For the week of October 1st- 5th, the data released in the Government of Liberia’s’ (GoL) Ministry of Health and Social Welfare (MOHSW) report included information on improvements in Ebola case reporting and focused on the numerous trainings that are being conducted.
International and National technical assistants arrived in many of the counties in order to provide training and support to medical staff and supervisors. Trainings are being conducted by groups including the CDC, Peace Corp and the Liberian Scout association among others. The trainings range in content from proper burial practices to Ebola prevention measures.
Currently there is no uniformity in terms of how trainings are conducted or by whom. While most counties now have regular international support staff training medical personnel and building a base of local experts to assist in further training community members, to date we have seen minimal collaboration. This raises concerns about messaging and ensuring that the information reaching all of the counties is accurate and relevant.
Based on the data from the National Reference Lab, there has been a decline in the number of Ebola cases that were confirmed positive through the first week of October. In this chart we see a variation in the total number of samples tested, but of those tested there is a decline in cases found positive for Ebola. One of the possible reasons for the variation in number of samples being taken may be due to low supplies and problems with transportation, as have been reported in Sinoe.
At the Arcelor Mittal hospital in Nimba County there was only one new reported case of Ebola and there were two patients that were referred to the Ebola Treatment Unit (ETU) were discharged. The hospital also sponsored the training of 17 new contact tracers. In Bomi County there were 6 patients that are in the holding center waiting to be transferred to a treatment facility. Additionally, in several communities it’s believed that families are still hiding sick family members in their homes. The CDC is currently working to help train medical personnel. The picture below shows the isolation ward that is currently being used for sick patients. Health workers at the Bong ETU went on strike this week and were demanding better incentives for their work caring for patients with Ebola. There have been unprecedented numbers of health care professionals getting ill, making their work very risky for them and their families. Meetings are being held among the CHSWT, IMC and other partners to resolve the health workers boycott.
Edward B. Kesselly Military Barrack located in Montserrado county has been a hub for training. The Health Promotion division that is part of the Ministry of Health has utilized these facilities to train 42 members of the Liberia Scout association, and educate over 25 new trainers from the military and civilian communities. An important milestone was also met this week, with all Montserrado ETU’s having reported their data using the new standardized forms. These forms allow the government to more accurately track ebola cases and monitor follow-up appointments with individuals who have come in contact with an ill person.
There is an urgent need in Grand Kru County for Personal Protective Equipment (PPE) where supplies are running low. The CHSWT received two new vehicles that will be used to assist the disinfection and burial teams but in order to maintain these operations PPE’s are also needed.
The distribution of drugs and supplies to health facilities in Sinoe county has continued but there is a shortage of test tubes needed for taking blood samples. Cheborken Town in Jedepo district has been quarantined by the local authorities after they were likely exposed to an infected individual and are refusing specimen collection and are not following safe burial guidelines. Material supplies are being received, like the vehicles from UNDP and UNMIL, but there are still critical needs, like the test tubes that need to be met.
One of the areas that needs increased attention to help slow the virus is community outreach. Reports of high rates of disbelief about Ebola from River Gee county, and the quarantine that went into effect in Cheborken town highlight the need for increased cooperation and communication with communities.
A new holding center has been constructed at the Pleebo Health Center, however Maryland county is one of the few areas that has reported no training activities. They have a strong need for contact tracers, burial materials, as well as designated transportation for Ebola patients and the specimen samples that must get to Monrovia for case confirmation.
There have been several thermo-monitoring checkpoints for travelers in Grand Cape Mount County in an effort to stop the spread. An additional burial team was trained in Sinje, where 6 new deaths were also reported.