Healthcare in LiberiaThe 2014-2016 Ebola outbreak in West Africa killed more than 4,800 people in Liberia and infected thousands of others. However, these data points only scratch the surface of Ebola’s effect on healthcare in Liberia. Ebola’s devastation affected the provision of healthcare services in West Africa and caused an additional 10,600 deaths due to HIV, tuberculosis and malaria. In countries such as Liberia, more medical training and equipment means healthcare in Liberia has strengthened since the Ebola outbreak. Ebola exposed the weaknesses in the healthcare system of Liberia and showed the Liberian government and international aid organizations particular areas needing improvement and reform.

The World Bank’s Involvement

After recognizing the struggles of Liberia’s healthcare system during the Ebola epidemic, the World Bank devised specific ways to assist Liberia. For example, in May 2020, the World Bank approved the Institutional Foundations to Improve Service for Health Project for Liberia (IFISH). The four-component program focuses specifically on improving health services and outcomes for women, children and adolescents. The six-year program costs $84 million, of which $54 million of funding comes from the United States. Roughly 50% of the budget will be dedicated to health facilities and construction in Liberia. The program also attempts to lay the groundwork for future Liberian healthcare officials. The program includes training health workers and financing certain undergraduate and postgraduate faculties.

The Yale Capstone Project

For multiple years, the Yale Jackson Institute for Global Affairs has worked alongside the Yale Global Health Institute to create a project-based global health course for Yale seniors. The program allows students to explore the intersection of public health and policy. The students of this program have contributed to recovery efforts in Liberia. The program has assisted in establishing proof to encourage partners and policymakers to undertake significant changes in Liberia’s main medical school. The 2015 class conducted case studies on Rwanda and Ethiopia to generate targeted policy solutions in Liberia. Overall, the partnership was deemed a “win-win” for Liberia and the students involved.

CDC Field Epidemiology Training Program

The Centers for Disease Control and Prevention (CDC) has been actively aiding healthcare in Liberia since 2007. However, it did not expand its Liberian focus until the Ebola outbreak. Accompanied by more traditional CDC programs such as malaria intervention and the provision of vaccines, Liberia receives assistance through the CDC’s Field Epidemiology Training Program (FETP). The three-tiered educational initiative aims to equip Liberian healthcare workers with the knowledge and tools to investigate and respond to disease outbreaks. At the close of 2016, Liberia had 115 FETP-trained staff. The FETP graduates will go on to provide field support in response to disease outbreaks across Liberia. With graduates from all 15 counties and 92 health districts in Liberia, fellows of FETP work to contain outbreaks and prevent them from turning into local or global epidemics.

Room for Improvement

Healthcare in Liberia is improving due to Liberia’s coordinated recovery efforts with multiple organizations. Nevertheless, Liberia still battles with increasing civilian access to healthcare and the funding of critical health institutions. For example, two-thirds of rural families need to travel for more than an hour to access a health center. These extended travel times can significantly impact the healthcare outcomes of Liberians. Moreover, hospitals are struggling to survive because funding from donors has slowed since the Ebola outbreak. In Liberia’s health system, primary healthcare facilities are largely underfunded.

While these struggles persist, they should not overshadow the significant improvements made since the Ebola outbreak. With aid, commitment and effort, healthcare in Liberia can improve further.

– Kendall Carll
Photo: Flickr

2021 Ebola Outbreak In February 2021, the West African country, Guinea, announced that it was facing an outbreak of the Ebola virus, the first the country has seen since the 2013-2016 outbreak. However, this time around, the 2021 Ebola outbreak may be different than that of five years ago.

What is the Ebola Virus?

The Ebola virus is a hemorrhagic fever that is often fatal with a mortality rate that is anywhere from 25% to 90%. The disease spreads through contact with bodily fluids. Ebola survives in nature by spreading between forest-dwelling bats and some other animals, though it sporadically transmits to humans when contact is made with a diseased carcass. Before the epidemic in 2013, most previous Ebola outbreaks occurred in rural communities with cases in the single or double digits.

Previous Ebola Outbreaks

The 2013-2016 epidemic was the largest Ebola outbreak by an unprecedented margin and was the first time the World Health Organization (WHO) considered the disease a major global public health threat. The epidemic, which also began in Guinea, took hold quickly and easily for many reasons. There had previously been no outbreaks of Ebola in West Africa. This caused people to assume the symptoms were that of Lassa fever, a more common disease in the region. The virus had been circulating for three months before the World Health Organization declared an outbreak in March of 2014.

The disease quickly spread within and around Guinea since the systems for contact tracing and containment were weak. By July 2014, it had reached the capital of Guinea, Conakry, and the neighboring capitals of Sierra Leone and Liberia. Funerary traditions and rituals increase transmission because they include touching and spending time with the dead body so traditional burial practices were forbidden.

By the time the WHO designated the virus a Public Health Emergency of International Concern, it was borderline out of control. By the end of the epidemic, Ebola had erupted in Guinea, Sierra Leone and Liberia. The disease also spread to other countries in Africa, Europe and the U.S. This resulted in nearly 30,000 cases with more than a third of fatalities.

The 2021 Outbreak of Ebola

In February 2021, one Ebola case was confirmed in the village of Goueke in the southeastern region of Guinea. As of March 3, 2021, the number has reached 17 reported cases, 13 of which are confirmed, along with seven deaths.

However, there is less cause for concern than there was five years ago. Though Guinea’s healthcare system needs improvement, past mistakes and experiences have prepared the region better than ever. The world is certainly better positioned to successfully manage the most recent Ebola outbreak.

Reasons for Optimism

  1. Speed: WHO personnel are already working with the Guinean healthcare system to squash the virus before it becomes a major outbreak. A week after the first case was reported, people began setting up testing sites, contact tracing and treatment facilities. Efforts were also made to improve community engagement to stop the spread.
  2. Prevention: President George Weah of Liberia and the WHO are taking preemptive measures to prepare Liberia and Sierra Leone for the possibility of the spread of the virus.
  3. Science: Since the last major outbreak, the WHO has approved two vaccines for use against the Ebola virus. In fact, unlike the last time, when there was no vaccine at all, 500,000 vaccines are ready to be delivered wherever there is an outbreak. The Guinean health ministry has already set up three vaccination sites in the region near the outbreak and had vaccinated more than 1,000 people at the end of February 2021. It is also using a system called ring vaccinations. This interrupts the spread by vaccinating people directly connected to an Ebola case.
  4. Precedent: There have been outbreaks of Ebola since 2016, and thanks to the above, none have gotten out of control. When the DRC had an outbreak in 2018-2020, nearly 50,000 people were already vaccinated, slowing the spread. Many other countries have approved the vaccines in preparation for a possible outbreak within their own borders.

Global panic arises whenever a deadly disease resurfaces in impoverished communities. However, sufficient preparedness, resources and lessons learned will likely ensure the 2021 outbreak of Ebola is short-lived.

Elyssa Nielsen
Photo: Flickr

ErveboIn 2014, an outbreak of Zaire ebolavirus in the West African countries of Guinea, Liberia and Sierra Leone resulted in more than 28,000 cases and 11,000 deaths. Ebola virus disease (EVD) outbreaks were documented since the 1970s. However, the widespread nature of the 2014 epidemic caused global fear. Many countries responded by imposing travel restrictions against West African nations. Fortunately, the U.S. Food and Drug Administration approved the first Ebola vaccine (Ervebo) in December 2019.

10 Facts About the Ervebo Ebola Vaccine

  1. Trials began in 2018. The World Health Organization (WHO) and the Democratic Republic of the Congo (DRC) began to trial Ervebo in 2018 as an investigational vaccine under an expanded access program. The DRC experienced the world’s second-largest Ebola outbreak. The vaccine use aimed to prioritize people most at risk such as healthcare workers.
  2. Roughly 290,000 people received vaccinations. In response to the Ebola outbreak in the DRC, more than 290,000 people have received the Ervebo vaccination under compassionate use protocols. Compassionate use allows for the limited allocation of an unlicensed vaccination due to a dangerous public crisis.
  3. Ervebo is 100% effective. A study in Guinea during the 2014-2016 outbreak indicates that Ervebo was 100% effective for individuals 18 and older. In a comparison of cases, Ervebo was 100% effective in preventing cases of Ebola with symptom onset more than 10 days after inoculation. The comparison involved 2,108 participants in an “immediate” vaccination group and 1,429 participants in a “delayed” vaccination group.
  4. Trials outside of West Africa. In addition to West Africa, trials of the Ebola vaccine occurred in Canada, Spain and the United States. Because Ebola is not endemic to Europe or North America, researchers wanted to measure the antibody response among individuals with no history of previous exposure. The antibody responses among participants in Canada, Spain and the U.S. were close to that of individuals in Liberia and Sierra Leone.
  5. Ervebo is safe for all participants. Roughly 15,000 individuals in Africa, Europe and North America were part of vaccine trials. The trials determined that the vaccine is safe and effective for all individuals. Individuals reported only minor side effects.
  6. Ervebo is a single-dose vaccine. Ervebo is a single-dose injection that does not require boosters. This allows for faster distribution and protection against EVD. The vaccine is a “live, attenuated vaccine that is genetically engineered to contain protein from the Zaire ebolavirus.”
  7. The vaccine received priority review. Due to the importance of developing an Ebola vaccine as a public health measure, Ervebo received a priority review and a tropical disease priority review voucher by the FDA under a program supporting the development of new drugs for the prevention and treatment of tropical diseases. Ervebo also received a breakthrough therapy designation to assist with the development of the vaccine. The FDA worked closely with the company, Merck & Co., Inc., and completed the evaluation in less than six months.
  8. The vaccine will be available to those most in need. Due to limited supplies of Ebola vaccines, Ervebo will be available as part of a ring vaccination strategy during future outbreaks. This strategy means that those most at risk will receive first priority. Vaccination efforts will start with people like healthcare workers and extend outward to other members of the community.
  9. A global stockpile will be available in January 2021. Beginning in January 2021, a global stockpile of the vaccine will be available through the International Coordinating Group (ICG) on Vaccine Provision. The ICG also manages stockpiles of cholera, meningitis and yellow fever vaccines and will be responsible for decision-making on allocation.
  10. Four African countries have licensed the vaccine. In February 2020, the Democratic Republic of the Congo (DRC), Burundi, Ghana and Zambia licensed the Ervebo vaccine. The license means the manufacturer can stockpile and widely distribute the vaccine within these countries. No further research or clinical trials are necessary with a license.

The Future

One cannot undo the damage of past outbreaks but the Ervebo Ebola vaccine may be a valuable tool for future Ebola prevention efforts. As the vaccine becomes widely available in future years, the World Health Organization hopes the population of West Africa will achieve herd immunity against the disease, eradicating the spread of EVD. The technology used in the development of the Ebola vaccine will also aid in the quick development of vaccines for future global outbreaks. As the world continues to struggle against COVID-19, the success of Ervebo provides a blueprint for the prevention and mitigation of future epidemics.

Eliza Browning
Photo: Flickr

5 Ways the DRC Can Slow the Spread of COVID-19
On November 18, 2020, the World Health Organization (WHO) and government officials in the Democratic Republic of the Congo (DRC) announced the end of the latest Ebola outbreak. This outbreak started in June 2020 amid the COVID-19 pandemic and was the 11th Ebola outbreak in the DRC since the first recognition of the disease in 1976. “It wasn’t easy, but we’ve done it!” tweeted the Regional Director of WHO, Dr. Matshidiso Moeti. The DRC, one of the most impoverished countries on earth, emerged from the wake of the most recent Ebola outbreak after learning some important lessons. The information gained from this occurrence has offered insight that can help slow the spread of COVID-19 on a global scale.

At the start of the pandemic, the country’s COVID-19 mortality rate was 10%. In just six months, that rate decreased to 2.5%. Here are the five key components the DRC discovered are vital in its attempt to slow the spread of a viral outbreak.

5 Ways the DRC Can Slow the Spread of COVID-19

  1. Community engagement is of extreme importance in slowing the spread of COVID-19. The Ebola aid response initially failed due to significant mistrust from people in the communities that needed help. The continuous conflict between the militant groups and the government made it difficult to earn the trust of DRC citizens. As the outbreak grew, aid workers realized that spending more time directly engaging with individuals in affected communities made them more trusting. Workers built confidence by increasing the community’s knowledge of the virus. Engagement from spiritual advisors, educators and other community leaders in addition to politicians and law enforcement is essential. These varying perspectives are useful in soothing fears, offering guidance and rooting out rumors and misinformation.
  2. Involving social scientists as soon as possible is paramount. Epidemics often sow seeds of resentment and suspicion within communities. As a result, these “seeds” often impede recovery and prevention efforts if allowed to grow. When scientists use their experience to analyze community structures, they can quickly identify areas of distrust. Their unique perspective on human behavior and cultural practices can then assist in developing solutions that are acceptable to all. Communities are then more likely to take ownership and come together to work towards strategies to slow the spread of the disease.
  3. Prioritizing the patient experience is mutually beneficial to the infected person as well as those providing the treatment. Stigma often follows survivors of Ebola with families and communities, with others expressing fear toward individuals even after they have recovered. Those recovering from COVID-19 often experience similar shaming. Conditions that result in trauma or embarrassment for the patient provide those who the virus may infect with a reason to ignore their treatment options. Performing care with respect, empathy and dignity offers a positive experience. This increases the chance that newly infected patients will seek help. Outreach in the form of education can reduce a community’s discontent. A better grasp of how the virus works and the recovery process provides understanding and relief.
  4. Deploying familial leaders for monitoring, early case detection, contact tracing, quarantine and follow-up is beneficial. As many see the leader in their family as a protector, this role is uniquely advantageous in increasing understanding of the disease itself. Family leaders are also in good positions to be the ones who take on the role of bolstering understanding of personal and family precautionary measures. An entire household working to slow the spread of COVID-19 can have a greater impact than individual effort.
  5. Taking action to ensure swift turnaround times for labs is important. One priority during the Ebola outbreak was getting lab results back to patients as quickly as possible. Primarily, this is to relieve any existing anxieties for the patient and the patient’s family. Additionally, quick turnaround allows for quick, public safety protocol execution to prevent the further spread of disease. This strategy is equally effective in the effort to slow the spread of COVID-19.

Even with one lethal and viral outbreak in the DRC finished, COVID-19 remains a very real and deadly threat. Through surviving Ebola, the DRC government grasped valuable, global lessons. The DRC government is using the tactics that proved successful in defeating the Ebola virus outbreak to slow the spread of COVID-19. As world leaders plan and devise strategies, the DRC’s successes serve as experienced examples in this globally critical situation with little precedent.

– Rachel Proctor
Photo: Flickr

Health Crisis in the Congo
The spread of a deadly disease is threatening The Democratic Republic of the Congo. This disease has led to a rise in unemployment, an uptake in crime, a decrease in the economic growth rate, as well as the illness and death of many Congolese people. Presently, the Congo is dealing with the aftermath of one of the most deadly outbreaks of Ebola yet, creating a certified health crisis in the Congo. Within the previous two years, records have determined that there have been over 3,000 Ebola cases and 2,000 resulting deaths. Additionally, the country’s deficit rating has been on a decline of over 2% in that time period.

Financial Troubles in the DRC

The Democratic Republic of the Congo also suffers from serious financial hardships. Over the years, things have improved somewhat for the region. The poverty rate has decreased slightly within the previous two decades. In addition, the overall economic growth rate had risen to 5.8% as of 2018. Despite these incremental increases, the Democratic Republic of the Congo ranks as one of the most impoverished countries, with its average citizens having to scrape by on as little as $1.90 per day.

Unfortunately, the positive economic factors occurred before the presence of this health crisis in the Congo. This caused the growth rate to drop back to 4.4% by 2019. The influx of disease within the region also stressed the economy, dropping it to the aforementioned deficit of 2%.

Violence in the DRC

Furthermore, the violence within the region has amplified the health crisis in the Congo. The Congo has a long history of violence with genocides occurring in both the 1800s and 1900s. Additionally, recent reports from the UN indicate that terrorist groups such as the Allied Democratic Forces (ADF) and an estimation of 100 other armed groups are in the region.

This not only makes it difficult for the delivery of medical supplies to combat this crisis, but it also dissuades the assistance of foreign aid, with many countries believing that their assistance will only entangle them in conflict. The presence of these groups has continued to expand in the area, and other terrorist affiliates, including ISIS, are taking notice. In 2019, Congolese President Felix Tshisekedi speculated that ISIS may grab a significant foothold to invade the Nord Kivu within the Congo.

The Alliance for International Medical Action (ALIMA)

The health crisis in the Congo forces responders to take action towards large-scale health care efforts. Not only has the Ministry of Health shown great awareness and urgency in addressing the needs of this crisis, but other non-governmental organizations have been making great strides to help as well.

The Alliance for International Medical Action (ALIMA), in cooperation with the World Health Organization (WHO) and partners, has created a treatment center in Beni to care for those speculated and confirmed to have Ebola. Preventative measures have received assistance through the provision of CUBE units and PPE by these organizations respectively. Additionally, WHO has provided over 1,600 individual responders to help combat the crisis.

Challenges

The battle against the health crisis in the Congo still holds many challenges. This is the latest outbreak of the disease in the Congo overall, with the first signs of it occurring as early as the 1970s. It was only during the last outbreak that the country utilized the Erevbo vaccine in the disease’s prevention. Over 300,000 people received the vaccine with a 100% efficacy rate, which represents a huge milestone along with other treatment and preventative measures.

Looking Forward

In November 2020, The Ministry of Health declared this crisis over. The DRC itself expects to increase its economic growth rate by 4.5%, thereby nullifying the 2.2% drop that it has seen. Yet, this supposed end is not as substantial as it may seem.

The disease still exists within animal DNA spread across the region, and infectious strains are able to remain in recovering victims for months following infection. The Ministry’s own announcement of the 10th outbreak’s end was quickly rescheduled in June 2020, due to the reemergence of this latest Ebola outbreak.

When asked about the possibility of a resurgence, WHO responded that “a robust and coordinated surveillance system must be maintained to rapidly, detect, isolate, test and provide care for suspected cases.” More alarmingly, the organization expressed that without this effort, the spread of Ebola could have easily eclipsed the borders of the DRC and become a global pandemic.

How quickly a resurgence could occur is unknown. However, it is clear that without a continued and international effort geared toward Ebola’s prevention that the possibility of a health crisis in the Congo could become an all too tragic and preventable reality.

– Jacob Hurwitz
Photo: Flickr

Economy in the DRC
On June 25, 2020, the Ministry of Health of the Democratic Republic of Congo declared that the 10th Ebola outbreak was over in three provinces. With the rise of COVID-19 cases in the country, Ebola cases have also increased significantly as social distancing became difficult in medical facilities. As of August 13, 2020, there have been 86 confirmed Ebola cases in the northwest Equateur province. As of July 3, 2020, there were a total of 3,481 cases in the entire country. With Ebola and COVID-19 cases rising, medical costs, personnel and resources will heavily affect the economy as government officials scramble to contain the outbreaks. Here is some information about how Ebola has affected the economy in the DRC.

Keeping Inflation in Check

The recent outbreaks in the Equateur province are in remote areas, regions that are difficult for medical supplies to reach. The lack of access to these areas requires an increase in medical cost support, however, the DRC currently cannot shoulder the financial burden due to the COVID-19 pandemic. The economy in the DRC has been stressed because of COVID-19 costs and has been adjusting rates in order to control inflation. During the week of August 10, the Central Bank of DRC increased the key interest rate from 7.5% to 18.5% in order to prevent inflation. Despite the pandemic, Central Bank experts are expecting an increase in the economic growth of 2.4% at the end of 2020. This would be a downward trend from expectations at the beginning of 2020.

Tracking COVID-19 and Ebola

The DRC will only be able to contain both viruses if it can properly document progression and transmission. However, the DRC has more than 500 regions of difficult terrain that do not have access to basic resources. These remote, populous areas are unable to receive medical resources or be properly tracked. They have less access to electricity, medical personnel and resources. The economy in the DRC has exacerbated most funds in order to contain the COVID-19 outbreak. However, the World Health Organization (WHO) has reported that almost 13,000 people have received vaccinations since the 11th Ebola outbreak that started near the end of July 2020.

International Aid

The U.S. Agency for International Development (USAID) is delivering an additional $7.5 million in humanitarian assistance to the DRC for Ebola. With these funds and WHO’s vaccine distribution procedures, testing facilities and medical personnel volunteers, the DRC will be able to more efficiently combat these pandemics.

Additionally, the DRC is receiving a $363 million loan from the International Monetary fund, $47 million from the World Bank and $40 million in emergency funds from the United Nations to strengthen the economy. These monetary aids will go toward the COVID-19 medical response, 11th Ebola outbreak vaccinations and necessary medical facilities.

Conclusion

Despite battling two pandemics at once, the DRC has maintained its composure and enacted the proper medical responses with the resources it has. The economy in the DRC has suffered because of the new Ebola outbreak. However, the DRC’s mission and determination to wipe out the last of the Ebola infections are unparalleled by previous responses. The DRC is on track to declaring another Ebola outbreak over.

Aria Ma
Photo: Flickr

Ebola Outbreak Funding Gap
Amid efforts to suppress the coronavirus effects, the Democratic Republic of the Congo (DRC) is now facing its 11th outbreak of Ebola since the discovery of the disease in 1976. The current outbreak officially began on June 1, 2020 — causing 24 deaths and garnering the attention of government officials and international agencies, such as the World Health Organization. The start of this outbreak coincides with the end of the 10th outbreak, which finished just 25 days earlier. Further complicating the latest outbreak is the fact that it comes when much of the international world is focusing on protecting themselves against the spread of the new coronavirus. As a result, there is an Ebola outbreak funding gap for what is required to sufficiently protect citizens of the DRC from the further spread of Ebola.

The Gap

The WHO reports that the $1.75 million raised so far will not last long enough to end the current outbreak. The organization estimates that the money will only last a few more weeks and that the unique location of the outbreak (in a more forested part of the country) is too costly to regularly send health officials.

This lack of funding could be a step backward for the country’s progress in limiting the disease. An outbreak in 2018 killed only 33 people, but from 2014 to 2016, 11,000 people died as a result of the disease. The main difference between the two time periods was the level of preparation and emergency funds to rely on, both of which are now decreasing due to the estimated gap.

The funding gap could have a direct impact on the current outbreak and may become a significant factor in the potential for new outbreaks. E.g., the recurrence of outbreaks is due to the virus’s presence in animals across the country. Therefore, there will most likely be another outbreak for which the WHO needs to be prepared.

Help from the United States?

The United States has donated more than $600 million to prevent the spread and minimize the devastation of previous outbreaks of the disease, in the DRC. This money has gone to building and managing health facilities, tracking the spread of the disease and evolving several safety measures for the country’s citizens. Those funds also went toward developing the two effective vaccines for Ebola and for transferring the dosages to citizens in need. Only a fraction of this money could make up for the lack of funding that the western part of the DRC needs today. Still, with most efforts and donations going toward coronavirus relief — very little attention has been placed on the current outbreak. This lack of attention contributes to the existing Ebola outbreak funding gap.

Looming Threats and Remaining Vigilant

A great challenge with this disease is that it could spread rapidly in the absence of a vaccine. Health officials typically vaccinate using a ring method — meaning they treat people that are near the center of the disease. Without the funds needed to disseminate the vaccine, the country’s infection rates could go up dramatically.

Officials are aware of this potential future, as the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus states, “This is a reminder that COVID-19 is not the only health threat people face. Although much of the world’s attention is on the pandemic, the WHO is continuing to monitor and respond to many other health emergencies.” Some are urging other countries and organizations to take on this mindset. Aid from the United States could prove a significant help in preventing loss of life in the DRC by closing the Ebola outbreak funding gap.

Aiden Farr
Photo: Pixabay

Education in Sierra LeoneMany important improvements in educational outcomes have occurred in Sierra Leone since 2015, especially for women and children. The country is bouncing back from the civil war, Ebola crisis and other serious challenges. This progress is partially owed to organizations that help children go to school. Several NGOs and community-based actors support education in Sierra Leone. Here is a small glimpse into the work of many.

4 Organizations Improving Education in Sierra Leone

  1. Street Child: Street Child’s goal is to improve the educational prospects of the world’s poorest and most marginalized children. Since its founding, the organization has helped more than 250,000 children escape poverty and go to school.  It originally started by improving education in Sierra Leone, where it began a project for 100 children in a small northern village. It has since expanded to serve children in ten other countries. Some of its work involves providing young girls with school supplies and giving families financial support. The organization also trains teachers and supplies classroom materials.
  2. Mother’s Club: After setbacks and challenges from the Ebola outbreak, mothers in Sierra Leone began organizing to ensure their children would receive a full education. Mother’s Clubs are village and community-based networks that sell products to fund their children’s schooling. Profits from farming, tye-dyeing, gardening and soap making pay for school supplies, books and uniforms. Thanks to these self-starters, with aid from international partners like UNICEF, communities can help drive positive educational outcomes.
  3. Girls Access to Education (GATE): Funded by U.K. Aid and its partners, Girl’s Access to Education (GATE) aims to help girls from disadvantaged households go to school and enables out-of-school girls to resume their education. Importantly, it also empowers communities to create their own solutions. The net enrollment rates in both primary and secondary education have consistently increased since 2013, due in part to their work. Where the literacy rate for girls ages 15-24 was less than 40% in 2005, that figure rose to 62.7% in 2018. The gap between male and female literacy rates continues to drastically decrease as well. This speaks to an overwhelmingly positive impact on Sierra Leone’s children and youth.
  4. Teach for All: Teach for All is a network of education partners and nonprofits who work together to help inspire change on a global scale. The organization announced Teach for Sierra Leone as its latest partner in July 2020. Similarly to other actors, Teach for Sierra Leone is community-driven and recognizes educational disparities in the country as an urgent issue. They aim to bridge education gaps by recruiting women and teachers from under-resourced schools whose efforts will help break the cycle of global poverty.

A Brighter Future

Overall, these organizations play a critical role in improving access to education in Sierra Leone. Currently, many schools have been disrupted due to COVID-19, but now radio lessons bridge the learning gap until reopening. So long as outside actors continue to provide foreign aid, assist in educational outcomes and empower communities, children in Sierra Leone will be able to reach their fullest potential.

Rachel Moloney
Photo: Flickr

Psychosocial Recovery from Ebola in Sierra LeoneCommunity healing dialogues are proving effective in providing psychosocial recovery from Ebola in Sierra Leone by addressing the trauma and stigma that survivors face. These sessions give community members a forum to raise and address their concerns about problems in the community, promoting health, wellness and prosperity in both psychosocial, emotional and economic senses. The dialogues seek to erase the stigma and promote economic recovery via micro-enterprise groups.

Poverty and Public Health Challenges

Sierra Leone is a West African country with a population of 7.5 million. Life expectancy is approximately 52 years for women and 51 years for men. The top ten causes of death include malaria, neonatal disorders, diarrheal diseases, tuberculosis and HIV/AIDS. Sierra Leone has the highest maternal mortality rate in the world (women have a one in 17 chance of dying from pregnancy or childbirth), in addition to one of the highest mortality rates for children under five. The country lacks a centralized public health system, and most people cannot access health care due to extreme poverty.

Support and Strides Amid Ebola

Sierra Leone had the highest number of fatal Ebola cases in the 2014-2016 outbreak. The disease’s severity prompted the CDC and NGOs like Partners in Health to provide resources and support. The CDC mounted its largest ever response to an outbreak in an individual country, providing services that included:

  • Epidemiological/strategical support
  • Infection prevention and control
  • Case management
  • Health promotion
  • Laboratory/diagnostic support
  • Emergency management
  • Border health
  • Research support

Partners in Health also provided emergency Ebola care and stayed in Sierra Leone after the outbreak to help strengthen the country’s public health system, staff, supplies and infrastructure. It has provided prenatal care, community health services, tuberculosis treatment, mental health care, blood banking and emergency medical services. The organization also established ongoing support systems for Ebola survivors. Strengthening Sierra Leone’s health system is an important means of both alleviating poverty and helping the country heal from Ebola. However, much work remains to be done.

Returning to Communities Through Healing Dialogues

Ebola is a disease with severe physical manifestations, but its social and psychological aftereffects can also be devastating and can help ensure that those affected remain in poverty.

In the words of one lifelong resident of Sierra Leone, “The Ebola outbreak in West Africa had the same psychological effects on individuals as war.”

Often, Ebola survivors are grieving for the deaths of their loved ones. At the same time, they face stigma and discrimination when trying to return to their communities because people fear that they still carry Ebola.

To address these complex and multifaceted issues, USAID’s Advancing Partners & Communities project introduced community healing dialogues. These meetings, which are conducted by trained facilitators, give community members space to talk through and resolve their concerns. These sessions are having positive effects on psychosocial recovery from Ebola in Sierra Leone for both survivors and their communities. Some survivors have been able to rejoin their communities free of stigma. In addition, the sessions serve as a forum for the community-based resolution of economic problems. For example, the forum led to a micro-enterprise group helping pay for a young woman’s school fee.

Sierra Leone’s Ebola outbreak was devastating on medical, economic and psychosocial levels. Support from governmental and non-governmental organizations have helped the country face these issues. Community healing dialogues have been extremely beneficial in aiding psychosocial recovery from Ebola in Sierra Leone.

– Isabelle Breier
Photo: USAID

Ebola Survivors
The Ebola epidemic that ravaged the Democratic Republic of the Congo (DRC) in 2018 claimed more than 2,250 lives. Doctors and nurses worked vigorously for months to treat patients and stop the spread of the deadly disease. Finally, in early March 2020, the DRC was able to announce that it had discharged its last Ebola patient. After the country’s lengthy battle with the virus, citizens are seeing that the end of the outbreak is finally within reach. With this new horizon in sight, here’s how Ebola survivors in Congo are giving back to their communities.

Interacting with Patients

There are more than 1,000 Ebola survivors in the DRC. These survivors have developed antibodies that can last up to a decade, allowing them protective immunity against Ebola. Essentially, if survivors come into contact with someone infected, they are not at risk of contracting the disease again.

This allows them to interact with sufferers who may feel isolated and alone during their treatment. Members of the Ebola Survivors Association were able to talk with and provide companionship to patients suffering from Ebola without making them feel alienated.

Spreading Awareness One Home at a Time

Members of the Ebola Survivors Association have been serving their community in Beni, a northeastern city in the DRC, by visiting homes to educate families on Ebola prevention strategies. One member, Gemima Landa, goes above and beyond as a way to thank the healthcare team that saved her life when she was infected.

Landa spends her week visiting countless neighborhoods in Beni. She shares her own story to enlighten families on how to stay healthy. She also makes regular visits to health centers to meet with mothers and pregnant women to explain to them how they have a crucial role in protecting their children against the deadly disease. Landa has been able to spread Ebola awareness and share life-saving information with hundreds of Congolese, and she isn’t the only survivor who’s making a difference.

Caring for Orphans of Ebola

With Ebola having taken so many lives across the country, it also left hundreds of children parentless as a result. Fortunately, survivors were quick to volunteer their time to step in and care for these orphans by providing love, attention and other necessities children desperately need during such a difficult time.

UNICEF also stepped in to help by partnering with survivors and opening nurseries close to Ebola treatment facilities. This is so that the caregivers would have a separate space to tend to the children. These nurseries provide daily screenings and checkups. Additionally, children who may have the disease can be cared for by survivors, who don’t have to risk being infected because they have developed an immunity.

There are now more Ebola survivors in the world than ever. The survivors in the Democratic Republic of the Congo have proven how valuable their help can be to impacted communities. If volunteers continue to band together and share their experiences, the world could be on its way to a healthier, Ebola-free future.

Hadley West
Photo: Flickr