endiguée dans le pays. « Si le compte à rebours a commencé le 24 août avec la sortie du dernier patient, il reste encore des maisons en quarantaine dont on n'espère qu'elles ne déclareront aucun nouveau cas » souligne Christian Mascaro, directeur des opérations d'Action contre la Faim en Sierra Leone. Le 6 août dernier, le Président sierra leonais avait prolongé l'état d'urgence, bien que la plupart des mesures ne soient plus effectives. Seule celle concernant les enterrements continue d'être appliquée, afin d'éviter les contaminations au moment des rites funéraires, lorsque les corps sont extrêmement contagieux.

L'agriculture, fortement affectée par l'épidémie

Action contre la Faim, présente au Libéria, en Sierra Leone et en Guinée, continue à travailler dans le district de Moyamba et la Zone de l'Ouest. En juin, les équipes spécialisées en sécurité alimentaire y ont démarré deux programmes pour soutenir les personnes vulnérables et les survivants d'Ebola afin qu'ils puissent retrouver les moyens de vivre décemment. « A Moyamba, les familles ciblées reçoivent de l'argent durant la période de soudure et à partir d'octobre, elles recevront des semences pour les cultiver. Les survivants d'Ebola dans la Zone de l'Ouest ont quant à eux un soutien direct pour mettre en place des activités génératrices de revenus » explique Christian Mascaro.

En effet, si la situation économique du pays se stabilise avec la fin des mesures d'urgence relatives à l'épidémie, l'impact d'Ebola reste fort au sein de la population, et particulièrement chez les plus vulnérables. L'EFSA (Emergency Food Security Assessment) annonçait en avril dernier que 43% de la population étaient en situation d'insécurité alimentaire. L'agriculture semble être le secteur le plus touché, avec une baisse moyenne de la production égale à 39%, et qui atteint la barre des 40% à Moyamba.

Mobilisation communautaire et coordination transfrontalière

« La crise d’Ebola qui a frappé l'Afrique de l’Ouest a clairement souligné l’importance de la mobilisation communautaire dans la gestion de l'épidémie. Elle permet une meilleure compréhension des enjeux liés au virus dans les communautés » souligne Christian Mascaro. L’approche CLEME (Community Led Ebola Management Eradication), développée par ACF, a permis aux communautés de Moyamba et Kambia de participer au contrôle de l’épidémie, en identifiant les comportements à risque et ceux qui permettent la réduction des transmissions. Les volontaires, issus des communautés, sont responsables entre autres de la mise en place et du respect des mesures d’hygiène. « Cette approche innovante dans la lutte contre Ebola est devenue indispensable car elle permet aux communautés de trouver des solutions en accord avec leurs besoins individuels et leur culture » conclut James Senesie, responsable des programmes Eau, Hygiène et Assainissement d’ACF.

Par ailleurs, l'amélioration de l'accès à l'eau et l'assainissement ainsi que celle des pratiques d'hygiène se poursuit dans les centres de santé. ACF travaille également dans le district de Kambia, à la frontière guinéenne où la surveillance communautaire est renforcée pour éviter les cas de transmissions transfrontalières. Une zone à risque, déjà touchée par des épidémies successives de choléra. La Guinée est aujourd'hui le dernier des trois pays d'Afrique de l'Ouest touchés par le virus qui continue à enregistrer des nouveaux cas d'Ebola.

En savoir plus sur l'approche CLEME

Porte-parole disponible pour interview
Contact presse: Agnes VARRAINE-LECA – avarraineleca@actioncontrelafaim.org
01 70 84 72 22 / 06 70 01 58 43

Action contre la Faim, 35 ans de lutte contre la faim

Créée en 1979, Action contre la Faim (ACF) est une organisation non gouvernementale internationale qui lutte contre la faim dans le monde. Sa charte des principes humanitaires - indépendance, neutralité, non-discrimination, accès libre et direct aux victimes, professionnalisme, transparence - fonde son identité depuis 35 ans. Sa mission est de sauver des vies en éliminant la faim par la prévention, la détection et le traitement de la sous-nutrition, en particulier pendant et après les situations d’urgence liées aux conflits et aux catastrophes naturelles. Action contre la Faim coordonne ses programmes autour de 4 domaines d’activités : nutrition, santé et pratiques de soins - sécurité alimentaire et moyens d’existence - eau, assainissement et hygiène - plaidoyer et sensibilisation. En 2014, Action contre la Faim est venue en aide à plus de 13,6 millions de personnes dans 46 pays à travers le monde.

HIGHLIGHTS

• Sierra Leone discharges final Ebola Virus Disease (EVD) patient; no new EVD cases reported in the country for the second consecutive week

• Overall weekly EVD case incidence across EVD-affected West African countries has remained at three confirmed cases for four consecutive weeks

• All EVD contacts in Liberia complete 21-day monitoring period; countrywide surveillance efforts continue

KEY DEVELOPMENTS

• The Government of Sierra Leone (GoSL) Ministry of Health and Sanitation discharged the country’s final EVD patient from the Makeni EVD treatment unit (ETU) in Bombali District on August 24. GoSL President Ernest Bai Koroma presided over a ceremony marking the event and attended by USG Disaster Assistance Response Team (DART) members, CDC representatives, and other EVD response actors. The GoSL also reported no new confirmed EVD cases during the week of August 17–23. Case investigators continue to monitor 38 contacts of known cases in Western Area, all of whom will complete their quarantine or monitoring period by August 29, provided no additional EVD cases occur. The UN World Health Organization (WHO) will declare the end of the current EVD outbreak in Sierra Leone following 42 days of no confirmed cases; the 42-day period began August 25.

• For the first time in four weeks, a health care worker contracted EVD during the week of August 17–23, according to WHO. The case was reported in Conakry, Guinea.

West Africa - Ebola Outbreak, Fact Sheet #44, Fiscal Year (FY) 2015 (as of August 28, 2015)

By Indrias G. Kassaye

For a village in Sierra Leone, the tight restrictions of Ebola quarantine bring the movements of everyday life to a stop. For children on their own, providing safety and care is especially challenging.

TONKOLILI DISTRICT, Sierra Leone, 27 August 2015 – When 16-year-old Emma Kamara’s mother left home for a long trading trip upcountry, she had no idea that her three children, left in the care of neighbours, would soon be under lockdown.

“Sometimes she stays away for a month. She doesn’t know we have been placed under quarantine,” says Emma. Her mum travelled on a Tuesday, and on the Friday Massesebe village was put under quarantine after a surprise new case of Ebola in their district of Tonkolili, in Sierra Leone.

Most people in the village, as across much of the country, work as farmers. The villagers often supplement their incomes through work in the mining areas in the northern part of the district. The mining industry – including diamonds, gold, iron and rutile – is the country’s biggest source of export earnings.

Emma’s mum is particularly vulnerable, because as a single-mother without access to land, she depends entirely on the cash she earns on these trading trips.

The latest Ebola case in Tonkolili district, where Massesebe village is located, was the first in 150 days, and it came from migration of a different sort – a sick man travelled back to the village from an Ebola hot spot in Freetown.

Cut off from the world

After the man’s death from Ebola, the whole village, including the Kamara children, was put under quarantine: Orange plastic quarantine barriers cordoned off the roadside homes from the rest of the world, and it would be 21 days, the maximum incubation period of the Ebola virus, until those residing inside their homes would walk out freely again.

Quarantining an entire village is not easy, because it shuts down the mobility that people depend on to meet their basic needs, like tending to farmland, collecting water, going to school, visiting the hospital, and trading. The Government, in partnership with the World Health Organization (WHO), UNICEF and a number of NGOs, rallied to make sure everyone had water, food, hygiene and sanitation facilities and supplies. For the children, toys, games and radios helped provide activity and school radio programmes.

But such conditions are less than ideal for children without a caregiver in the home.

“When we were assessing the situation of children in the quarantined village, we found Emma and her two brothers living alone,” says Amie Tholley, UNICEF Child Protection Officer. “These children are without a caregiver – no one to make sure they are following proper hygiene and sanitation measures, and no one to make sure they are safe, which can be particularly difficult for an adolescent girl. The best place for them is at the Observation Interim Care Centre [OICC]. Meanwhile, we will try to get word to their mother.”

Care and protection

Operated by the NGO Child Fund, with support from UNICEF, the OICC in neighbouring Magburka provides temporary care and protection for high-risk, asymptomatic children without a caregiver. Trained Ebola survivors, who are now resistant to the virus, care for the children, providing counselling and support, keeping them entertained with books, games, toys and films while monitoring for any signs of the virus. If symptoms become manifest, the children will be referred to a treatment centre for diagnosis.

The staff welcome and register the children, and after bathing and changing into new clothes, it isn’t long before they are comfortable in their new surroundings.

“We are all fine here,” says Emma. “My brothers are okay. We are enjoying playing games and watching films. We watched ‘Famous Kids’ this morning. We are also eating lots of food. I don’t miss the quarantine at all – we are happy to be here.”

Meanwhile, the search is on for Emma’s mother to inform her where her children are. She might not have even heard about the quarantine.

Transition home

When the 21-days end, Emma and her brothers return home with a care package, including clothes, sheets, mattresses, household items and other supplies to ease the transition from quarantine.

Their mother had sent word through their uncle, who will visit them regularly to make sure they are doing well.

The last Ebola patient in Sierra Leone, also from the village of Massesebe, was discharged on 24 August, and without further cases, the country will be declared free from Ebola transmission 42 days later.

As of 26 August, there have been 8,697 confirmed cases of Ebola, with 3,586 confirmed deaths from the virus in Sierra Leone.

UNICEF works in partnership with a large number of partners, including WHO, the UK Department for International Development, the Office of US Foreign Disaster Assistance, the Government of Japan, Irish AID, and National Committees for UNICEF, to respond to the Ebola outbreak, including the recovery phase. UNICEF’s current US$178 million appeal to respond to the Ebola crisis in Sierra Leone through end of July remains underfunded, with $122.6 million received to date, leaving a funding gap of $55.2 million.

Regional Highlights

 In the last month, the number of confirmed cases of Ebola in the region has drastically decreased.

o In the week ending 16 August 2015, there were three confirmed cases of Ebola, all of which were reported in Guinea.

o In the last two weeks, the number of contacts under observation has halved from 1,600 to 800.

 The demand for Emergency Telecommunications (ET) Cluster support has decreased accordingly and the Cluster will phase out by the end of October 2015. Comprehensive transition plans for each country have been defined with the aim of ensuring a smooth transition of the services to commercial solutions, avoiding any possible interruptions in the services.

o Users have been informed about ET Cluster transition plans through emails, formal letters of agreement as well as ET Cluster local meetings.

o To ensure the continuity of services beyond the end of October, the ETC is supporting users to transition the services to local Internet Service Providers (ISP).

o As of 20 August, the ET Cluster is providing internet services to 33x humanitarian facilities across the three affected countries of Guinea, Liberia and Sierra Leone. Since the beginning of the operation, more than 1,600 users have registered to use the internet connectivity provided by the ET Cluster.

o The ET Cluster is also providing radio services in 21x towns across Guinea, Liberia and Sierra Leone to ensure Ebola responders have access to secure telecommunications. Staff from various organizations have also received radio training to build local capacity.

 At the beginning of August, Pastor Lovo was replaced by Michael Ngisiro as Sierra Leone ICT Coordinator. As of 1 September, Roberto Salazar will be replaced by Habib Shashati as Guinea ICT Coordinator.

Source: Reuters - Sun, 30 Aug 2015 19:53 GMT
Author: Reuters

FREETOWN, Aug 30 (Reuters) - The body of a woman who died in Sierra Leone has tested positive for the Ebola virus, less than a week after the last person confirmed to have had the disease was released from hospital, health officials said.

The new death, if confirmed, would represent a setback for efforts to end an 18-month regional epidemic that has infected more than 28,000 people and killed more than a third of them.

Read the full article on AlertNet

SITUATION OVERVIEW

• There were 3 confirmed cases of Ebola reported in the week to 23 August, all of which were reported from Guinea. No new confirmed cases were reported from Sierra Leone for the second consecutive week. Overall case incidence has held at 3 confirmed cases per week for 4 consecutive weeks. In addition, the number of contacts under observation continues to fall, from over 800 on 16 August to approxi-mately 600 on 23 August throughout 4 prefectures in Guinea and 2 districts in Sierra Leone. All contacts associated with the recent cluster of cases in Tonkolili, Sierra Leone, have now completed the 21-day follow-up period. However, there remains a significant risk of further transmission.

• No cases were reported from Sierra Leone in the week to 23 August: the second consecutive week without a confirmed case. The last case to be diagnosed with EVD completed treatment and was discharged from an Ebola treatment centre on 24 August after testing negative twice for EVD. The number of contacts under follow-up has declined from 72 contacts across 3 districts (Tonkolili, Western Area Urban, and Western Area Rural on 19 August to 29 contacts in Freetown) and Western Area Rural on 23 August, after all contacts associated with the Tonkolili cluster of cases completed follow-up.

• As of Sunday, 30 August, the National Ebola Response Center and the Ministry of Health and Sanitation has reported a new swab con-firmed Ebola case in Kambia. The case was a 67 year old female farmer. 14 contacts have been line listed so far. This marks the first new case after 3 weeks with no Ebola cases in Sierra Leone.

Freetown, Sierra Leone | AFP | lundi 31/08/2015 - 16:25 GMT |

Une femme décédée a été testée positive à Ebola le 28 août en Sierra Leone, quatre jours après la sortie d'hôpital du dernier malade traité et guéri dans ce pays anglophone d'Afrique de l'Ouest, a appris l'AFP de sources concordantes.

Cette femme est tombée malade et est décédée dans son village de Sella Kafta, dans la région de Kambia (nord-ouest). Le prélèvement effectué sur son corps a été testé positif à Ebola, a expliqué Sidi Yaya Tunis, porte-parole du Centre national de contrôle d'Ebola (NERC) sur la radio privée locale Democracy FM.

"Nous avons dépêché une équipe à Sella Kafta. Nous avons déjà identifié dix personnes" ayant été en contact avec elle et qui sont considérées comme "à haut risque", a affirmé M. Tunis.

"Nous avons déjà isolé" ces dix contacts, "nous évaluons la nécessité de placer tout le village en quarantaine en cas de besoin", a-t-il ajouté.

Le test d'Ebola positif à Sella Kafta a été confirmé à l'AFP par des sources indépendantes dans la région, selon lesquelles il s'agit d'une femme au milieu de la soixantaine. Tombée malade, elle est décédée et a été inhumée le 28 août. Elle ne s'était pas rendue récemment en Guinée ou au Liberia, pays voisins également affectés par l'épidémie.

La Sierra Leone espérait être sur la bonne voie pour être débarrassée du virus après la sortie d'hôpital, le 24 août à Makeni (est), de la dernière malade d'Ebola traitée avec succès dans le pays, qui n'avait pas connu de nouvelle infection depuis plus de deux semaines.

Cette épidémie qui a touché l'Afrique de l'Ouest est la plus grave depuis l'identification du virus en Afrique centrale en 1976. Depuis fin 2013, elle a fait environ 11.300 morts sur environ 27.500 cas - pour l'essentiel en Guinée, en Sierra Leone et au Liberia, d'après l'Organisation mondiale de la Santé (OMS).

Dans son dernier rapport hebdomadaire publié le 26 août, l'OMS confirmait que la Sierra Leone n'avait enregistré aucun nouveau cas pour la deuxième semaine consécutive. Le Liberia ne compte plus de cas, il en a été recensé trois en Guinée durant la semaine précédant le rapport.

D'après l'OMS, un pays est déclaré exempt du virus 42 jours - soit deux fois la durée maximale d'incubation - après le dernier cas connu.

Selon Sidi Yaya Tunis du NERC, une équipe de l'OMS séjourne actuellement en Sierra Leone pour expérimenter un vaccin contre Ebola testé avec succès en Guinée. Elle doit se rendre à Kambia pour inoculer le vaccin aux contacts recensés dans la région pour prévenir toute contamination, a-t-il dit.

rmj-cs/mrb/sba

© 1994-2015 Agence France-Presse

Editorial

As this half centenary issue of Field Exchange contains a number of guest editorials by individuals who were involved in Field Exchange from the start, we are going to keep this one short. It is pretty much 20 years since the idea of a Field Exchange and the ENN was mooted at an inter-agency conference in Addis Ababa. A throw away comment by Helen Young at the meeting planted the seed of an idea; Helen remarked that the Addis meeting was unusually productive as it brought together field practitioners, academics and donors who could all learn from each-other and wouldn’t it be great if we could find a forum to enable this kind of ‘exchange’ to take place more regularly. The acorn tree that is now Field Exchange and the ENN grew from this one comment.

For the editors of Field Exchange, there has always been one core principle that has held sway. It is that the written word has unique value. Emerging from the ashes of the Great Lakes emergency in 1994/5 where mistakes and learning from previous decades appear not to have been heeded, Field Exchange was predicated on the realisation that institutional memory is fragile and that the written word can uniquely preserve learning. There is nothing wrong with the ‘oral tradition’ but memories are fallible in a way that the written word is not.

Over the 20 years of editing Field Exchange, we have also come to see how the process of writing up field experiences adds value. Those who put pen to paper are compelled to organize their thoughts and learning logically, to self-examine and to make only claims or recommendations that can be supported by written evidence which in turn can be scrutinised by others. Elements of learning that take place through the writing process would almost certainly not occur if simply recounted orally. The written word promotes accountability for what is said. Furthermore, it enables dissemination of learning at scale. The ENN has also learnt that even in situations where draft articles are withdrawn from publication (very othen for reasons of sensitivity and risk to programmers), the very process of writing has enabled the authors(s) and their organisation(s) to learn from the programme experience even though this learning may not be disseminated more widely.

Whether the written word appears in print or digitally is perhaps less important but is still relevant. Many of our readers only have limited or expensive online access. Furthermore, it is notable (if not a little surprising) to find in Field Exchange evaluations that our readers still have a strong attachment to the hard copy even when they have online access. Flicking through the pages of Field Exchange in a life that is dominated by ‘screen time’ for many may well be a welcome relief and a better reading (and learning) experience. We, of course, now produce Field Exchange (and its sister publication Nutrition Exchange) both in print, e-copy and online: we also plan to embrace multi-media developments, which may allow for wider and cheaper dissemination to our readership Over the years, the ENN has expanded into a range of activities including technical reviews, operational research, technical meeting facilitation, and development of guidance and training material.

Our activities are largely informed by from the privileged overview of the sector we obtain through pulling together Field Exchange. This expanded scope of work is thus a product of your work in contributing to the publication. Field Exchange has therefore been, and remains, the cornerstone of what ENN does.

On to the edition in hand; as ever, we have a wide range of articles covering innovations and challenges in programming. A special section looks at lessons and plans for delivering treatment of severe acute malnutrition (SAM) at scale in Northern Nigeria, with three articles by UNICEF/ACF/Mark Myatt; ACF; and Results for Development (R4D) on the topics of coverage, costs, cost-effectiveness and financial sustainability of CMAM. This includes a proposed sampling based approach to estimate the number of deaths averted by the Nigerian CMAM programme which is accompanied by two ‘peer review’ postscripts.

An editorial by CIFF, a lead investor in the Northern Nigerian CMAM programming, introduces the section. Also on the theme of CMAM in Nigeria, an article by MSF documents malnutrition peaks associated with malaria peaks and highlights the fact that medical care typically does not come under CMAM funding, is implemented by different ministries and agencies and is often under resourced.

The logistical challenges of nutrition programming are reflected in an article from South Sudan by ACF, UNICEF and CDC, which describes the technical innovations that enabled nutrition surveillance in a vulnerable but quite inaccessible population. The response to flooding in Malawi in early 2015 is the topic of another article around CMAM by Concern. Whilst providing immediate support, they found lack of surge capacity and sub-standard existing SAM treatment services, despite longstanding external investment in the recent past. How to sustain long term CMAM programming once the NGOs ‘go home’, remains the 'million dollar question'.

At the other end of the spectrum, an article by Help Age International describes the burden of care and experiences of non-communicable disease (NCD) programming in Lebanon amongst older Syrian refugees and vulnerable Lebanese. It reflects there is progress but a lot yet to be done to meet NCD and associated nutrition needs in humanitarian programming. The remaining articles cover a range of topics – infant feeding support in the Philippines from the perspective of a local NGO responding to Typhoon Haiyan in 2013; experiences of the Sustainable Nutrition and Agriculture Promotion (SNAP) programme in the Ebola response in Sierra Leone authored by IMC and ACDI-VOCA; and UNICEF experiences of a combined SMARTSQUEAC survey in Chad that saved on time and costs.

We have a run on views pieces in this edition, as well as a rich mixture of research summaries.

An article by Ajay Kumar Sinha, Dolon Bhattacharyya and Raj Bhandari on the challenges of undernutrition in India provides a fascinating insight into the complexities of national and sub-national programming and highlights the need for coordinated actions. India also features in a research summary from MSF that shares great insights into community perceptions and behaviour around SAM treatment in Bihar. Resilience and nutrition is the topic of an article by Jan Eijkenaar which provides insights into the ECHO funded Global Alliance for Resilience Initiative in the Sahel. There are also some must read articles on accountability to affected populations, a topic that hasn’t featured strongly in Field Exchange in the past and to which we all too easily pay ‘lip service’. One piece describes ground breaking work in the Philippines by Margie Buchanan-Smith et al and the other is a very personal but experience based viewpoint by Andy Featherstone on progress and pitfalls around accountability over the last 20 years or so.

As a final word, we would like to thank all those authors who have written material for Field Exchange in the past and encourage those who are thinking about writing in the future to get in touch with us to discuss potential topics. We are here to support you in many different ways, from a ‘brainstorming’ conversation to review of a fledgling idea to editing. In this issue, we’ve included a guide to the process to help. Over the years, our content has become more ‘technical’ but we welcome more informal contributions too; it is great to see a few letters in this edition and we would love to receive more.

We would also like to thank our many readers for taking an interest in the publication and sincerely hope that the hard won experiences and learning that appear in Field Exchange quickly and positively continue to inform your personal practice and agency programming for the benefit of those with whom you work. So here is Field Exchange 50 – Enjoy!

Jeremy Shoham & Marie McGrath Field Exchange Co-editors

Freetown, Sierra Leone | AFP | Monday 8/31/2015 - 20:36 GMT

A woman who died last week in northern Sierra Leone tested positive for Ebola, the National Ebola Response Centre (NERC) said Monday, in a setback for the country's bid to gain Ebola-free status.

There had been celebratory scenes last week when the country's last known Ebola patient was released from hospital in the central city of Makeni after being cured of the virus, raising hopes the west African nation may finally have beaten the devastating epidemic.

Sources contacted by AFP confirmed that the woman was in her mid-60s and lived in Sella Kafta village in Kambia District.

A swab taken after her death Friday confirmed she had contracted Ebola.

She had not travelled to either Liberia or Guinea, two other countries also blindsided by the worst outbreak of Ebola in history, which has killed some 11,300 people since first emerging in December 2013 in Guinea.

"We have sent a team from here to Sella Kafta village and we have already identified ten high-risk contacts that we are focusing on to stem any possible transmission," the NERC's communication director Sidi Yahya Tunis said in an interview with a local radio station.

"We have already isolated the high-risk contacts and are assessing whether the village will be isolated if need be," he added.

Tunis also said that a World Health Organization team which successfully tested an Ebola vaccine in Guinea that has been billed as possibly marking "the beginning of the end" of the virus would join NERC in Kambia to vaccinate contacts of the latest victim to "stop any possible train of transmission".

Tunis said people should "remain calm and not be frustrated over the development".

News of the new Ebola death came as a new school year got underway Monday, with measures in place to try prevent the spread of the virus.

Children's temperatures were being checked at many schools, and students were directed towards buckets of chlorine to wash their hands.

Schools were closed for more than eight months at the height of the Ebola outbreak.

rmj/cb

© 1994-2015 Agence France-Presse

Freetown, Sierra Leone – 31 August 2015: Detection of a new case of Ebola virus disease in Kambia, Sierra Leone after the country had marked almost three weeks of zero cases has set in motion the first ‘ring vaccination’ use of the experimental Ebola vaccine in Sierra Leone.

A team of experts in ring vaccination has travelled from Conakry, Guinea to join a large WHO and Ministry of Health team already in the district where the new case has been reported. The source of the Ebola virus transmission is being investigated and all the people who may have been in contact with the infected person are being traced.

“Although no-one wanted to see more cases of Ebola virus disease in Sierra Leone, we kept all our teams on alert and ready to respond and close down any new transmission” said Dr Anders Nordstrom, WHO Representative in Sierra Leone.

Heightened surveillance for Ebola virus disease in Sierra Leone includes swabbing all people who have died at home and testing those swabs for Ebola virus. On Saturday, 29th August, a swab taken from a woman who died aged around 60, in the village of Sella, Tonko Limba, Kambia district, tested positive for Ebola virus.

Members of the team currently conducting the ring vaccination trial in Guinea, drove from Conakry in Guinea to Kambia, Sierra Leone on Sunday to begin work.

The Guinea team were met in Kambia by another team from Freetown, who had been trained and prepared last week by WHO in order to be ready should there be any new Ebola virus infections in Sierra Leone.

The Guinea ring vaccination trial is a Phase III efficacy trial of the VSV-EBOV vaccine (Merck, Sharp & Dohme) which is being conducted by WHO and partners*. Interim results published last July show that this vaccine is highly effective against Ebola. The ‘ring vaccination’ strategy involves vaccinating all contacts -the people known to have come into contact with a person confirmed to have been infected with Ebola (a ‘case’) - and contacts of contacts.

Following publication of those results, the Sierra Leone government requested that the trial be extended to Sierra Leone. The WHO Sierra Leone country office immediately sent a team to Guinea to organize this, ensuring that all the correct procedures and protocols are followed. WHO and partners then trained 18 Sierra Leonean health care workers on implementation of the study protocol.

“The training was done to ensure teams are ready to rapidly perform ring vaccination should there be new confirmed cases of Ebola in Sierra Leone,” said Dr Margaret Lamunu, WHO technical co-ordinator of the Ebola response in Sierra Leone, who is managing the extension of the ring vaccination trial in Sierra Leone.

*Partners in the Guinea Ebola vaccine trial

The Guinea Ebola vaccine trial is the coordinated effort of many international agencies. WHO is the regulatory sponsor of the study, which is implemented by the Ministry of Health of Guinea, WHO, Médecins sans Frontières (MSF), EPICENTRE and the Norwegian Institute of Public Health. In Sierra Leone, the trial is being implemented by the Ministry of Health and WHO with the Guinea Ebola vaccine trial team.

The trial is funded by WHO, with support from the Wellcome Trust, the United Kingdom Department for International Development, the Norwegian Ministry of Foreign Affairs to the Norwegian Institute of Public Health through the Research Council of Norway, the Canadian Government through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre and Department of Foreign Affairs, Trade and Development and MSF.

The trial team includes experts from The University of Bern, the University of Florida, the London School of Hygiene and Tropical Medicine, Public Health England, the European Mobile Laboratories among others.

For more information

Dr Margaret Harris - Media Officer, harrism@who.int, tel: +41 796 036 224 / +232 76533284

Mr Saffea Gborie - Communications Officer, Sierra Leone, gboriesa@who.int, Tel: +232 78335660

DISCHARGED CASES

• Total Survived and Discharged Cases = 4,047

NEW CASES

• New Confirmed cases = 0 as follows:
  Kailahun = 0, Kenema = 0, Kono = 0 Bombali = 0, Kambia = 0, Koinadugu = 0, Port Loko =0, Tonkolili = 0 Bo = 0, Bonthe = 0, Moyamba = 0 Pujehun = 0 Western Area Urban = 0, Western Area Rural = 0, Missing = 0

CUMULATIVE CASES

• Cumulative confirmed cases = 8,698 as follows:
  456 Kailahun = 565, Kenema = 503, Kono = 253 Bombali = 1,049, Kambia = 254, Koinadugu = 109, Port Loko = 1,484, Tonkolili = Bo = 314, Bonthe = 5, Moyamba = 209, Pujehun = 31 Western Area Urban = 2,285, Western Area Rural = 1,164, Missing = 14

CUMULATIVE DEATHS

• Total cumulative confirmed death is 3,587

• Probable cases = 287

• Probable deaths = 208

• Suspected cases = 4,624

• Suspected deaths = 158

Ebola Virus Disease Situation Report

PROVIDED BY:

The Ministry of Health and Sanitation

For more information, please contact:

District level: District Health Management Team

National level: Directorate of Disease Prevention and Control, E.mail: dpcsurveillance@gmail.com Website: www.nerc.sl or www.health.gov.sl Mobile: 117 (Toll free)

Freetown, Aug. 31, 2015 (MOHS) – The Ministry of Health and Sanitation is to conduct its first Service Level Agreement (SLA) with 14 approved Implementing partners at the Miatta Conference Centre in Freetown Tuesday September 1, 2015.

The 14 SLA presented to the Programme Review Committee are expected to receive certified approval today for meeting the criteria set by the Ministry.

The 2015 Service Level Agreement (SLA) initiated by the Leadership of the Ministry, Dr. Abu Bakarr Fofanah is a guide for implementing partners supporting the Public Health Sector in Sierra Leone.

This is the first phase of the SLA that would be signed by the Ministry and the Implementing Partners prior to activities to be undertaken with the health sector. Highlights of the ceremony among others would include signing at the level of the Minister, Chief Medical Officer and countersigned by the District Medical Officers at the receiving district.

JAK/MOHS

Makeni, Aug. 31, 2015 (MOHS) – The Ministry of Health and Sanitation has concluded its 3 days District Workshop to develop operational plans for the implementation of the Health Sector Recovery Plan.

Addressing participants at the closing ceremony at the Wusum Hotel conference hall in Makeni, Deputy Minister of Health and Sanitation 1, Mr. Foday Sawi described the Ministry’s Post Ebola Recovery Plan as comprehensive but requires critical steps to get it translated into positive actions that would make the necessary impact.

He noted that all the districts at the end of the workshop had plans that are aligned with the National Recovery Plan, adding that with the available information of data collecting tools in the districts, he is optimistic of meeting the challenges to sustain the plan for posterity.

Mr. Sawi encouraged participants to sensitize their colleagues as they go back to their various districts, describing the current status of the Ebola outbreak as “a battle in continuation” that needed community engagement, monitoring and supervision and other key interventions.

The Deputy Minister paid tribute and condolences to the lost doctors, nurses and other health workers whose contributions would have also been vital for the development and implementation of the Recovery Plan describing them as fallen heroes in the fight against the Ebola virus disease.

Deputy Chief Medical Officer and Chairman Operational Team for the Early Recovery Plan, Dr. Sarian Kamara while giving an overview on the workshop and the achievements, underscored the importance of the inclusion of all checklists into the National Plan, financial management and disbursement and Key Performance Indicators.

She said participants were able to develop their operational plans per district and that each district was able to apply key performance indicators on the available tools, and agreed on the timelines.

The WHO Country Representative, Dr. Anders Nordstrom expressed satisfaction over the category of participants noting that District Medical Officers, Medical Superintendents in hospitals, Monitoring and Evaluation Officers and District-Based Recovery Team Data Analysts all have key roles to play if the implementation of the plan is to achieve its desired objective.

The early 6-9 months Recovery Plan he said would help participants improve services and expand on health systems in the areas of reporting, operation, community engagement and other key challenges.

He reiterated WHO’s continued support and commitment in collaborating with the Ministry of Health and Sanitation to bring the Ebola fight to an end.

The State House District Liaison Presidential Team Representative, David Sam Suale’ reiterated their commitment to provide coordination at a satisfactory level and encouraged the Health Ministry to ensure they take the lead in the implementation of the plan.

He expressed gratitude to donor partners who have been providing support and appealed for continued cooperation in building a resilient health system.

The Director, Health Systems, Strengthening, Policy, Planning and Information, Dr. Samuel Kargbo recalled that 13 years ago when the civil war ended in the country with devastation on the health facilities across the country, the Ministry used the required strategy with the help of government and partners to recover and bring back normalcy in the health care delivery system, similarly he said the Ebola outbreak in May 2014 had a grip on the weak health system and inspired them with a learning lesson to do more.

He described the Recovery Plan as unique, pointing out that using the five pillars: Patient and health workers safety, Essential health care delivery services, Health workforce, Community ownership, Health information management system and surveillance would be a winning tool for the recovery programme.

Other speakers include representatives from UNICEF, UNFPA and presentations on the MOHS Early Recovery Plan by Regina Bash Taqi, Status of the plan by Audric Mitraros, Planning and monitoring tools by Wogba Kamara and the next steps by Planning Specialist, Mr. Philip Amara.

JAK/KK/MOHS

The Famine Early Warning Systems Network (FEWS NET) monitors trends in staple food prices in countries vulnerable to food insecurity. For each FEWS NET country and region, the Price Bulletin provides a set of charts showing monthly prices in the current marketing year in selected urban centers and allowing users to compare current trends with both five-year average prices, indicative of seasonal trends, and prices in the previous year.

West Africa can be divided into three agro-ecological zones or three different trade basins (West Basin, Central Basin and East Basin). Both important for understanding market behavior and dynamics.

The three major agro-ecological zones are the Sahelian, the Sudanese and the Coastal zones where production and consumption can be easily classified. (1) In the Sahelian zone, millet is the principal cereal cultivated and consumed particularly in rural areas and increasingly, when accessible, in urban areas. Exceptions include Cape Verde where maize and rice are most important, Mauritania where sorghum and maize are staples, and Senegal with rice. The principal substitutes in the Sahel are sorghum, rice, and cassava flour (Gari), the latter two in times of shortage. (2) In the Sudanese zone (southern Chad, central Nigeria, Benin, Ghana, Togo, Côte d'Ivoire, southern Burkina Faso, Mali, Senegal, Guinea Bissau, Serra Leone, Liberia) maize and sorghum constitute the principal cereals consumed by the majority of the population. They are followed by rice and tubers, particularly cassava and yam. (3) In the Coastal zone, with two rainy seasons, yam and maize constitute the most important food products. They are supplemented by cowpea, which is a significant source of protein.

The three trade basins are known as the West, Central, and East basins. In addition to the north to south movement of particular commodities, certain cereals flow horizontally. (1) The West basin refers to Mauritania, Senegal, western Mali, Sierra Leone, Guinea, Liberia, and The Gambia where rice is most heavily traded. (2) The Central basin consists of Côte d'Ivoire, central and eastern Mali, Burkina Faso, Ghana, and Togo where maize is commonly traded. (3) The East basin refers to Niger, Nigeria, Chad, and Benin where millet is traded most frequently. These three trade basins are shown on the map above

Key Messages

• Stressed (IPC Phase 2) and Crisis (IPC Phase 3) food security outcomes are expected to persist through September 2015 due to a prolonged lean season caused by below-average food availability and atypically weak household purchasing power. The highest levels of food insecurity will be observed in Bo, Kambia, Port Loko, Moyamba, Kailahun, and Kenema districts where poor households are currently experiencing food consumption gaps.

• In early August, the government lifted its ban on weekly markets. Improving market functioning and the upcoming harvest in October will help food and income sources normalize, contributing to Minimal (IPC Phase 1) in most areas. However, poor households in Moyamba, Kenema and Kailahun districts are projected to remain Stressed (IPC Phase 2) due to a slower recovery from this year’s Ebola-related shocks.

Freetown, Sierra Leone | AFP | Tuesday 9/1/2015 - 16:16 GMT |

Fifty people have been placed in quarantine in northern Sierra Leone after the death of a middle-aged woman from the Ebola virus, medical officials said Tuesday, in a setback for the country's bid to gain Ebola-free status.

"We are conducting an epidemiological investigation to trace the extent of the transmission" as the woman ho died was sick for 5-10 days without the authorities being alerted, Ibrahim Sesay of the National Ebola Response Centre (NERC) told a local radio station.

Given the 50 people identified as at high-risk "we should not be surprised if we see new cases coming out," from the new case

identified in the village of Sella Kafta in the northern district of Kambia, he said.

"Ebola is like the main actor in an horror film. Defeat the actor and he is likely to get up again," Sesay added.

There had been celebratory scenes last week when the country's last known Ebola patient was released from hospital in the central city of Makeni after being cured of the virus, raising hopes the west African nation may finally have beaten the devastating epidemic.

The latest victim had not travelled to either Liberia or Guinea, two other countries also blindsided by the worst outbreak of Ebola in history, which has killed some 11,300 people since first emerging in December 2013 in Guinea.

News of the new Ebola death came as a new school year got underway Monday, with measures in place to try prevent the spread of the virus.

Children's temperatures were being checked at many schools, and students were directed towards buckets of chlorine to wash their hands.

Schools were closed for more than eight months at the height of the Ebola outbreak.

Reports from Kambia said community leaders and residents remained "in a state of shock" over the news.

An elder and long time resident in Sella Kafta, Sampha Mansaray told AFP by phone that "the community is in mourning over the death."

"We have been thorough in observing all restrictions to keep Ebola out of our community but we have now failed the rest of the country by being the place that has halted the countdown" towards Ebola-free status, the 60-year-old farmer lamented.

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