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
Freetown, Nov. 2, 2015 (MOHS) – Senior officials from the Ministry of Health and Sanitation, officials from WHO, DFID and the Commonwealth have concluded a four-day assessment tour in six districts to get first-hand knowledge on the level of preparedness of District Health Management Teams (DHMTs) ahead of the NERC/MOHS transition phase.
The six districts include Port Loko, Kambia, Bombali, Koinadugu, Tonkolili in the north and Kono in the east.
Addressing staff of the Koinadugu District Health Management Team, the Chief Medical Officer and Team Lead, Dr. Brima Kargbo commended staff for the hard work in the fight to contain the Ebola virus disease in their district, observing that lots have been done and encouraged them to do more.
The visit he said, aimed at reviewing district level preparedness for establishing and sustaining minimum standards in all health facilities.
Dr. Kargbo reiterated the need to ensure that all mainstream health facilities are capable of effective surveillance, triage screening, Infection Prevention and Control and case management of possible Ebola virus disease cases and safe provision of optimal care for all patients.
November 7, 2015 Dr. Kargbo said is expected to be declared Ebola free in Sierra Leone, and come December 31, 2015 NERC to hand over responsibilities to the Ministry of Health and Sanitation, adding that the Ministry should be prepared to take full responsibility to improve the health care delivery services as against any future outbreak.
In developing a resilient health care delivery system, the Chief Medical Officer stressed that the destiny of the country lies in the hands of the Ministry of Health and appealed for team work to move the health system of the country forward. He called on the DHMT to identify gaps, and submit budget proposal to the Ministry for support.
In his presentation, WHO Clinical Lead, Tim Dempsey described the transition as very important noting that it moves the country’s health care delivery system forward for sustainable development.
He informed his audience that four special infectious disease units would be established at the 34 Military Hospital in Freetown, Kenema, Makeni and one in either Bo or Kono, stressing the need for safe isolation centre in every facilities to ensure they conduct case definition, patient referrals and Ebola testing.
The visit he said does not only focus in getting to zero, but to prepare them for any future outbreak of any infectious diseases, and urged them to develop clinical guidance on diagnosis and management of Ebola virus disease, and to also identify gaps tied with a budget proposal.
The District Medical Officer, Koinadugu, Dr. Francis Moses disclosed that their last case was in April 16, 2015 adding that they have not recorded any new case for over 194 days.
He enumerated surveillance, laboratory facility, contact tracing, isolation, case management, social mobilization, community engagement and survivor care as activities undertaken in the district.
In preparation for the transition, Dr. Moses said they have established Public Health Emergency Management Committee, District Disaster Management Committee, District Emergency Operation Centre and training among others.
In the area of gaps, the District Medical Officer advocated for more vehicles and ambulances, ambulance drivers, ambulance nurses/paramedics, isolation staff, screening and triage, data management and vehicle maintenance.
The Health Systems Specialist, Public Health/Surveillance, Commonwealth, Dr. James Akpablie commended the Koinadugu DHMT for the good presentation with cost for funding, and re-emphasized the need for surveillance and social mobilization and community engagement.
Dr. Akpablie appealed for effective border screening between Sierra Leone and Guinea as cases are coming from Guinea.
In Kambia , the District Medical Officer, Dr. Foday Sesay in his presentation disclosed high risk of Ebola virus disease importation from Forecariah in Guinea with active transmission.
He said they are currently conducting intensive surveillance in all chiefdoms with focus on border manning with 12 integrated teams.
In the area of transition and recovery, Dr. Sesay said they are working towards a smooth transition from DERC to DHMT with effective district epidemic preparedness and response system, adding that there is need to strengthen coordination of epidemic response, improve laboratory capacity for processing and testing of samples, effective management of suspected EVD cases and other epidemic prone diseases among other key issues.
The Chief Medical Officer, Dr. Brima Kargbo commended them for the hard work and urged them to continue the good work.
The Acting District Medical Officer, Koidu Government Hospital, Dr. Ronald Marsh in his presentation said on the level of preparedness, the Government hospital has eight isolation beds and Condama Community Health Post and Kayima Community Health Centre with two isolation beds each.
He said they have developed transition activities, District Incident Management Organogram, identified District Emergency Operation Centre membership and defined role and responsibilities for minimum standards among others.
Similar visits were held in Port Loko, Bombali and Tonkolili districts.
KK/MOHS/SLENA
CAMEROUN
21 000 PERSONNES TOUCHÉES PAR LES INONDATIONS
Selon un rapport d'évaluation sur le terrain de Médecins sans
Frontières publié le 29 octobre, environ 21 000 personnes ont été
touchées par les inondations dans la localité de Zina, dans la région
de l'Extrême Nord du Cameroun.
RÉPUBLIQUE CENTRAFRICAINE (RCA)
AU MOINS 10 TUÉS DANS UNE RECRUDESCENCE DE LA VIOLENCE
Le 2 novembre, une personne a été tuée par des hommes armés
qui ont mis le feu à des dizaines de maisons dans la capitale
Bangui. Des centaines de personnes ont fui leurs maisons le même
jour suite à une attaque sur le quartier PK-5. Depuis le 26 octobre,
au moins 10 personnes ont été tuées et plus de 30 blessées à
Bangui.
NIGER
MANIFESTATIONS POUR DÉNONCER LES PRÉPARATIFS ÉLECTORAUX
Le 1er novembre, des milliers de manifestants antigouvernementaux
ont défilé à Niamey, la capitale du Niger pour
dénoncer ce qu'ils déclarent être des irrégularités dans les listes
électorales avant les élections présidentielles. En février 2016, le
Président Mahamadou Issoufou devrait briguer un second mandat
de cinq ans.
NIGERIA
338 OTAGES LIBÉRÉS
Le 27 octobre, 338 personnes détenues en captivité par Boko
Haram ont été libérées lorsque des troupes ont attaqué un camp
dans les villages de Bulajilin et Manawashe sur les bords de la forêt
de Sambisa, dans l'Etat de Borno. Les anciens captifs, huit
hommes, 138 femmes et 192 enfants, ont été emmenés à Mubi,
dans l'Etat d'Adamawa, par les militaires.
MALADIE A VIRUS EBOLA (MVE) / RÉGIONAL
1 NOUVEAU CAS EN GUINÉE
La Guinée a enregistré un nouveau cas d'Ebola, le 30 octobre, chez
un nouveau-né dont la mère est confirmée être infectée par le virus.
Si aucun nouveau cas n’est rapporté, la Sierra Leone sera déclarée
exempte de la maladie le 7 novembre. À compter du 1er novembre,
le Libéria a atteint 60 des 90 jours de la surveillance active et a été
déclarée exempte d’Ebola depuis le 3 septembre.
CAMEROON
21,000 PEOPLE AFFECTED BY FLOODS IN THE FAR NORTH
According to a field assessment report by MSF released on 29
October, around 21,000 people have been affected by floods in
the Zina locality in Cameroon’s Far North region.
CENTRAL AFRICAN REPUBLIC (CAR)
AT LEAST 10 KILLED AMIDST RENEWED VIOLENCE
On 2 November, one person was killed in the capital Bangui by
armed men, who set fire to scores of homes in the city. Hundreds
of people fled their homes in the capital on the same day
following an attack on the PK-5 neighbourhood. Since 26
October, at least 10 people have been killed and more than 30
wounded in Bangui.
NIGER
THOUSANDS MARCH TO DENOUNCE VOTE PREPARATIONS
On 1 November, thousands of anti-government protesters
marched in Niger's capital to denounce what they say are
irregularities in voter lists ahead of presidential elections. In
February 2016 President Mahamadou Issoufou is expected to
seek a second five-year mandate.
NIGERIA338 HOSTAGES FREED
On 27 October, 338 people held captive by Boko Haram were
freed when troops raided a camp in Bulajilin and Manawashe
villages on the edge of Sambisa Forest in Borno State. The
former captives, comprising eight men, 138 women and 192
children, were taken to Mubi in Adamawa State by the military.
EVD REGIONAL
1 NEW CASE IN GUINEA
Guinea recorded one new Ebola case on 30 October in a newborn
baby whose mother is confirmed to be infected with Ebola.
If no new cases are reported, Sierra Leone will be declared
Ebola free on 7 November. As of 1 November, Liberia has
reached day 60 of the 90 days of active surveillance and has
been Ebola free since 3 September.
Goal:
Ensure continuous access to fortified cooking oil and wheat flour for at least 85 percent of the population of West Africa.
Life of Project:
January 2011 – September 2016
Total USAID/West Africa Funding:
U.S. $2.88 million
Geographic Scope:
Benin, Burkina Faso, Cape Verde, Cote D’Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone and Togo.
Implementing Partner:
Helen Keller International
Feed the Future Initiative:
Feed the Future’s nutritional strategy is aimed at increasing nutritional levels in West Africa, especially within the first 1000 days of life.
Project Description:
Micronutrient deficiencies are responsible for widespread health and economic consequences, including maternal mortality, child mortality, stunting, blindness, chronic anemia and reduced capacity to work. West Africa is challenged with pervasive, severe and chronic malnutrition and micronutrient deficiency.
Fortify West Africa, part of the Feed the Future Initiative, works to harmonize fortification policies and standards and encourage private sector adoption of fortification to reach the most vulnerable mothers and children with vital micronutrients such as vitamin A, iron, folic acid and B vitamins. Fortify West Africa has made fortified oil and flour common even in rural communities and helped promote the Enrichi regional fortified product brand. A number of stakeholders are responsible for program implementation and success, including: the West African Economic and Monetary Union (UEMOA), the Economic Community of West African States (ECOWAS), milling and cooking oil industries and private companies producing micronutrients for fortification.
Program Components:
• Harmonizing standards between UEMOA and ECOWAS states to encourage intra-regional trade.
• Advocating to ECOWAS and UEMOA states to mandate fortification of locally produced and imported cooking oil and wheat flour.
• Promoting the Regional Enrichi logo on fortified foods to certify these foods for trade and for the consumer.
• Training officials on monitoring and quality control using testing (called “I-checks”) at manufacturing and market levels.
Results:
• 12 of 15 ECOWAS countries have mandatory legislation for fortifying cooking oil and 14 out of the 15 have mandatory legislation for fortifying wheat flour.
• An estimated 84 percent of the total population of ECOWAS has access to micronutrient-fortified wheat flour and 74 percent has access to vitamin A-fortified vegetable oil.
• The Enrichi logo is a successful example of a harmonized regionally approved brand that will build consumer awareness and promote fortified foods in West Africa.
CORAF/WECARD Objective:
Conduct, coordinate and disseminate research on agriculture practices and improved seeds to member states and national research centers.
Support from USAID/West Africa:
2002 to Present
Linked Programs:
CORAF partners with USAID’s
West African Seed Program.
Geographic Focus:
22 member states: Benin, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Cote d’Ivoire, Democratic Republic of Congo, Gabon, the Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo.
Description
The West and Central African Council for Agricultural Research and Development (CORAF/WECARD) was created in 1987 to “improve the efficiency and effectiveness of small-scale producers and to promote the agribusiness sector.” It focuses on developing new technologies and innovations to benefit farmers in the region and on collecting and dispensing agricultural data. It also strengthens and coordinates the existing regional agricultural systems, as well as giving policy options to its member states that can encourage agricultural growth.
CORAF/WECARD is one of the main implementers of the Comprehensive Africa Agriculture Development Program (CAADP) Pillar 4, which had the goal of 6 percent agricultural growth by 2015. To date, nine countries have exceeded this target (Angola, Eritrea, Ethiopia, Burkina Faso, Republic of the Congo, Gambia, Guinea-Bissau, Nigeria, Senegal, and Tanzania) and another four have achieved growth of between 5 and 6 percent. In June 2014, the African Union extended this mission, setting a new goal of doubling agricultural productivity by 2025
USAID Support
USAID support to CORAF/WECARD has strengthened its capacity to build a solid base of research information in West Africa. CORAF/WECARD’s work increases farmer access to information on food and farming systems, natural resource management, markets and trade, climate change adaptation and biotechnology. It also focuses on scaling up agricultural technologies to strengthen the link between research and the farm so farmers can improve productivity and increase profit. One example of this is in Benin, where CORAF/WECARD discovered that, if farmers precede rice cultivation with cowpeas, they will get the same yield from the rice with half of the usual amount of mineral fertilizer. CORAF/WECARD disseminates thousands of such best practices that have an enormous impact on the labor to profit ratio of farming in the region.
USAID support to CORAF/WECARD also includes improving the production and availability of quality-certified seeds for farmers in the region through the West African Seed Program, thus improving farmers’ yields and crop quality.Activities Supported by USAID/West Africa in 2013
• Baseline studies on agricultural research and post-harvest research for five value chains including maize, rice, millet, sorghum and livestock.
• Trials on high-yielding varieties of rice, maize and sorghum resistant to major biotic and abiotic stresses.
• Tests to improve the market quality of targeted cereal and traditional meat processed products.
• Capacity building for producers and agro-processors.
Key CORAF/WECARD Technologies and How They are Being Scaled Up
1) Climate-smart crop varieties like submergence-tolerant rice, drought-tolerant sesame and maize, heat tolerant and high-yielding millet and sorghum. Scaling up methods include demonstration plots and engaging all value chain actors, from plant breeders to private sector partners, to encourage commercializing new varieties of seeds.
2) Integrated Soil Fertility Management includes crop and site-specific fertilizer recommendations, best practices to rehabilitate degraded land and preserve soil fertility, and urea deep-placement (UDP) of fertilizer to maximize efficiency. These best practices are dispersed through demonstrations of deep placement of fertilizer and training agro-dealers so they can educate customers on how to most efficiently use fertilizer
3) Post-Harvest Quality Management through improved storage containers and post-harvest practices to reduce aflatoxin levels, which in large amounts can cause fungus growth. Promotion of storage container use and demonstrations of small-scale grain harvest machinery (stripper, thresher, and winnower) are dramatically reducing waste.
CORAF/WECARD and the Presidential Feed the Future Initiative
Feed the Future is focused on creating sustainable improvements in agriculture by building the capacity of West African organizations that can take ownership of agricultural work in the region. CORAF/WECARD’s work targets every step in the value chains of staple crops and thus improves every aspect of West African small farmers’ livelihoods: better yields, more efficient and sustainable inputs, better access to markets and market data, and less wasteful processing. CORAF/WECARD’s strategy aligns with the mission of Feed the Future: holistic and long-term efforts to eliminate food insecurity in West Africa.
Goal:
Increase regional availability and use of appropriate and affordable fertilizers.
Life of Project:
2012 – 2017
Total USAID Funding:
U.S. $20 million
Geographic Scope:
West Africa Region
Implementing Partner:
International Fertilizer Development Center (IFDC)
Regional Partners:
Africa Fertilizer and Agribusiness Partnership, ECOWAS, CORAF, CILSS
Program Description:
Fertilizer use in West Africa is far below the world average, leaving farmers without an important input that can significantly improve yields. The USAID West Africa Fertilizer Program (WAFP) aims to improve agriculture productivity by giving farmers better access to high quality, affordable fertilizers. The program strengthens private sector capacity for supply and distribution, and provides regional decision makers with critical fertilizer recommendations and subsidy program and impact information. WAFP also works with public officials to harmonize national fertilizer regulations and implement quality control programs to meet the Economic Community of West African States (ECOWAS) regional standards.
Program Components:
• Implementing the regional ECOWAS fertilizer regulations, technical assistance for harmonization and national level quality control to decrease adulterated fertilizer sales.
• Establishing a private-public sector West Africa Fertilizer Stakeholder Forum and forming a private sector-led Trade Association.
• Providing access to critical market information and financing for fertilizer importers, blenders and distributors.
• Providing up to date recommendations to suppliers, blenders and users of fertilizer for crops and conditions across West Africa.
• Conducting fertilizer subsidy studies and facilitating consensus-based recommendations for subsidy efficiency and policy reform.
Accomplishments:
• Facilitated development and conduct of West Africa Fertilizer Stakeholders’ Forum, a first ever innovative platform for public-private sector dialogue and business opportunities for fertilizer stakeholders in West Africa.
• Facilitated implementation of the ECOWAS fertilizer regulatory framework by providing technical assistance for adoption of the main regulation, and by embarking on joint missions with CORAF, CILSS and ECOWAS to advocate for the implementation of seed, pesticides and fertilizer regulations.
• Facilitated publication of the ECOWAS main fertilizer regulation in the national gazettes of eight Member States.
• Established extensive geo-spatial database and directory of fertilizer stakeholders across West Africa.
• Successfully piloted an e-tracking platform in Ghana to monitor and track subsidized fertilizer distribution.
• Completed feasibility study for West Africa Fertilizer Traders’ Association.
Goal:
Expand the production and supply of quality certified seeds by increasing the capacity of the private sector and existing seed alliances and institutions in West Africa.
Life of Project:
2012 – 2017
Total USAID Funding:
U.S. $9 million
Geographic Scope:
Benin, Burkina Faso, Ghana, Mali, Niger, Nigeria, Senegal (main activities). Seed policy and regulations also cover Mauritania, Chad, Cape Verde, Cote d’Ivoire, Gambia, Guinea, Guinea Bissau, Liberia, Sierra Leone and Togo.
Program Description:
One of the largest constraints to productivity in West African agriculture is the inefficiency of the regional seed system. In response, the USAID/West African Seed Program (WASP) was initiated in 2012 through USAID’s regional partner, the West and Central African Council for Agricultural Research and Development (CORAF/WECARD). WASP’s goal is to increase the production of quality-improved certified seeds in West Africa’s seed supply from 12 percent to 25 percent. The West African seed value chain lacked strong links between seed producers, certifiers and farmers. WASP works to facilitate such links by recognizing the relationship between public and private sectors, and the central role of the private sector in the development of more standard quality seeds. WASP also increases the coordination capacity of regional seed networks including national seed associations, which are critical to the long-term success of a robust and high quality regional seed supply.
The WASP program helps farmers to access higher quality seeds that improve yields and are resistant to pests and drought. WASP also encourages intra-regional trade by harmonizing regional seed standards and policies.
Program Components:
• Establishment and support of networks of plant breeders, quality controllers, certification personnel and West African members of the African Seed Trade Association (AFSTA).
• Effective implementation of a regional seed policy, facilitating seed trade between ECOWAS Member States.
• Production of sufficient quantities of quality-improved seeds to meet breeders’ demand to expand certified seed production.
• Development of a strong West African private sector to ensure the supply of certified seeds of standard quality.
• Capacity building of the National Seed Trade Association (ANCS), allowing it to fully play its role as a seed industry leader.
Expected Outcomes:
• An increase in the supply of certified seeds from 10-12 percent of total supply to 25 percent of total supply by 2017.
• The establishment of an inclusive and operational Alliance for Seed Industry in West Africa (ASIWA).
• The development of a National Quarantine Pest List for Togo, Benin and Ghana.
WASP Role in the Presidential Feed the Future Initiative:
Feed the Future is focused on permanent, foundational improvements to food economies that will support farmers in the long term. Its strategy is to identify constraints to create efficiency in production, and build the capacity of West Africans. WASP focuses on building the private sector and establishing seed networks so that farmers can have access to high quality seed supply that is self-sufficient.
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
Freetown, Sierra Leone | AFP | 11/5/2015 - 03:54 GMT
by Rod Mac Johnson
The Ebola epidemic is expected to be declared over in Sierra Leone on Saturday, when the west African nation will have gone 42 days without any new infections.
But jubilation over ending the outbreak in the impoverished nation, where almost 4,000 deaths have been reported, has been tempered by caution, with neighbouring Guinea still battling the virus.
Ebola was found in a 25-year-old pregnant Guinean woman and two of her children in Forecariah district, near the Sierra Leone border, in mid-October.
Her baby was delivered during her treatment and also tested positive, the World Health Organization (WHO) said in the latest of its weekly updates on the crisis on Wednesday.
Guinea is now monitoring 382 possible contacts, 141 of them deemed "high risk", it said.
Palo Conteh, the head of Sierra Leone's Ebola response, told a news conference in Freetown on Wednesday there were no plans for "an elaborate celebration".
Instead, the WHO will deliver a formal declaration in the capital on Saturday of the end of the epidemic.
"I feel proud that I was, with the support of my staff, able to save the nation from the virus. If I had not tackled Ebola with my team, the nation would have perished," he told AFP.
"We have to be vigilant as it is not the end of Ebola but the end of the current outbreak. We have fought the disease and we have won."
Since emerging in December 2013, the worst outbreak of Ebola in history has infected a reported 28,500 people, with 11,300 deaths registered.
The real toll is widely believed to be significantly higher than the official data, however, with under-reporting of probable Ebola cases rife in the early stages.
Saturday's announcement marks the official end of a battle which was prematurely thought to have been nearing its conclusion on previous occasions.
President Ernest Bai Koroma led a festive ceremony on August 24 celebrating the discharge of Sierra Leone's last known patient but the optimism was shattered by the deaths of a 67-year-old woman and, two weeks later, a 16-year-old girl.
The 42-day countdown began again after the last case was confirmed free of Ebola after a second consecutive negative test on September 25.
While the primary cost of the outbreak has been in human life, the crisis has also wiped out development gains in Sierra Leone, which was devastated by 11 years of civil war ending in 2002.
The World Bank estimates that Sierra Leone will lose at least $1.4 billion in economic growth in 2015 as a result, leading to an "unprecedented" GDP contraction of 23.5 percent.
The economic damage has been exacerbated by a sharp decline in global iron ore prices and the collapse of the mining sector amid an exodus of foreign investors.
Ebola spread to Sierra Leone 18 months ago, when a young pregnant woman and an older housewife were diagnosed as the country's first cases.
Both had attended the funeral of a widely-respected faith healer known as Mendinor, whose "powers" were renowned on both sides of Sierra Leone's border with Guinea.
The grandmother, whose real name was Finda Nyuma, had been treating sick patients in her home village, the diamond-mining community of Koindu, a few hours' walk from Gueckedou in Guinea, where the outbreak began.
"She was claiming to have powers to heal Ebola. Cases from Guinea were crossing into Sierra Leone for treatment," Mohamed Vandi, the top medical official in Kenema, told AFP in August last year.
Fourteen women were infected by two distinct strains of the highly infectious virus during Nyuma's traditional burial rites -- which involve "laying hands" on the body -- according to subsequent scientific studies.
Before they died they fanned out across the Kissi tribal chiefdoms, starting a chain reaction of infections, deaths, funerals and more infections which reached Freetown in July.
At the peak of the outbreak in the second half of 2014, Sierra Leone and its neighbours were reporting hundreds of new cases a week, their health services overwhelmed and social order on the brink of collapse.
The International Crisis Group (ICG) highlighted in a report last week a variety of exacerbating factors linked to poverty and weak healthcare, but also a lack of trust in the governments of the affected countries.
"In its initial phase, many west Africans thought Ebola was a ploy to generate more aid funding or reinforce the position of ruling elites," it said.
"And when Ebola proved real enough, political machinations and manipulation needlessly hindered the early response."
ICG also pointed to a failure of the international community, including the WHO, which it said "stalled for far too long on declaring an international health emergency, then proved incapable of mounting an effective response".
rmj/ft/ccr
© 1994-2015 Agence France-Presse
Highlights
Guinea is last of the Ebola Virus Disease (EVD)-affected countries in West Africa currently recording active cases. As of 1 November, Sierra Leone had gone 37 days of the 42-day countdown to a declaration marking the end of Ebola virus transmission in the human population on 7 November, if no further cases are reported.
Liberia as of 1 November has reached day 60 of the 90 days of enhanced surveillance and has been free of EVD transmission since 3 September.
In Guinea, a government-led 21-day surveillance campaign is underway in the new active area and surrounding villages, namely Tana market and the sub-prefecture of Kaliah, Forécariah.
In Liberia, the Office of U.S. Foreign Disaster Assistance (OFDA) has confirmed its support to an EVD Emergency Preparedness and Response consortium led by International Rescue Committee (IRC) and including other humanitarian partners.
In Sierra Leone, WHO and partners are launching a full-scale viral persistence study after the completion of the pilot study. The full study will enrol female survivors as well as males, and will assay a wide range of body fluids.
KEY FINDINGS
As the response moves towards recovery and long-term development planning, the perceptions of the younger generation on the crisis highlight their priorities for the future. Like the focus group discussion, the report covers three main themes: the main impacts of Ebola on student life (negative and positive), current concerns, and recommendations for recovery and development plans.
The main impacts of Ebola were felt to be on education, social life, health, and the economy, as well as the stigma of Sierra Leoneans from abroad. However, students equally emphasised positive impacts from the outbreak, such as the improvement of infection prevention practices and the mobilisation by communities against Ebola, while positive effects have been less highlighted by responders.
Fear of Ebola’s re-emergence, uncertainties around the disease, and popular complacency were most cited as current concerns. Survivors were frequently mentioned during the discussion. When asked whether they would accept survivors in their communities, students responded positively. However, when asked about safe and dignified burial workers, students expressed fear and resentment, as they perceived them to be responsible for the disruption to their traditional burial practices and potential sources of infection1. Stigmatisation of safe and dignified burial workers appeared much stronger among the students, while it has been less discussed by humanitarian responders.
Students felt strongly that the government and the international community should strengthen the health and education systems to ensure the population understands and respects the rules needed to protect them from the disease. Other priorities were for further research on the cause of the outbreak and the virus’s persistence in the body of survivors, developing a vaccine, and tighter containment measures in future response.
The main sources of information about Ebola were radio, TV, and social media. Religious leaders, UN agencies and health practitioners were the most trusted sources for the students.
It can be recalled that in March 2015, Buddhist Tzu Chi Foundation, contributed significantly towards the fight against Ebola in Sierra Leone. During its second visit to Sierra Leone from July 13 to August 9, Tzu Chi Foundation learned that its multi-functional portable beds and blankets served well the needs of health facilities and Ebola orphans. And the foundation’s Jing-Si instant rice arrived just in time to alleviate hunger, especially from Ebola orphans and some poor amputees. The gratitude shown to Master Cheng Yen and the entire Tzu Chi Foundation was remarkable, demonstrating just how grateful Sierra Leoneans are for those who helped them in their time of despair.
Tzu Chi’s return in July was to contribute more support to health facilities across the country, providing hospitals and clinics 687,000 face masks; 700 high quality, new stethoscopes; and a complete hospital bed set; and 1,056 women clothes for female Ebola survivors. A total of 14 government hospitals and nine faith-based clinics and hospitals in 10 of 12 districts and Western Area (Freetown and surrounding) benefited from the medical supplies. Tzu Chi’s goal for donating medical supplies was to contribute towards enhancing health worker safety while providing services to patients, preventing patient to health worker cross infection. One important lesson learned while in Sierra Leone was that providing health workers the needed medical supplies strengthens their brevity to treat and save lives.
Of the many subpopulations affected by Ebola, none, perhaps, is in a direr situation than those who survived the deadly disease. In addition to stigma and the difficulty to reintegrate into their communities, Ebola survivors face many challenges, such as psychological trauma and loss of property. When someone tests positive for Ebola, his or her home or living space is stripped and sprayed with chlorine and properties burnt to avoid or reduce infection risk. Those who are fortunate to survive the fatal disease, return home to nothing. The difficulty of going back home to your community after miraculously surviving Ebola and get accepted is one thing, but to find nothing that you can identify as your own possession steals your dignity and adds to the pain of being an Ebola survivor.
The most troubled of that population are adult women. That was the reason Tzu Chi Foundation saw it fit to donate brand new, excellent quality clothes to 250 female Ebola survivors. Beneficiaries demonstrated gratitude for the support and said that Tzu Chi Foundation restored some of their lost dignity by providing them something they can call their own and improved their appearance. It was very touching to see women dance and thank Tzu Chi Foundation for the clothes they received, something so simple that many other people around the world take for granted.
As Sierra Leone and Guinea continue to reduce infection rates, and as we pray for the end of Ebola to come quickly, Tzu Chi Foundation returned from yet another humanitarian mission with a better understanding of how to help the people of Sierra Leone in the post-Ebola recovery phase. Health facilities need more support in the areas of medical supplies, especially latex gloves. A critical component of the post-Ebola recovery plan is achieving infection prevention and control (IPC) goals, which can only be accomplished with sufficient supply of latex gloves in health facilities throughout the country. The challenges for using latex gloves in health facilities across Sierra Leone are two: there is no culture of using one pair of gloves per patient per contact; and insufficient supply of gloves. Tzu Chi observed the problem firsthand across Sierra Leone; hospitals and clinics were out of gloves or low in supply, including large government hospitals. Among other medical needs are blood pressure machines, manual hospital beds, mattresses, sterilizers, consumables, and capacity building.
In December 2015, Tzu Chi Foundation hopes to return to Sierra Leone with more support for health facilities and Ebola survivors and orphans, and begin planting the seeds of love right in the heart of Newton community.
In Magazine Wharf, one of Freetown’s largest slums, rivers of stinking mud and debris tumble from the central market, down a steep hill crammed with precarious wood- and tin-built dwellings. The homes continue all the way down to the sea, where there is a small fishing port.
Read the full article](http://www.theguardian.com/global-development/2015/nov/05/sierra-leone-ebola-uk-military-magazine-wharf-freetown)
Highlights:
· No new cases were reported in Sierra Leone in the period from 15 to 28 October 2015. If no further cases are reported, the end of the outbreak will be declared on 8 November 2015. UNICEF and partners continue to reinforce messaging around the need to remain vigilant and keep practicing safe behaviours.
· In response to the recent flare-up in the bordering Guinean district of Forécariah, UNICEF, through its implementing partners, is continuing to strengthen social mobilization activities on the need to maintain vigilance, report the influx of persons across the borders, intensify the screening, and report any rumors to the District Ebola Response Center.
· The Global Handwashing Day was celebrated on 15 October 2015. To mark the day, UNICEF facilitated the distribution of soap and engaged communities in all districts, through its implementing partners, on key messages related to the importance of hand washing.
· UNICEF, in collaboration with the Ministry of Social Welfare, Gender and Children’s Affairs (MSWGCA), continued to support the implementation of Project Shield. Project Shield aims at addressing the care for survivors and the risk of resurgence of sexual transmission. UNICEF and NGO partner GOAL trained 80 survivors on 12-13 October 2015 in the Western Area, on the registration and verification process of other survivors in pilot wards. The exercise was completed on 24 October 2015. Project Shield was also launched in Bombali district, where 22 survivors were trained on psychological first aid and are ready to be deployed to support the registration and verification exercise of all survivors in the district.
· UNICEF initiated the bridge education program, in collaboration with the Ministry of Education, Science and Technology (MEST) and the District Education Office, through the orientation of 1,000 teachers across the country. The bridge education support programme, which will benefit more than 3,000 pregnant school girls, is not in parallel to the formal education system, but will serve as an opportunity for pregnant girls to access education in their communities through either community learning centres or school-based learning spaces that will facilitate their reintegration into the formal education system after giving birth.
Sierra Leone: Pregnant schoolgirls excluded from school and banned from exams
Thousands of pregnant girls, excluded from mainstream schools and barred from sitting upcoming exams, risk being left behind as Sierra Leone moves forward from the Ebola crisis, Amnesty International said in a report published today.
The report, Shamed and blamed: Pregnant girls’ rights at risk in Sierra Leone, reveals how the prohibition, confirmed by the government in April this year and sometimes enforced through humiliating physical checks, not only stigmatizes an estimated 10,000 girls but risks destroying their future life opportunities. With exams scheduled for 23 November, Amnesty International is calling on authorities to immediately lift the ban.
“Excluding pregnant girls from mainstream schools and banning them from sitting crucial exams is discriminatory and will have devastating consequences. Education is a right and not something for governments to arbitrarily take away as a punishment,” said Sabrina Mahtani, Amnesty International’s West Africa Researcher.
"As Sierra Leone moves forward from the devastating Ebola crisis, it is vital that these girls, are not left behind."
On 2 April the Minister of Education, Science and Technology issued a statement banning pregnant girls from “school settings”. The justification given for this policy - namely to protect "innocent girls” from negative influences – only serves to reinforce stigma through language that blames and shames pregnant girls.
Amnesty International has documented how this ban has been enforced in some schools through humiliating and degrading treatment of girls. Girls have been subjected to degrading physical searches and tests. Some have had their breasts and stomachs felt by teachers to “test” for pregnancy. Others have been compelled by their school to take pregnancy tests.
Amnesty International interviewed 52 girls, some of whom said they felt scared at the possibility of being accused of being pregnant, while others described the feeling of humiliation at being physically assessed.
One 18 year-old girl told Amnesty International how all girls were checked by teachers before they were allowed to sit an exam:
“They touched our breasts and stomachs to see if we were pregnant. Some girls were made to take urine tests. One of the teachers was wearing gloves when she was checking us. I felt really embarrassed when this happened to me. Many girls left as they were scared the teachers would find out they are pregnant. About 12 pregnant girls did not sit their exams.”
Whilst the way in which girls are “tested” for pregnancy is not part of government policy, the practice is widely known. Amnesty International is calling on the government to issue urgent directives banning such humiliating and degrading treatment of girls.
In late October 2015 temporary alternative classes for pregnant school girls funded until July 2016 by donor countries, particularly Ireland and the UK, were introduced.
While the government claims that more than 3,000 pregnant schoolgirls have registered for this scheme, the classes are held in different premises or at different times to their peers and the girls are still banned from exams. It has also been criticized by local experts for its lack of choice and the stigmatizing effect of persistent exclusion from mainstream education.
Amnesty International urges that the attending of the alternative system, which should be of equal quality and content, be optional for those girls who do not wish to continue at mainstream school.
While some of the girls interviewed by Amnesty International said they support the alternative system, others wanted to attend school with their peers. Amnesty International has called on the government and the donors to make the alternative system optional for those girls who do not wish to continue at mainstream school.
As the Ebola crisis spread last year, schools in Sierra Leone were closed between June 2014 and April 2015 as part of emergency measures to reduce infection rates. During this period, there was an increase in adolescent pregnancy. Many of these pregnancies resulted from rights violations including failure to protect girls from sexual violence. Quarantines and an already overstretched healthcare system, meant that girls were not able to access sexual and reproductive health support or advice to protect themselves from early and unwanted pregnancies. Sex education in schools is limited and was removed from the curricula after the war over a decade ago.
In 2004, after the end of the civil war, the Truth and Reconciliation Commission recommended that the government stop the practice of excluding pregnant girls from education. The Commission called this practice "discriminatory and archaic".
“Pregnant girls are being blamed and shamed in Sierra Leone. They are being denied key chances to move forward with their lives, and to ensure early pregnancy does not become the event that determines the rest of their lives,” said Sabrina Mahtani.
"As the country emerges from the Ebola crisis, pregnant girls we met expressed their desire to help build up their country. Many wanted to become much needed nurses, doctors or lawyers. Unless their exclusion from mainstream education is reversed and the ban from sitting exams is lifted these girls’ dreams will not be realized."
Background
The Ebola crisis that struck Sierra Leone in March 2014 and continued throughout 2015 hit all parts of the country’s population, with already marginalized groups like girls particularly affected.
The exclusion of pregnant girls from mainstream education and from sitting exams pre-dates the outbreak of Ebola; however, the official declaration of the ban when schools re-opened has sparked renewed debate and concern about this issue in Sierra Leone. The Human Rights Commission of Sierra Leone described the ban as discriminatory, stigmatizing and likely to worsen the marginalization of pregnant girls and women.
The Ministry of Education, Science and Technology has itself recognized that there has been an increase in adolescent pregnancy during the Ebola outbreak. It is not clear how many girls are affected the ban. Official figures suggest three thousand, but experts mapping the situation indicate that the true figure is far higher, likely to be an estimated 10,000 pregnant girls.
There are at least two crucial exams that all visibly pregnant girls are currently unable to take. Firstly, there is the Basic Education Certificate Examination (BECE), which is the exam all students must pass to guarantee admission into senior secondary school or other higher level education centre, such as vocational schools. The second key set of exams are the West African Senior School Certificate Examination (WASSCE), which can be taken in a range of subjects including English, mathematics, sciences and arts, as well as economics and other commercial subjects. The WASSCE exams are necessary to get into university or college and are also important for potential employers.
Sierra Leone has been under siege from the EVD epidemic for more than a year. According to World Health Organisation, this outbreak has been classified as the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976, with Guinea, Liberia and Sierra Leone as the most severely affected countries in the West Africa region.
The outbreak in Sierra Leone started in May 2014, and as at 4th November 2015, according to the Ministry of Health and Sanitation, the country recorded a cumulative (laboratory confirmed) infected cases of 8,704, confirmed deaths of 3,589 (of which 221 are healthcare workers),and 4,051 survivors.
According to the WHO, a country will be declared Ebola-free 42 days after the last confirmed case has tested negative or has deceased. Sierra Leone started its new countdown on Saturday 26th September, after discharging its last two known patients from the Treatment Center in Kambia District. The country is to complete its 42 days of ‘0 cases’ period by midnight Friday, 6th November 2015. All actors in the country and across the world are anticipating that on Saturday, 7th November 2015, Sierra Leone will be declared free of Ebola, which will also initiate a 90-day period of heightened vigilance to prevent reoccurrence of the infection in the country.
ACF has been in Sierra Leone since 1991 supporting the national authorities in the fight against hunger in the Moyamba, Kambia and western rural and urban districts (which happened to be high transmission areas during the outbreak), through its nutrition, health, food security and livelihoods, water sanitation and hygiene programmes of intervention. ACF has been involved in robust social mobilization by training and giving support to case investigators and contact tracers; has been providing water, sanitation and hygiene structures for quarantined homes, communities and health facilities; has been, providing trainings for healthcare workers on infection prevention and control; has been giving nutrition, psychosocial and livelihood support to survivors and has also been distributing reunification kits to survivors and people loosing family member(s) to Ebola. ACF has been actively involved in promoting good hygiene practices (especially hand washing) in communities as major tools in the fight to tackle the disease in the country.
As we approach this historic day , ACF Sierra Leone is calling on all to be vigilant, not be complacent and still maintain a system of heightened surveillance and good hygiene practices as we get to and stay a resilient zero.
Los equipos locales de Médicos del Mundo celebran el momento mientras animan a continuar con las medidas preventivas
Madrid, 6 de noviembre de 2015.- Mañana, la epidemia de ébola quedará oficialmente erradicada de Sierra Leona, el país que más casos de la enfermedad ha registrado, con 14.104 -entre probables y confirmados- y casi 4.000 muertes. La Organización Mundial de la Salud (OMS) considera así controlado el brote, al haber pasado 42 días después del último caso comprobado.
Sin embargo, José Félix Hoyo, cooperante de Médicos del Mundo y responsable de Operaciones Internacionales de la organización, considera que el 7 de noviembre no es el fin del ébola. "Es sólo la demostración de que el Gobierno de Sierra Leona y las organizaciones presentes en el país han conseguido frenar la expansión mortífera de este virus, pero teniendo en cuenta que se siguen registrando casos en Guinea, no se puede bajar la guardia", afirma.
"Además, ahora nos enfrentamos a una crisis de salud pública de mayores dimensiones que las del propio ébola, con la estructura sanitaria del país muy debilitada", remarca Hoyo. Una afirmación que queda confirmada con la contundencia de los datos: se calcula que sólo el 50% del personal sanitario del país está activo en este momento y el 74% de las y los habitantes considera que la situación de salud es peor que hace un año.
El virus no sólo mató a miles de personas, sino que alejó a la población de los centros sanitarios por el miedo a la infección. Esto ha supuesto una dramática reducción de la utilización de estos servicios en Sierra Leona -hasta un 70% comparado con la situación pre-ébola-, el descenso en un 60% de la tasa de vacunación infantil o el hecho de que solo la mitad de la población solicite asistencia sanitaria cuando se enfrenta a un problema de salud.
En total, se estima que más de 3,5 millones de personas están en riesgo debido a las necesidades insatisfechas de salud que aquejan al país. Comienza ahora un largo trabajo para crear las condiciones necesarias para que esto no vuelva a ocurrir.
¿Qué pasa con las personas supervivientes?
El equipo psicosocial de Médicos del Mundo se embarcó en un estudio de necesidades, tanto de supervivientes del ébola como de las familias afectadas por el brote en el distrito de Koinadugu. Se trataba de comprobar cuáles eran sus condiciones de vida, de salud y su reintegración en la comunidad una vez que la epidemia ha quedado controlada.
Y las cifras son alarmantes: el 90% de las y los supervivientes de ébola perdieron a familiares durante el brote. De media, cada superviviente ha perdido a cinco de ellos. Un 74% de los hogares afectados por la enfermedad han perdido al cabeza de familia.
También son significativas las estrategias que, según las propias personas supervivientes, les ayudan a afrontar su situación. Entre ellas destacan el apoyo de su comunidad y de su familia, la música -en un 21% de las personas entrevistas-, la agricultura -que les permite tener la mente ocupada y sentirse útiles-, los aspectos espirituales y la apuesta por la educación de sus hijos e hijas, algo muy llamativo en una zona con un 85% de analfabetismo.
El estigma
Quienes han sobrevivido declaran haberse sentido estigmatizados en un 29% de los casos, lo que potenció su sentimiento de soledad. Afortunadamente, este rechazo fue disminuyendo con el paso del tiempo, de tal manera que sólo un 13% se sigue sintiendo discriminado/a en la actualidad. En esta disminución del rechazo ha sido clave el papel del personal sanitario, higienistas y trabajadores/as sociales locales, que se han encargado de concienciar a las poblaciones y derribar mitos sin base real.
En estos momentos, lo que ocurre es que algunas personas tratan de camuflar síntomas de cualquier otra enfermedad. Creen que mostrar debilidad física puede ser entendido como que el virus sigue presente en su cuerpo, por lo que tienen miedo de mostrarse enfermos por si eso desencadena de nuevo el rechazo.
NOTA: La intervención de Médicos del Mundo en Moyamba (Sierra Leona) ha sido financiada íntegramente por la cooperación británica. El proyecto en el distrito de Koinadugu se ha acometido por fondos propios y por distintos financiadores tanto nacionales como internacionales (Bob Geldof foundation, DfID, USAID, Canal de Isabel II, Principado de Asturias, Ayuntamientos de Zaragoza, Oviedo, Avilés, Siero, Castrillón y Langreo). Ambas intervenciones se han realizado en coordinación con el Ministerio de Salud del país.
On the eve of Sierra Leone being declared ebola-free, Caritas says the impact of the epidemic is likely to linger long into the future in the West African country.
Over 3,500 people died in Sierra Leone after the highly-contagious virus spread through the country and neighbouring Liberia and Guinea in 2014. Over 11,300 people died from the disease in the three countries in the period between March 2014 and November 2015.
A country must have no new infections for 42 days to be declared ebola-free. Sierra Leone is expected to reach this milestone on 7th November.
“The declaration of an ebola-free Sierra Leone is a wonderful moment but the struggle for many people isn’t over,” says Suzanna Tkalec, humanitarian director at Caritas Internationals. “The impact of the epidemic has been particularly hard on children who lost a year of schooling, which will affect their future prospects, and who lost parents or close family members, leaving them emotionally, economically and socially vulnerable. Other members of communities are trying to rebuild their lives and livelihoods having faced grief and a period of great trauma.”
An estimated 12,000 children were made orphans by ebola, according to reports in March 2015. Others have been separated from parents, become malnourished or face stigma if the disease affected their family or they survived it.
Children were out of school for nearly a whole academic year. Caritas provided school fees, school kits, books and recreational activities, reunification packages for families and tried to maintain some constancy.
Food production went down in Sierra Leone as farmers abandoned their farms and some border crossings were closed to stop the spread of the disease but also preventing the entry of migrant farm workers. Caritas has been providing cash grants, seeds and tools to get people back to work.
Caritas has given food, hygiene items and counselling to people affected by ebola and their families.
Caritas and the local Church has worked on various levels to help local communities deal with the ebola epidemic. A key part of its work has been awareness raising regarding hygiene practices and involving community and faith leaders to prevent the spread of the disease. Caritas organised “safe burial teams” who ensured that people who had died from ebola had a dignified funeral but those who buried them followed guidelines to ensure they didn’t contract the disease.
The poor healthcare system in Sierra Leone was weakened even further by the demands brought by ebola. In the long-term Caritas is supporting the local health structures by providing medicines and equipment to help it become more sustainable.
“There is still a lot to be done but we, as a community should pause for a moment, exhale, and thank all who did what they could, in some cases laying down their lives, for our beloved Salone, [Sierra Leone],” says Fr Peter Konteh, director of Caritas Freetown.
For more information, please contact Michelle Hough on +39 06 69879721 / +39 334 2344136 or hough@caritas.va.
