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- 03/07/16--13:58: _Guinea: Women’s Res...
- 03/07/16--19:34: _Sierra Leone: UNICE...
- 03/08/16--12:32: _Guinea: IOM Guinea ...
- 03/09/16--03:01: _World: Crop Prospec...
- 03/09/16--08:48: _Sierra Leone: Stren...
- 03/09/16--09:38: _World: Long range f...
- 03/09/16--23:37: _World: Communicable...
- 03/11/16--04:51: _Sierra Leone: GIEWS...
- 03/11/16--08:02: _World: Communicable...
- 03/11/16--15:11: _Sierra Leone: Sierr...
- 03/14/16--05:40: _Guinea: Reporting D...
- 03/15/16--09:24: _Niger: West and Cen...
- 03/15/16--09:30: _Niger: Afrique de l...
- 03/15/16--12:00: _World: Polio this w...
- 03/15/16--21:20: _Niger: Routes Migra...
- 03/15/16--21:28: _Niger: Migrant Rout...
- 03/16/16--03:36: _Sierra Leone: UNHRD...
- 03/16/16--04:40: _Sierra Leone: Sierr...
- 03/16/16--10:34: _Sierra Leone: WHO E...
- 03/17/16--02:15: _Sierra Leone: World...
Between February 5 and 8, 2016, The Chief of Mission of IOM Guinea went to the forest region to visit IOM’s sub-office newly installed in the region, Points of entry that are being built by IOM and meet local authorities.
Between February 8 and 11, 2016, IOM organized a training workshop for agents of community talks in Boke, in partnership with the Red Cross, WHO and Unicef.
Between February 8 and 12, 2016, IOM supported the Health Department of the town of Conakry (DSVCO) in developing Operational Action Plans over carrying for Ebola survivors.
- 03/09/16--03:01: World: Crop Prospects and Food Situation No. 1, March 2016
- 03/11/16--04:51: Sierra Leone: GIEWS Country Brief: Sierra Leone 10-March-2016
- Cereal production in 2015 recovered significantly from previous year’s Ebola‑affected level
- Prices of main staples generally stable
- In spite of significant improvement of food situation, about 420 000 people still need food assistance
- 03/11/16--08:02: World: Communicable disease threats report, 6-12 March 2016, week 10
The volume of cross-border trade flows and transactions are below-average across most of the country. Rice and cash crop production for the 2015/16 season was lower than the 2014/15 season, and prices are currently above average. Poor households are facing diminished purchasing power and many are incapable of meeting their livelihood protection needs.
Stressed (IPC Phase 2) food insecurity or higher is expected for at least 20 percent of rural district populations.
A normal start to the next cropping season is expected and international forecasts indicate that there are high chances of average to below-average rainfall. Households are currently engaged in land preparation activities for rice and off-season crops. Employment opportunities for weeding and harvesting of minor crops is expected to improve household income and food access during the lean season.
Most poor households are still likely to remain Stressed (IPC Phase 2) until the start of the harvest in September. Acute food insecurity among a small portion of these households could deteriorate into Crisis (IPC Phase 3), as they start to face slight food gaps due to higher food prices once the lean season starts in May. Labor availability in the form of weeding and other activities is expected to be normal or above normal for the remainder of the year due to the end of several bans around public gathering. This should increase household and improve food access for poor households.
- 03/15/16--12:00: World: Polio this week as of 9 March 2016
8 March marked International Women’s Day - a great opportunity to thank the many thousands of women who have been instrumental in the progress of polio eradication around the world. Read more here.
A new short film shown at the Ministerial Conference on Immunization in Africa demonstrates the value of the polio infrastructure in serving broader health goals. Watch the video here.
There are six weeks to go until the globally synchronized switch from the trivalent to bivalent oral polio vaccine.
- 03/15/16--21:20: Niger: Routes Migratoires: Niger 2016 (9 mars 2016)
- 03/15/16--21:28: Niger: Migrant Routes: Niger 2016 (9 Mar 2016)
UNHRD continues to dispatch operational equipment for its Partners, most recently supporting WFP by sending ICT equipment to Freetown in Sierra Leone.
During the worst of the crisis, UNHRD facilities in Accra and Las Palmas served as regional staging areas and the Accra depot hosted UNMEER headquarters.
On behalf of WFP, UNHRD procured and dispatched construction material and equipment for remote logistics hubs, Ebola Treatment Units (ETU) and Community Care Centres. In collaboration with WHO, UNHRD also procured and dispatched equipment to establish camps for teams tracing EVD. Members of the Rapid Response Team (RRT) set-up supply hubs, an ambulance decontamination bay and ETUs.
Sierra Leone YMCA should maintain and build on the relationships established and/or strengthened with community leadership and stakeholders throughout the Ebola outbreak emergency response. All YMCAs should ensure they coordinate directly with local communities and leaders, other stakeholders and NGOs- including any relevant working groups or taskforces.
Investment and support should continue for young volunteers, particularly community health peer educators as community engagement should continue while the Ebola outbreak continues.
Additional training could be offered to volunteers to build their capacity further.
There should be a particular emphasis on engaging and involving young volunteers in future emergency response and on using existing YMCA volunteer groups. Local dialects should be used for community sensitization and budgeting for appropriate stipends for young volunteers is also crucial.
Investment should be made to build capacity of YMCA staff in a variety of skills areas including: emergency response design, budgeting and reporting, monitoring and evaluation.
Sierra Leone YMCA should develop a Disaster Preparedness Plan to guide future disaster response and outline plans for scaled up community disaster risk reduction (DRR).
Confirmation of funds available for YMCA emergency response projects should be made more rapidly from contributing YMCAs and international YMCA partners in future.
Efforts should be made to improve coordination and communication between Regional Alliances of YMCAs, WAY and other international YMCA partners.
A disaster fund should be established and maintained at all levels to enable immediate response to future disasters: national YMCAs, Regional Alliances of YMCAs, and the World Alliance of YMCAs (WAY).
Efforts should be mode to ensure YMCAs are confident following the International YMCA Emergency Response Protocol and Templates . A. review of the templates should be planned by WAY with support from international YMCA partners such as Y Care International.
Emergency response project budgets should include reasonable office and staff cost recover amounts and a psychosocial support budget line for staff - Efforts should be made to ensure evaluations and learning from YMCA emergency response is shared within the YMCA Movement and beyond.
- 03/16/16--10:34: Sierra Leone: WHO Ebola Situation Report - 16 March 2016
AfDB releases new report on the impact of Ebola on women
On the occasion of International Women’s Day, March 8, 2016, the Office of the African Development Bank’s Special Envoy on Gender, Geraldine Fraser-Moleketi, has launched a report on “**Women’s Resilience: Integrating Gender in the Response to Ebola**.”
The AfDB-commissioned study brings to light a topic that has often been discussed, but never investigated concretely – did Ebola affect women and men differently? The answer is a resounding yes. Bank experts have long suspected that infectious diseases tend to exacerbate the socio-economic vulnerabilities that are present prior to an outbreak, and that knowledge has been confirmed by this AfDB report.
Having visited Liberia, Sierra Leone and Guinea-Conakry in August 2015, at the height of the epidemic, VP Fraser-Moleketi noted, “I met women and men working tirelessly to eradicate this disease. Countless lives were lost in this battle and the repercussions will be felt for years to come in terms of economic growth. For women, there was, and still is, a danger of reverting to the way things were before.”
The report investigates the futility of trying to build resilience to Ebola and future infectious disease shocks in households and communities without also addressing systemic gender inequality. Factors that entrench vulnerability for the entire population must be addressed in the immediate response, medium-term mitigation and long-term intervention. The gender effects of Ebola in the region are influenced by the skills and strategies used prior to the outbreak, and the mechanisms individuals used to cope and adapt differ.
The report also highlights that the lack of gender disaggregated data should not limit interventions, and that all efforts must be made to collect the relevant information to combat the inequalities underscored by disease outbreaks now. The insights contained in this report are not only invaluable for dealing with other epidemics, but may also assist in the prevention of further outbreaks.
One of the recommendations of the report was to establish a Social Investment Fund. The AfDB has since invested $33 million into the Post-Ebola Social Investment Fund, a project supported by the US State Department.
The African Development Bank’s level of ambition in improving quality of life remains high. It is determined to make the best of its resources to provide access to health, social protection and education to all Africans, men and women, young and old, across the continent, to overcome a key constraint on Africa’s development and set the continent on the path to inclusive growth.
• 2 Ebola cases were confirmed on 14 and 20 January 2016 in Tonkolili. By 11 February, all contacts of the index case had completed followup. If no further cases are detected, transmission linked to this last cluster of cases will be declared to have ended on 17 March. During the reporting period, the affected communities were all fully discharged from quarantine, with no subsequent positive cases reported.
• In response to the EVD cases in Tonkolili, UNICEF continued to support the quarantined communities in the affected districts of Tonkolili, Kambia and Port Loko. In the context of emergency preparedness, UNICEF was identified by the Inter-Agency Rapid Response Team as Incident Manager to lead the response in Tonkolili and Kambia.
• UNICEF support to the overall response included provision of water and hygiene kits, psychosocial support, and learning materials to the communities. In Kambia and Bombali, UNICEF also provided support to the Ebola Treatment Centers for Infection Prevention and Control and WASH activities.
• Through intensified community engagement, all missing contacts in the district of Kambia willingly returned to their communities. The EVD event was therefore officially closed. With a view to adjusting subsequent response to future events, should they arise, UNICEF contributed to the lessons learned exercise conducted by the InterAgency Rapid Response Team.
Situation of the Ebola Virus Disease after its resurgence in Sierra Leone
Since confirmation of two EVD cases on January 14 and 20 in neighboring Sierra Leone, all contacts linked to those cases had completed follow-up by 11 February 2016, according to the WHO Situation Report of 17 February. Efforts to locate several untraced contacts in the district of Kambia in Sierra Leone continued until 24 February. If no further cases are detected, transmission linked to this cluster of cases will be declared to have ended on 17 March.
After the Ebola Virus Disease reappeared in Sierra Leone, Guinean authorities decided to strengthen health surveillance activities at the country’s borders with Sierra Leone. IOM remains a key partner in implementing these activities. Following the Government’s request, IOM systematically screens all people going through the 48 official and non-official Points of entry along the border.
No new case has been reported in Guinea since the official end of the epidemic was declared by WHO.
Global crop prospects benign, but hunger intensifies in areas suffering from conflict
Food security worsens further in Southern Africa due to drought
9 March 2016, Rome - Thirty-four countries, including 27 in Africa, are currently in need of external assistance for food due to drought, flooding and civil conflicts, according to a new edition of FAO's Crop Prospects and Food Situation report released today.
The figure has grown from 33 last December, after the addition of Swaziland.
Drought associated with El Nino has "sharply reduced" 2016 crop production prospects in Southern Africa, while expectations for the harvest in Morocco and Algeria have been lowered due to dry conditions.
Also in areas of Central America and the Caribbean, ongoing dry conditions linked to El Nino may affect sowings of the main season crops for the third consecutive year.
Moreover, persistent conflicts in Iraq, the Syrian Arab Republic, Yemen, Somalia, and the Central African Republic have taken a heavy toll on the agricultural sector, further worsening the humanitarian crisis in those countries.
In most cases, the impact of conflict extends into neighbouring countries such as Cameroon and the Democratic Republic of Congo that are hosting refugee populations.
In several countries already in need of external assistance for food, conditions generally worsened in the past three months, according to the report from FAO's Global Information and Early Warning System (GIEWS), mainly in the Southern Africa sub-region, where food prices have reached record highs.
The report also warned that last year's reduced production would negatively impact the food security situation in the Democratic People's Republic of Korea, where "most households were already estimated to have borderline or poor food consumption."
Elsewhere, the outlook for the 2016 crops already in the ground, mostly winter grains in the northern hemisphere, is generally favourable. Early forecasts indicate large 2016 wheat crops in most countries of Asia.
March 9, Freetown, Sierra Leone: In a collaborative effort between the Government of Sierra Leone and its development partners to improve the access to and availability of high-quality health services in the country, the Ministry of Health and Sanitation (MOHS), JSI Research & Training Institute, Inc. (JSI), Action Contre la Faim, and Save the Children will officially launch the Advancing Partners & Communities project: “Strengthening Reproductive, Maternal, Neonatal, and Child Health (RMNCH) Services as part of the Post-Ebola Health Sector Recovery in Western Area” on Wednesday, March 9th, 2016 at the Sierra Leone Bank Complex. The project is funded by the United States Agency for International Development (USAID).
The Advancing Partners & Communities project goal is to reduce the high rates of neonatal, under-five, and maternal mortality in the country. The focus of its interventions is to increase the capacity of the health workforce and community platforms to provide high-quality reproductive, maternal, neo-natal, and child (RMNCH) services, in line with the MOHS infection prevention control (IPC) and water sanitation and hygiene guidelines. More than USD 4 million will be invested in rural and urban Western Area to enhance quality, safety, and access to health services in about 90 community health facilities. The project expects to train and actively support more than 600 health professionals and community health workers in a range of RMNCH and IPC topics, along with renovations in 40 health facilities, provision of delivery kits and other medical equipment, and improvements in water supply through borehole drilling and the repair of existing wells.
"The health facilities in the communities…are the first level of care where health services are delivered to the population... the idea is to improve those to keep disease morbidity very low. In each of the RMNCH areas, we have challenges and partners can actually support addressing a range of issues, from improving staff skills to facility renovations, community engagement, or equipment. And there’s sustainability, making sure that good practices stay and health care delivery is able to go on after the project’s capacity building and productive work. At the DHMT, we are very happy to work with [Advancing Partners & Communities] and we do welcome USAID’s invaluable input into our work and the welfare of our people.”
Dr. T. T. Samba, District Medical Officer of Western Area.
In Sierra Leone, the USAID-funded Advancing Partners & Communities project is implemented in five districts through a partnership of national and international organizations led by JSI and FHI 360, in collaboration with Action Contre le Faim, Adventist Development and Relief Agency, GOAL, International Medical Corps, and Save the Children. Action Contre le Faim and Save the Children are implementing partners in Western Area Urban and Western Area Rural respectively.
Below average precipitation and drought have raged since last year on the SADC region, the outlook for the remaining months of the current season indicated below average precipitation very likely over most of the eastern part of the region including Zambia, Malawi, Mozambique, Zimbabwe, easternmost of Botswana, South Africa, Lesotho, Swaziland and the center of Madagascar. The drought situation and related consequences will persist during the coming months.
Over the southern half of the DRC, northern Angola, westernmost part of Tanzania, Burundi, Rwanda, southwestern Uganda, Guinea, Sierra Leone, Liberia, southern Ghana, Togo, Benin and southwestern Nigeria, below average precipitation is very likely. However, given the low vulnerability in these areas, significant impacts are very unlikely from March to June 2016.
Between March and June 2016, southern Cameroon, Guinea Equatoria,l Gabon, Congo, northernmost part of DRC, southeastern Tanzania, northeastern Mozambique, northern Madagascar and Comoros Island are expeting above average precipitation.
Over southtern sahel, above average precipitation associated with a normal to early start of the season are very likely during April to June 2016.
Near to above average temperature is very likely over most of Morocco, Mauritania, Mali, Niger,
Mozambique, and South Africa, Algeria, Tunisia, western Libya, northern Burkina Faso, southern Angola, southeastern most of DRC, Zambia, Malawi, Zimbabwe, Botswana, Namibia, Lesotho and Swaziland
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 28 February to 5 March 2016 and includes updates on Zika virus, haemolytic uraemic syndrome in Romania and seasonal influenza.
FOOD SECURITY SNAPSHOT
Recovery in 2015 cereal production compared to previous year’s Ebola‑affected harvest
Harvesting of the 2015 main rice crop was completed in December. Rains and soil moisture were generally adequate during the cropping season, allowing satisfactory development of crops. Moreover, Sierra Leone was declared free of the Ebola virus transmission in the human population in November 2015. The Ebola Virus Disease (EVD) outbreak had a serious impact on labour availability during last year’s cropping season. In spite of floods in some areas, which partly affected the production of rice and tubers, preliminary estimates indicate that 2015 cereal production increased by 10 percent compared to the previous year’s output. Production of rice, the main cereal grown in the country, is also estimated to have increased by 10 percent. Similarly, the cassava harvest increased significantly. In 2014, the EVD outbreak resulted in a serious shock to the agriculture and food sectors. Rice production declined by 8 percent compared to 2013. In particular, cereal production in Kailahun was substantially affected by the outbreak that started to spread when crops were being planted and grew during the crop maintenance period, and then expanded rapidly during the critical harvesting period for the staple rice, maize and cassava crops.
The ECDC Communicable Disease Threats Report (CDTR) is a weekly bulletin for epidemiologists and health professionals on active public health threats. This issue covers the period 6-12 March 2016 and includes updates on Zika virus, haemolytic uraemic syndrome in Romania and seasonal influenza.
Stressed food insecurity outcomes expected to continue through September
The recent Ebola outbreak in West Africa infected more than 28,000 people and claimed more than 11,000 lives. As Guinea, Sierra Leone and Liberia grapple with the challenges of the post-Ebola period, there’s no shortage of analysis on the operational issues and systemic flaws that shaped both the epidemic and the response. But what can we learn about how local media performed in providing accurate, timely information to the public, to health care workers, and to those setting policy at the local and national level? To answer that question we examined articles and studies carried out or published during the epidemic from January 2014 through November 2015, and conducted interviews with journalists, editors and public health experts directly involved in the response. What we discovered could help shape public health communications strategies for future health emergencies, and help media organisations better tailor their reporting to respond to the real time information needs of their audience.
Local journalists play a central role in times of crisis, and their proximity to affected populations means they are sometimes the first responders. In addition to life saving information, independent journalists provide accountability, signaling gaps in service delivery by investigating and reporting on abuses of trust. And, as survivors grapple with stigma and families and communities process extreme loss, the media can help by enabling these stories to be told and shared.
From the outset of the Ebola crisis, local media was largely overlooked. Decision makers and key donors rolled out a medical/clinical response that focused on treatment and sidelined efforts to provide critical lifesaving information to the public. In Liberia, for example, a Media Working Group failed to include a single member of the Liberian media. When funding started to flow to international NGOs in the summer and fall of 2014 for communications and outreach, many established best practices for communicating with communities during humanitarian crises went unheeded. Top-down institutional messaging was pushed out to the population, with local media used as (poorly) paid platforms to disseminate these messages rather than as professionals tasked with shaping vital lifesaving information. Messages were often contradictory, leading to what has been characterised by one practitioner as a “chaotic” information landscape. With the outbreak spinning out of control in late 2014, it became increasingly evident that public resistance to messaging was a significant barrier to the adoption of health seeking behaviors in communities at risk.
To understand how things could have gone so fatally wrong it helps to look at the form and content of health messaging at the outset of the crisis. The first public health messages to the population in Guinea were built around three pieces of information: Ebola was highly contagious, mortality rate was 90%, and there was no cure. Messages scripted by health ministries and international organisations were broadcast across FM networks and on the few local television stations. Designed to contribute to public education, the messages, in some cases, produced the opposite effect.The focus on viral transmission fed both fear driven responses and the stigmatisation of affected individuals and communities.
As Jeffrey Stern wrote in Vanity Fair magazine, in Guinea “the message from the government and the health workers (and local media) had undercut the incentive to cooperate”. The public service announcements fueled, rather than prevented, panic. As Stern reported, “people in Guinea were as frightened by the response to Ebola as they were to Ebola itself”.
Health experts and blogs from front-line workers in Guinea, Sierra Leone and Liberia have also described this pervasive fear of Ebola, and the challenges of communicating uncertainty from medical experts and scientists without further igniting fear and undermining public trust in health authorities.
The efforts to prevent and control the spread of Ebola were met with reticence, and in some cases violence, from the population. As the number of infections grew exponentially in August and into September 2014, a wide network of public health responders, humanitarian actors, anthropologists, media experts and academics mobilised to address questions of public doubt, fear and resistance to the scientific discourse adopted by public health officials and government.
One group of experts convened at Massachusetts General Hospital in Boston, while in Dar es Salaam another group that included religious leaders, traditional healers and media from East and Central Africa met to gather first hand lessons from past Ebola epidemics. Several important recommendations emerged from these meetings: first, work with communities not against them, involving community leaders to formulate appropriate containment measures; and second, “share early, listen to beliefs and read rumors”. In other words, don’t just counter rumors but read them for information on possible cases (alerts) and to better understand community explanations of the causes of Ebola.
Understanding deeply rooted mistrust
The international organisations tasked with leading the response as well as front line medical teams had been caught off guard, believing that disseminating “correct” messages through the “right” medium would address lack of knowledge in a population deemed largely ignorant. What they failed to take into consideration were the social, political and economic factors that had eroded public trust in the authorities. Writing in African Affairs, researchers Wilkinson and Leach from the Institute of Development Studies described the legacy of distrust in government, the politicisation of Ebola (and electoral politics, especially in Guinea), longstanding experiences of state and foreign actors being seen as “alien, oppressive or self-serving”, and deep social and economic inequality. The authors explained public resistance to risk communication as a rejection not of biomedicine, but of the heavy handed and authoritarian approach by official sources that were not trusted by the population.
A crisis of governance, a crackdown on press freedom
In all three Ebola affected countries, lack of transparency by authorities at all levels of the government and by organisations affiliated with the response contributed to suspicion and reticence. Government officials and donors sought to ensure messages were centrally approved, leading to confusion surrounding the process and important delays. Limitations of press freedom hampered the media’s ability to provide an accurate picture of the epidemic to local audiences and to counter rumors and misinformation.
In the NY review of Books, Helen Epstein explored the rapid and unprecedented spread of Ebola in Monrovia’s urban environment and what she calls the “fundamentally political” aspects of the epidemic. Epstein’s assertion that most Liberians were “so profoundly estranged” from their government that they didn’t believe the warnings echoes is the empirical findings from Liberia during the epidemic. This estrangement or lack of confidence has been widely traced to high levels of corruption and a prevailing climate of impunity. Epstein links public discontent with Sirleaf and her government to Liberia’s failure to address issues of transitional justice as well as limited access to the “material benefits of development.”
In all three countries, the legacy of decades of civil conflict and the ongoing and sometimes bumpy democratic transition has resulted in a complex and problematic relationship between the authorities and the press. The impact of government interference on access to lifesaving information and the transparent and accountable deployment of resources is addressed in reports from international press advocacy groups Reporters without Borders, Committee to Protect Journalists, and The Media Foundation for West Africa, as well as in articles by the international media. Documented incidents include attacks, curfews, undue restrictions, censorship, harassment and threats. Ebola’s “massive toll” on freedom of expression was especially acute in Liberia and was largely seen as being political.
Meeting the information needs of women
Women were particularly vulnerable throughout the crisis, not only to exposure and infection due to their roles as caregivers but also to an increase in sexual violence. As well as being more exposed, a study in Liberia by Oxfam also revealed there were important differences in access to Ebola prevention and treatment information for men and women. Lower literacy and economic status, reduced access to radio either because they didn’t own one or didn’t control the use of the family radio, and less unstructured time to access radio, all contributed to a lesser consumption of public health messaging. According to the Liberian Demographic and Health Survey (2013) 56% of women lack exposure to mass media on a regular basis.
Going beyond messaging
Perhaps the most interesting finding from the empirical research we reviewed has to do with Public Service Announcements, or PSAs – the nearly ubiquitous short messages broadcast on radio and television with the intent of raising awareness or change behaviour. Contrary to common practice and belief, the literature reviewed in this study suggests that an overreliance on PSAs as a format for the transfer of information to the population could be linked to significant information gaps as identified by survey respondents in all three affected countries.
In Liberia, a qualitative study carried out in two counties surveyed individuals engaged in self-reliance in order to contain Ebola in their communities. Respondents told researchers they were not seeking more basic information on Ebola but better information on practical steps to take in the face of health sector collapse. The repetitive messages on “What is Ebola?” provided enough information for people to be afraid but not enough to respond effectively given the realities of health service delivery. Health messaging failed to provide the ‘higher order’ practical information that communities were desperate for. There was a failure to respond to questions in real time and to provide accessible information that could meet people “where they are”. A real-time evaluation00796-1/abstract) of community based social mobilisation strategies in Guinea found that “static materials such as informational posters and pre-taped PSAs” had negligible effects.
Multiple studies confirm that high levels of basic knowledge of Ebola did not translate into health seeking behaviors. Studies in all three countries expose the very complex and overlapping social aspects of the disease that would be difficult to address in unidirectional 30 second PSAs. Focus groups carried out in Guinea for Save the Children revealed a demand for greater technical information on Ebola. Limited health reporting and messages that were highly “directive” had left an information gap: lack of understanding, or false understanding, of the virus (including confusion between Ebola and HIV); disconnect between the messages and reality (messages to go to the hospital, but hospitals didn’t have rapid tests); and lack of clarity (confusion between “survivors” and “convalescent patients”).
Conclusions and recommendations
The lessons from the Ebola response are numerous. We’d like to conclude by summarising two in particular that stand to have a sustained impact on the quality of health information for populations in low resource settings, and on the media’s particular responsibility in holding authorities to account:
1. Invest in local capacity for science and health journalism and broadcast technology.
Credible local media in each of the three countries struggled to cover the costs of fielding journalists and fueling generators for airtime, while international NGOs, some without in-country experience, received donor funds for communications campaigns. These same organisations, while claiming to partner with local media, often set the terms of that engagement without seeking to better understand what support local media needed to respond to the information needs of the audience. Stipends to cover broadcast fees were unilaterally decided in INGO budgets; local media, strapped for cash, had no choice but to take what was offered.
By pushing out PSAs across radio and television, not only did we miss an opportunity to fully respond to the populations’ need for information in real time, but there has been little or no long term benefit for the journalists that will continue to report from the front line of public health. An investment in building journalistic skills and broadcast reach is a long-term investment in a country’s health, and can be an important preventative measure in resource poor settings. Support for the establishment of local associations that include members of the media, academics from the health sciences, government/non-governmental organisations working in community health can strengthen knowledge transfer. These local associations could be the focal points for future responses.
2. Build an evidence base
Donors, academics and implementing organisations should make independent and rigorous evaluations using qualitative and quantitative research methodologies a part of all public health communication projects. Lack of time and funding for evaluation meant that baseline studies as well as comparative studies between country strategies and outcomes, with the potential to provide addition texture to our understanding of socio-cultural factors in the uptake of health information, have not been conducted.
Furthermore, we identify the need to study the impact of media development, defined to include not only the professional capacity of journalists to report on science and health, but also the enabling environment for an independent and pluralistic media sector, on the delivery of public health information. There is evidence[AB14] that conflict can be a primary driver of health inequalities, as “fragile states” are unwilling or unable to deliver basic services to their population. The impact of a free and independent media in these settings could inform a more integrated approach to post-conflict interventions aimed at improving long term health outcomes that include greater health sector accountability and service delivery.
CENTRAL AFRICAN REPUBLIC
LRA GUNMEN ABDUCT VILLAGERS
Suspected LRA gunmen on 8 March looted a village in the eastern Haute-Kotto province, and kidnapped six men to transport the stolen goods. The attackers are reported to have had 19 kidnapped women and children with them. Separately, authorities in the southeastern Haut-Mbomou province announced the arrest of LRA’s third highest-ranking leader who is to be transferred to the capital Bangui
GUNMEN KILL 18 IN BEACH RESORT ATTACK
Eighteen people were killed on 13 March when armed men attacked a seaside resort in Grand-Bassam, east of Côte d’Ivoire’s commercial capital, Abidjan. Al Qaeda in the Islamic Maghreb claimed responsibility. In January, gunmen had attacked a hotel and a café in Burkina Faso’s capital Ouagadougou, killing at least 28 people, two months after an attack in a Bamako hotel in Mali, that claimed 20 lives. A three-day national mourning has been declared in Côte d’Ivoire following the attack, the first of its kind in the country.
TWO KILLED, 60 ADBUCTED BY SUSPECTED BOKO HARAM MEMBERS
Armed attackers suspected to be Boko Haram members on 7 March raided Bikaram island on Lake Chad, killing two people and wounding three others. On 2 March, around 60 people were abducted in the eastern Lac Region by suspected Boko-Haram elements.
The abductees, displaced Chadians in the Baga-Sola area, were trying to return to their homes on Lake Chad islands despite a government ban. Several return attempts have recently been stopped
KIDNAPPED AID WORKERS FREED
Three aid workers abducted on 3 March in Nord Kivu Province were freed on 8 March.
The three had been kidnapped while driving in a convoy through Lubero region.
OVER 400 MENINGITIS CASES REPORTED
From 1 January to the end of February, Niger recorded 417 cases of meningitis, including 34 deaths. One district in the region of Niamey has reached the epidemic threshold, and two districts in the regions of Dosso and Tillabery have hit the alert level.
This year, health authorities have identified 21 districts as being at risk. During the same period last year, around 100 cases had been recorded, rising to 345 by the end of March 2015. Burkina Faso, Ghana, Mali and Togo have also reported epidemic levels of meningitis in various districts.
EBOLA VIRUS DISEASE (EVD)
NO NEW CASES FOR NEARLY TWO MONTHS
There have been no new infections since the last case in Sierra Leone on 20 January.
Ebola transmission is set to be declared over in Sierra Leone on 17 March, if no new cases erupt. Guinea is observing a 90-day surveillance period, ending on 27 March.
Liberia was declared free of the virus on 14 January.
DES HOMMES ARMÉS DE LA LRA ENLÈVENT DES VILLAGEOIS
Le 8 mars, des hommes armés soupçonnés d’appartenir à la LRA ont pillé un village dans la province orientale de la Haute-Kotto, et ont enlevé six hommes pour transporter les biens volés. Les assaillants auraient été accompagnés de 19 femmes et enfants enlevés. Par ailleurs, les autorités de la province sud-est du Haut-Mbomou ont annoncé l'arrestation du troisième plus haut gradé de la LRA qui doit être transféré à la capitale Bangui.
18 TUÉS DANS UNE STATION BALNÉAIRE
Dix-huit personnes ont été tuées le 13 mars quand des hommes armés ont attaqué la station balnéaire de Grand-Bassam, à l'est de la capitale commerciale de la Côte d'Ivoire, Abidjan. Al-Qaïda au Maghreb islamique a revendiqué l’attaque. En janvier, des hommes armés avaient attaqué un hôtel et un café dans la capitale du Burkina Faso, Ouagadougou, tuant au moins 28 personnes, deux mois après une attaque dans un hôtel de Bamako au Mali, qui a coûté la vie à 20 personnes. Un deuil national de trois jours a été décrété en Côte d'Ivoire après l'attaque, le premier du genre dans le pays.
DEUX MORTS, 60 PERSONNES ENLEVÉES PAR DES MEMBRES PRÉSUMÉS DE BOKO HARAM
Des assaillants armés soupçonnés d'être des membres de Boko Haram ont attaqué le 7 mars l’île de Bikaram sur le lac Tchad, tuant deux personnes et en blessant trois autres.
Le 2 mars, environ 60 personnes ont été enlevées dans la région est du Lac par des éléments présumés de Boko Haram. Les personnes enlevées, des déplacés tchadiens dans la région de Baga Sola, essayaient de retourner chez elles sur les îles du lac Tchad malgré l'interdiction du gouvernement.
Plusieurs tentatives de retour ont été récemment empêchées par les autorités locales.
LIBÉRATION DES TRAVAILLEURS HUMANITAIRES ENLEVÉS
Trois travailleurs humanitaires enlevés le 3 mars dans le Nord-Kivu ont été libérés le 8 mars. Les trois hommes avaient été enlevés lors de la conduite d’un convoi à travers la région du Luberon.
PLUS DE 400 CAS DE MÉNINGITE SIGNALÉS
Du 1er janvier à la in du mois de février, le Niger a enregistré 417 cas de méningite, dont 34 décès. Un district de la région de Niamey a atteint le seuil épidémique, et deux districts dans les régions de Dosso et Tillabery ont atteint le niveau d'alerte. Cette année, les autorités sanitaires ont identifié 21 districts comme étant à risque. Lors de la même période l'an dernier, environ 100 cas avaient été enregistrés, passant à 345 fin mars 2015. Le Burkina Faso, le Ghana, le Mali et le Togo ont également signalé des niveaux épidémiques de méningite dans divers districts.
MALADIE À VIRUS EBOLA (MVE)
AUCUN NOUVEAU CAS DEPUIS PRÈS DE DEUX MOIS
Il n'y a eu aucune nouvelle infection depuis le dernier cas en Sierra Leone le 20 janvier.
La transmission Ebola sera déclarée terminée en Sierra Leone le 17 mars, si aucun nouveau cas n’apparait. La Guinée observe une période de surveillance de 90 jours se terminant le 27 mars. Le Liberia a été déclaré exempt du virus le 14 janvier.
Le projet Missing migrants répertorie les morts de migrants le long des diverses routes migratoires dans le monde. Cette carte montre les différents parcours et concentre le Niger. #MissingMigrants.
Missing Migrants Project tracks deaths of migrants along migratory routes across the globe. This map shows the different paths with a focus on Niger. #MissingMigrants.
The world's worst Ebola outbreak began in Guinea in December 2013 and by late 2015 had led to more than 11,000 deaths in Guinea, Sierra Leone and Liberia. The first cases of Ebola were confirmed in Sierra Leone in May 2014 and led to more than 14,000 cases of Ebola in the country, and just under 4,000 deaths. The Ebola outbreak had an impact not just on health, but also livelihoods, education, food security and community relationships. Sierra Leone YMCA responded to the emergency through a number of projects, reaching more than 37,000 people with information on Ebola through trained community volunteers or 'peer educators' and more than 2,500 people with food support.
In July 2015, Y Care International facilitated an evaluation to identify lessons learned from the response and areas for improvement for future emergency response. Overall more than 30 people were consulted in the evaluation process including staff from national and local branches of Sierra Leone YMCA, project beneficiaries, peer educators and community stakeholders. This report provides an overview of Sierra Leone YMCA's Ebola outbreak emergency response projects, summarises the findings of the evaluation, and gives a set of key recommendations for future emergency response, both for Sierra Leone YMCA- relevant also for other local/national organisations -and the wider YMCA Movement.
The key recommendations are as follows:
Human-to-human transmission linked to the most recent cluster of 2 cases of Ebola virus disease (EVD) first reported from Sierra Leone on 14 January will be declared to have ended on 17 March, 42 days after the second and last case in the cluster provided a second consecutive negative blood sample (RT-PCR) and was discharged. Human-to-human transmission linked to the most recent cluster of cases in Liberia was declared to have ended on 14 January 2016. Guinea was declared free of Ebola transmission linked directly to the original outbreak on 29 December 2015, and will complete its 90-day period of enhanced surveillance on 27 March 2016.
With guidance from WHO and other partners, ministries of health in Guinea, Liberia, and Sierra Leone have plans to deliver a package of essential services to safeguard the health of the estimated more than 10 000 survivors. So far over 350 male survivors in Liberia have accessed semen screening and counselling services. In addition, over 2600 survivors in Sierra Leone have accessed a general health assessment and eye exam.
To manage the residual risks of Ebola reintroduction or re-emergence, WHO has supported the implementation of enhanced surveillance systems in Guinea, Liberia, and Sierra Leone to alert authorities to cases of febrile illness or death that may be related to EVD. In the week to 13 March, 1611 alerts were reported in Guinea from all of the country’s 34 prefectures. All alerts were reports of community deaths. Over the same period, 9 operational laboratories in Guinea tested a total of 370 new and repeat samples (17 samples from live patients and 353 from community deaths) from 17 of the country’s 34 prefectures. In Liberia, 663 alerts were reported from all of the country’s 15 counties, most of which (544) were related to live patients. The country’s 5 operational laboratories tested 595 new and repeat samples (399 from live patients and 196 from community deaths) for Ebola virus over the same period, compared with 921 samples the previous week. In Sierra Leone 1494 alerts were reported from the country’s 14 districts. The majority of alerts (1142) were for community deaths. 952 new and repeat samples (19 from live patients and 933 from community deaths) were tested for Ebola virus by the country’s 7 operational laboratories over the same period.
17 March 2016, Freetown—The World Health Organization joins the government of Sierra Leone in marking the end of the recent flare-up of Ebola virus disease in the country. As of today, 17 March, 42 days have passed, two incubation cycles of the virus, since the last person confirmed to have Ebola virus disease in the country tested negative for a 2nd time.
This latest flare-up of Ebola brings to 3,590 the number of lives lost in Sierra Leone to an epidemic that devastated families and communities across the country and disrupted every aspect of life.
Today marks another milestone in the country’s effort to defeat Ebola. WHO commends Sierra Leone’s government, partners and people on the effective and swift response to this latest outbreak. From nurses, vaccinators and social mobilizers to contact tracers, counsellors and community leaders, Sierra Leoneans in affected districts mobilized quickly and their involvement and dedication was instrumental and impactful.
The rapid containment of the flare-up was also a real-time demonstration of the increased capacity at the national, district and community level to respond to Ebola outbreaks and other health emergencies and mitigate their impact. Investments made in rapid response teams, surveillance, lab diagnostics, risk communication, infection prevention and control measures and other programmes were put to the test and clearly paid off.
However, WHO continues to stress that Sierra Leone, as well as Liberia and Guinea, are still at risk of Ebola flare-ups, largely due to virus persistence in some survivors, and must remain on high alert and ready to respond.
Strong surveillance and emergency response capacity need to be maintained, along with rigorous hygiene practices at home and in health facilities and active community participation. Care, screening and counselling also need to be provided for survivors as part of improved health services for all.
WHO will continue to work with the Government of Sierra Leone and partners to build a more resilient health system that can prevent, detect and respond to future outbreaks and to revive and strengthen essential health services across the country.
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