Summary
IFRC’s Ebola strategic framework is organised around 5 outcomes:
The epidemic is stopped
National Societies have better Ebola preparedness and stronger long term capacities
IFRC operations are well coordinated
Safe and Dignified Burials (SDB) are effectively carried out by all actors
Recovery of community life and livelihoods Six emergency appeals were launched to combat Ebola Virus Disease (EVD) outbreaks in Guinea, Liberia, Sierra Leone, Nigeria and Senegal, while providing coordination and technical support at the regional and global level.
In helping stop the epidemic, the appeal operations employ a 5 pillar approach comprising: (1) Beneficiary Communication and Social Mobilization; (2) Contact Tracing and Surveillance; (3) Psychosocial Support; (4) Case Management; and (5) Safe and Dignified Burials (SDB) and Disinfection.
Smaller preparedness and response operations were financed by the IFRC Disaster Response Emergency Fund (DREF) in Mali, Cote d’Ivoire, Cameroon, Togo, Benin, Central African Republic, Chad, Gambia, Kenya, Guinea Bissau and Ethiopia. In total, 16 countries in Africa have launched emergency operations relating to this outbreak.
Over the past two weeks case incidence has declined in both Guinea and Sierra Leone, and transmission has been restricted to districts in and around Conakry and Freetown. Liberia reported its first case in three weeks.
The epicentre of the outbreak, in the tri-border area around the Guinean prefecture of Gueckedou, the Liberian county of Lofa, and the Sierra Leonean district of Kailahun, has not reported a confirmed case of EVD for over 90 days. Notwithstanding these improvements, cases continue to be identified outside of registered contacts, and the number of reported unsafe burials has increased, suggesting that the outbreak in Guinea continues to be driven by unknown chains of transmission.
The total number of confirmed and probable cases is similar in males and females. Compared with children (people aged 14 years and under), people aged 15 to 44 are approximately three times more likely to be affected. People aged 45 and over are three to five times more likely to be affected than are children.
The President of Guinea has declared a Health Emergency in Lower Guinea, in response to the high number of cases that continue to present in the region. In this reporting period, Guinea has recorded 112 confirmed cases and 84 deaths. With two days remaining in March, the month has seen 39 more cases and 15 more deaths than February. The epidemic is now concentrated in Conakry and in surrounding prefectures in Lower Guinea, particularly in Forécariah. The IFRC and Guinea Red Cross (GRC) continue to redirect human resources to reinforce teams in Lower Guinea and to increase the response capacity in the region.
With the epidemic now concentrated in Lower Guinea, resistance and acts of violence have also become concentrated in and around Conakry. There were six security incidents reported by GRC SDB teams and IFRC delegates during this reporting period, and all but one occurred in Conakry. In response to the continuing insecurity, 70 GRC volunteers in Conakry and Forécariah participated in security training run by the IFRC. The IFRC and GRC continue to work with local officials and coordinate with national awareness campaigns in order to reduce security incidents and improve the safety of volunteers and staff.
Planning and preparations are underway for the Presidential campaign in advance of the election in November, 2015, and to make contingency plans for the 2015 rainy season which will begin in June. In addition to the logistical challenges that the rainy season will present, humanitarian actors are anticipating secondary epidemics of other diseases.
After 27 days without any new EVD cases, a new case was confirmed in Liberia on 20 March 2015 in Montserrado County. The patient died in an Ebola treatment unit, after ten days of intensive care. The source of transmission has not been identified, although it is being suggested that the woman may have contracted the disease through sexual contact. Research has shown traces of Ebola in semen of some survivors for at least 82 days after the onset of symptoms, meaning that survivors could carry the disease long after they have recovered. The Ministry of Health (MOH), with the support of partners, is following up a total of 185 contacts in Montserrado.
A measles outbreak has been identified in Grand Bassa, with a total of 27 children under five years testing positive.
In Sierra Leone, a three-day nationwide lockdown that was imposed to control the spread of Ebola ended on 29 March. The measure was enacted to allow heath officials to identify people who might be infected with the virus and to raise awareness about the disease.
The supply of food, water, and adequate sanitation facilities to quarantined areas has become challenging, and is being exacerbated by poor coordination between agencies and road access issues, particularly in rural areas. In addition, poor mobile phone coverage is impeding disease surveillance in Koinadugu, Kailahun, and Pujehun.