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5 Ways to Improve Water Quality in Sierra Leone

Water Quality in Sierra LeoneSierra Leone is a small, tropical country located on the west coast of Africa. Despite its six-month “wet season,” characterized by 90% humidity and torrential rainfall, Sierra Leone struggles to provide quality drinking water to its citizens. As of 2019, the Centers for Disease Control and Prevention (CDC) reports that 98% of Sierra Leoneans do not have access to clean drinking water and that “most households lack basic sanitation.” Fortunately, there are many organizations, both internal and external, that are seeking to combat poor water quality in Sierra Leone. These organizations utilize five strategies to broaden access to clean water.

5 Strategies to Broaden Access to Clean Water

  1. Installing Wells. Many of the wells in Sierra Leone are dug by hand and are unable to reach underground aquifers where clean water is stored. For this reason, many nonprofit organizations, such as World Hope, Living Water and Sierra Leone Rising, are prioritizing efforts to install deeper wells in both urban and rural areas of Sierra Leone. Generally, the installation of a quality, long-lasting well costs about $11,000. To minimize the cost of developing these much-needed wells, World Hope and Sierra Leone Rising are teaming up, splitting the cost of building 20 wells. Between 2017 and 2018, World Hope drilled 45 wells in Sierra Leone and its neighboring country, Liberia. When people have local access to clean water wells, they are less prone to diseases and do not have to waste as much productive time seeking out potable water.
  2. Monitoring Local Water Sources. Many of the water sources in Sierra Leone are polluted and spread diseases to the people who drink from them. This is why the CDC is partnering with public health officials in Sierra Leone to better monitor water quality and respond to waterborne disease outbreaks. The CDC began guiding “public health staff” in 2018, successfully training 50 employees “to detect and respond to waterborne diseases like cholera and typhoid.” Those 50 staff members went on to teach 500 other community members the same methods of water testing. As a result of these training sessions, new job opportunities are arising, the spread of waterborne illness is decreasing and water quality in Sierra Leone is improving nationwide.
  3. Expanding the Sanitation Sector. The Millenium Challenge Corporation (MCC) is a foreign aid agency based out of the United States, working in Sierra Leone since 2015 in an effort to improve the country’s poor water quality. The program helped draft the first digital map of the water distribution system in Freetown, the capital of Sierra Leone, which will allow water companies to “better assess the water system’s performance” and “more efficiently address service delivery problems,” ultimately providing more Sierra Leoneans with access to clean, safe water. The nation also recently drafted blueprints to expand all water and sanitation services in urban areas and neighboring towns by 2023, aiming to reach all cities by 2030. With the expansion of the sanitation sector, improved water quality in Sierra Leone is inevitable.
  4. Developing Rainfall Collection Systems. During Sierra Leone’s six-month wet season, the country experiences torrential rains and flooding. However, “from November to April,” the country experiences a harsh dry season during which droughts and water shortages are commonplace. This is why the Freetown city mayor, Yvonne Aki-Sawyerr, campaigned in 2021 to install “more than 160 rainwater harvesting systems” in rural areas outside of the capital. Each rainwater harvesting system has the capacity to collect between 5,000 and 10,000 liters of water, which means that citizens can harness excess water during the rainy season to use during the dry season droughts.
  5. Installing Public Latrines and Handwashing Stations. In an effort to fight the spread of COVID-19, Mayor Aki-Sawyerr is also working to install easily accessible latrines and handwashing stations throughout the city of Freetown. So far, she has built handwashing kiosks in 23 different marketplaces and has hired citizens to monitor each station and use a megaphone to remind shoppers of the importance of washing their hands. Many of the natural water sources in Sierra Leone are contaminated due to poor waste management and a lack of access to functional latrines. To help improve the water quality in Sierra Leone, the mayor is installing public bathrooms in addition to the handwashing kiosks. These public restrooms will help contain liquid and solid waste so that it does not seep into the nation’s water supply, significantly reducing the spread of disease.

Looking Ahead

Historically, Sierra Leone has faced many obstacles, including civil war, extreme seasonal weather and devastating outbreaks of the Ebola virus and COVID-19. However, the small African nation is taking great measures to improve the water quality in Sierra Leone so that its citizens have access to clean, safe drinking water all year round.

– Hannah Gage
Photo: Flickr

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Healthcare in Liberia Since the Ebola Outbreak

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

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Youth in Nepal Combat COVID-19 Misinformation

COVID-19 misinformationOne of the issues relating to the COVID-19 pandemic is misinformation about COVID-19 on social media. The spread of misinformation can resemble the spread of a virus. In an interconnected era, information and misinformation on social media and the internet can spread exponentially. COVID-19 misinformation can be dangerous when it impacts human behavior in a way that puts people at higher risk of transmission.

Misinformation and COVID-19

Fighting COVID-19 means fighting its transmission through the use of masks and gloves and social distancing. However, a 2020 research study conducted by Harvard Kennedy School examines COVID-19 misinformation and how it impacts human behavior during the pandemic. The study found a link between misinformation about COVID-19 and lower use of social distancing measures: “We thus draw a clear link from misinformation circulating on social media, notably Twitter, to behaviors and attitudes that potentially magnify the scale and lethality of COVID-19.” However, if social media is perceived as part of the problem, it can also be part of the solution.

COVID-19 in Nepal

Nepal has been strongly affected by the COVID-19 pandemic. The Centers for Disease Control and Prevention (CDC) considers Nepal a high-risk country to travel to in terms of COVID-19 levels, suggesting that travelers avoid all travel to the country. The CDC deems Nepal level 4, the highest designation for COVID-19 risk.

The Asian Development Bank predicted that the onset of COVID-19 would reduce Nepal’s GDP by 0.13% and leave almost 16,000 people unemployed. Nepal’s tourism sector, which contributes 8% to the economy, has been severely hit. Tourism has declined significantly from 70% pre-pandemic to less than 10%. COVID-19’s harsh economic impacts have left the country struggling to recover. As impacts of the COVID-19 pandemic quickly spread, so has COVID-19 misinformation.

Youth Collaboration

The Volunteer for Action (V4Action) group is a collaborative effort by the U.N. Volunteers program, UNICEF, the UNDP, the WHO and the U.N. Resident Coordinator’s Office (UNRCO). It was launched on March 19, 2020, and the group consists of more than 500 youth volunteers across Nepal with the collective goal of curbing COVID-19 misinformation in Nepal.

The tasks of the group include sharing verified and accurate information about COVID-19 on social media platforms and reporting COVID-19 misinformation in Nepal on UNICEF’s Joint Fight Against Misinformation rumor-tracking platform. In total, more than 100 myths were sent to the UNICEF misinformation platform for debunking. Personalizing the response to cater to the demographic, the volunteers made informative videos in local languages to provide COVID-19 education to people.

Social Media to Fight COVID-19

Overall, V4Action harnesses the power of the youth and social media in influencing the public in a positive way. In addition to debunking inaccurate information about the pandemic, the V4Action volunteers also conducted online research. They efficiently tracked online rumors about COVID-19 using surveys and reported them accordingly.

On one hand, social media can be used to spread misinformation and incite panic. On the other hand, social media can help educate populations on important issues. The V4Action volunteers had an essential role in educating the Nepalese population during the COVID-19 pandemic. They used social media to connect with the population and share fundamental information to limit the transmission of COVID-19. Perhaps, more importantly, they underlined the importance of mental health awareness, solidarity and unity during challenging times.

– Soizic Lecocq
Photo: Flickr

5 Facts About Tuberculosis in Mozambique

Tuberculosis in MozambiqueMozambique continues to struggle with the political and economic effects of a civil war that ended in 1992. More than half the country’s population lives below the poverty line and suffers disproportionately from HIV and tuberculosis (TB). Here are 5 facts about tuberculosis in Mozambique.

5 Facts About Tuberculosis in Mozambique

  1. Detection Rates – The TB detection rate in Mozambique is relatively low, however, many people who suffer or die from tuberculosis in Mozambique go undiagnosed and untreated. Despite its prevalence in Mozambique, the country rates among the lowest in the world for TB, with a 57% detection rate. In comparison, its neighbors Zimbabwe and South Africa report  83% and 76% detection rates respectively. With a population of 29.5 million people, an estimated TB incidence of 551/100,000 and an under 5 mortality rate of 73 per 1,000 live births, Mozambique’s current status demands better diagnostic and treatment tools. Organizations like Health Alliance International (HAI), a nonprofit organization based in Seattle, Washington, identified detection and diagnosis as a major obstacle for Mozambique and provided necessary diagnostic technology to aid the country’s underfunded medical facilities. The organization’s work has helped to improve TB detection across the nation. In addition, Apopo, another U.S. nonprofit enterprise that fights TB, trains rats to detect the disease in sputum, with the goal of increasing testing rates.
  2. Healthcare – Half the nation lives without accessible healthcare — an estimated 50% of the population of Mozambique live at least 20 kilometers from the nearest healthcare facility, likely contributing to the nation’s disproportionately low detection and treatment rates of TB. In fact, an HAI study revealed that 65-80% of people diagnosed with TB in Mozambique do not receive treatment. In response to this deficit, HAI created an online network of test results and TB personnel called GxAlert that allows patients to receive the care they need. Since its implementation in 2014, the program has successfully linked 52 facilities nationally and now accounts for 80% of all people diagnosed and treated for drug-resistant TB in Mozambique. This development promises to lower TB-related deaths, as Mozambique boasts a TB treatment success rate of 90%.
  3. Tuberculosis and HIV – While people diagnosed with HIV are the most vulnerable to TB, it is the leading cause of death among people diagnosed with HIV in Mozambique. HIV has a prevalence of 12.6% in people from ages 15 to 49, and 56% of TB patients in Mozambique also carry HIV. Consequently, groups like the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) do crucial work for the elimination of tuberculosis in Mozambique. EGPAF has deployed “cough officers” to healthcare facilities across the nation to ensure that people co-infected with HIV and TB receive proper care. In 2018, EGPAF’s efforts helped to treat 8,249 TB patients in the province of Gaza.
  4. Economic Instability – Mozambique’s problems run deeper than healthcare — efforts made to improve the diagnosis and treatment of HIV and TB patients in Mozambique have brought technology and healthcare providers to the nation, but economic instability threatens healthcare progress. Mozambique also suffers from poverty, malnutrition and mental health crises brought about by civil war and political unrest. For these reasons, the CDC, WHO and HAI have worked with the government of Mozambique for years to establish essential infrastructure and provide financial resources. For example, the CDC has worked with the National TB Program in Mozambique for nearly 10 years. Early diagnosis, integrating TB and HIV services and diagnosis and treatment of drug-resistant TB are the main areas of focus.
  5. Anyone Can Help – Anyone can help eliminate TB by contacting their representatives in Congress and advocating on behalf of those suffering from the disease. Organizations like HAI and The Borgen Project provide crucial educational information for those who want to make an impact. Help support the End Tuberculosis Now Act by emailing Congress (it only takes 25 seconds) or by adopting a HeroRAT with Apopo.

– Will Sikich
Photo: Flickr

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Infection Prevention and Control in Sierra Leone

Infection Prevention and Control in Sierra Leone
Sierra Leone did not have an existing infection prevention and control program before its 2014-2016 Ebola epidemic. However, infection prevention and control is an essential element aiding in eradicating and preventing cross-infection among the community, patients, health care providers and hospital visitors.

The Current Course of Action

The Ministry of Health and Sanitation, with the help of the Centers for Disease Control and Prevention (CDC), has made significant strides in an attempt to get Sierra Leone’s health sector back on the right track. This partnership involves the implementation of the National Infection Prevention and Control Action Plan (IPC) to prevent future infection and disease. The IPC will enable the equipping of health facilities and open up conditions for the resources required for standard and transmission-based precautions. Further, the goal of the IPC aims to prevent and contain health care-associated infections.

The CDC’s Involvement

Disease threats are spreading faster than ever before but the CDC’s efforts in Sierra Leone have helped improve the country’s prevention, detection and ability to respond to infectious disease outbreaks. These abilities remain especially key before outbreaks become epidemics with the potential to affect global populations.

The CDC has played an important role in infection control in Sierra Leone, even establishing a country office in 2015 to focus on global health security. The CDC has been diligently working with Sierra Leone on surveillance, emergency management, strengthening laboratory and the workforce capacity to respond to disease outbreaks.

More than 700 CDC staff members served on over 1,000 deployments to Sierra Leone after the Ebola outbreak. Further, this makes it the CDC’s largest outbreak response ever in a single country. Sierra Leone, as of November 2015, is Ebola-free.

Keeping Infection and Disease Under Control in Sierra Leone

Sierra Leone has taken a different approach to sustain the infection prevention and control. The country has invested in ongoing training for its health care workers. These efforts have helped ensure a safe working environment for all, with lower health care-associated infection risks. Health care workers and hospitals have improved their disposal of waste practices, hiring individuals to clean, along with disposing of the waste.

In addition, Sierra Leone has heightened awareness of infection prevention and control with the aid of supported sanitation and hand hygiene campaigns. These campaigns aid in the creation of a culture of hand-washing and have drastically reduced cross-infection among patients, thus eradicating Ebola.

As Dr. Keiji Fukuda, the WHO Assistant-Director General, states, “When health workers are infected at work, this puts other health care workers at risk. Understanding where the breach in these measures is occurring and taking the steps needed to fully implement infection prevention and control measures can put an end to these infections.”

– Na’Keevia Brown
Photo: Flickr