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
DISCHARGED CASES = 4,051
CUMULATIVE CASES = 8,704
CUMULATIVE DEATHS =3,589
European Union - EMERGENCY ONG ONLUS : Promoting Health and Education for children in Western Area Rural District, Sierra Leone
EMERGENCY ONG ONLUS organization is pleased to announce the results of the first semester of the activities related to the project in Goderich and in the Western Area Rural District. The project, entitled "Paediatric healthcare in Sierra Leone: a network for service delivery and coordination among Civil Society Organizations - Local Authorities - Government Institutions", is co-funded by the European Union and implemented in partnership with the Western Area Rural District Council (WARDC), and Precious Gems Rescue Mission International (PGRMI), a national voluntary organization.
The main aim of the project is to improve health and educational service delivery for vulnerable children in the Western Area Rural District by facilitating strong partnerships among civil society organizations and local authorities.
The project will establish a network for the promotion of children's health and education in order to coordinate and implement national health programmes on malaria and malnutrition treatment for children in WARD and Freetown area. EMERGENCY, in collaboration with the two partners - WARDC and the PGRMI - is leading an intervention to strengthen local capacities and enhance the coordination of government and community based actors.
The project will also strengthen health services delivery with the provision of free medical treatment and hospitalization available in EMERGENCY Paediatric Centre in Goderich and through the implementation of health promotion activities in 60 schools in the Western Area, which will address children, teachers and communities. These activities will ensure that the communities receive education sessions on good hygiene promotion, the importance of immunization, the risk of malaria and child nutrition.
Six months after the beginning of the project 480 awareness sessions have been held in 20 schools in WARD and 16,645 children have been treated in EMERGENCY Paediatric Centre OPD and 957 admitted in the paediatric ward.
Furthermore, the project minimizes the risk of school drop-out of sick children hospitalized in EMERGENCY Paediatric Centre for long periods, mainly due to trauma injuries, by providing individual and group lessons to sick hospitalized children. To date, the two teachers from PGRMI have provided remedial classes to 52 children hospitalized. In addition to these remedial classes, the two teachers have also played a crucial role in talking with the families of children not enrolled in schools about the importance of education.
Freetown, Sierra Leone, 20/10/2015
For more information, please contact:
Mr Luca Rolla, EMERGENCY Programme Coordinator, Goderich, Sierra Leone Phone: +23276611386 E-mail: pcsierraleone@emergency.it
Mr Gibril Foday-Musa, European Delegation, Sierra Leone E-mail: gibril.foday-musa@eeas.europa.eu
Slow start to rainy season in southern Africa, flooding risks remain in Guatemala, Somalia, and Ethiopia
Africa Weather Hazards
Persistently below average rainfall since August over several bimodal areas of Côte d’Ivoire,
Ghana, Togo, Benin, and Nigeria has led to an increase in moisture deficits and a degradation of ground conditions, resulting in drought.
Below-average rainfall since August has led to increased moisture deficits throughout several provinces in southern South Sudan and northern Uganda. Dry conditions stretch into Lake Victoria regions of western Kenya.
Poorly distributed rainfall has resulted in drought, which has severely impacted ground conditions and already led to livestock death across parts of north-central eastern Ethiopia.
Heavy rains over the last 2 weeks have led to swelling rivers in Somalia and Southern Ethiopia. The Shabelle River and the Jubba River are forecast to be near or above flood stage. Flood risk is high for the middle and lower reaches of the Shabelle and moderate for the lower portions of the Jubba River. Additional forecast rain threatens to exacerbate the situation, maintaining the risk for river and flash flooding.
Erratic and poorly distributed rainfall over the past month has led to early-season moisture deficits in the sugarcane growing region of South Africa. Vegetation indices reveal that ground conditions are already degrading.
NEW CASES
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
DISCHARGED CASES = 4,051
CUMULATIVE CASES = 8,704
CUMULATIVE DEATHS =3,589
Acute food security is improving with the arrival of new harvests
KEY MESSAGES
According to the World Health Organization’s October 21st Ebola situation report, there have been no new confirmed Ebola cases over the past 21 days in Sierra Leone. The absence of new Ebola cases, along with the removal of internal movement restrictions, is favoring a slow economic recovery and improved household income levels.
Harvesting began in October and will continue until the end of December for rice, sweet potatoes, cassava, maize, groundnuts, and vegetables. These average to above-average harvests mark the end of the lean season (June-August) as they reduce the need for market purchases and are strengthening poor households' food access.
Food security will significantly improve in the next three months compared to previous months with average availability of food at the household level, higher market stock levels, stable food prices, and increased income opportunities through farm labor and the sale of farm products. Consequently, many areas are expected to face Minimal (IPC Phase 1) acute food insecurity through at least March.
However, due to a slower recovery from Ebola-related shocks, poor households in Kenema, Kailahun, Kambia, Pujenhun, Port Loko,
Tonkolili, and Kono continue to face reduced purchasing power, which is preventing them from fully meeting their non-food needs, such as education and healthcare costs. These seven districts, therefore, are projected to be Stressed (IPC Phase 2) through March 2016.
Confidential and Open Source Data
This report examines trends over the first half of 2015 in both open-source and agency-reported data. We are pleased that this quarterly security analysis includes information from 11 contributing agencies - one more than last quarter. As compared to last quarter, this edition contains more reported incidents both from open sources (88, up from 51) and agencies (223, up from 198). As described below, many of the additional reported incidents affected humanitarian infrastructure and occurred in Africa and the Middle East. The number of reported severe events remained constant between the first and second quarters of 2015.
This edition introduces a basic incident rate for hotspot countries, calculated using the number of reported events divided by the number of contributing agencies present in a country (see box, page 6). The regional maps on pages 7 to 11 show those countries that appear on both the total incident and incident rate hot spot lists in orange.
The three hotspot rankings below (open source, incident count, and incident rate) illustrate three options for determining the most insecure countries for humanitarian agencies. Each of the methods illustrates only a selective part of the picture, underlining the fact that each remains an imperfect measure in the absence of better data.
We also carefully examined open-source and agency-reported events to avoid double counting the same event. In this edition, we indicate the origin of the data as open source (OS), agency reported (AR) or dual source events (DE), which refer to events reported in both sources. To our surprise, we discovered only seven events reported by contributing agencies and in open sources over the first six months of 2015. This represents 1.4 percent of all events (8/562) and raises questions about overall scale of threats and violence that affect humanitarian aid.
Page 4 and 5 are dedicated to Yemen. They discuss incidents reported between January and June 2015 in open sources and by the four contributing agencies present in the country
Highlights
This month, household coping did not improve in all three countries as above average rainfall levels may have delayed improvements normally seen in September.
As in recent months, prices, manual labour rates and corresponding terms-of-trade remain generally stable.
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
- DISCHARGED CASES = 4,051
- CUMULATIVE CASES = 8,704
- CUMULATIVE DEATHS =3,589
EBOLA OUTBREAK UPDATES November 1, 2015.
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
DISCHARGED CASES = 4,051
CUMULATIVE CASES = 8,704
CUMULATIVE DEATHS =3,589
Makeni, Nov. 2, 2015 (MOHS) – The School of Midwifery Masuba, Makeni (SOMM) has produced 58 certified trained and qualified Midwives graduated from the school on October 31, 2015 to join the fight against maternal and newborn mortality.
The maternal and newborn ‘soldier’ would be deployed in rural communities where there are growing challenges in the fight to reduce maternal and newborn deaths in the country. The school which was established in January 2010 has a traditional annual intake for two years training programme for both the public and private sectors. The school has trained over 400 since its inception.
Head of School, Mrs. Francess Fornah said the five year old institution has grown in status and stature with limited human resource staffing to making it more viable, and appealed for urgent assistance to put on government payroll 16 staff that are providing sacrificial and patriotic services to the development of the school.
She told the audience that 135 students are currently in training and appealed for the construction of additional staff quarters and hostel accommodation since the present structure accommodates only 35 students.
The School in collaboration with the Directorate of Nursing Services and the Nurses and Midwives Board, Mrs Fornah said was able to review the school’s curriculum to meet with international standards and thanked UNFPA, WHO and the Medical Research Centre (MRU) for their continued support.
To the set four (4) certified midwives, the Head of School encouraged them to adopt an optimistic attitude and to be honest and dedicated workers.
The Chief Nursing Officer, Matron Hossinatu Kanu rated the training of midwives as far back as the early 1560, describing the midwife as a person who has acquired the requisite qualifications to be registered and, or legally licensed to practice midwifery.
She said despite the gains made by the government in the health sector, maternal and child mortality remain what she referred to as intractably high, with 156 per 1,000 and 1165 per 100,000 live births, according to the 2013 Demographic and Health Survey by Statistic Sierra Leone. These poor health indicators, she said are as a result of a range of implementation challenges including the critical shortage of health workers that the country is currently facing, pointing out only 288 midwives with 48 percent serving in Freetown from the UNFPA 2014 Draft Midwifery mapping.
Matron Kanu told her audience that in view of the prevailing situation, government has made a potential commitment to increase the number of midwives from 288 to 1,145 with a view to ensuring that all designated facilities have a minimum number of satisfactory midwives. The Nursing Directorate she said is in the process of developing a policy frame work with strategic direction in support of the 2015-2020 Recovery Plan, and beyond. The Nursing and Midwifery staff comprised more than 70 percent of the total health workforce, and the strategic direction frame work aimed at providing guidance and lead to the nursing and midwifery workforce, opined the Chief Nursing Officer.
She disclosed that there is now provision for nurses and midwives to become Specialists and Consultants in their different disciplines, adding that Nurses and Midwifery Tutors were omitted in the previous scheme of work but have now been included into the scheme.
The other good news disclosed was the change in the nomenclature of Maternal and Child Health Aides and Nursing Aides to Assistants with provision of six months Nursing Assistants training. Plans are also currently underway for capacity building to develop standards for nursing and midwifery education and practice as part of a continuous quality improvement for posterity. The Chief Nursing Officer said.
She encouraged the newly certified midwives to combine their responsibility to managing other staff with ongoing activities, work as a team, and endeavor to carry out research that would help move the profession forward.
The UNFPA Country Representative, Dr. Bannet Ndyanabangi lauded the school for the progress made, and congratulated the midwives for the successful completion of the training. He reiterated UNFPA’s continued commitment and support to the development of midwifery in Sierra Leone.
Making the Keynote address on the theme “Strengthening Quality Midwifery Care”, Deputy Minister of Health and Sanitation 1, Foday Sawi Lahai described the newly certified midwives as foot soldiers and heroines that are produce to provide quality health care for the maternal and newborn.
He noted the constraints and challenges in working in remote areas, inadequate housing, incentives motivation, and the request for additional hostels and staff quarters for the school to strengthen output.
The Ministry of Health and Sanitation, Mr. Sawi Lahai said is in the midst of challenges ranging from logistics, infrastructure and human resource capacity among other key issues, adding that the Ministry in its Post Ebola Recovery Plan is poised to building a resilient health system across the country.
He reminded the audience about the re-emergence of the Ebola with the potential attack on Guinea, describing the situation as a battle to stay zero, and implored Sierra Leoneans to avoid complacency as the Ministry, and partners are working towards ensuring sustainable zero.
One of the proud recipients receiving her certificate from the newly elected President, West Africa College of Nursing Sierra Leone Chapter, Mrs. Patricia Bah
Other speakers include the Director, Medical Research Centre (MRC), Mr. Abdul Karim Jalloh, the President, Sierra Leone Midwives Association, Sr. Safiatu Foday and the Chairman for the occasion, Director, Reproductive and Child Health, Ministry of Health and Sanitation, Dr. Santigie Sesay.
Highlights of the ceremony include commissioning and distribution of certificates to the midwives by the Registrar, Nurses and Midwives Board, Mrs. Hannah Coker and Sr. Fatmata Dabo, Senior Tutor, School of Midwifery Masuba, Makeni, and a skit performance by Final Year students.
JAK/KK/MOHS/SLENA
(MissionNewswire) In 2014, Don Bosco Fambul, a leading educational and vocational organization that serves disadvantaged youth in Freetown, Sierra Leone, in collaboration with Catholic Caritas and Sierra Leone Prisons Service, launched the Legal Support Project with the intention of helping the most disadvantaged inmates incarcerated at Pademba Road Prison in Freetown. The project provides legal representation for poor inmates who would otherwise be unable to access legal services to ensure their rights are upheld. As a result of this project, one young prisoner held for nearly six years without a conviction, has been released.
The prisoner, Musa Brima, was accused of fraud he did not commit. He saw a judge only once at the start of his imprisonment to declare he was not guilty and then was largely forgotten by the system until identified by Salesian missionaries. When his case was brought back to court, the judge told him he was free and could go home.
“I remember well my time in prison because when you live through a sad reality you count every day hoping this terrible nightmare will end,” says Brima. “It was wonderful to be able to go home free and unhindered, after all this time, and hug my wife and my three children.”
Many of the prisoners who will be assisted through the project do not have family outside the prison to ensure that the court and prison system acts in a fair and balanced way. Don Bosco Fambul hopes the project will free up to 100 inmates who have been held for more than three years without a conviction. “We obtain the information for which prisoners are eligible for the legal support from personal interviews with the detainees, and we check the prison register to verify their requests and their claim that they had been in prison for more than three years,” says Brother Lothar, director of Don Bosco Fambul. Prison life in Sierra Leone offers very little hope for rehabilitation or reintegration back into society once a prison term has ended. According to the 2011 Human Rights Watch report, prisons in Sierra Leone face overcrowding and inadequate food as well as lack vital sanitation and health care. Inmates die from overcrowding, illness and violence.
All too often, minors are detained for petty crimes and end up falling prey to prison violence, giving them little hope for the future upon their release. The 2011 report noted that the population of the country’s largest detention facility, Pademba Road Prison in Freetown, was designed for 324 detainees but had over 1,300 inmates at the time of the report with the number continuing to grow. In addition to providing legal support, Don Bosco Fambul provides education and counseling services to reach youth inside the prison. A long-term partnership between the prison and Don Bosco Fambul was established to allow the opening of a youth counseling center for the prisoners that is staffed four hours each day with two social workers and three assistants. The goal of the center is to give youth and their families the necessary tools for rehabilitation and reintegration upon release.
Don Bosco Fambul is also providing food and water to more than 70 inmates of Pademba Road Prison each day while offering counseling services, medical assistance and stress therapy to ensure inmates are mentally fit when their prison terms have ended.
“Youth incarcerated in Sierra Leone must see hope for the future if we expect to deter them from crime and other dangerous behavior,” says Father Mark Hyde, executive director of Salesian Missions, the U.S. development arm of the Salesians of Don Bosco. “Our goal is for youth to use their time in prison constructively and through counseling, begin to address what brought them to the prison in order to prevent their return.”
Sources:
Human Rights Watch 2011 Report – Sierra Leone
UNICEF – Sierra Leone
Liberia: After first being declared free of Ebola transmission on 9 May, six new cases were confirmed in Liberia at the end of June following the death of a 17-year-old boy. Liberia was again declared free of Ebola virus transmission on 3 September 2015, and has now entered a period of heightened surveillance.
Guinea: Three new confirmed cases in the country in the week ending 25 October. All three new cases are from the same household in the sub-prefecture of Kaliah, Forecariah, and are registered high-risk contacts linked to a case from the same area last week. The country also reported three cases the previous week. There are currently 364 contacts under follow-up in Guinea (an increase from 246 the previous week), 141 of whom are high-risk. An additional 233 contacts identified during the past 42 days remain untraced. Therefore there remains a near-term risk of further cases among both registered and untraced contacts.
Sierra Leone: The last case to receive treatment for Ebola in Sierra Leone was confirmed free of the virus after a second consecutive negative test on 25 September. The country will be declared free of EVD transmission on 7 November assuming that no further cases are reported and it will enter into a period of enhanced surveillance.
MSF Staff on ground (as of 1 November)
Total: 75 international and about 1,024 national
Guinea: 26 international, 480 national
Sierra Leone: 31 international, 275 national
Liberia: 18 international, 269 national
Overview
1.The emergency is not over – the Ebola epidemic in West Africa continues in Guinea where three new cases were recorded last week.
Though Ebola has faded from the news headlines, the epidemic in West Africa continues to claim lives. Currently, the main challenge comes from a weak surveillance monitoring system which is fragmented across the region. There were three confirmed new cases of Ebola in Guinea in the country in the week ending 25 October and 364 known contacts (141 high risk) are still being followed up across the country.
Getting to this stage has taken massive resources but getting to zero and staying there requires the most meticulous, difficult work of all - we cannot lose focus now and must guard against complacency until the outbreak is declared over across the region and the period of heightened vigilance is completed without incident.
A sustained and well-functioning surveillance and rapid response system is essential in order to get to and then maintain zero cases of Ebola across West Africa and also to respond to cases of other diseases with epidemic potential including measles and cholera which have previously broken out in the region.
The Ebola outbreak has created a particularly vulnerable group in Ebola survivors and investments into their universal access to healthcare needs to be scaled up.
Ebola survivors face continuing health challenges, suffer from stigmatisation in their communities and need specific and tailored care.
There are an estimated 15,000 Ebola survivors in West Africa, many of whom continue to face ongoing physical and mental health problems. The post-Ebola syndrome may include joint pain, chronic fatigue, hearing problems and eye problems. The eye conditions can potentially lead to blindness without prompt access to specialty care. In addition, survivors are at risk of stigmatisation in their communities.
Investments into timely access to a comprehensive care package for Ebola survivors, including medical, psychosocial care and protection, need to be scaled up rapidly. Ebola survivors need access to a comprehensive care package, including medical, psychosocial care and protection against stigma.
A focus on potential sexual transmission may divert attention away from the need for a sustained and well-functioning surveillance and response system needed to get to and maintain zero cases. Many unexpected cases of Ebola are blamed on sexual transmission from male survivors but when these cases of sexual transmission are actually investigated we see that they have usually been infected by the normal means: unsafe burials, care giving, etc. The majority of the male survivors are of a sexually active age and most of them were ill about a year ago at the peak of the epidemic, if sexual transmission of Ebola was as common as it is portrayed in the media, we would literally be seeing thousands of cases. Going forward, we should not assume that all cases of unexplained origin are due to sexual transmission, and we should not blame the victims. Years of experience in the treatment of STIs have shown that this is not an effective disease control strategy.
Operational highlights
MSF’s Ebola response started in March 2014 and had included activities in the three most affected countries of Guinea, Liberia, and Sierra Leone as well as Nigeria, Mali and DRC. MSF currently employs around 75 international and around 269 national (or locally hired) staff in Guinea, Liberia and Sierra Leone.
Since the beginning of the epidemic:
10,287 patients admitted to MSF Ebola management centres
5,225 patients confirmed with Ebola
2,475 patients recovered from Ebola in our centres
Highlights per country
Guinea
There were three new confirmed cases in the country in the week ending 25 October. All three new cases are from the same household in the sub-prefecture of Kaliah, Forecariah, and are registered high-risk contacts linked to a case from the same area last week.
The country also reported three cases the previous week. There are currently 364 contacts under follow-up in Guinea (an increase from 246 the previous week), 141 of who are high-risk. An additional 233 contacts identified during the past 42 days remain untraced.
Conakry: Nongo ETC
A three-month-old baby. Admission of a pregnant woman. Nongo is the only centre ready to treat pregnant woman.
Forecariah
Three new cases were detected in the prefecture. Both of cases were high-risk contact of the last community death.
Liberia
After first being declared Ebola free 9 May, a 17-year-old boy died on 29 June, resulting in five further cases of the virus. The outbreak was declared over again on 3 September and the country is now observing a period of heightened vigilance.
With the national health system decimated by the outbreak – and near to 200 Liberian healthcare workers having dead from Ebola according to official statistics - MSF is focusing activities on supporting the recovery of health facilities, hoping to encourage Liberian people to feel confident they can go to hospital once again and have their healthcare needs looked after.
Monrovia
In Monrovia, MSF is running a 74-bed pediatric hospital, including a neonatal intensive care unit, aiming to contribute to restoring the provision of secondary healthcare in the aftermath of the Ebola outbreak. In September, 374 children were cared for at the hospital. Twenty-five percent of the cases admitted in the Emergency Room suffered from malaria.
MSF also runs a clinic for Ebola survivors in the premises of the hospital. Former patients have to face stigma and discrimination while accessing care, as well as social and economic problems (loss of work, loss of housing, etc.). MSF provides general outpatient consultations, and addresses mental health needs to a group of more than 500 identified former Ebola patients, which are estimated to be one-third of all survivors in Liberia. Common complaints are joint pains and ophthalmic issues, for which MSF guarantees referral to external specialists.
Sierra Leone
With Ebola unseen in Sierra Leone for many weeks, and the outbreak hopefully to be declared over on 7 November, MSF is focusing activities in Sierra Leone on survivor health care and surveillance in Western Area (Freetown) and Tonkolili (Magburaka). There are also plans to begin non-Ebola health activities in several districts of the country.
Bo
The so-called “core” ETC in Bo was closed on 15 October after several months with no positive cases recorded in the district or indeed the entire southern part of the country.
Magburaka
MSF is running a survivor health clinic in Magburaka town as well as a mobile clinic in the surrounding villages in Tonkolili and Bombali districts. At the end of September the team was supporting a cohort of 171 survivors with medical and mental health activities.
Freetown – Hastings (replacement Kissy)
MSF was running an Ebola Maternity Centre in Hastings, with specific obstetric services for Ebola positive pregnant women in need of tailored care. Over the last months the centre also accepted patients other than pregnant women who presented with symptoms of Ebola. The centre will close once the outbreak is declared over.
Freetown – Surveillance and contact tracing
MSF works in coordination with the District Ebola Response Committee (DERC) to identify and respond to suspect cases of Ebola in Freetown. Despite the fact that Ebola has not been seen for marry weeks, isolating and testing those who meet admission criteria remains and important element of the response.
Summary The West Africa Ebola Virus Disease (EVD) outbreak is the largest and most widespread in history, both in terms of caseload and geographical spread. The first outbreak began in Guinea in December 2013 and thereafter spread to Liberia and Sierra Leone.
January 2015: Emergency Appeal Revision 1 available here.
March 2015: Six Months update available here.
October 2015: Combined Operations Update No. 27 issued and available here.
Since the first cases were confirmed, the Red Cross Red Crescent Movement, comprising National Red Cross Red Crescent Societies, the IFRC Secretariat and the International Committee of the Red Cross (ICRC) have been an essential component of the extensive global effort mobilized to stop the epidemic.
Six Emergency Appeals were launched to respond to and combat EVD outbreaks in Guinea, Liberia, Sierra Leone, Nigeria, Senegal and the Ebola Global Coordination and Preparedness Appeal. Three Appeals in Guinea, Liberia and Sierra Leone are still active whilst coordination and technical support continues at the regional level. Smaller preparedness and response operations were financed by the IFRC Disaster Response Emergency Fund (DREF) in Mali, Cote d’Ivoire, Cameroon, Togo, Benin, Central African Republic, Chad, Gambia, Kenya, Guinea Bissau and Ethiopia. In total, 16 countries in Africa launched emergency operations relating to this outbreak.
Three out of 16 countries in West Africa (Guinea, Liberia and Sierra Leone) are affected by the EVD. Nevertheless, it is having an economic impact not only on these affected countries but many others in the region. The EVD outbreak is currently ongoing in the following 2 countries: Guinea and Sierra Leone, and has caused significant mortality, with reported rates up 70%.
This 12 month update seeks to review how National Societies in West Africa were able to improve their capacity in helping stop the EVD epidemic while working with Ministries of Health and other Partners in response to the needs. In addition, essential regional and global-level coordination and support was provided to the Movement’s Ebola response and preparedness activities, summarised under the outcomes and outputs listed from page 6 below.
A Real Time Evaluation (RTE) was commissioned by the IFRC Secretariat to assess the Red Cross response to the 2014 Ebola crisis in Guinea, Sierra Leone and Liberia from March 2014. The intention of the RTE was specifically to look at implementation issues, with a focus to improving the on-going and future response needs of affected populations. The scope included the assessment of activities to improve the response to affected populations, stakeholders, partners and donors, building on lessons learnt so far in this outbreak.
Reports indicate that critical projects have stalled in various sectors as a result of Ebola across West Africa. The sectors most likely to be affected are trade, tourism and agriculture. It is therefore important to revise this Emergency Appeal for those in the worst-hit nations of Guinea, Sierra Leone and Liberia, as the economic impact will be felt for a long time to come. It is therefore envisaged that this Emergency Appeal will be revised to reflect the changing epidemiological situation in West Africa, in which transmission is declining and EVD operations in Guinea, Liberia and Sierra Leone are scaling down their response activities and transitioning to early recovery programming. After more than one year of emergency response activity, the EVD operation will integrate into the existing IFRC Africa Zone structure, while maintaining coordination and preparedness functions and enhancing documentation, evaluation and research of the Red Cross Red Crescent Movement EVD response in collaboration as appropriate with external partners. The regional and global EVD operation structure, located in Accra and Geneva, will close by the end of the year but IFRC country operations will continue to be guided by a regional approach and strategy, and supported in a range of technical areas.
Goal:
Support synergistic food-security related programming opportunities at the grassroots level.
Life of Project:
October 2011 – July 2017
Total USAID Funding:
U.S. $3.55 million
Geographic Focus:
Ghana, Senegal, Liberia, Benin, Gambia, Sierra Leone, Togo, Guinea, Burkina Faso, and Cameroon
Program Description:
Working together, USAID and the Peace Corps leverage investments in training and capacity building in multiple West African countries to extend benefits across the region. Cross-border technical exchanges and regional trainings lead to the dissemination of best practices. This exchange results in increased food security activities in the communities where Peace Corps Volunteers work in West Africa, with a special focus on women.
This program also builds community capacity at the grass-roots level to strategically respond to food security vulnerabilities such as food shortages and price increases. USAID will provide resources for ten countries till July 2017. The three key objectives of the program are the following:
• Increase availability of healthy foods, especially for women and children.
• Increase accessibility of healthy foods by decreasing poverty and increasing incomes.
• Improve utilization of available food to improve nutritional status of women and children.
Key Accomplishments to Date: (from 1,110 volunteers)
• FY 2012: 4 countries, 50 food security projects: U.S. $110,500.00
• FY 2013 to Sept. 2014: 10 countries, 62 projects: U.S. $149,000.00
• 6,147 people trained in child health and nutrition
• 3,472 people trained in maternal health and nutrition
• 8,436 people received agricultural sector productivity or food security training
• 4,221 farmers applied new technologies or management practices
• 1,236 members of producers organizations and community based organizations received capacity-building assistance
• Database with 1,100 technical food security resources
Written by Kieran McConville
Published on October 29, 2015
Mahommad Samba Kamara stands outside a small tin shack in the pouring rain, watching his team suit up in protective gear to collect another body in the back streets of Freetown, capital of the West African nation of Sierra Leone.
This time it’s nine month old Aminata Samura. According to local social worker Claudia Fofana, she was sick with a fever for three days, had attended hospital, but died early this morning. Aminata’s mother is staying with relatives — too upset to attend her little girl’s funeral.
As the burial team carry Aminata’s body to a waiting hearse, it’s difficult to even see the outline of her tiny form inside the white plastic body bag.
“When you bury so many children it’s like seeing the country deteriorating… it’s very, very sad… very discouraging,” Mahommad says quietly. “We are collecting children every day — children are dying more than adults.”
And his impression is not wrong. One result of the government’s decision to have all burials around Freetown carried out by medical burial teams is a ready supply of indisputable data.
“What you see here is fact. Even if you don’t know about figures, you see this is not a story — it’s fact.” In a small hut on a hillside just outside the city, Amadu Turay is slowly turning the pages of the large hardback book which serves as the register for Waterloo cemetery. Column after column lists the names and details of those buried here, many of them children, many very young. This is one of only two burial grounds that has been operational over the past year in Freetown and its hinterland, both managed by international NGO Concern Worldwide.
Back at Concern’s office, country director Fiona McLysaght sits in front of a computer screen. “Because we have been solely responsible for managing cemeteries here, it’s given us a unique opportunity to see exactly how many people are dying, who they are, and their ages,” she says. “Up until now, this information just wasn’t there.”
The analysis of those figures has revealed some startling statistics. Hundreds of children under the age of five are dying every month. And what’s most disturbing is that the latest available data – for the months when only a handful of Ebola cases were being recorded – shows the highest numbers of child deaths. In June of this year, 744 children under the age of five died in Western Area. The figure for July was 849.
Emily Cummings, who works with Concern’s Child Survival Project, has been responsible for analyzing the figures. “We’ve known for a long time that the infant mortality rate in Sierra Leone is one of the worst in the world, but when you calculate a rate, you are basically taking a sample and producing an abstract. This is the first time we see actual numbers we can monitor on a monthly basis.”
Exactly how bad the problem is and whether it’s improving or worsening is hard to tell. The absence of reliable data from past years and the delay in conducting a census — caused by the Ebola crisis — makes it difficult to calculate a real rate. But Sonnia Magba Bu-Bukeijabibi, one of the country’s most senior statisticians, calls the figures revealed in Concern’s data “staggering.”
“If this is happening in Western Area, where you expect to have the most sophisticated facilities, imagine what’s happening in the provinces. We need studies to find out the underlying causes [and] focus group discussions. We need to talk to communities.” Magba Bu-Bukeijabibi works for the government-run agency Statistics Sierra Leone.
So why are all these young children dying? Sister Josephine Pewa, a veteran nurse midwife, is based at George Brook peripheral health unit in one of the Freetown’s poorer neighborhoods. “Respiratory tract infections, diarrhea, malaria, poor feeding practices,” she says, listing some of the most common ailments that kill infants and children here. “Often, the mothers will delay coming to us and go instead to traditional birth attendants in their community.” This delay in seeking medical care, for whatever reason, is definitely a factor. But the story is more complicated than that.
Across the city, in another back alley, another Concern burial team removes the body of another child from a scant tin dwelling. Tricia Povere was four months old. Her mother, Hawa Jawara, tells us her daughter became sick with diarrhea and vomiting on Sunday evening. She brought her to the local health facility on Monday and was given drugs. “But she got worse and on Tuesday she was vomiting blood,” Hawa says.
Then she recounts how they brought Tricia to a different hospital on Wednesday, where blood tests were carried out and she was given a prescription for a different set of medicines. “She died on the way home,” Hawa says simply. What exactly Tricia died of and why it happened is unclear. But, according to those who work among the Freetown’s poor, cases like this are not unusual.
“In the US, we can’t imagine a child not living long enough to celebrate their fifth birthday. Here it’s very common — it’s as though it’s somehow expected that at least one child or more in a family will not live to the age of five,” says Megan Christensen, health advisor for Concern Worldwide US. She feels that extreme poverty and sub-optimal health care are the root causes. “These children are dying from things that are preventable, that are easily treated with the appropriate care and supplies. We need to start asking ourselves very seriously why this is and what are we going to do about it.”
Emily Cummings points out that the introduction in 2010 of free healthcare for pregnant women, breastfeeding mothers, and children under five seems to have had little impact on the problem. “It’s frustrating,” she says. “A lot of work and money and people’s efforts and time have gone into addressing this over the past decade, and still the numbers are so bad and in some cases getting worse. Sometimes you ask yourself what’s left to do.”
One solution, Cummings says, may be to try to use the information on child mortality to galvanize communities. “People’s behavior here is so influenced by people of status, by leaders in the community,” she says. “We’ve begun to gather data from community health workers and bring it back to those leaders. Often they don’t realize how bad the problem is, and this is a powerful way to get their attention.”
Elsewhere, in one of Sierra Leone’s more rural districts, a pilot project to use former traditional birth attendants as health promoters is seeing some positive results. These women, who are influential within their own communities, have been trained to encourage pregnant women and mothers to attend clinics regularly and in a timely way.
Back in Waterloo cemetery Megan Christensen walks through the children’s section, which stretches across a wide area of the rain-soaked hillside. “It’s startling when you come out here and see all of these tiny graves,” she says. “Each one represents someone’s child… this is horrible. The Ebola outbreak has given us a glimpse of what’s happening to children and mothers in Sierra Leone and, as the international NGOs start to scale down and leave, we simply can’t ignore what we’ve discovered. This is a crisis as big as Ebola.”
This bulletin examines trends in staple food and fuel prices, the cost of the basic food basket and consumer price indices for 70 countries in the third quarter of 2015 (July to September).1 The maps on pages 6–7 disaggregate the impact analysis to sub-national level.
• FAO’s global cereal price index still continued to fall in Q3-2015, down 12.7 percent year-on-year and is now at 2010 levels.
• The real price2 of wheat dropped a further 14 percent over the last quarter. Prices are 30 percent lower than in Q3-2014, thanks to record production in 2015, abundant global supply and strong export competition.
• The real price of maize has dropped 2 percent since Q2-2015 and is 3 percent lower than in Q3-2014. However, global production 2015/16 is projected to be lower than this year.
• The real price of rice has fallen by 1 percent since Q2-2015 and is 15 percent lower than Q3 last year.
Despite reduced production amid increased global utilisation, weakened import demand has kept rice prices in check.
• In Q3-2015, the real price of crude oil dropped by 19 percent compared with Q2-2015 and reached a level last seen in 2004.
• The cost of the minimum food basket increased severely (>10%) during Q3-2015 in four countries:
Ghana, Myanmar, Syria and Tanzania. High increases (5–10%) were seen in Benin, Ethiopia, Haiti, Kenya and Mali. In the other monitored countries, the change was low or moderate (<5%).
• Price spikes, as monitored by ALPS (Alert for Price Spikes), are evident in 16 countries, particularly in Ghana, India, Malawi, Myanmar, South Sudan,
Sudan and Yemen (see the map below).3 These spikes indicate crisis levels for the two most important staples in the country, whether they are either cassava, maize, rice, wheat, sorghum or sugar.
With Ebola in retreat, Sierra Leoneans yearn for a return to normality. But for the burial teams tasked with upholding public safety, life remains far from normal
Nadene Ghouri in Freetown
Samura Osman, a former soldier, died at home from an unspecified illness. He was 35. Osman’s corpse – a potential public health risk following the Ebola outbreak – lies swaddled and zipped in a body bag, awaiting safe burial by a team of trained volunteers equipped with masks and protective clothing.
As Sierra Leone counts down to 7 November in the hope it will be declared Ebola-free – the date marks 42 days since the last recorded case – families must continue to bear the strict public safety procedures that have helped to contain the disease. No shaking hands, washing hands when entering or leaving buildings, and safe burials for all, whatever the cause of death.
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Above-average rains forecast for Greater Horn expected to sustain the risk of flooding during early November.
Suppressed rains expected to continue for several parts of southern Africa.
1) Persistent below-average rainfall since August over several bimodal areas of Cote d’Ivoire, Ghana, Togo, Benin, and Nigeria led to strong moisture deficits and a degradation of ground conditions. Increased rainfall since October has resulted in much improved ground conditions in the region.
2) Heavy rainfall over the past several weeks has led to swelling rivers in Somalia and southern Ethiopia. The Shabelle and Jubba Rivers are forecast to be near or above flood stage. Flood risk is high for the middle and lower reaches of the Shabelle and moderate for the lower portions of the Jubba River. Increased rainfall during early November is expected heighten the risk for flooding.
3) Very low and poorly distributed precipitation has led to a prolonged delay of seasonal moisture available for cropping early season activities. Combined with higher than normal temperatures, the developing dryness is also exacerbated by pre-existing ground conditions associated with a poor monsoon last year which has depleted water resources, and may lead to an intensification of negative impacts. Suppressed rainfall is forecast across the region during early November.
SUMMARY
One new confirmed case of Ebola virus disease (EVD) was reported from Guinea in the week to 1 November. The case is the newborn child of a 25-year-old woman who was confirmed as a case in the prefecture of Forecariah during the previous week. The child was delivered in an Ebola treatment centre (ETC) in Conakry, and is currently undergoing treatment. The mother died after giving birth. Her other two young children were also confirmed as cases during the previous week and are receiving treatment. The 3 confirmed cases reported the previous week generated a large number of high-risk contacts in Forecariah who are now entering the second week of their 21-day post-exposure follow-up period. On 1 November there were 382 contacts under follow-up in Guinea (compared with 364 the previous week), 141 of whom are high-risk. Therefore there remains a near-term risk of further cases among both registered and untraced contacts. Sierra Leone reported zero cases for a seventh consecutive week, and will be declared free of EVD transmission on 7 November if no further cases are reported.
Case incidence has remained at 5 confirmed cases or fewer per week for 14 consecutive weeks. Over the same period, transmission of the virus has been geographically confined to several small areas in western Guinea and Sierra Leone, marking a transition to a distinct, third phase of the epidemic. The phase-3 response1 coordinated by the Interagency Collaboration on Ebola2 builds on existing measures to drive case incidence to zero, and ensure a sustained end to EVD transmission. Enhanced capacity to rapidly identify a reintroduction (either from an area of active transmission or from an animal reservoir), or re-emergence of virus from a survivor, and capacity for testing and counselling as part of a comprehensive package to safeguard the welfare of survivors are central to the phase-3 response framework.
The single new confirmed case reported from Guinea in the week to 1 November is the tenth case in the Forecariah branch of the Ratoma transmission chain, and the fourth confirmed case from the same family and household from the village of Kondeyah, in the subprefecture of Kaliah, Forecariah. Of 382 contacts under follow-up in Guinea on 1 November, 43 were located in Conakry with 339 located in Forecariah. Of a total 141 high-risk contacts, 7 are located in Conakry with 134 located in Forecariah. In the past 42 days, 1 contact from Forecariah has been lost to follow-up.
In Sierra Leone, all contacts linked to the country’s 2 most recently active chains of transmission, Bombali and Kambia, have completed 21-day follow-up. The last case to receive treatment was confirmed free of EVD after a second consecutive negative test on 25 September. The country will be declared free of EVD transmission on 7 November if no further cases are reported.
Robust surveillance measures are essential to ensure the rapid detection of any reintroduction or re- emergence of EVD in currently unaffected areas. Nine operational laboratories in Guinea tested a total of 615 new and repeat samples in the week to 1 November. In Liberia, 1162 new and repeat samples were tested over the same period in the country’s 4 operational laboratories. 1437 new samples were collected in Sierra Leone and tested by 9 operational laboratories.
