Field Notes

Examples of practice from the field.

The first mile: community experience of outbreak control during an Ebola outbreak in Luwero District, Uganda

Background: A major challenge to outbreak control lies in early detection of viral haemorrhagic fevers (VHFs) in local community contexts during the critical initial stages of an epidemic, when risk of spreading is its highest (“the first mile”). This paper documents how a major Ebola outbreak control effort in central Uganda in 2012 was experienced from the perspective of the community. It asks to what extent the community became a resource for early detection, and identifies problems encountered with community health worker and social mobilization strategies. Continue reading →

Community Led Ebola Management and Eradication (CLEME)

The CLEME (Community Led Ebola Man- agement and Eradication) programme aims at triggering the behavioural change needed by the communities to strengthen community resilience to the outbreak and prevent further resurgence by ensuring real and sustainable improvements through: Providing the communities with the means to conduct their own appraisal and analysis of the Ebola outbreak, their safety regarding the disease and its con- sequence if nothing is done; Instilling a feeling of urgency in engaging in community actions that will prevent the community experiencing infections; Supporting Continue reading →

Terms of Reference: Individual or team to conduct assessment of Ebola contact tracing mHealth application

A team of researchers from the London School of Hygiene & Tropical Medicine and Innovations for Poverty Action Sierra Leone developed a study evaluating the use of mobile technology in improving the process of tracing contacts of Ebola patients in Sierra Leone. As part of this study, the team, with the help of a developer, designed a customized application using Dimagi’s CommCare that has been implemented in the district of Port Loko. The research team seeks an individual or small group of mHealth experts to Continue reading →

Understanding why ebola deaths occur at home in urban Montserrado County, Liberia

Ebola Virus Disease (EVD) home deaths occur as the result of infected persons not being detected early and sent to Ebola Treatment Units (ETU) where they can access care and have an improved chance of survival. From a public health standpoint, EVD deaths should not occur at home. Individuals suspected of being infected with EVD should be identified through case investigations or contact tracing efforts and then referred to an ETU, thus decreasing their risk of dying as well as minimising the risk of exposing Continue reading →

Ebola: demanding accountability and mobilizing societies to avoid a deadly relapse

The enduring Ebola epidemic has taught the world some hard lessons over the last 12 months, which we must take to heart. Despite early warnings, and the extraordinary efforts of local healthcare workers and private medical humanitarian organisations, the epidemic has exposed the institutional failures that saw the Ebola outbreak spiral far out of control, with tragic and avoidable consequences. In particular, we should reflect on the role civil society must play in response, and how it can spur on mandated international bodies to shake Continue reading →

Community-Based Ebola Care Centres: A Formative Evaluation

The Ebola outbreak in West Africa differed from others in its unprecedented size and the high proportion of human-to-human transmission occurring in the community. This report presents an analysis of the impact of Community Care Centres (CCCs) on communities in Sierra Leone. Much has been written about the leadership and coordination of the response – or the lack of it. The emphasis of this evaluation is on the views on the development, implementation and relevance of the CCCs from the perspective of the communities next Continue reading →

Managing health crises after Ebola

The outbreak of Ebola that has affected West Africa since December 2013 is the largest to date, with enormous human and economic costs. It has also exposed weaknesses in the global response system, including the handling of communication and complex social responses. What can we learn from this to better manage future health emergencies? This Spotlight presents an in-depth analysis including opinions, facts and figures, and key resources. It features commentary by Sylvie Briand of the WHO, Rosamund Southgate of Médecins Sans Frontières and Annie Continue reading →

A year on, Guineans finally lay Ebola souls to rest

GUECKEDOU, 28 April 2015 (IRIN) – Forty-six-year-old Maurice Ouendeno stares silently at the arm of his blue plastic lawn chair. He waits a few minutes before beginning his story. “They said we did not have the right to bury him,” he says, finally looking up. Sadness, mixed with a bit of anger, flashes briefly across his face. “We understood why, but it was painful. It was so painful not to be able to give him the send-off he deserved.” His father, Tamba Lamine Ouendeno, died Continue reading →

Village Responses to Ebola Virus Disease and its Prevention

The present document is the eighth and final report in a series presenting descriptive results of a survey of responses to Ebola and Ebola control in 26 villages in all three provinces of rural Sierra Leone, fieldwork for which was undertaken in December 2014. The report covers three villages in Gbo chiefdom, in Bo District. Some emphasis is placed on how inconsistencies of Ebola response are perceived at local level, and undermine trust. Ebola responders should not only improve the quality of their messages, but Continue reading →

Ebola’s Ecologies – Limn January 2015 Issue

This issue of Limn on “Ebola’s Ecologies” examines how the 2014 Ebola outbreak has put the norms, practices, and institutional logics of global health into question, and examines the new assemblages that are being forged in its wake. The contributions focus on various domains of thought and practice that have been implicated in the current outbreak, posing questions such as: What has been learned about the ambitions and the limits of humanitarian medical response? What insights are emerging concerning the contemporary organization of global health Continue reading →