National Ebola Response Centre
District Update – Bonthe: 12 to 18 January 2015
1. Key Messages
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There is concern over the condition of the Holding Centre
There are insufficient burial teams for the size of the district
Hazard pay continues to be outstanding or late
The DMO and DC have a poor working relationship
No Transmission District
2.
Hot spots
New cases this week
New Burials this week
None
0
28
New cases last week
Burials last week
0
31
2. Current Situation
Bonthe District continues to be a low transmission district and only experiences occasional cases that appear
to be isolated. The last corpse that tested EVD positive was in the week commencing 29th December 2014.
There are currently no households quarantined in Bonthe, so if any new cases arise they are not coming from
known transmission chains. These occasional cases may indicate under reporting, which could pose a risk of
further outbreaks.
The DERC Command Centre is established, but it remains under-equipped and under-staffed, whilst its
operations are hampered by the geography of the district which includes riverine areas, marshy areas and bad
roads. The DERC is proposing to establish a sub-office in Bonthe municipality as the main DERC office is located
in Mattru Jong, making it very difficult to react quickly to issues raised along Bonthe riverine chiefdoms.
The DERC does not always bury 100% of dead bodies each day, only reaching 80% on certain days. This is
mainly due to the difficulty of accessing some communities and at times the non-availability of vehicles and
fuel. Two boats have been provided by World Vision to respond to alerts calls made by the riverine chiefdoms.
However, these boats are often not available when needed and are not properly equipped to protect HCWs
from EVD infection. The district is therefore requesting sea ambulances which are better suited to the task,
the request for which World Vision are currently reviewing.
Suspected EVD and burial alert calls have been received from all the chiefdoms within the district with the
exception of Dema Chiefdom. As we would expect standard levels of sickness and mortality in the chiefdom,
this may be an indication of under reporting from Dema. The NERC has also had one report of an unsafe burial
being conducted in Dema, which may be an indication of more widely spread unsafe practices, though we
have been unable to corroborate this report. In our view it is important that the chiefdom is encouraged to
make burial alerts in order to ensure all funerals are safe and dignified as per the established practice across
the country, for the purpose of reducing the risk of infection from an undiagnosed EVD death in the
community.
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National Ebola Response Centre
District Update – Bonthe: 12 to 18 January 2015
Bothne is also reporting hazard pay issues. All of the original DERC staff have been paid, but the District
Coordinator is reporting that additional staff that he has brought on still have pay outstanding. These pay
issues are one example of the wider hazard pay problems happening across the country which are currently
being resolved by the NERC leadership.
Finally, there is a poor working relationship between the District Coordinator and the District Medical Officer.
This is impacting on the ability of the NERC to monitor and support the Command Centre’s activities. The
Situation Room continually receives conflicting information from each of them on pay and other problems in
the district, and NERC analysts are frequently fed inaccuracies due to their attempts to undermine each other.
The District Coordinator and District Medical Officer should be encouraged to resolve their differences and act
in a unified way in order to defeat Ebola in their district. The District Coordinator also needs to be encouraged
to spend more time in the district.
3. Challenges to response
Hazard pay is the greatest issue in the district, with recent threats of strike action by swabbers, contact tracers,
surveillance teams and other Health Care Workers due to non-payment of their allowances.
The Command Centre is under resourced and it is still not fully operational. Lack of office equipment continues
to impact operations and personnel are having to use their personal laptops. World Vision have solved the
previous connectivity issues by providing internet access for the site.
The DERC is concerned about a shortage of burial teams (currently two) and has requested to have one team
per chiefdom to allow a swift response to dead body alerts and to discourage unsafe burials. They have also
requested more personnel to ease the work of surveillance teams within the district, and have identified a
requirement for an additional 120 contact tracers.
The DERC is requesting support for additional transport resources for its response staff. Surveillance teams
are spread across the district’s five zones to allow for a faster response but do not have enough vehicles for
all teams. More motorbikes are needed for contract tracers in each chiefdom, and they also have concerns
about the robustness of their current vehicles which they do not deem to be suitable for the poor road
conditions in the district.
In addition to the above mentioned constraints, the other requested needs from the DERC are as follows:
 A satellite phone for Dema Chiefdom due to the lack of coverage in certain chiefdoms
 Renovation of the Holding Centre at Mattru Jong as there are no beds, water supply or electricity
o Comment: Though cases are low in number it is not clear whether investment in the holding
centre is better than supporting the set up of CCCs
 A food storage facility at the DERC
Please note the District Data Dashboard has been deliberately removed. Since the district has not
experienced any recent confirmed cases, the graphs and charts remain empty
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