Caring for the Sick

Developing nuanced analysis about the location and practices of patient management; involving survivors, caretakers and community leaders in improving home-based and institutionalized care; rights and realities of palliative care; understanding the medical and social implications of triage and isolation; social integration of community based care facilities; developing a continuum of care; supporting sero-discordant mothers and new-borns.

Two evaluations of community Ebola interventions, two different results

This spring, when my team from the Ebola Response Anthropology Platform evaluated Community-Based Ebola Care Centres (CCCs) in Sierra Leone, one thing we constantly heard complaints about was human-resource management. Residents of the communities where the Centres were located grumbled about favouritism: well-paying jobs in the Centres were given to friends and family of the local paramount chiefs. Local health authorities questioned the medical competency of CCC staff. Staff in primary health units complained about unequal pay and benefits. We focused on the views on the development, implementation and 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 →

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 →

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 →

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

European Commission
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 →

Policy Briefing on Community-based Ebola Care Centres

European Commission
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 →

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 →

Community perceptions of Ebola response efforts in Liberia: Montserrado and Nimba Counties

This study aimed to support Oxfam’s Public Health Promotion (PHP) strategy through a rapid qualitative assessment of the remaining social barriers to compliance with Ebola prevention and treatment messages. At the time of the study, most Liberians had a high awareness of Ebola prevention and treatment information. However, new infections continued to occur in “hot spots” around the country. A preliminary assessment suggested that negative perceptions and fear of Ebola response efforts contributed to non-compliance and resistance in some areas. Research activities assessed the sources Continue reading →

Unsung Heroes on the Ebola Frontline

The “selflessness of aid workers and medical volunteers” was praised both by the Queen in her Christmas message and by TIME magazine, who named ‘The Ebola Fighter’s their person of the year 2014. This emphasis on international staff, particularly doctors and nurses, gives a misleading impression about who is doing what in West Africa, and overlooks the huge contribution that national staff are making in their fight against ebola. Even when national staff are recognised, the focus again tends to be on the doctors and nurses, with some attention Continue reading →

Village Responses to Ebola Virus Disease in Rural Eastern Sierra Leone: Second Interim Report

This report provides further output from an anthropological study of 25 villages affected by Ebola Virus Disease in eastern and central Sierra Leone, undertaken as part of the DFID-funded social mobilization initiative for Ebola prevention in Sierra Leone. Eight focus group transcripts for 3 villages in Kenema District are presented, covering local responses to health issues, and Ebola in particular. Supporting material from a matching questionnaire-based study of health behavior and perceived causes of Ebola is also provided. Of particular relevance are two summary tables Continue reading →