Ebola/EVD: Additional Coverage

UNMEER [UN Mission for Ebola Emergency Response] @UNMEER #EbolaResponse
UNMEER’s website is aggregating and presenting content from various sources including its own External Situation Reports, press releases, statements and what it titles “developments.” We present a composite below from the week ending 3 January 2014.

UNMEER External Situation Reports
UNMEER External Situation Reports are issued daily (excepting Saturday) with content organized under these headings:
– Highlights
– Key Political and Economic Developments
– Human Rights
– Response Efforts and Health
– Logistics
– Outreach and Education
– Resource Mobilisation
– Essential Services
– Upcoming Events
The “Week in Review” will present highly-selected elements of interest from these reports. The full daily report is available as a pdf using the link provided by the report date.

:: 02 Jan 2015 UNMEER External Situation Report
Key Political and Economic Developments
1. SRSG Banbury concluded his farewell visit to the three most affected countries in Sierra Leone from 30 to 31 December. He travelled to Bombali District, where he met with members of the District Ebola Response Center and visited three Ebola Treatment Units as well asa Community Care Center. He also met with President Ernest Bai Koroma in Freetown to commend him for his leadership and engagement on the Ebola crisis. . The President thanked UNMEER for the support provided to date, noting its positive impact on the ground. He expressed his hope that Sierra Leone, with the support of the international community, will be able to fully contain the Ebola outbreak by mid-2015 and pursue the economic agenda that had been set.
2. In his New Year’s Day Address, President Ernest Bai Koroma called on the country to begin a week of fasting and prayers to end the Ebola outbreak. The President urged people not to touch the sick or corpses and not to disobey quarantine orders. The President also indicated that schools, which have been closed since July due to the outbreak, would reopen soon.
Resource Mobilisation
11. The OCHA Ebola Virus Outbreak Overview of Needs and Requirements, now totaling USD 1.5 billion, has been funded for USD 1.1 billion, which is around 74% of the total ask.
12. The Ebola Response Multi-Partner Trust

:: 31 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
1. On 29 December, the Prime Minister of Guinea visited the construction site of the new centre for epidemiological research and microbiology funded by the Russian aluminum company Rusal in Kindia. The centre will become part of the Institut Pasteur de Guinée which has secured funding from the Institut Pasteur in France and the French Government to enhance its capacity for surveillance, detection and prevention of infectious diseases in Guinea and the sub-region.
2. On 30 December, three national trade unions in Guinea issued a statement requesting that the government decrease the retail price of gasoline and fuel to reflect the drop in the price of oil in the global market. They have also urged the government to honour its pledges concerning the revised pay scale of civil servants and retirees. This request comes at a time when six other trade unions have threatened to launch
Response Efforts and Health
5. To support the Government of Sierra Leone’s response to the EVD outbreak, the World Bank and UNFPA have designed a joint project to reinforce and scale-up contact tracing, so as to strengthen the existing surveillance system.
7. In Liberia, WHO has identified the growing need for more disaggregated epidemiological data on children affected by the Ebola crisis for cross-cluster planning. Other vulnerable groups (patients, affected families, the elderly and the disabled) should also be considered.
Outreach and Education
16. In Guinea, the prefect of Lola prefecture conducted a sensitization mission in the village of Thuo on 30 December to address community resistance. Thuo has seen a flare-up of EVD cases in the past ten days and 2 new suspected cases were transferred today to the ETC in Nzérékoré. Members of the local community have reportedly threatened EVD response partners who have mostly left the area due to the tensions. The return of response partners is pending the outcome of the prefect’s mission. Save the Children has begun identifying 40 children in Thuo who have lost one or both parents to EVD with the aim of providing protection, but they will only deploy after a lifting of community resistance in Thuo.
17. Similarly, on 29 December, the prefectural coordination in Nzérékoré prefecture, Guinea, deployed a sensitization mission to the resistant communities of Banzou North and Zeremouda. The mission faced difficulties in engaging in dialogue with the members of the local community in both areas. UNMEER’s FCM covering Nzérékoré is following up to ascertain the reasons for resistance in these specific communities.
Essential Services
19. In Sierra Leone, the World Bank and UNFPA have developed a joint project to support the Government of Sierra Leone to establish appropriate arrangements to revitalize Reproductive, Maternal, Adolescent and Newborn Health (RMANH) services in the context of Ebola.
20. In Liberia, the Ministry of Health with support from UNFPA is conducting fistula prevention awareness in two counties (Margibi and Grand Bassa). UNFPA also hired a local NGO (Liberia Prevention Maternal Mortality) to conduct Maternal and Newborn Health (MNH) needs assessments in 20 health facilities in four Counties (Montserrado, Cape Mount, Margibi and Grand Bassa).

:: 30 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
2. The Minister of Health of Guinea is continuing his sensitization and oversight mission in EVD affected prefectures. On 27 December, the minister took part in the prefectural coordination meeting in Nzérékoré, attended by the main response partners. The prefectural coordinator gave a briefing on the current situation, highlighting challenges including persistent resistance in communities in Sadou, Banzou North, Baya and Zenemouda; insufficient supply of thermo flash thermometers; lack of equipment and electricity; lack of an office for the prefectural coordination; and weak coordination among response partners. Concerning local resistance, the minister advised that partners must enable community members to take ownership of the sensitization process to engage their respective communities. Concerning the Community Watch Committees (CWCs), response partners briefed the minister that a number have been established but their members have not yet received training and are not operational. The minister stressed that partners involved with the CWCs had to work faster and he warned that alternative measures would be taken in case partners could not deliver on the operationalization of CWCs. He also encouraged response partners to better integrate their activities under the umbrella of the prefectural coordination and to increase their actions in the field where flare-ups and resistance are persistent.
Response Efforts and Health
4. UNDP has made additional incentive payments to 758 health personnel working in four ETUs in Guinea, ensuring their continued engagement in saving patients. The agency was requested by Guinea’s National Coordination Unit against Ebola to complete existing salaries with incentive pays for the French Red Cross, Doctors without Borders and Alima, three Non-Governmental Organizations (NGOs) operating ETUs in Donka, Macenta, Kissidougou and Nzérékoré. Together with UNMEER and the World Bank, UNDP assisted the Ministry of Health in harmonizing incentives, and ensured that US$ 220,000 were deposited in local banks.

:: 29 Dec 2014 UNMEER External Situation Report
KEY POINTS
– A field hospital donated by Israel will be established as an Ebola Treatment Unit (ETU) in Dubreka, Guinea.
– UNICEF joined partners in engaging the population of the quarantined and neighboring villages of Lonfaye town and Yekepa town, Liberia, following two separate outbreaks there.
– In response to measles cases in Lofa county, Liberia, the UNICEF-supported periodic intensification of routine immunization, or PIRI, is ongoing across all of the 15 counties.
Response Efforts and Health
3. On 26 December, the National Ebola Response Coordinator informed UNMEER that a field hospital donated by Israel would be established as an ETU in Dubreka, Guinea. He added that the target opening date was 15 January. This ETU and the one in Coyah will help relieve the caseload on the ETU in Conakry (Donka) coming from prefectures adjacent to the capital.
4. According to recent data from the Liberian health ministry, there have been at least 1,042 confirmed cases of children with EVD in the country. The number of children identified by name and location as orphaned by EVD is 4,115. All of the children identified are currently receiving follow-up and psychosocial support. Over 250 volunteer contact tracers, trained and engaged by UNICEF, are now reporting cases of children orphaned or otherwise affected by EVD. UNICEF is working to ensure that children who have lost their parents due to EVD continue to receive care through a kinship arrangement. That way children may be from becoming institutionalized, for example in an orphanage.
Essential Services
15. West Africa’s fight to contain EVD has hampered the campaign against malaria, which is a fully preventable and treatable disease. In Guéckédou, Guinea, doctors have had to stop pricking fingers to do blood tests for malaria. Bernard Nahlen, deputy director of the US President’s Malaria Initiative, said Guinea’s 40% drop in reported malaria cases this year is likely because people are too scared to go to health facilities and are not getting treated for malaria. Nets for Life Africa, a New York-based charity that provides insecticide-treated mosquito nets, said some 15,000 Guineans died from malaria last year.
16. In response to measles cases in Lofa county, Liberia, the UNICEF-supported periodic intensification of routine immunization, or PIRI, is ongoing across all 15 counties. The goal is to rapidly reduce the number of unimmunized children against measles. This intensification comes in lieu of an immunization campaign, which is not recommended in the EVD context. Vaccinators are being trained simultaneously across the country on infection prevention and control measures, supervision during PIRI and on how to conduct outreach sessions in remote areas. In addition, UNICEF provided basic infection control kits, including infrared thermometers, to 500 health facilities providing immunization services in Liberia.

:: 26 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
1. Sierra Leone has declared a lockdown of at least three days in the north of the country to try to contain an EVD flare-up there. Response workers will go door to door to look for suspected cases of EVD. Shops, markets and travel services will be shut down. Sierra Leone had already banned many public Christmas celebrations. Alie Kamara, resident minister for the Northern Region, indicated that “muslims and christians are not allowed to hold services in mosques and churches throughout the lockdown, except for christians on Christmas day”. No unauthorized vehicles will be allowed to operate, except those officially assigned to EVD-related assignments. The lockdown is scheduled to last for at least three days, but this could be extended if deemed necessary.
10. The Liberian health ministry has received permission from the World Bank to release funds for the payment of workers’ salaries to the counties. Unfortunately the pre-Christmas deadline was missed, but the plan to pay all workers in the counties through banks and off-site payments is being completed by the government. UNDP will support the teams financially and logistically to execute the payments, which are planned over several days and are expected to begin through the holiday period. Separately, funds that had been provided to banks in time were not paid to contact tracers and active case finders by the 23rd, due to banks’ liquidity issues. There were demonstrations at the health ministry as a result.
11. UNDP has received a request to pay more than 400 workers in Montserrado, Liberia, including staff of the newly established IMS for the county. UNDP, as a provider of last resort, will seek to ensure that all other avenues for payment have been exhausted before committing to these payments.
Essential Services
21. From 10-16 December, as part of the Integrated Management of Acute Malnutrition (IMAM), a total of 18,885 children under 5 were screened at the community level in 64 out of 149 chiefdoms (389 communities) in Sierra Leone. 506 were referred for treatment at the Peripheral Health Units that provide nutrition treatment services.

:: 24 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
1. The director of the US Centers for Disease Control and Prevention (CDC), Dr. Tom Frieden, said on Monday that even though the number of cases in West Africa has not reached worst-case scenario predictions, the world remains at risk until it drops to zero. “I’m hopeful about stopping the epidemic, but I remain realistic that this is going to be a long, hard fight”, he said. On his recent visit to Liberia, Guinea and Sierra Leone, Dr. Frieden said he had seen “real momentum and real progress” in combating the virus. “I am hopeful that we are going to see continued progress. The challenge is not to let up, not to be complacent and to really double down”. Asked about the CDC’s report in September that in certain scenarios, EVD cases could reach 550,000 by January, Frieden replied: “The projections we released a few months ago showed what could happen if nothing more were done – in fact an enormous amount has been done.”
2. Peter Piot, a leading researcher who helped to discover EVD, has also said that the EVD crisis is likely to last until the end of 2015, warning that vaccines would take time to develop. Professor Piot was one of the scientists who discovered EVD in 1976 and is now director of the London School of Hygiene and Tropical Medicine. He said that even though the outbreak has peaked in Liberia and was likely to peak in Sierra Leone in the next few weeks, the epidemic could have a “very long tail and a bumpy tail”. Piot stated: “We need to be ready for a long effort, a sustained effort for probably the rest of 2015.” But he added that he was impressed by the progress that he had seen on a recent visit to Sierra Leone: “Treatment units have now been established across the country. You don’t see any longer the scenes where people are dying in the streets”.
Response Efforts and Health
5. A Nigerian peacekeeper diagnosed with EVD, who had been evacuated to the Netherlands for treatment, has recovered and has returned to the UN mission in Liberia. The peacekeeper will resume duties while undergoing monitoring and psychological counseling. The man arrived in the Netherlands earlier this month. The Netherlands has followed Germany, France and Switzerland in taking on EVD patients at the request of the World Health Organization.

:: 23 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
1. The United Nations must learn lessons from the EVD crisis and begin preparing now for the next outbreak of a deadly disease, Secretary-General Ban Ki-moon said in New York after returning from a visit to West Africa. “We must learn the lessons of Ebola, which go well beyond strengthening public health systems”, Ban stated. “The international community needs better early warning and rapid response.” The UN chief said he will launch a serious effort to “explore what more we can do to stay ahead of the next outbreak of disease — a test that is sure to come.” Ban also called for recovery efforts to be stepped up in West Africa in order to rebuild shattered economies, get children back in school and begin caring for EVD orphans.
2. Sierra Leone is withdrawing its troops from Somalia after the African Union blocked the West African country from rotating its soldiers over fears for EVD. Sierra Leone sent 850 troops to Somalia in 2013 for a 12-month deployment to fight jihadist terrorist group al-Shabab. Their rotation was delayed after a group of 800 soldiers, who were waiting to replace their comrades in Somalia, were quarantined after one of the soldiers was tested positive for EVD. In August, Somalia’s President Hassan Sheikh Mohamud said no new troops from Sierra Leone will be deployed to his country after calls by activists and a campaign on social media by Somalis calling for a halt to the deployment.

:: 22 Dec 2014 UNMEER External Situation Report
Key Political and Economic Developments
1. United Nations Secretary-General Ban Ki-moon made a three-day tour of the region on Friday and Saturday, visiting Liberia, Sierra Leone, Guinea, Mali and Ghana. He met with the leaders of those countries as well as with survivors of Ebola Virus Disease (EVD), healthcare workers and UN staff. In Liberia, the SG participated in an Incident Management System (IMS) meeting with EVD response partners, where he discussed current trends and the next steps in the response. He warned against complacency at what remains a critical time. The Secretary-General also visited several treatment facilities. On his visits he was accompanied by the Director General of WHO, Dr. Margaret Chan, the UN Special Envoy on Ebola, Dr. David Nabarro, and the Head of UNMEER, Anthony Banbury.
2. In Guinea, Secretary-General Ban Ki-moon warned about rising EVD infection rates in the south-east of the country. While infection rates in Liberia, one of the nations hardest hit by the outbreak, have been slowing, other areas have registered an uptick in the rate of the disease’s progress. Infection rates in south-eastern Guinea, the region where the deadliest outbreak in history began a year ago, have also failed to decline substantially. Solid cross border collaboration is necessary to prevent a resurgence of the epidemic, Ban said in Conakry. The Secretary-General also warned of the serious socio-economic consequences the outbreak is likely to have in the affected countries. “While our immediate priority is to stop the spread of the disease, it is not too early to start thinking about recovery,” Ban said. “We must scale up our efforts to restore basic social services, strengthen health services, support economic activity and build up the countries’ resilience.”
3. In Sierra Leone, Ban Ki-moon met Rebecca Johnson, a Sierra Leonean nurse who caught the virus but survived. She recounted how she fell gravely ill, recovered and is now back treating EVD patients. Ban said he was moved by Johnson’s story, especially that she still faced a stigma as a survivor. “There should be no discrimination for those who have been working or helping with Ebola. Those people are giving all of themselves,” Ban said. He also made it clear that UNMEER is intended to be a short term mission: “My intention is not to keep UNMEER longer than one year. If that isn’t the case, people will regard it as a failure”.
Response Efforts and Health
6. Last week, in support of quarantined households in the Western Area of Sierra Leone, UNICEF has distributed 2,580 jerry cans, together with a 21-day supply of aqua tabs. To date, UNICEF has provided around 6,648 quarantined households with 23,720 jerry cans and 254,643 aqua tabs, benefiting 40,164 people in quarantined households and communities. Supplies have been distributed through WFP packages. UNICEF also delivered a total of 184,000 litres of safe water to two 100-bed EVD treatment centers, while setup work is ongoing in two new 24-bed Community Care Centers (CCCs) in the Western area. UNICEF, with its partners, has also ensured that 12 newly constructed CCCs were fully stocked with Water, Sanitation and Hygiene (WASH) packages.
7. In Sierra Leone, UNDP has supported the payment of hazard pay entitlements for 16,000 EVD workers in five days, through a mobile cash transfer system. With concurrent support to the government of Sierra Leone by UNDP, the World Bank and the African Development Bank, policy and guidelines are being drafted to streamline the system.
Outreach and Education
15. Last week, 8,220 households in Liberia were reached through door-to-door campaigns with EVD prevention messages as well as through 167 meetings and group discussions, reaching 13,787 women, 11,142 men and 8,912 children across all counties. 675 community leaders and elders were engaged.
16. In the first week of December, 1,414 social mobilizers were trained by UNICEF in Sierra Leone. 48% were women and 44% were less than 25 years old. Participants were trained on topics including infection prevention and control, home protection, safe burial practices, and quarantined households. 370 religious leaders and 65 paramount chiefs were sensitized to support social mobilization activities in 8 districts. Social mobilizers engaged by partners reached 5,867 households to disseminate key messages and sensitize the community.