WORLD VISION SIERRA LEONE EBOLA OUTBREAK QUESTIONS AND ANSWERS August 9, 2014 How did Ebola transmission start in Sierra Leone? March 19, 2014, the first notification of Ebola was received in Sierra Leone from Guinea, noting Ebola was possibly moving across the border from Guinea to Sierra Leone. An epidemiologic investigation team immediately was sent to Kono to undertake contact tracing and identification and monitoring of suspects. The first laboratory-­‐confirmed case of Ebola in Sierra Leone occurred in May 2014 and has since spread across national and district borders. The Sierra Leonean government has declared a national emergency and the World Health Organization (WHO) has declared a Global Grade 3 Emergency for West Africa. How many people have been affected? As of August 9, 2014, the U.S. Centers for Disease Control (CDC) estimates that there have been 730 cases of Ebola in Sierra Leone and 315 fatalities as a result. In this outbreak other cases and deaths have occurred in Liberia, Guinea, and Nigeria—all countries without World Vision programming. This is the most severe outbreak of Ebola since its discovery in 1975. Sierra Leone is the most affected country in this outbreak in numbers of cases and deaths thus far. Is any sponsored child or their family affected so far? We have no reports of sponsored children or close family affected. Are any World Vision Area Development Programs (ADPs) affected? Yes. Cases have been reported in Jong ADP and Makpele ADP. A nurse who was working in Bum ADP died of Ebola after contracting Ebola when he went to take care of his mother in Kailahun district, a non-­‐World Vision operational district. A case has been reported in Malen ADP and cases have been reported in Bo and Koidu, where World Vision Sierra Leone (WVSL) has its base offices for Bo and Kono bases respectively. How will the Ebola virus disease affect World Vision’s operations? The impact on World Vision’s programs in Sierra Leone has been significant as markets and schools have been closed and livelihoods are affected and cross-­‐border traffic is embargoed. This has had a negative impact on child and family well-­‐being across the nation. World Vision Sierra Leone is participating in the National Task Force, led by the Sierra Leone Ministry of Health, through community sensitization and awareness campaigns to curb the spread of Ebola. Page 1 of 1 The Ebola outbreak will affect World Vision’s operations in a number of ways. The declaration of a state of emergency means that World Vision is slowing down implementation of program activities. This will affect project monitoring, child monitoring, and follow-­‐up in the affected ADPs as WVSL has scaled visits to registered children in those areas for the safety of staff, registered children, and their families. Project activity implementation, especially trainings and others workshops, will be affected as there is a ban on public meetings and gatherings, other than for the purpose of Ebola. Up to 20 percent of currently available funding within the affected ADPs can be applied to the response efforts in order to save lives. This would mean some planned activities might not be implemented, and a number of our grants would be impacted, resulting in delays in meeting targets. If the spread is not contained, there is every likelihood that some of our sponsored children and family members will be affected. This would result in disruption to sponsorship operations because affected communities will be quarantined for 21 days, according to the proclamation by the President. Rumours and misconceptions about Ebola are rife, making the control of the spread of the disease extremely challenging. Many community members believe that people are injected with the Ebola virus and killed in a bid to create an emergency. Others think that because there is no cure, people are deliberately killed to avoid spread of the disease. As a result people are refusing referrals to medical care, and instead are escaping to non-­‐affected areas—the main means of the spread of the disease. Some communities are becoming antagonistic to health workers. Already, reports from the field indicate that pregnant women are refusing medicals referrals and that attendance at health facilities is dropping drastically. Are you planning to close offices? World Vision has not decided to close any district/base offices. A number of staff who are due leave have been encouraged to proceed on leave to reduce the number of people within our offices at this time. World Vision is keeping core staff to support implementation of activities for the Ebola outbreak response. The situation will remain like this for the next month, after which the situation will be reviewed. What is the government doing so far? The Ministry of Health and Sanitation has developed an initial plan for the Ebola response. The government is leading the national response. Two treatment/isolation centers are located in two districts, which are now the epicentre of the outbreak—Kenema and Kailahun districts. One of the centers is run by Medecins Sans Frontieres (MSF) and the other is run by the Ministry of Health and Sanitation. The government is working with UNICEF and other partners to develop communication materials for the public. WHO and the Centers for Disease Control and Prevention is supporting and advising the government on the epidemiology of the disease. An Emergency Operations Center (EOC) has been established to coordinate the response. The EOC has instituted the following activities with the aim of combating the spread of the disease in the country: •
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Food supplies have commenced in affected communities and households in the Kailahun District and will begin in other affected areas. The Red Cross has deployed one treatment center to service the Kenema District. The current Ebola treatment center at the Kenema Government Hospital Premises will be relocated to this new treatment center once construction is completed. The 117 call center has been relocated to the Emergency Operations Center at the WHO and staffing has been increased to accommodate the current volume of calls. Page 2 of 2 •
Additional contact tracers have been trained and are being deployed in affected communities and districts across the country. The general public is being advised that these contact tracers are not in these communities to intimidate or harm them, but to stop the potential spread of the disease What is World Vision’s current response to the Ebola outbreak? WVSL is a member of the national task force in the fight against Ebola. The office has played a leading role in conducting successful awareness programs at various locations in the country and the office continues to be a key player in contributing to the strategy and work plan of the local Ministry of Health. a. Response in Sierra Leone: World Vision is on the National Task force chaired by the Minister of Health and Sanitation and on the coordination sub-­‐committee chaired by the Chief Medical Officer. World Vision is also on the District Task Forces in all four operational districts of Bo, Bonthe, Kono, and Pujehun. World Vision has also set up a National Task Force coordinated by Omaru D. Sesay and will appoint a Response Manager once a National Office Declaration is done. b. WVSL interventions to support children, families and communities in operational areas: •
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World Vision is supporting the design and implementation of awareness raising and knowledge campaigns on Ebola through radio programs, community level support for surveillance and early detection, and referrals. Expanded social mobilization, door-­‐to-­‐door awareness campaigns, and providing necessary support to the district health team as they continue with contact tracing and follow-­‐ups. Cancellation of all meetings, trainings, and information workshops not related to the outbreak. Multiple information, education and communication materials in the form of banners and posters that have been distributed in Bonthe and Bo district; and jingles to radio stations in Kono, Sherbro Island, Pujehun, and Mattru Jong. In Freetown, a popular theater group has been contracted to do marketplace sensitizations in 22 markets from the far east of Freetown to the west, in an effort to mitigate behaviour and take steps to avoid contact with the disease. Bo base is working with the Mission for Sierra Leone and the Interfaith Group to carry out messages on Ebola to their congregations on how they can prevent the disease from spreading. Ebola Task force has been set up at National Offices and Base Offices to manage the Ebola information and communication flow and work with respective District Medical Health Teams. Duplication of radio jingles produced on Ebola for the Ministry of Health and Sanitation have been distributed to all community radio stations. c. Support to government initiatives: World Vision has been working with local organizations to conduct awareness raising and sensitization on Ebola prevention and control in Freetown and in all four operational districts. And World Vision is scaling up community engagement on Ebola prevention and control, in an effort to dispel rumours and misconceptions in our operational districts. We are supporting Community Health Workers through district health management teams to conduct house-­‐to-­‐house sensitizations, surveillance and contact tracing, as well support interfaith groups to continue to sensitize their members in churches and mosques. Page 3 of 3 What are the precautionary measures in other countries? The teams in Senegal, Ghana, and Mali are in alert and participating to coordinate meetings organized by the health authorities. Regular updates and information about Ebola are shared with all staff and associates. These preventive measures will be scaled up to all other countries in the region. Will you continue sponsorship programming in the midst of the government’s declared state of emergency? Sponsorship operations will continue in non-­‐affected ADPs but would be challenging for affected ADPs in terms of monitoring and follow-­‐up of registered children. Because public gatherings have been banned, sponsorship and other project implementation would be affected in this situation. The situation will be reviewed regularly and Support Offices updated accordingly. The focus of the National Office at this time is to provide optimum support for the Ebola Virus Disease emergency response. Where to find more information? For more information on the Ebola outbreak, visit the World Health Organization (WHO) website at http://www.who.int/en/ Fast Facts (8-­‐9-­‐14) •
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Total Sierra Leone population: 5.9 million Ebola cases in Sierra Leone: 730 Ebola deaths in Sierra Leone: 315 Total cases (four countries): 1,848 (CDC) Total deaths (four countries): 1,013 (CDC) Edited from WV Relief website document, 8.14.14, TKE Page 4 of 4