Urgent action needed for 80m children whose education has been hit by emergencies

The number of children whose education has been disrupted by conflicts and natural disasters has increased to 80 million.

The shocking statistic for 2015 is revealed in an education in emergencies "scorecard" published today by A World at School, which calls for urgent action from world leaders.

There have been a record number of children affected by crises - including attacks on education, wars, natural disasters and health alerts such as Ebola.

Despite that, and the biggest refugee crisis since World War II, less than 2% of all humanitarian aid in 2015 went to education. That has left an annual funding shortfall of $9 billion.

The scorecard looks at the progress - or lack of it - in funding education in 28 countries hit by emergencies.

They include those affected by the five-year Syrian conflict - with 5.4 million children in need of education within Syria and another 700,000 in neighbouring countries - and Nepal, where thousands of schools were decimated by the earthquakes in 2015.

Other key facts from the report - titled Don't Leave Them Out - include:

Of the 80 million affected children, 37 million have been forced out of school

While the funding needed for education in emergencies has risen 21% since 2000, donor funding has fallen by 41%

Commitments from the top 10 donors to education in emergencies dropped 28% - and six of them decreased their funding by more than 50%

World leaders will meet at the first ever World Humanitarian Summit in Turkey in May. A World at School is calling on them to:

Launch an ambitious new platform for education in emergencies and commit to provide at least $2 billion annually

Urgently publish the the schedule and scale of donor commitments to education so host countries can make plans

Commit to make the funding of education in every emergency a priority

Theirworld - the children's charity behind A World at School - works on education in emergencies and has supported the publication of the scorecard.

Tom Fletcher of Theirworld said: “All children have a right to education and a better future - but emergencies across the world are disrupting the schooling of around 80 million children.

"In the face of increasing needs and the immense cost of not investing today, it is shocking that less than 2% of all humanitarian aid goes to education. Humanitarian aid must provide children with a safe school, a future and hope.”

Theirworld has also today launched the #SafeSchools campaign. You can play your part in telling world leaders to act urgently by signing the #SafeSchools petition. You can sign here now.

Of the 133 total education appeals made since 2010, just six - four related to the crisis in Syria - received nearly half of all funding. Four education appeals received no funding at all in 2015.

The new figure of 80 million children whose education has been directly affected by emergencies and prolonged crises has been compiled by the Overseas Development Institute.

Despite the inadequate request of $643m from a shortfall of $9bn, education requests were on average just under a third funded

Susan Nicolai, Head of Development Progress at ODI, said: “The new analysis has confirmed what we all feared, that 2015 was a disastrous year for children who had their education disrupted by wars and natural disasters.

"World leaders need to urgently guarantee that there isn’t a future humanitarian emergency response where education isn’t seen as critical. Without this we will continue to see short term crises result in multi-generational disasters.”

A new platform to fund education in emergencies would ensure children caught up in the next crisis are in a safe school and not at risk of child labour, early marriage, trafficking or extremism.

In the aftermath of a humanitarian emergency, a safe place to learn and play can help children to deal with trauma and provide vital health and safety information.

Being in school protects children and young people from immediate and future exploitation and poverty.

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 13-19 March 2016 and includes updates on Zika virus, haemolytic uraemic syndrome in Romania and seasonal influenza.

Japan - The Japanese Government has allocated a total of 46.8 million funding to support IOM’s operations in assisting vulnerable migrants, displaced persons, refugees, returnees and affected communities in the midst of conflicts and crises continuing in various parts of the world.

More than the half of the amount (USD 25.5 million) has been allocated towards IOM programs in Sub-Saharan Africa including Chad, Djibouti, Ethiopia, Kenya, Mali, Mauritania, Nigeria, Sierra Leone, Somalia, South Sudan and Uganda.

The funds will support life-saving and recovery activities and increase the resilience and human security of vulnerable displaced populations and host communities in the above mentioned countries. It will also contribute to increasing the capacity of various governments in humanitarian border management to cope with displacement resulting from conflicts and to combat terrorism.

IOM offices in Middle East and North Africa, including Iraq, Jordan, Syria, Turkey and Yemen, have also received a significant amount from the funding for the regional response to Syrian crisis and assistance to internally displaced persons in Yemen and Iraq.

In Afghanistan, the funding will be used in providing assistance to vulnerable Afghan returnees from Iran and Pakistan in border areas and to build local capacities in the country through return of skilled nationals from Iran.

In Ukraine, Japanese funding will help IOM to improve access to basic services and livelihoods in selected communities in the conflict-affected Donbass region.

Funding will also support the Serbian Government with humanitarian border management to address currently increased migration flows along the Western Balkan route.

The Japanese government has supported IOM’s humanitarian and recovery activities in the past including the delivery of immediate lifesaving relief, community stabilization and early recovery activities, as well as emergency return and reintegration assistance for migrants caught in crises.

For further information, please contact Yuko Goto, IOM Tokyo. Tel: +81 33595 0108, Email: iomtokyo@iom.int

Key messages

• Providing access to clean water in sufficient quantities is essential to sustain life and promote health in emergency and crisis situations. Basic sanitation and appropriate hygiene behavior and management are essential conditions to create a safe living environment.

• The European Commission is one of the largest humanitarian donors in providing water, sanitation and hygiene (WASH) assistance with almost €120 million alone allocated in 2015 to projects in this sector.

• The Commission increasingly supports projects which incorporates WASH components within other sectors, such as nutrition or shelter, in order to increase effectiveness.

• Climate change, urbanisation and rapid population growth put pressure on natural resources. Needs in the field of WASH are growing much more rapidly than available funding. To meet these challenges, the Commission promotes best practices.

• Speed of response, coordination and working with civil protection actors are priorities for the Commission's WASH operations.

By Mirabelle Enaka Kima, IFRC

When the Ebola outbreak was confirmed in Guinea two years ago, one of the reasons the virus spread so quickly was due to the high amount of people traffic across the borders of Guinea, Liberia, and Sierra Leone. To mitigate the introduction of new Ebola cases or other diseases by cross border travellers, the Red Cross has introduced a community event-based surveillance system. It is successful, in large part, due to the engagement of community members. - See more at: http://www.ifrc.org/en/news-and-media/news-stories/africa/guinea/preventing-diseases-from-crossing-borders-in-west-africa-post-ebola--72032/#sthash.OHa3FxZ1.dpuf

Settled near the Kolantin River, a Red Cross health screening post is now part of the picturesque landscape at the popular Binticabaya border crossing between Guinea and Sierra Leone. Outfitted with a hand washing kit, a thermometer, and a register, volunteers at the screening post are ready to monitor people crossing the river between the two countries.

"I cross twice a week to visit my wife who lives in a nearby village in Sierra Leone," says one soldier as he stops to wash his hands before going for his temperature check.

Morlaye Bangoura and Fode Camara Ali live in the Tassin District community on the Guinean side of the border. They were recently recruited as Red Cross  volunteers to conduct health screenings at the Binticabaya post. Installed behind their desks, they are busy registering new arrivals.

"We register all those who pass by,” says Fode Camara Ali. “Hand washing and temperature control are compulsory for everyone. When a person’s temperature is above normal, they are asked to sit and rest for few minutes, before I take his temperature again. If there is no change, I contact the district health team for further investigation and follow-up.

"So far, we have not recorded any suspected case of Ebola. Still, we maintain maximum vigilance and strictly observe the control rules while applying self-protection measures to avoid any risk of exposure to the virus."

Mixed community reaction

Fatoumata Drame welcomes the protective measures. She crosses to Kempo an average of three times a week to sell products from her farm and to buy  products which she does not find in Guinea.

Carrying her son, she stops to wash their hands. "The screening post helps us to preserve our health. It would be silly to avoid it. By not respecting the measures put in place, we are exposed and could be contaminated by someone coming from Kempo. This would make everyone panic,” says Fatoumata.

Though most community members follow the enforced procedures without  hesitation, there has been some resistance due to the presence of chlorine in the water. "We have noted some reluctance by women to wash their hands because of the smell of chlorine. When that happens, we multiply our  awareness efforts around the importance of observing these rules for the sake of everyone’s health in the community," explains Fode Camara Ali.

The Red Cross Society of Guinea has installed nine health screening posts in the sub-prefectures of Moussaya, Farmoya, and Sikhourou and has deployed 20 volunteers to conduct daily screenings of travellers.   

A further 140 volunteers have been trained and mobilized to conduct door-to-door awareness raising and focus group discussions on hygiene education and promotion. They are also involved in infection control through community event-based monitoring.

Acceptance by communities of these initiatives is primarily the result of the adoption of a community-based approach. Deployed volunteers are members of the communities they serve which helps ensure ownership, sustainability, and acceptance. In addition, religious and traditional leaders play a key role in community dialogue to prevent any resurgence of the Ebola epidemic or other  diseases.

"The active commitment of traditional authorities has also helped us achieve acceptance of these surveillance tools which will help ensure early warnings for various diseases,” explains Dr Madeleine Thea, surveillance officer for the International Federation of Red Cross and Red Crescent Societies (IFRC) in the Forécariah region.

The community event-based surveillance system began in January 2016 to comply with the 90 day period of heightened surveillance and is conducted in collaboration with other partners involved in the Ebola response operation. Activities are focused in the areas of Forécariah, Boke, and Guekédou bordering Sierra Leone, Guinea Bissau, and Liberia respectively.

In Guinea, the International Federation of Red Cross and Red Crescent Societies’ (IFRC) recovery plan of 23 million Swiss francs focuses on providing support to people affected by the outbreak, and includes activities related to strengthening resilience to future disease outbreaks, improving access to health care and psychosocial support, improving food security and livelihoods; and National Society development. The recovery plan is currently 14 per cent funded.

Traditional healers played a critical role in helping communities understand and accept prevention and protection measures during the Ebola emergency response. Tomorrow we will look at the role traditional healers can play in post-Ebola recovery efforts.

• See more at: http://www.ifrc.org/en/news-and-media/news-stories/africa/guinea/preventing-diseases-from-crossing-borders-in-west-africa-post-ebola--72032/#sthash.OHa3FxZ1.dpuf

Eight West African countries explore ways of leveraging contribution of forests to water security

21 March, 2016, Rome - FAO today launched a new programme aiming to enhance the critical role of forests in improving water quality and water supplies, on the occasion of the UN's International Day of Forests.

The programme, focused specifically on the close relationship between forests and water, will start off by looking at ways to improve water security in eight West African countries: Gambia, Guinea, Guinea-Bissau, Mali, Mauritania, Niger, Senegal and Sierra-Leone. The agency will work with local communities to raise their awareness of the interactions between forests and water and help them to integrate forest management in their agricultural practices to improve water supplies.

FAO is using this year's International Day of Forests celebration to shine a spotlight on how forests can contribute to improving water availability, especially in countries facing scarcities of this precious resource which is becoming increasingly important in the face of climate change.

"The challenges are many, but the goal is very clear: to ensure the sustainable management of forest and water resources on the planet," said FAO Director-General Jose Graziano da Silva in his remarks at the IDF ceremony in Rome. "Promoting forest restoration and avoiding forest loss will require a significantly increased level of funding and innovative financing, including from private funds and traditional investors, in the coming years."

"FAO is committed to providing a neutral platform for negotiations and dialogue, to encourage greater interaction among all the parties working to achieve sustainably managed forests," he added.

Focus on improved monitoring

The programme kicks-off with a first focus on setting up a forest-water monitoring framework to help countries assess potential forest benefits in terms of water resources. This will involve developing a set of standardised monitoring indicators and field methods to identify which forest management interventions result in improved water quality and enhanced supplies. This data will be in turn used to develop better-informed practices and policies to unleash the full potential of forests in improving water supply.

The monitoring framework will be piloted in West Africa's Fouta Djallon Highlands, with field activities having kicked off this month. The project, funded by the Global Environmental Facility, is being jointly implemented by FAO, the United Nations Environment Programme (UNEP) and the African Union (AU).

Forests and the water cycle

The water security of eight out of ten people in the world is under threat. Forests have an important role in providing and regulating water at the local and regional levels in a number of ways, from groundwater recharge and erosion control to promoting precipitation through evapotranspiration.

Forested watersheds and wetlands provide about 75 percent of the planet's freshwater resources, while over one third of the world's largest urban centres depend on protected forests for a significant proportion of their water.

In addition to boosting supplies, forests also maintain water quality: it is estimated that every $1 spent on sustainable forest watershed management can save $7.5 to $200 in water treatment costs.

"The role of forests for water is becoming even more important in the face of climate change, with increased incidences of extreme climate events such as flooding and drought, and increased water insecurity," said FAO Assistant Director General of Forestry, René Castro. "The new programme that we've launched today aims to showcase that forestry is not always in competition with agriculture and urban development for water, but on the contrary can address water and food security issues and produce more resilient landscapes".

The International Day of Forests celebrates and raises awareness of the importance of all types of forests, and trees outside forests, for the benefit of current and future generations.

FAO also used the occasion of the day to highlight the major contribution of forests to achieving Sustainable Development Goals (SDGs). While SDG 15 addresses the need to sustainably manage forests and trees, forests also play a vital role in achieving those goals related to ending poverty, achieving food security, and ensuring sustainable energy, and in particular SDG 6 on providing clean water and sanitation.

Regional Bulletin #15

Key messages

• February marks the end of the rice cultivation season and peak agricultural activity in the region. Household food security levels measured through the rCSI are virtually identical to those measured in December 2015.

• In Liberia and Sierra Leone, the average national rCSIs have improved since last year, February 2015. In Guinea, the rCSI has also improved compared to June 2015.

• At the end of the rice harvest season, prices of rice are slightly higher in February 2016 compared to December 2015 in Guinea and Sierra Leone.

• In Liberia and Sierra Leone, comparing prices from February 2015 to February 2016, commodity prices have not increased considerably while manual labour wages have risen approximately 10%. As a result, average household purchasing power, measured in terms of trade, have improved since last year.

Coping Strategies

The Reduced Coping Strategies Index (rCSI) measures the frequency and severity of the mechanisms households employ when faced with food shortages such as skipping meals. A higher score indicates households are resorting to more frequent and/or severe negative coping strategies. Detailed information on the rCSI can be found here.

Starting September 2015, with the end of the lean-season, coping improved gradually across the three countries. Improvements in coping have since leveled-off as coping levels are nearly identical in December 2015 and February 2016. There are no statistically significant differences in the rCSI or duration of specific coping strategies at national, sub-national levels or wealth groups. Changes in the rCSI by gender (sex of head of household) are also not appreciably different from December though as normally seen in all three countries, female headed households have higher average negative coping levels than male headed households .

Household food security, measured by the rCSI, has improved since last year. Comparing median rCSI scores from February 2015 to February 2016 there has been improvement in median rCSI scores in Liberia (from 14 to 11) and Sierra Leone, (from 13 to 10). In Guinea, median rCSI scores have improved considerably, comparing June 2015 (19.2) to February (12.4). (all reported rCSI scores use p < 0.05, Mann-Whitney test).

Summary

Pursuant to General Assembly resolution 69/274 B, the present report outlines the key findings from the dedicated lessons learned exercise conducted with regard to the United Nations Mission for Ebola Emergency Response (UNMEER).

I. Introduction

1. In September 2014, at the height of the Ebola crisis, the Secretary-General, in identical letters dated 17 September 2014 to the President of the General Assembly and the President of the Security Council (A/69/389-S/2014/679), proposed the establishment of the first ever United Nations emergency health mission to harness the capabilities and competencies of all the relevant United Nations actors under a unified operational structure to reinforce unity of purpose, effective ground-level leadership and operational direction. The Secretary-General’s intention to establish the United Nations Mission for Ebola Emergency Response (UNMEER), following a joint appeal dated 29 August 2014 from the Presidents of Guinea, Liberia and Sierra Leone for the United Nations to coordinate international support for nationally led response efforts, was welcomed by the General Assembly and the Mission was established on 19 September 2014 following the adoption of General Assembly resolution 69/1.

2. In the lead-up to the Mission’s establishment, the spread of Ebola in West Africa outpaced the capacity of the World Health Organization (WHO) and front-line responders to put in place the logistics, medical and material capacities needed to stem the spread of the virus. United Nations country teams in the affected countries undertook programme criticality exercises in order to repurpose activities to respond to Ebola-related needs, but existing capacities required galvanizing support to scale up the level and pace of their interventions so as to be commensurate with the escalating emergency. WHO advocated that it required substantial resources and robust logistics capacities to scale up to the level required. There was debate among Inter-Agency Standing Committee principals as to how to classify the crisis and whether the humanitarian community was best placed, or capacitated, given overstretch with multiple level-three crises to respond to an outbreak. Ultimately, the Inter-Agency Standing Committee did not designate the Ebola crisis as a level-three humanitarian emergency.

3. On 8 August 2014, in line with the unanimous view of the Emergency Committee convened under the International Health Regulations for the 2014 Ebola Virus Disease outbreak in West Africa, the Director General of WHO declared that the Ebola outbreak met the conditions to be classified as a public health emergency of international concern. On 12 August, the Secretary-General appointed a United Nations System Senior Coordinator for Ebola Virus Disease, who later was reappointed as Special Envoy on Ebola on 23 September 2014. On 8 September, the Secretary-General activated the Organization’s emergency response mechanism and named a Deputy Ebola Coordinator and Operation Crisis Manager to support the operationalization of the overall response plan of the United Nations. International health experts projected that Ebola was spreading at an exponential rate. The outbreak was no longer just a public health emergency, but had become multidimensional, requiring a whole-of-system response. The Security Council, in its resolution 2177 (2014), which was unanimously adopted on 18 September 2014, declared the Ebola outbreak a threat to international peace and security.

4. At the time of writing, according to WHO, there have been 28,638 cases and 11,316 deaths as a result of the Ebola outbreak in West Africa. The outbreak wrought serious humanitarian, economic, development and health consequences for the people and countries affected. Sixteen months since the passage of General Assembly resolution 69/1, the world faces a dramatically different situation, with transmission of the disease, directly linked to the 2014 outbreak, having been declared over in Guinea, Liberia and Sierra Leone. Subsequently, all three countries have experienced small flare-ups of new cases associated with virus persistence in survivors; in all cases, the continued prevention, surveillance and response capacities in countries and among responding partners has resulted in rapid containment.

Résumé

Conformément aux dispositions de la résolution 69/274 B de l’Assemblée générale, le présent rapport rend compte des principales conclusions de l’examen des enseignements tirés sur la Mission des Nations Unies pour l’action d’urgence contre l’Ebola.

I. Introduction

1. En septembre 2014, au paroxysme de la crise de l’Ebola, le Secrétaire général a proposé, dans des lettres identiques datées du 17 septembre 2014, adressées au Président de l’Assemblée générale et au Président du Conseil de sécurité (A/69/389-S/2014/679), l’établissement de la première mission sanitaire d’urgence des Nations Unies visant à exploiter les capacités et les moyens de toutes les entités compétentes des Nations Unies, dans le cadre d’une structure opérationnelle unique, en vue de renforcer la cohésion des objectifs et d’augmenter l’efficacité de la direction des opérations sur le terrain. La proposition du Secrétaire général en vue de la création de la Mission des Nations Unies pour l’action d’urgence contre l’Ebola (MINUAUCE), à la suite d’un appel conjoint à l’ONU, lancé le 29 août 2014 par les Présidents de la Guinée, du Libéria et de la Sierra Leone à l’ONU, pour qu’elle coordonne l’appui international à l’action menée sur le plan national, a été favorablement accueillie par l’Assemblée générale dans sa résolution 69/1 du 19 septembre 2014, qui porte création de cette mission.

2. Pendant la période précédant la création de la Mission, l’Organisation mondiale de la Santé (OMS) et les premiers intervenants ont été dépassés par la vitesse à laquelle le virus Ebola s’est propagé en Afrique de l’Ouest alors qu’ils s’efforçaient de mettre en place les moyens logistiques, médicaux et matériels requis pour en freiner la progression. Les équipes de pays des Nations Unies dans les pays touchés ont entrepris d’évaluer les programmes par ordre d’importance afin de réadapter les activités et d’être en mesure de répondre aux besoins suscités par le virus de l’Ebola mais compte tenu des capacités existantes, il a fallu mobiliser un appui en vue d’accroître le volume et le rythme des interventions, pour qu’elles soient à la mesure d’une urgence qui ne faisait que croître. L’OMS a fait valoir qu’elle avait besoin de ressources considérables et de capacités logistiques robustes pour intensifier les activités afin d’atteindre le volume requis. Un débat a eu lieu avec les principaux représentants du Comité permanent interorganisations sur la façon de classer la crise et de déterminer si les organismes humanitaires étaient les mieux placés – ou s’ils avaient les moyens nécessaires – étant donné qu’ils étaient sollicités à l’excès, avec des niveaux multiples de crises, pour faire face à une épidémie. Au bout du compte, le Comité permanent interoganisations n’a pas désigné la crise de l’Ebola comme une situation d’urgence humanitaire de niveau 3.

3. Le 8 août 2014, conformément à l’avis unanime rendu par le Comité d’urgence, réuni en vertu du Règlement sanitaire international, concernant la flambée de maladie à virus Ebola en 2014 en Afrique de l’Ouest, le Directeur général de l’OMS a déclaré que l’épidémie d’Ebola réunissait les conditions requises pour être classée comme une situation d’urgence sanitaire publique de portée internationale. Le 12 août 2014, le Secrétaire général a nommé un Coordonnateur principal du système des Nations Unies pour l’Ebola, qu’il a ensuite désigné le 23 septembre 2014 Envoyé spécial pour l’Ebola. Le 8 septembre, le Secrétaire général a activé le mécanisme d’intervention en situation d’urgence de l’Organisation et a nommé un Coordonnateur adjoint pour l’Ebola et Responsable de la gestion de la crise, afin d’appuyer l’application du plan d’intervention global de l’ONU. Des experts mondiaux de la santé ont estimé que l’Ebola se propageait à un taux exponentiel et que l’épidémie, de simple situation d’urgence sanitaire publique, s’était transformée en crise pluridimensionnelle, qui nécessitait l’intervention du système tout entier. Dans sa résolution 2177 (2014), adoptée à l’unanimité le 18 septembre 2014, le Conseil de sécurité a déclaré que l’épidémie d’Ebola constituait une menace pour la paix et la sécurité internationales.

4. Au moment de l’établissement du présent rapport, l’OMS avait recensé 28 638 cas et 11 316 décès à la suite de l’épidémie d’Ebola en Afrique de l’Ouest, qui avaient eu de graves conséquences sur les plans humanitaire, économique, du développement et de la santé, pour les populations et les pays touchés. Seize mois après l’adoption de la résolution 69/1 de l’Assemblée générale, le monde fait face à une situation radicalement différente, la transmission de la maladie, directement liée à l’épidémie de 2014, ayant été officiellement déclarée terminée en Guinée, au Libéria et en Sierra Leone. Les trois pays ont connu par la suite de petites flambées en raison de nouveaux cas associés à la persistance du virus chez des rescapés; dans tous les cas, la poursuite de la prévention et de la surveillance et le renforcement des capacités d’agir dans les pays et parmi les partenaires d’intervention ont permis d’enrayer rapidement l’épidémie.

CABO VERDE

FIRST CASE OF MICROCEPHALY REPORTED

On 15 March, the national health director reported the first case of microcephaly in a new-born with probable relationship to Zika virus. The case was identified on 14 March in the capital city, Praia. WHO was immediately notified in compliance with the International Health Regulations. On 11 February, the Ministry of Health announced that 40 pregnant women suspected of Zika virus infection are being closely monitored. Zika epidemic in Cabo Verde was officially declared on 22 October 2015. As of 6 March, 7,500 suspected cases had been registered.

CENTRAL AFRICAN REPUBLIC

MENINGITIS OUTBREAK KILLS 24

An outbreak of meningitis since January in the northern Ouham Province has killed 24 people and infected 90 others, the Health Ministry announced on 16 March. MSF will lead an investigation mission to identify the extent of the epidemic and consider vaccination.

GUINEA

EMERGENCY RESPONSE ASSESSMENT COMPLETED

On 18 March, a 23-member team completed a ten-day assessment of national capacity on Disaster Risk Reduction and Emergency Preparedness and Response. The multi- disciplinary team was composed of Government officials from key entities, UN agencies, UNDAC and EU civil Protection experts, Red Cross and NGOs. Over 80 structures or services were visited in the capital Conakry as well as N’zérékoré, Kankan and Mamou regions.

NIGER

ATTACKS TARGET SECURITY FORCES

Armed men on 16 March shot dead three gendarmes and injured a civilian near the border with Mali. The following day, four suicide bombers hit a military convoy in the southern Bosso region, killing the local military commander and injuring two others. Separately, run-off presidential election was held on 20 March. President Mahamadou Issoufou is expected to be re-elected after the opposition boycotted the vote.

NIGERIA

IDP RELOCATION BUDGET APPROVED

The Senate on 15 March approved US$50 million for the relocation, rehabilitation and resettlement of internally displaced persons in Adamawa, Borno and Yobe states - the worst-affected by Boko Haram violence.

EBOLA VIRUS DISEASE

NEW CASES EMERGE IN GUINEA

Ebola has re-emerged in Guinea. As of 21 March, three confirmed, three probable and one suspected cases were reported in the south-eastern N’zérékoré Prefecture. Five patients have since died. So far 961 contacts from 181 households have been identified. Among them 120 are high-risk. Guinea’s latest flare-up was confirmed on 17 March, just hours after Sierra Leone was declared free of the virus. Liberia has closed its border with Guinea.

CABO VERDE

PREMIER CAS DE MICROCÉPHALIE SIGNALÉ

Le 15 mars, le Sénat a approuvé 50 millions $ pour la relocalisation, la réhabilitation et la réinstallation des personnes déplacées dans les états de l’Adamaoua, Borno et Yobe - les plus touchés par la violence de Boko Haram.

RÉPUBLIQUE CENTRAFRICAINE

L’ÉPIDÉMIE DE MÉNINGITE TUE 24 PERSONNES

Le ministère de la Santé a annoncé le 16 mars que l’épidémie de méningite qui sévit dans le nord de la province d’Ouham depuis janvier a tué 24 personnes et infecté 90 autres. MSF va mener une mission d'enquête pour déterminer l'étendue de l'épidémie et envisager la vaccination.

GUINÉE

L’ÉVALUATION DE L'INTERVENTION D'URGENCE TERMINÉE

Le 18 mars, une équipe de 23 membres a effectué une évaluation de dix jours des capacités nationales en matière de réduction des risques de catastrophe et de préparation et réponse aux situations d'urgence. L'équipe multidisciplinaire était composée de représentants du gouvernement, des organismes des Nations Unies, d’experts en protection civile de l'Union Européenne et de l’UNDAC, la Croix-Rouge et des ONG. Plus de 80 structures ou services ont été visités dans la capitale Conakry, ainsi que les régions de N'zérékoré, Kankan et Matou.

NIGER

DES ATTAQUES CIBLENT LES FORCES DE SÉCURITÉ

Des hommes armés ont abattu le 16 mars trois gendarmes et blessé un civil près de la frontière avec le Mali. Le lendemain, quatre kamikazes ont attaqué un convoi militaire dans la région sud de Bosso, tuant le commandant militaire local et en blessant deux autres. Par ailleurs, le second tour de l'élection présidentielle a eu lieu le 20 mars. Le Président Mahamadou Issoufou devrait être réélu après que l'opposition ait boycotté le vote.

NIGERIA

LE BUDGET DE RELOCALISATION DES DÉPLACÉS INTERNES APPROUVÉ

Le 15 mars, le Sénat a approuvé 50 millions $ pour la relocalisation, la réhabilitation et la réinstallation des personnes déplacées dans les états de l’Adamaoua, Borno et Yobe - les plus touchés par la violence de Boko Haram.

MALADIE À VIRUS EBOLA (MVE)

NOUVEAUX CAS EN GUINÉE

Ebola est réapparu en Guinée. Au 21 mars, trois cas confirmés, trois probables et un suspect ont été signalés dans le sud-est de la préfecture de N'zérékoré. Cinq patients sont décédés. Jusqu'à présent, 961 contacts issus de 181 ménages ont été identifiés. Parmi eux, 120 sont à haut risque. La dernière flambée en Guinée a été confirmée le 17 mars, quelques heures seulement après que la Sierra Leone ai été déclarée exempte du virus. Le Liberia a fermé sa frontière avec la Guinée.

FREETOWN – The United Nations World Food Programme (WFP) welcomes today a US$ 2.2 million contribution from the Government and the people of Japan that will enable WFP to support 77,000 people affected by the Ebola outbreak so that they can recover and receive the food and nutrition assistance they need.

“This significant contribution comes at a time when the people of Sierra Leone need support to recover from the widespread effects of the Ebola outbreak that swept through Sierra Leone in 2014 and 2015. Japan’s partnership with WFP will enable us to continue supporting the government’s Ebola recovery efforts to improve food security and nutrition across the country,” said Peter Scott-Bowden, WFP Country Director in Sierra Leone.

The donation will go towards purchasing cereals, pulses, and fortified nutritious foods for smallholder farmers, acutely malnourished children and pregnant and nursing mothers, and other vulnerable groups. It will enable WFP to provide food-for-work opportunities that will result in improved livelihoods for vulnerable communities, such as production of more and better quality rice, and increased access to markets by improving road conditions.

WFP will also provide food assistance to youth as an incentive for their participation in Technical and Vocational Education and Training activities (such as tailoring, carpentry, weaving) that will help build a more productive workforce and enhance social protection.

In line with the National Ebola Recovery Strategy that prioritizes restored access to maternal and child healthcare, WFP will be able to provide 40,000 moderately malnourished children and mothers with nutritional support. In addition, WFP will roll out a pilot stunting prevention programme, distributing specialised nutritious food to children under two years old in the Tonkolili district – one of the districts with the highest rate of stunting, at 41.2 percent.

The preliminary results of WFP’s 2015 Comprehensive Food Security & Vulnerability Analysis (CFSVA) indicated that almost half of the population doesn’t have enough food to eat, with some districts recording up to 70 percent of the population food-insecure. The agricultural sector which is the primary source of income for more than half of the population was the hardest hit due to movement restrictions and bans on group labour which interrupted planting and harvesting cycles.

WFP in Sierra Leone leads the fight against hunger and builds long-term food security through vital food assistance programmes. As one of the frontline agencies in the Ebola response, WFP has an essential role to play in helping people recover and transition back to normality.

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WFP is the world's largest humanitarian agency fighting hunger worldwide, delivering food assistance in emergencies and working with communities to improve nutrition and build resilience. Each year, WFP assists some 80 million people in around 80 countries.

Follow us on Twitter @WFP_WAfrica, @wfp_media

For more information please contact (email address: firstname.lastname@wfp.org): Francis Boima, WFP/Sierra Leone, +232 76750587

Geneva, 23 March 2016– With two new cases of Ebola virus disease recently confirmed in Guinea, and three probable and two suspect cases identified, the Red Cross Society of Guinea, with the support of the International Federation of Red Cross and Red Crescent Societies (IFRC), has mobilized teams of trained volunteers to aid in the response.

“The confirmation of new cases is a vivid reminder of the need to maintain a fast and efficient response capacity in all three West African countries which were affected by the Ebola outbreak,” said Norbert Allale, head of IFRC regional Ebola operations. “In Guinea, we have provided refresher training to some of our safe and dignified burial volunteers who are now on standby to respond should the number of confirmed cases increase.”

Forty beneficiary communications volunteers also received refresher training and have been deployed to the affected community and surrounding area to actively look for potential Ebola cases and to reinforce to residents how they can protect themselves from Ebola through proper hygiene.

The two new cases were confirmed in a remote village in the southern prefecture of Nzérékoré on 17 March 2016. They were taken to a treatment facility where one of the patients, an 8-year-old girl, has since passed away. Three other people, all members of the same family, passed away in the weeks previous, all exhibiting symptoms consistent with Ebola. A further 370 contacts have been identified and are being traced and monitored. These are the first cases since the Ebola outbreak was declared over in Guinea in late December 2015.

“The Red Cross was among the first to respond when the Ebola outbreak was confirmed in March 2014,” said Allale. “Long after other actors have packed up and gone home, our network of community-based volunteers will continue to respond when there are flare-up cases, and support communities as they embark on the long road to recovery.”

Working through the National Red Cross Societies of Guinea, Liberia, and Sierra Leone, the IFRC’s recovery plans focus on implementing food security and livelihoods projects for families of Ebola survivors and other vulnerable groups; disaster preparedness and response measures; water, sanitation and hygiene interventions in schools; community-based health and first aid programmes, and psychosocial support for those most affected by Ebola. Across the three countries, the IFRC’s Ebola outbreak recovery operations total close to 89 million Swiss francs, however, the three country-specific Emergency Appeals are currently 14 per cent, zero per cent, and one per cent funded, respectively.

“There are thousands of trained Red Cross volunteers who want to help their countries recover from the Ebola outbreak, and the Governments of Guinea and Sierra Leone have already promised to incorporate some of these volunteers into the rebuilding of community-based health care systems,” added Allale. “To do this, funding is needed. If we have to scale back our activities due to insufficient funding, this will prolong the time it will take for communities to fully recover and become more resilient. We strongly encourage donors and partners to return some of their focus to the vulnerable people of West Africa.”

The world’s largest Ebola outbreak claimed more than 11,300 lives, the majority of them in Guinea, Liberia, and Sierra Leone.

For further information, please contact:

In Guinea:

Mirabelle Enaka-Kima, Communications delegate, IFRC
Mobile: +224 624 196 530, E-mail: mirabelle.enaka@ifrc.org

In Dakar:

Moustapha Diallo, Senior communications officer, IFRC
Mobile: +221 774 501 004, E-mail: moustapha.diallo@ifrc.org

In Nairobi:

Katherine Mueller, Communications manager, IFRC Africa
Mobile: +254 731 688 613, E-mail: katherine.mueller@ifrc.org

In Geneva:

Benoit Carpentier, Team leader, public communications, IFRC
Mobile: +41 792 132 413, E-mail: benoit.carpentier@ifrc.org

INTRODUCTION

Outbreaks of Ebola virus were first discovered in the 1970’s in various central African countries, however, the West Africa outbreak that started in December 2013 has been the largest and most devastating to date.

There are five different types of Ebola virus and the West African outbreak was caused by the Zaire species, which is known to have a very high mortality rate. As of February 2016, 28,603 people have been infected and 11,301 patients died in the three most affected countries of Sierra Leone, Guinea and Liberia. A limited number of additional cases were reported in Nigeria, Mali, the United States of America, Senegal, the United Kingdom, Spain and Italy due to the repatriation of infected citizens by medical evacuation and persons entering countries well and then becoming sick from the virus causing further spread among close contacts.

The epidemic can be divided into four phases (1). The first phase was from December 2013 to March 2014, during which the first infections occurred in a remote region of Guinea. The inadequate health infrastructure present and the first time appearance of the virus in this region resulted in cases presenting unrecognised and therefore spread occurred undetected. The second phase from March to July 2014 heralded the confirmed spread of Ebola to the neighbouring countries of Liberia and Sierra Leone. At this time, Médecins Sans Frontières (MSF) had multiple teams on the ground responding to the escalating crisis (2) and were vocal about the need for both national and international assistance (3). During this phase hundreds of healthcare workers became infected and died from the virus.

The third phase of the outbreak from August to December 2014 saw an exponential rise in the number of cases across the three most affected countries, including for the first time outbreaks in major urban settings. Overstretched MSF Ebola treatment centres (ETC) were forced to turn away cases. On August 8th, the Director-General of the World Health Organization (WHO) declared the Ebola outbreak a public health emergency of international concern. The fourth phase, from December 2014 to January 2016 was characterized by decreasing numbers of new cases. This was achieved through a combination of community, national and international efforts. A number of trials for new vaccines and treatments started during this phase.

MSF in close collaboration with other actors such as the WHO and Ministry of Health (MoH), has been detecting and controlling Ebola outbreaks for decades in various African countries and uses six pillars for its approach:
- Isolation of cases and supportive medical and mental health care in dedicated ETC’s - Contact tracing - Awareness raising in the community
- A functioning surveillance and alert system
- Safe burials and house spraying
- Maintaining healthcare for non-Ebola patients

These six pillars have brought previous outbreaks under control relatively quickly. The size and spread of the recent West African outbreak made it difficult for all these six control measures to be implemented quickly and as a result the virus spread.

Prior to this outbreak, the volume of scientific research available on Ebola was limited. MSF ETC’s admitted over 5,200 confirmed Ebola cases, of which almost 2,500 have been cured (MSF Ebola crisis information update #19). No other national, international or non-governmental organisation has cared for more patients with Ebola than MSF.

This placed MSF in the unique position of being able to use its data and experience to answer scientific questions about Ebola and how it spreads. The main objective of MSF has always been to provide medical care to those in need and this was never jeopardised by research needs.
The type of research MSF was involved in varied. Some research used routine patient data that was collected in the ETC’s as part of standard care to answer questions such as which factors increased a patient’s chances of survival?

Other research required the collection of very specific information in order to assess for example if a trial vaccine prevented new cases of Ebola. Anthropological research required going out into the communities and asking people what they thought of Ebola and the efforts to control it.

MSF carried out research in a number of areas including epidemiology (describing the disease and its spread), vulnerable patient groups, clinical trials for new treatments, community views of Ebola, operational issues and effects of the outbreak on general healthcare. These areas of research closely reflect the six pillars of Ebola control mentioned earlier. This document aims to summarise the key findings of this research, and identify lessons learnt and knowledge gaps.

The severity of the West Africa Ebola epidemic saw MSF launch one of the largest emergency operations in its 44-year history.

Between March 2014 and December 2015, MSF responded in the three most affected countries - Guinea, Sierra Leone and Liberia – and also to the spread of cases to Nigeria, Senegal and Mali. At the peak of the epidemic, MSF employed nearly 4,000 national staff and more than 325 international staff who ran Ebola management centres as well as conducted surveillance, contact tracing, health promotion and provided psychological support.

MSF admitted 10,310 patients to its Ebola management centres of which 5,201 were confirmed Ebola cases, representing one-third of all WHO-confirmed cases. In total, the organisation spent nearly 104 million euros tackling the epidemic between March 2014 and December 2015. During the first five months of the epidemic, MSF handled more than 85% of all hospitalised cases in the affected countries.

Today MSF continues to support Guinea, Liberia and Sierra Leone by running Ebola survivor clinics that provide a comprehensive care package, including medical and psychosocial care and activities to counter stigma.

Through this short report, MSF would like to provide transparency about its expenditure linked to the worst Ebola outbreak in history.

GUINEA

Guinea was declared free of Ebola the 28th of December 2015. MSF is now running an Ebola clinic for survivors in Conakry. In February, there were 126 psychological consultations and 181 medical consultations at the clinic. In addition to this, the MSF team also carries out sensitization activities at the clinic and in the community.

On 17 March, the Guinean government announced two new confirmed deaths and three suspected cases, in the first re-emergence of the virus in the country since the outbreak was declared over in December 2015. MSF is not involved in case management but is ready to provide support if needed.

LIBERIA

The last patient was tested negative and discharged on the 4th of December. Liberia was then declared Ebola free on 14th of January. According to WHO, the last cluster of cases is now understood to have been a result of the re-emergence of Ebola virus that had persisted in a previously infected individual.

The Liberian national health system, which was already among the weakest in the world, has been decimated by the outbreak – close to 200 Liberian healthcare workers having died from Ebola according to official statistics, which represents 8% of all health workers in the country. MSF is now focusing activities on helping to restore offer of healthcare, notably through a MSF-managed paediatric hospital in Monrovia. Before the epidemic, there were 220 inpatient paediatric beds in Monrovia, but in April 2015, when MSF opened its paediatric hospital, all paediatric wards had closed. At the end of 2015, 122 inpatient beds were available. But this is clearly not enough for a city of 1,4 million inhabitants, with an estimated 17% of them being children under 5-years-old.

Monrovia – Paediatric hospital and survivors clinic

In Monrovia, MSF is running a 91-bed paediatric hospital, the Barnesville Junction Hospital (BJH), including a 22-beds neonatal intensive care unit, aiming to contribute to restoring the provision of emergency and secondary healthcare for children in the aftermath of the Ebola outbreak.

In 2015, more than 3,400 consultations took place in the emergency room of the hospital, and over 3,000 children were admitted in the inpatient ward. MSF also runs a clinic for Ebola survivors in the premises of the hospital.

Former patients have to face stigma and discrimination while accessing care, as well as social and economic problems (loss of work, loss of housing, etc.). MSF provides general outpatient consultations, and addresses mental health needs to a group of more than 500 identified former Ebola patients, which are estimated to be a third of all survivors in Montserrado county.

Teams have been providing consultations also to patients who are not identified as survivors, because of the lack of certificates of cure / discharge from ETCs. Compared to identified survivors, their access to medical and social assistance has therefore been even poorer. Common complaints are joint pains and ophthalmic issues. For the latter, MSF provides care in collaboration with a Liberian eye clinic.

About 400 survivors have been seen since April 2015, 168 are actively followed. 32 patients are under psychiatric treatment and 35 patients are currently followed for eye problems. MSF also offers supportive mental health services to frontline workers during the outbreak (ETU staff, burial teams, etc.), as well as members of the families of survivors.

SIERRA LEONE

The country was declared free of EVD transmission on 7 November but a new death was confirmed on 14 January, followed by an additional case on 20 January. Sierra Leone was once again declared free of EVD transmission on 17 March.

MSF played a key leading role in treating people who suffered from Ebola and continue to provide medical and psychosocial services to some of the country’s 4,000 Ebola survivors in Freetown and Tonkolili district. New projects on maternal and child health opened in different towns of the country, as the already fragile health system has been further weakened by the burden of the Ebola epidemic. MSF is also maintaining an emergency response capacity through a small team.

Freetown – Survivor clinic

The survivor clinic in Freetown has been running since February 2015, providing primary healthcare and mental health support, with currently around 140 consultations per month. MSF also runs community sensitisation and stigma reduction activities.

Magburaka – Survivor clinic

By the end of February 2016, the MSF survivor care in Tonkolili has been integrated into the MoH primary healthcare system. We are still following a small number of survivors with mental health support, medical care and referral, but the majority of patients have been discharged from our program. While supporting survivors, we saw a reduction in medical complaints and improvement of the mental health status.

Tonkolili District – Reproductive and Child Health

The project continues to support paediatrics and maternity in Magburaka hospital. 10 days after MSF started supporting the hospital in January, a new Ebola case was identified in Magburaka. The team managed to continue medical care in the hospital throughout this new outbreak, which was rapidly contained. MSF is also supporting the screening and isolation facility at the hospital. In February, we admitted 152 children to the paediatric ward and 83 women to maternity.

Koinadugu District – Maternal and Child Health

In Kabala hospital, in Koinadugu district, MSF will open a new project with the aim to increase access to free maternal, neonatal and paediatric care while ensuring health care to Ebola survivors in the district and effective response to outbreaks and emergencies in the area.

By Katherine Mueller, IFRC, Lisa Pattinson, IFRC, Louise Juul Hansen, PS Centre

One year ago, the IFRC launched the campaign #wordsagainstebola. One of the elements of the campaign was a banner for Facebook with the words “Stop Ebola with hope” and the picture of a smiling young girl with a strong, but soft gaze.

The girl in the picture is named Kadiatu Bangura, and the picture was taken the day she was released from the Red Cross Ebola treatment centre in Kenema Sierra Leone. She was 11 years old, alone, separated from her mother, father, and siblings who were all taken to different facilities after falling ill with the potentially deadly disease. Today, Kadiatu is 13 years old and healthy.

When Kadiatu arrieved at the Kenema treatment centre, she was their second patient – their youngest patient – and severely ill with Ebola. Disoriented and confused, Kadiatu thought she was meeting the devil when she first saw staff in their protective gear approach her. “They gave me food but I couldn’t eat,” says Kadiatu, quietly. “I was feeling bad in my stomach. My neck was aching, and I was also thinking about my mother.”

Over the course of the following two weeks, Kadiatu’s strength began to return. “I started feeling better. I was playing. They brought me balloons and paper and crayons, and some peanuts because I really like them,” says Kadiatu.

She formed friendships with other patients, falling under the maternal wing of Haja Kargbo, a mother who lost two of her own children to Ebola before falling victim to the indiscriminate disease herself.

After two blood tests came back negative, Kadiatu was given the good news. She could go home. She had a final shower to ensure any potential contaminants remained on-site. She said goodbye to Haja, received her ‘survivor’ certificate, and then, “the staff brought me music and said we should dance. So we danced to Michael Jackson,” says Kadiatu.

It was a happy moment, but also one that still haunts her. During a recent visit to her home in Waterloo, Kadiatu willingly obliges a suggestion to dance. However, just seconds into the music and tears are again flowing down the now-teenager’s cheeks as she is transported back to the treatment centre and her time there.

For now, she is focusing on improving her grades. Her favourite subject is math, but she receives the best mark in religious studies. With a goal of making her father proud, Kadiatu says, “I want to help people. I want to be a lawyer.”

The shower that Kadiatu received before leaving the treatment centre is a symbolic as well as practical measure. “My nickname is Happy Shower,” smiles Jestina Boyle, a Red Cross psychosocial assistance volunteer at the Kenema Ebola treatment centre. With Jestina’s encouragement and counselling skills, patients experienced the so-called ‘happy shower’ which is what survivors go through before crossing the threshold of the restricted high-risk area back to the normal world. The happy shower is an affirmation that they have survived this vicious virus and are washing away the disease.

“Often when patients are admitted to the centre with a positive diagnosis, many want to give up. But I don’t let them. I tell them to eat, to drink, to walk around, to do something. Just don’t give up,” says Jestina. Many of the patients had already experienced terrible loss to the disease. In some cases, their immediate family had succumbed to the disease and they were the only one remaining. Other times they had been infected while caring for someone and had then unwittingly contaminated their spouse and children. Needless to say, feelings of guilt can be enormous and many patients slide into depression.

Jestina was a lifeline for many in these dark times. “I give them hope. So many thought they were dead and then, by changing their thinking, it helps them survive. We pray together, or they see me praying for them and they realize that it is not their time. God has brought them here to survive.”

Keeping people motivated can carry its own toll as it is a very emotionally charged job. Jestina is a creative person and links her passion for caring with singing and dance which instantly uplifts her and those around her. “I sing to keep myself happy, it’s what I have to do when I see so many people dying. I see that my work has helped people, more are walking out of this centre Ebola-free.

“Treatment is only part of survival. It makes the body strong but with a weak mind, the person won’t survive. Now, when I make the mind strong, the body becomes stronger and people survive.”

GUINEA

Guinea was declared free of Ebola the 28th of December 2015. MSF is now running an Ebola clinic for survivors in Conakry. In February, there were 126 psychological consultations and 181 medical consultations at the clinic. In addition to this, the MSF team also carries out sensitization activities at the clinic and in the community.

On 17 March, the Guinean government announced two new confirmed deaths and three suspected cases, in the first re-emergence of the virus in the country since the outbreak was declared over in December 2015. MSF is not involved in case management but is ready to provide support if needed.

LIBERIA

The last patient was tested negative and discharged on the 4th of December. Liberia was then declared Ebola free on 14th of January. According to WHO, the last cluster of cases is now understood to have been a result of the re-emergence of Ebola virus that had persisted in a previously infected individual.

The Liberian national health system, which was already among the weakest in the world, has been decimated by the outbreak – close to 200 Liberian healthcare workers having died from Ebola according to official statistics, which represents 8% of all health workers in the country. MSF is now focusing activities on helping to restore offer of healthcare, notably through a MSF-managed paediatric hospital in Monrovia. Before the epidemic, there were 220 inpatient paediatric beds in Monrovia, but in April 2015, when MSF opened its paediatric hospital, all paediatric wards had closed. At the end of 2015, 122 inpatient beds were available. But this is clearly not enough for a city of 1,4 million inhabitants, with an estimated 17% of them being children under 5-years-old.

Monrovia – Paediatric hospital and survivors clinic

In Monrovia, MSF is running a 91-bed paediatric hospital, the Barnesville Junction Hospital (BJH), including a 22-beds neonatal intensive care unit, aiming to contribute to restoring the provision of emergency and secondary healthcare for children in the aftermath of the Ebola outbreak.

In 2015, more than 3,400 consultations took place in the emergency room of the hospital, and over 3,000 children were admitted in the inpatient ward. MSF also runs a clinic for Ebola survivors in the premises of the hospital.

Former patients have to face stigma and discrimination while accessing care, as well as social and economic problems (loss of work, loss of housing, etc.). MSF provides general outpatient consultations, and addresses mental health needs to a group of more than 500 identified former Ebola patients, which are estimated to be a third of all survivors in Montserrado county.

Teams have been providing consultations also to patients who are not identified as survivors, because of the lack of certificates of cure / discharge from ETCs. Compared to identified survivors, their access to medical and social assistance has therefore been even poorer. Common complaints are joint pains and ophthalmic issues. For the latter, MSF provides care in collaboration with a Liberian eye clinic.

About 400 survivors have been seen since April 2015, 168 are actively followed. 32 patients are under psychiatric treatment and 35 patients are currently followed for eye problems. MSF also offers supportive mental health services to frontline workers during the outbreak (ETU staff, burial teams, etc.), as well as members of the families of survivors.

SIERRA LEONE

The country was declared free of EVD transmission on 7 November but a new death was confirmed on 14 January, followed by an additional case on 20 January. Sierra Leone was once again declared free of EVD transmission on 17 March.

MSF played a key leading role in treating people who suffered from Ebola and continue to provide medical and psychosocial services to some of the country’s 4,000 Ebola survivors in Freetown and Tonkolili district. New projects on maternal and child health opened in different towns of the country, as the already fragile health system has been further weakened by the burden of the Ebola epidemic. MSF is also maintaining an emergency response capacity through a small team.

Freetown – Survivor clinic

The survivor clinic in Freetown has been running since February 2015, providing primary healthcare and mental health support, with currently around 140 consultations per month. MSF also runs community sensitisation and stigma reduction activities.

Magburaka – Survivor clinic

By the end of February 2016, the MSF survivor care in Tonkolili has been integrated into the MoH primary healthcare system. We are still following a small number of survivors with mental health support, medical care and referral, but the majority of patients have been discharged from our program. While supporting survivors, we saw a reduction in medical complaints and improvement of the mental health status.

Tonkolili District – Reproductive and Child Health

The project continues to support paediatrics and maternity in Magburaka hospital. 10 days after MSF started supporting the hospital in January, a new Ebola case was identified in Magburaka. The team managed to continue medical care in the hospital throughout this new outbreak, which was rapidly contained. MSF is also supporting the screening and isolation facility at the hospital. In February, we admitted 152 children to the paediatric ward and 83 women to maternity.

Koinadugu District – Maternal and Child Health

In Kabala hospital, in Koinadugu district, MSF will open a new project with the aim to increase access to free maternal, neonatal and paediatric care while ensuring health care to Ebola survivors in the district and effective response to outbreaks and emergencies in the area.

HIGHLIGHTS

 Three new EVD cases confirmed in Guinea; more than 1,000 contacts identified

 WHO declares end to Sierra Leone’s most recent EVD cluster

 GoL launches electronic platform for Liberian health workers to track and report public health threats

KEY DEVELOPMENTS

 Between March 17–23, the Government of Guinea (GoG) and the UN World Health Organization (WHO) confirmed three new cases of Ebola Virus Disease (EVD) in Guinea, originating in N’zérékoré Prefecture’s Koropara town. Health care workers linked all three confirmed cases to three deaths in late February and early March in Koropara, which healthactors now consider probable cases. All three newly confirmed cases have since died.

 USAID/OFDA recently committed $3.1 million to International Medical Corps (IMC) to bolster rapid response capacity in Guinea. With USAID/OFDA support, IMC maintains four rapid response teams (RRTs) to support the GoG’s response to new EVD cases.

Following the confirmation of new cases, an IMC staff member deployed to Koropara to conduct initial assessments, and IMC RRTs remain on standby to assist response activities.

Ebola wreaked havoc in his beloved country, killing thousands of people and closing all of the schools for months.

But as Liberia slowly got back on to its feet, Moses Owen Browne was determined to spread the word that every child should get a quality education.

One of A World at School's Global Youth Ambassadors, Moses worked with Liberia's eight other GYAs to collect an incredible 75,000 signatures for the #UpForSchool Petition.

He liaised with local communities and schools in 13 of Liberia's 15 counties, even travelling by river to reach remote areas. So he is well placed to assess where Liberia stands today, on the second anniversary of the Ebola outbreak that killed more than 11,000 people in three West African countries.

Moses sent us these thoughts on the progress made since schools reopened last year and what still needs to be done. You can also read about how Ebola disrupted the education of five million children.

Everything was at a standstill in Liberia during the height of the Ebola outbreak. Although it is officially over, the immense negative impact is still being felt throughout the country.

The health sector is struggling to be restored. Many children are orphans and out of school.

The deadly disease has killed over 4800 people here, with 10,695 cases being reported across Liberia, according to the latest United Nations report.

Our next-door neighbour Guinea has just recorded new cases, which is worrisome for us in Liberia.

The education sector has a limited supply of teachers, low enrollment and classes are overpopulated. The Liberian economy is struggling to recover with basic commodities and prices are on the increase. A 25kg bag of rice once sold for L$1200 ($17) is now at L$1600 ($20).

From every indication, it may take a little longer before the actual recovery work can start.

The health sector needs rebuilding, enrollment in school will have to increase and basic social services such as safe drinking water, good sanitation and dealing with the trauma created in the minds of the people will take a little longer to heal.

We remain watchful and very vigilant. The fight against the largest and most protracted Ebola epidemic in history is not over yet.

Schools have reopened, businesses across the country have restarted and everyone is hoping the situation will remain stable.

Hope can now be allowed that children and communities in Liberia will go back to normal life. But the challenges remain.

As we move towards the recovery phase, we call on national and international partners, donor organisations, the international community and staff to continue the fight against Ebola.

I think there is a need to focus on child protection, ensuring all children affected receive the appropriate support and get to live in a nurturing environment.

This will empower girls and boys in Liberia to maintain access to essential food security and livelihood services, to rebuild national socio-economic resilience to prevent future outbreaks.

Rebuilding health systems, restoring people's trust in government, finding more effective ways to communicate with the public and jump-starting the economy are all major areas of intervention.