Ebola is wrecking years of health and education work in Sierra Leone and Liberia following their civil wars, forcing many charity groups to suspend operations or re-direct them to fighting the epidemic.

More than a decade of peace and quickening economic growth had raised hopes that the nations could finally reduce their dependency on foreign aid and budgetary support; now Ebola has undermined those achievements, charity workers and officials say.

"The impact of Ebola will take us completely back to it being a basket case," said Rocco Falconer, CEO of educational charity Planting Promise in Sierra Leone. "The impact on some activities have been simply catastrophic."

The two countries worst hit by Ebola have struggled to recover from the wars that raged through the 1990s until early in the 21st century, killing and maiming tens of thousands, and devastating already poor infrastructure.

In Sierra Leone, aid made up one-fifth of economic output in 2010, according to officials, though this had been shrinking as growth accelerated thanks to a boom in the country's commodities exports. Britain and the European Union are the main donors with funds directed to health, education and social assistance.

But Planting Promise's experience typifies the problems of non-government organizations (NGOs) since Ebola hit West Africa, infecting more than 20,000 people and killing nearly 8,000.

It had spent six years in Sierra Leone developing farms and using the profits to fund local schools. The project had just become self-financing for the first time when the outbreak was detected in March.

After that, things fell apart. Planting Promise was forced to withdraw its expatriate staff in June and the following month it closed its five primary schools where nearly 1,000 pupils had studied. It has also shut down its food processing factory.

Though sales have dived, it continues to pay about 120 staff, eating into its reserves. This has forced the group to return "cap in hand" to donors to ask for more money, Falconer said.

 © REUTERS/Baz Ratner Health workers rest outside a quarantine zone at a Red Cross facility in the town of Koidu, Kono district in Eastern Sierra Leone December 19, 2014.

© REUTERS/Baz Ratner Health workers rest outside a quarantine zone at a Red Cross facility in the town of Koidu, Kono district in Eastern Sierra Leone December 19, 2014.

The highly contagious disease has brought normal activity to a near halt in the two countries. Governments have issued strict quarantine orders on communities, restricted people's movement and closed schools. They have also banned gatherings, communal work and markets.

Paul Saquee, the chairman of the council of chiefs in Sierra Leone's eastern Kono region, said disruption to the long-term agricultural development projects of one NGO would have knock-on effects. "It means the work they were doing before suffers and next year we will have less food supply," he told Reuters.

RETHINKING STRATEGY

In Liberia, the epidemic dashed President Ellen Johnson Sirleaf's hopes of shifting the focus of aid to investment.

"Now Ebola is here and all of those efforts have been brought to a standstill. We could be starting from scratch again," said Jennah Scott, director of the Liberia Philanthropy Secretariat, a government agency. "That is very heartbreaking."

The World Bank and other donors have pledged hundreds of millions of dollars in aid. But Scott is concerned that money will go mostly to United Nations agencies and large NGOs, rather than local organizations.

"We need to get more support to local NGOs because they are the ones who stay in Liberia," said Scott, whose organization channels around $20 million in aid a year into Liberia.

The WaterAid organization, which works to improve access to safe water, hygiene and sanitation services in developing countries, had to suspend plans to drill 100 boreholes in Sierra Leone and provide services to four villages in Liberia.

Apollos Nwafor, WaterAid's West Africa advocacy manager, said the countries hit by Ebola suffered from broken health systems and food insecurity as well as a lack of safe water, sanitation and hygiene.

WaterAid was now lobbying donors to step up funding in these areas. "Ebola has become a hydra-headed crisis," Nwafor said.

OneVillage Partners, a rural development agency, started seven years ago with post-war reconstruction in villages in eastern Sierra Leone. It has since moved into other activities such as micro-loans for small business.

Since the Ebola outbreak, it has used its knowledge and relationship with villagers to educate them about Ebola, even though this was not its area of expertise.

The group suspended its programs in July and laid off some staff. Now its activities include delivering soap and working with communities to stop the spread of the disease.

While the virus has set the clock back on years of promising aid initiatives, the immediate work of showing local people how to avoid becoming infected is vitally important.

"Everywhere we looked, there was just wholesale denial and a lot of misinformation going around about Ebola," said Chad McCordic, Community Project Manager at OneVillage Partners.

(Additional reporting by Daniel Flynn; Editing by Ed Stoddard and David Stamp)

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AuthorLiberia Philanthropy Secretariat

As seen in the graph below the number of confirmed ebola cases have tapered off since mid November.  The graph compares the number of confirmed cases reported in patient databases with the numbers reported from the Ministry of Health and Social Welfare (MOHSW) SITRep reports.  The information from patient databases has not been updated since the end of November.  However, based on our data the number of confirmed cases have not been this low since before the middle of June last year.  During December there was a daily average of 22 new cases and 10 deaths reported, and the daily average has declined as it moved into January.

County Updates

In December, 55% of confirmed Ebola cases were reported from Montserrado County.  Currently there are 4,441 contacts throughout the country that under follow-up.  The reports from last week provided updates on Grand Cape Mount, Sinoe and Margibi counties which are currently three of the regions with the highest number of cases.  The map below shows the full breakdown of reported cases in the different counties for December 26th through January 1st.

In Grand Cape Mount County there were fifteen total confirmed cases. Three of these were from Tewor district and one was from Gola Konneh, from these cases three were confirmed post mortem. There were another four suspected deaths in Golakonneh, Tewor and Garwula districts, but these have not been confirmed.  A pregnant woman in labor was referred to Bomi County and later transferred to a hospital in Monrovia.  She reportedly received poor care in Monrovia before returning to Bomi where she died.

Sinoe County confirmed one case of Ebola from an individual that had not been on the contact tracing list.  This case occurred in Polay’s town and several days later a suspected case was reported in a town within a 30 minute walk from there. This individual who is suspected of having Ebola was also not on the contact tracing list.

Margibi County decided to drop individuals from their contact follow-up who were not linked to a confirmed case or who may have completed their 21 days of follow-up. They made this change in order to streamline their contact tracing process and ensure individuals that most need the follow-up are being visited by tracing teams.

ETU Update

There are discussions about limiting the bed capacity of Ebola Treatment Units (ETU) located outside of Monrovia.  However, there are no current plans to make adjustments to the building and management of the Community Care Centers. One new ETU opened in Grand Bassa County on December 22nd with the potential for caring for 50 patients.  There are three ETUs that were expected to open on the outskirts of Monrovia between January 1st and January 7th.  It has not been confirmed if they have actually opened.  Internal reports stated that four ETUs reported sewage problems at the beginning of January. 

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AuthorLiberia Philanthropy Secretariat

December 30, 2014

The Ministry of Health and Social Welfare (MoHSW) SITRep report for 24 December 2014 stated there were 7977 cases of Ebola reported since the beginning of the outbreak.  Based on the confirmed mortality rate we can estimate there are 4500 Ebola survivors. Fighting Ebola is still the priority of the MoH, however these survivors are in need of support from communities and the MoH.  On December 22, the MoHSW started an assessment of survivors to understand what they need to be successful.    

Based on information from internal sources there was a high need to establish standard operating procedures for the handling of the data on Ebola patients.  There have been some problems with the names of survivors getting out, so there is a need to standardize the procedures for how this information is handled.  Protecting the names and information of these individuals is an important part of the support the government can provide to the survivors.

The psychosocial plan to help those affected by Ebola includes a number of priorities including:

·      Support affected families and children including communities to reduce anxiety and fear

·      Work with partners to improve the quality of care for patients and their families

·      Provide survivor kits and psychological follow-up for affected families.

·      Facilitate the psychological process for families from investigation through bereavement

  Photo Credit: M. Holden Warren

Photo Credit: M. Holden Warren

Currently, many of these goals are being undermined by fragmented programs to support survivors. One of the needs that has been identified is a better registration system for survivors to help develop a stronger network and quickly get people the services they need.  There are programs for survivors throughout Liberia executed by various NGOs but many of them focus on providing food and the distribution of goods is described as unequal, or the support is limited.  Additionally, there are support meetings held for survivors but many of the participants lack the transportation needed to attend meetings.  Many Ebola survivors lost most of their possessions and even their homes as people destroyed clothes and bedding to try and stop the spread of Ebola.  It costs approximately $1400 for a family of 6 focused on non-food items like mattresses, pots and pans and clothing. Currently, the MoHSW does not have a donor to provide these non-food items to survivors and their families.  

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AuthorLiberia Philanthropy Secretariat

The Ministry of Health (MoH) reported in the December 18th SITRep that the number of Ebola cases are still at a dangerous level.  The epidemic started when only one new case was confirmed every ten days.  When the epidemic gained momentum in July, there were three new confirmed cases per day.  Since July, the rate of new cases per day peaked near 80 and has since declined to its current average of 6 new cases per day.  Although recent months have seen a huge decline in confirmed cases Ebola is still at an extremely dangerous level.   The below map illustrates the locations of confirmed cases over the past 21 days.  The absence of cases in certain areas, like Lofa, illustrates the success of some Ebola training programs and community education campaigns, and the need to replicate these successes particularly in cluster areas.

In our previous article on Ebola Hotspots, we discussed the need for focusing on reaching rural communities and identifying outbreak clusters.  From the MoH SITRep reports, we gathered information about some of these cluster areas.  In a community in Grand Bassa, near the border of Margibi county, there have been 22 confirmed Ebola cases in the past 21 days.[i]  Another hot spot was identified in the southern part of Sinoe county and five cases have been confirmed.  In addition, a hot spot team was dispatched to Nimba county in mid-December, but their findings have not yet been reported.[ii]

The confirmed cases in these hotspots are outside the ETU treatment areas and so far there is no information on where these individuals are being treated.  However, based on the confirmed case numbers from the nearest ETUs it does not appear they were admitted to one of these facilities.  On December 22nd, there were 76 total patients in Ebola Treatment Units across the country and of these, 33 were confirmed cases.

Based on the Rapid Isolation and Treatment of Ebola (RITE) strategy, hot spot teams are deployed when counties notify the Ministry of Health (MoH) of cases in an area.  The hot spot teams’ priorities are to:

  • Promote rapid isolation of:
    • Probable/suspect ed cases
    • Asymptomatic contacts
  • Confirm the presence of Ebola in community
  • Provide community education and psychosocial support
  • Support safe transport and safe burial
  • Conduct situational assessment (e.g., population size and mobility, accessibility to current ETUs, security concerns, communication needs)

The goals of the hot spot teams are very [Description: The figure above is a photograph showing a nearly impassable bridge on the road connecting Sinoe County, Liberia with Monrovia, the closest location with Ebola treatment units during September 2014.] [i] similar to the teams in urban areas; except they face more logistical challenges.  According to a December 19th CDC report, confirming Ebola cases is challenging because of a lack of trained personnel, poor transportation and communication networks.  For example, Sinoe county reported 5 confirmed cases but they do not have a laboratory technician that is trained in handling Ebola samples.  In addition, case investigation teams operating in Grand Bassa county have walked as many as eight hours to reach communities where there were reported cases, in part because of inaccessible roads caused by inclement weather.  According to these reports a lack of telephone coverage has also hindered the investigation and reporting of Ebola cases.   According to internal sources, the case reporting procedures that were established in urban areas require data to be transferred to five separate individuals for approval in order for case information to be entered into reports. The reporting of this data is almost exclusively dependent on telephone networks.

These challenges are part of the reason why the confirmation of just three cases per day is still considered a dangerous level.  The time it takes from being notified about a potential hot spot, down to the confirmation of a case varies across the region and is affected by a large number of factors.  As a result contact tracers and medical personnel have to play catch up when hot spots are found and the danger of transmission during this period is high.

[1] Dec 18th SITRep

[1] Dec 18th SITRep

[1] Dec 22nd Action Item Log

[1] Road picture from CDC Report: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6350a5.htm?s_cid=mm6350a5_w

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AuthorLiberia Philanthropy Secretariat

The Ebola Strategy Roadmap that was coordinated by The World Health Organization (WHO) emphasizes the importance of mobilizing and sustaining health workers and support staff that run treatment facilities. So far there have been 366 cases of Ebola amongst health workers in Liberia.  Providing training for health workers is key to improving the safety of the workers, as well as reducing the overall Ebola transmission.  The Ministry of Health’s (MoH) goal is to have 100% of Health Care Workers (HCW) certified in at least one Ebola training course.  This goal is based off the 3500 individuals that MoH has determined work directly with Ebola patients or are responsible for the cleaning and maintenance of facilities.  Courses are being held on different dates across the country but priority for the trainings is being given to:

1.     Liberian health workers

2.     Individuals who will conduct trainings for Liberian Health Workers

3.     Medical Staff who actually work in Ebola Treatment Units

4.     Medical Staff who are working in underserved communities

The pie chart below is based on data from our internal sources and shows the percentages of trainings that were completed by health care workers. We did not receive details on the curriculum of the training courses, so we are unable to explain the difference between the phases.  However, we do know that the training courses build on one another and were created in a partnership between MoH and WHO.  Therefore, we can presume that the course phases will follow the priorities that WHO discussed in their strategy roadmap, including: the proper use of Personal Protection Equipment and Sanitation.  The following pie chart shows that 56% of HCWs completed their phase 1 and 2 trainings and an additional 21% have fully completed their training.  Based on this information the MoH will reach its goal of having 100% of health care workers trained in at least one Ebola course by Dec 31st. 

liberia ebola health care worker training.png

As the health care workers complete these new Ebola trainings we hope to see a downward trend of cases.  For the week of December 1st through December 7th, there were five counties that had zero suspected cases of Ebola, these included: Lofa, River Cess, Grand Gedeh, River Gee and Maryland.  The following chart shows the updates on numbers of suspected and probable cases for the different counties across a two week period.  When comparing the two weeks there are minor fluctuations in the number of suspected cases.  Montserrado County currently has the highest number of suspected cases.

Looking at the number of suspected cases is important, because its shows the effectiveness in the health workers ability to identify potential Ebola cases.  Additionally, these numbers include people that may not have laboratory test results back.  Depending on the patients location the lab results can take a few days to recieve.  For example, on December 5th there were 45 probable or suspected cases across Liberia, and 5 cases were confirmed positive, but there were 54 lab tests completed.  Then on December 7th there were 10 probable or suspected cases, and 7 of these cases were confirmed positive, but it was reported that there were 59 lab tests completed.  For December 7th this leaves a total of 49 more lab tests completed than there were probable or suspected cases reported.  The high variation between the suspected and confirmed cases and the lab result number makes it difficult to tell how many actual cases are happening on a given day.  There are several different possibilities for the cause of these variations, including the delay in laboratory test results, but because of these variations the total number of suspected and probable cases pictured above provides a good overview of the progress in the different counties over time.  As the health worker trainings are completed we anticipate seeing a reduction in the error margin between suspected and confirmed cases.

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AuthorLiberia Philanthropy Secretariat

Lofa County was the epicenter of Ebola in Liberia; just four months ago almost 80 new cases were reported in a single week.  In follow-up to our previous blog on improvements in Lofa County, new data indicates that Lofa should reach Day 42 this week and we are awaiting official confirmation.  In order for a country to be declared free of Ebola by the World Health Organization it must go forty two days without any new cases.  Day 42 is used as an indicator because it’s twice the incubation period for the illness. Counting starts from the last day a person has had contact with an infected patient.  After 42 days have passed the risk of another case developing is very low. 

Confirming Lofa County Ebola free will help reinvigorate the rest of Liberia as we battle this disease. While data collection and reporting has improved, clarifications are still needed about data reported during the last two weeks before celebrating Day 42 in Lofa.  According to the Lofa County Ebola Treatment Unit’s (ETU) report for November 28th, the last confirmed Ebola case in the clinic was on October 24th.  Based on this information Lofa County would already have passed its Day 42 Mark.  However, reports from internal sources indicate that December 10th would be 40 days without any new cases.  Based on this information Day 42 in Lofa should have been Today, December 12th.

The Ministry of Health’s Contact Investigation Summary (Figure 3: Left) from December 1st reports that there were 66 contacts still being visited by contact tracers last week.  More information on the status of these individuals is needed to determine if they were confirmed negative for Ebola or if they have completed their 21 day follow-up without showing symptoms.  It is clear more information is needed from officials before Day 42 can be declared, but we are encouraged by the data and Médecins Sans Frontières’s departure from the Lofa ETU.  Their assistance downsizing the clinic and preparing it for normal operations indicates they don’t anticipate a spike in cases.

The improvements in Lofa are encouraging and we look forward to officially confirming day 42 for the county.  We expect to see other Liberian counties follow suit as medical staff focus on hot spots and Liberians continue following preventative protocols. As the Ebola clinic transitions back to normal operations and as residents of Lofa begin moving forward; their success brings hope to the rest of Liberia. 

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AuthorLiberia Philanthropy Secretariat

Liberia has met 73% of its target of having 1733 beds for Ebola patients.  This target bed capacity counts the spaces at ETUs and does not include space at Community Care Centers (CCCs).  As of December 2nd there were 657 free beds across Liberia, from a total of 12 Ebola Treatment Units (ETUs).  There is a focus on building ETUs in the underserved counties, with 19 ETUs and 21 CCCs scheduled to be built, but recent declines in Ebola cases leave us wondering if this is still the best strategy.

While ETUs are staffed by medical personnel, the CCCs are staffed by the family members of patients.  The CCCs are often built in places where an ETU is not easily accessible and serve primarily as a temporary care site until patients can be moved to an ETU. They are designed to get patients into isolation quickly in order to reduce transmission by limiting their contact with family to the single person that has agreed to care for them. 

Current ETU and CCC Locations

Bomi County currently has one active ETU with a capacity of 20 beds.  A CCC is planned to be built in order to support the ETU.

Bong County has a single ETU that has a capacity of 51 beds.  One CCC is planned.

Lofa County has one 40 bed capacity ETU in operation.  Two new ETUs and one CCC are planned to help support the ETUs.

Margibi has two ETUs that combined can handle 51 patients.  Additionally they have one CCC.  A third ETU is planned. 

Montserrado County currently has 5 ETUs including those in Monrovia, totaling 552 beds.  There are four more ETUs planned in Montserrado and one ETU that has been completed and is intended to open as a training site.  In addition, there are four CCCs that are scheduled to be built.

Nimba County has one 36 bed ETU in operation. Two ETUs are planned.  In addition there are three CCCs that are scheduled to be built.

River Gee has no ETUs but one functioning CCC.  There is one ETU and one CCC scheduled to be built.

Grand Bassa has no ETU but one CCC.  There is one ETU and one CCC planned for the county. 

Gbarpolu currently has no ETU or CCC but there is one ETU and two CCCs planned.

Sinoe County currently doesn’t have an ETU or CCC, but there are two CCCs that are planned.

Grand Cape Mount, Grand Gedeh, Maryland, River Cess, and Grand Kru, counties all don’t have an ETU or a CCC.  However, there is plan for one ETU and one CCC in each of these counties.

Locations for ETUs are chosen based on a number of factors including the size of the population, the intensity of the epidemic in an area, and their accessibility to vehicle transportation.  The map below shows the population information of different counties in Liberia based on a survey in 2005.  The map details the differences in population density across the counties, and helps us to understand how the development of some of the ETUs and Clinics have been prioritized, and the challenges of setting up ETUs in some counties, like River Cess, where population density is lower.

Is Building New ETUs The Best Strategy?

There is a need to guarantee that all counties are able to properly treat Ebola patients, but we want to ensure that the Ebola response is being flexible and actively addressing the highest needs.  Rates of admittance to the ETUs have been dropping over the last several weeks.  ETUs take 1 to 2 months to complete, but the construction is just a small part of the time it takes for a facility to open because it’s dependent on negotiations with NGOs and international partners, trained health workers availability, adequate incentives and benefits, medical supplies, equipment, transportation, and accommodation for international staff.   As a result opening a CCC is much faster than opening an ETU because one medical provider can monitor multiple facilities.  

When looking at the distribution of ETUs and CCCs and then comparing it to data on Ebola cases we found that the majority of cases are coming from counties that have multiple ETUs, with the exception of Sinoe.  On December 1st it was reported that there were 12 new cases in Montserrado County, 5 new cases in Margibi, 3 in Bong, 2 in Grand Bassa, and 1 in Sinoe.  The southern portion of Liberia doesn’t have an ETU and Maryland and River Gee counties both have large population centers but there were no reported cases there for Dec 1st.  

There is no question that areas that currently have no active CCC or ETU need assistance in dealing with Ebola patients; However the decisions to build these facilities were in part based on data of the number of cases in an area which is now outdated. The time delay in establishing ETUs makes us question whether the establishment of the ETUs is still the best way to assist communities at this point.  Additionally, the reported cases being confined primarily to areas with ETUs has us question what reporting processes are set up to report Ebola cases outside the established clinics? Are there really no new cases in some counties areas?  Or is the lack of facilities limiting the accuracy of the data? Is the continued focus on establishing ETUs in part to more accurately gauge the Ebola rates in these areas?  And if the Ebola reporting is accurate across the counties, then what is the plan for the ETUs that are being built and will likely go unused?

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AuthorLiberia Philanthropy Secretariat

For months there has been a race to rapidly bolster the health infrastructure by training medical personnel, building clinics and acquiring medical equipment; all in an effort to get ahead of Ebola.   In an interview with Politico, Bill Gates discussed the importance of health infrastructure in the prevention and treatment of disease.  He believes that the initial delay in reporting of Ebola was one of the reasons that it spread so quickly.  This delayed reporting is an indicator that the health system was not prepared to handle an outbreak of this kind.

The Government of Liberia’s (GoL) Ministry of Health and Social Welfare (MOHSW) department, has worked to overcome pitfalls in its system and tackle Ebola. From previous reports from GoL we’ve seen data standards being set and subsequent improvements in reports from clinics across the country.   There is increasing pressure on Hospitals, Community Care Clinics (CCCs) as well as Ebola Treatment Units (ETUs) to have designated data managers in order to improve reporting.  Additionally, there are 17 new ETUs that are planned and the 21 new CCCs that are scheduled to be completed in December.  

These new clinics are being overseen by the local County Health Teams in conjunction with an international partner at each site.  There are still reports of communities resisting being treated at these centers and some locations that were chosen for clinic sites are being constructed in communities that don’t want them there. 

As new clinics pop up around the country, The Liberia Philanthropy Secretariat hopes to see an inclusive health infrastructure plan that details how management of these health facilities can be transformed to meet the general health needs of Liberians.  The health infrastructure improvements are vital to fighting Ebola, but a long term commitment and strategy are needed to ensure the management and maintenance of a robust health system. Our hope is that these new facilities will be the outline for future comprehensive clinics that can provide effective monitoring and reporting of data to help prevent an epidemic, like Ebola, from taking root in the future. 

The county updates for the week of November 21st through the 27th show some communities’ uncertainty about the importance of the clinics and details the different needs across the region.  For example, In Sinoe County, the community members of Karquekpo had previous agreed to have a CCC built in their community and they are now resisting its development.

In Margibi County there was difficulty last week conducting meetings with contact tracers because of a lack of transportation and communication capacity.

There may still be areas of resistance in Grand Cape Mount County to the safe burial practices being taught.  This is drawn from information that a funeral in Bendaja resulted in the infection of one man and several of his family members.  Additionally, there are several individuals including two orphaned children that completed their quarantine.

In Bong County the burial teams are making it to communities and assisting with the burials but samples are not always being collected from suspected bodies.  It is unknown if this is due to short supplies of test samples, objections from family members, or insufficient training.

Montserrado County health care workers have continued to see high casualties even with the training from international organizations.  This week three workers became infected and have been admitted to the local CCC.

Active Case Searches are being conducted by the Ebola Task Force in Bomi County in the Dewoin, Klay and Suehn Mecca Districts.  This is part of an effort to stamp out potential hot spots and find individuals that are still in need of treatment.

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AuthorLiberia Philanthropy Secretariat

Humanity United and The Tony Elumelu Foundation are shining examples of the committed partners that are needed to strengthen Liberia’s capacity and emerge from this outbreak with a united vision for Liberia’s future.  The Liberia Philanthropy Secretariat (LPS) has been working with foundations over the years to build partnerships with Liberian organizations and is grateful to all of its partners who have risen to address our urgent needs to fight Ebola.

To Date, LPS has helped facilitate large grants made by Humanity United to organizations in the fight against Ebola.  Pam Omidyar, good friend of President Sirleaf and co-owner of Ebay, and Randy Newcomb, Executive Director of Humanity United, reaffirm their dedication to Liberia in a letter to President Ellen Johnson Sirleaf:

“We share your great faith in Liberia’s resilience.  It is with this faith that we have supported the growth and re-development of Liberia since 2007.  And now, as your country deals with this devastating attack, we stand with you and with all of your Liberian friends in the struggle to face this disease, overcome it and rebuild.”

Humanity United has been involved in Liberia since 2007, and has worked on issues ranging from capacity building for civil society to economic development and natural resource management.  They have donated over $12 million worth of grants to organizations and civil society working in Liberia.  President Ellen Johnson Sirleaf’s letter to Humanity United acknowledges the importance of the long term commitment by Humanity United to Liberia. In her letter she states:

"Humanity united has been a true friend to Liberia.  You have supported us through the restoration of our peace and stability, rebuilding trust in our legal and justice system, and when it was time to focus on propelling our economy forward you joined us in our drive to support entrepreneurship and job creation and encouraged other foundations and philanthropists to do the same."

We are proud to have such committed partners to help drive Liberia’s recovery and are encouraged by the commitment of African organizations, like The Tony Elumelu Foundation. They recently committed $400,000 to President Ellen Johnson Sirleaf’s Ebola response effort.

The Liberia Philanthropy Secretariat supports President Ellen Johnson Sirleaf’s  statements about needing to begin the planning of post-Ebola economic revitalization and the important role that financial institutions and international organizations will play in bolstering the agriculture and macro-finance sectors. LPS is proud that our mission to engage philanthropists in Liberia has helped bring organizations like Tony Elumelu Foundation(TEF) and the United Bank for Africa(UBA) together to overcome this outbreak. TEF is founded by Tony Elumelu, African millionaire with an estimated net worth of $400million USD, the Managing Director of UBA, and an active philanthropist who supports business development and entrepreneurship in Africa. Their donation to President Ellen Johnson Sirleaf’s Ebola Response showcases the importance of support from African based institutions, and their prominent roles in the future of the country.

The support of all these organizations has been vital in fighting the Ebola epidemic and their visions for the future of Liberia post-epidemic inspire us to continue our work.  We hope that you will join us in sharing your ideas for Liberia’s future on twitter.  @LIBPhilanthropy and keeping up to date with what’s happening through our website.

 

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AuthorLiberia Philanthropy Secretariat

For the week of November 16th through November 21st, we have compiled the data released in the Government of Liberia’s (GoL) Ministry of Health and Social Welfare (MOHSW) report.  Based on the information from these reports in conjunction with feedback from a local epidemiologist we see the continued trend of a decline in reported cases.

During a teleconference with Dr. Mosoka Fallah, an epidemiologist in Liberia, he emphasized the importance of involving communities in the Ebola effort.  He recommends that communities keep a log of visitors to and from their area. Additionally, he mentioned that outreach to more isolated communities is becoming a focus and that outreach teams are advising communities to immediately isolate anyone showing symptoms of Ebola in order to curb the transmission rates.

The importance of reaching remote areas and the improvement in data collection that we’ve discussed in previous reports is being addressed through several collaborative actions.  Rapid Response is beginning to prepare five teams that will be deployed to different hot spots areas.  There is also a push to get more data from the contact tracing teams and for the ETUs/CCCs to hire two new staff members that will be dedicated to investigate cases and manage data.

The distribution of cases amongst the counties has been changing.  We are seeing fewer people admitted to ETU’s and holding centers in Lofa, but there continue to be cases in other counties, such as Bong.  This week there have been fewer reports of counties lacking vital supplies like Personal Protection Equipment and patients are continuing to be transferred to ETU’s in Monrovia from other nearby areas. 

Montserrado County reported that one individual being followed by contact tracers had become symptomatic.

There were four individuals from Amenia in Cape Mount County that were transferred to the Island Clinic ETU.  Additionally there were five community burials that took place in Gola Konneh, Garwular and Tewor.

There is less data this week from individual counties but as we’ve described, there is more information on the country wide strategies that are happening.  We hope this is an indicator of improved coordination and collaboration that will help drive Liberia to the 42 day mark.

 

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AuthorLiberia Philanthropy Secretariat

For the week of November 3rd through November 14th, the data released in the Government of Liberia’s (GoL) Ministry of Health and Social Welfare (MOHSW) report included information on the supply needs of different counties as well as concerns over regions that aren’t currently accessible because of poor roads.

The reporting of Ebola cases has been standardized between the counties but there are still difficulties getting regular data from all of the Holding Centers and Treatment Units.  This graph shows the number of people who have been admitted, are currently in treatment or have been discharged from facilities across Liberia for the week of November 10th.

From the beginning of November Grand Cape Mount County had five probable cases reported and two of these individuals are refusing to be transferred to the ETU.  The county has continued to receive new supplies including two ambulances, donated by the Global community and a Senator.  There are many cases that are being transferred to ETUs in Monrovia from other areas.  In total there have been 27 new patients admitted to ETUs in Monrovia.

In Sinoe County training and prevention activities have been ongoing.  The county task force team held a meeting at the F.J. Grante Hospital with 55 members of the Chiefs and Elders Traditional Council from the ten health districts in the county.  There were 173 Community Health Volunteers trained by Medical Team International across six districts within the county.  Concern is growing over the Ebola Holding Unit’s staff having not received pay since August and the lack of funds to purchase clothing and supplies for survivors that are being discharged from the holding center.

There are some immediate supply needs in Gbarpolu County where there is currently no working ambulance.  Several districts including Gou Nwolala, Kongba and Belleh are a high level concern since the roads have been damaged and are currently impassible by vehicles.  There is also no cell phone network in many of these areas, so there is a need for VHF radios to help reach these isolated places.

Grand Kru County received donations from the Cavalla Rubber Corporation including gloves, buckets and soap to help support the efforts of the County Ebola Taskforce.

Challenges with tracking patients have continued to be reported.  Currently in Bomi County an individual who was suspected to have Ebola was transported from Tulamu to Monrovia, but no one is aware of the patients status or location.

River Cess County has received an ambulance to help communities around Kayah Town.  The Contact Tracers have continued to monitoring individuals and there were 11 contacts that have now become symptomatic.  There were 6 probable cases that were transferred in ambulances from Kayah’s Town to the ETU in Montrovia.  The Morweh community has also rejected the efforts of the burial team.

Montserrado County has reported that it is currently treating 180 cases of Ebola.  There were 13 individuals being monitored by contact tracers that have now become symptomatic.  It is unknown how many of these individuals have been transferred to the ETU.

There was one suspected case from Karnwee town in Nimba County that was diagnosed at the Saclepea Comprehensive Health Center and has been sent to the ETU in Ganta.

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AuthorLiberia Philanthropy Secretariat