Africa APPG inquiry: Community led health systems & the Ebola outbreak

The Ebola crisis of 2014-15 has brought questions around the roles of communities and health systems into sharp relief – both in relation to crisis response, and to the challenges of post-crisis recovery and building resilience to future epidemics. The Institute of Development Studies is pleased to make this submission to the APPG inquiry on these crucial questions. This submission draws upon this work and highlights the need for developing health systems and health crisis response mechanisms that actively seek, engage and adapt to local Continue reading →

Aid agencies must continue to adapt to changing demands of Ebola crisis

Some of the UK’s leading aid agencies’ prevention work, such as safe burials and awareness raising, in response to the Ebola epidemic in Sierra Leone is “impressive” but must continue to adapt to the changing situation in West Africa, an independent review of the DEC response said today. The Ebola crisis appeal response review conducted in March 2015 by the Institute of Development Studies for the DEC found that member agencies utilised their existing networks and relationships in Sierra Leone to scale up programmes after Continue reading →

Ebola Crisis Appeal – Response Review

This is the review of the Ebola Crisis Appeal Response in Sierra Leone of the Disasters Emergency Committee (DEC) that unites 13 of the largest UK humanitarian charities to raise funds in response to major international humanitarian crises. The review team consisted of an external team leader, a DEC member representative and the DEC chief executive with complementary roles and expertise. Fieldwork took place from 8th to 18th February. The team visited Freetown and Western Area, Port Loko Bombali, and Tonkolili. They used semi-structured questionnaires to Continue reading →

Special Report: Why Sierra Leone Can’t Get Rid of Ebola

Dr. Ernest Bai Koroma, the president of the Republic of Sierra Leone, was having trouble “getting to zero,” and his underlings were getting antsy. “We need one more push,” said Major Palo Conteh, the commander of Sierra Leone’s National Ebola Response Centre (NERC) and a former Olympic quarter miler. “It’s like in the 400 meters when you’re 20 meters from the finish line, that’s the time to kick hard.” Brigadier General David Taluva, a jovial officer with the physique of a shot putter, had other Continue reading →

Never Again: Building resilient health systems and learning from the Ebola crisis

It took the threat of a global health crisis to illustrate the failings of Africa’s health systems. Resilient health systems, free at the point of use, are evidently a global public good. They are essential for the provision of universal health coverage and for a prompt response to outbreaks of disease. Resilient health systems require long-term investment in the six key elements that are required for a resilient system: an adequate numbers of trained health workers; available medicines; robust health information systems, including surveillance; appropriate Continue reading →

Ebola can be transmitted sexually for weeks after recovery – education is crucial

Conflicting messages on the length of time that Ebola remains in semen after recovery make education and prevention confusing. We need to avoid mixed messages and focus on girls’ rights, says anthropologist Pauline Oosterhoff. When I met members of a women’s secret society in Sierra Leone this February, they proposed drastic measures to stop Ebola from spreading through sexual contact. All survivors should be quarantined for three months, they said. Male survivors need to be locked up because they cannot control their urge to have sex. Women Continue reading →

Policy Briefing on Community-based Ebola Care Centres

A component of the Ebola epidemic control policy in Sierra Leone is triage and isolation in decentralised Community Care Centres (CCCs) or Holding Units, from where transfer to Ebola treatment units (ETUs) is arranged for those diagnosed as positive. The epidemic is currently waning, there are sufficient beds in the ETU, yet new micro-epidemics emerge, raising questions about the future role and relevance of the CCC. This briefing summarizes the preliminary findings of a formative evaluation conducted by the UK based Ebola Response Anthropology Platform 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 →

How Ebola infection spreads and terminates in rural Sierra Leone

Ebola is a new disease in Upper West Africa. Populations have taken time to learn the nature of the risk it poses. Persons carrying infection initially do not know that they have the sickness. They carry out their daily activities, and seek help from their families and traditional remedies when and where they become symptomatic. Nearly all infection, so far as is known, is associated with the “wet” phase of the illness and handling the corpse of a deceased victim. This period of major infection Continue reading →

What causes Ebola Virus disease?

The four villages in this report are found on the edge of the Gola Rainforest National Park, Sierra Leone and have been studied by members of the present team at intervals since 1987. The aim of this long-term study was to understand social composition and social change in forest-edge communities, and how these communities were adapting to conservation rules and opportunities. These villages have now been restudied as part of the SMAC community mobilization program for prevention of Ebola Virus Disease. This study, which was Continue reading →