Recovering Education in Sierra Leone After Ebola

As of this year, Sierra Leone is an Ebola-free country. However, thousands of lives were lost during the epidemic, and while it may be over, the effects of the disease are still crippling the country, especially economically.

During the epidemic, schools were shut down to prevent further spread of the disease. These closures stalled the learning of almost 1.8 million children. For nine months, the youth of Sierra Leone were not only living in fear of Ebola but also of falling behind in their studies.

With the loss of “181 teachers and 945 students,” according to UNICEF, it was difficult for Sierra Leone to reopen schools again in 2015. Education in Sierra Leone had been on the rise since the end of the country’s civil war in 2002. The Ebola epidemic cracked that stable foundation and led to “an accelerated curriculum to shorten the duration of academic years” to make up for what school-aged children had missed.

Due to the increase of poverty in Sierra Leone, education has been put on the back burner for many families. Many children are now reliant on other family members to care for them, which means they are now less likely to finish their education.

Beginning in 2015, the charity Street Child has been working hard to recover education in Sierra Leone. They have found that 12,000 children no longer have an adult to support them because of Ebola. The CEO of Street Child, Tom Dannatt, said, “…unless we help families out of poverty, their children remain out of school. It is likely that their life prospects will be bleak as a result.”

Street Child runs a program called Livelihoods Programme, which supports the businesses of poor families that cannot afford school for the children they’re responsible for. The program provides grants to start small businesses. Training programs are also available along with these grants.

Another organization, Dubai Cares, started Education in Emergencies: Evidence for Action (3EA), a program focused specifically on recovering education in Sierra Leone. The goal of the program is to “improve teaching methodologies, ways to monitor and mentor staff, and reinforcing teaching styles that improve classroom performance.” 3EA encourages a positive learning environment and fitting the lessons to accommodate each student.

The Livelihoods Programme and Education in Emergencies: Evidence for Action have so far proven to be successful approaches to improving the education system in Sierra Leone. Both have allowed a greater number of children to go back to school, despite the country’s serious poverty. The future generation of Sierra Leone is not going to remain a victim of the Ebola epidemic, thanks to help from charitable organizations and knowledgeable people.

– Mackenzie Fielder

Progress Toward Eradicating Ebola

Eradicating Ebola is the global community’s next step in ensuring worldwide health. The disease is rare but extremely contagious, and causes internal and external bleeding as well as a severe fever. As soon as the virus enters the body, it weakens the immune system by attacking immune cells. In time, it causes blood vessels to carry less blood, which results in organ failure and eventual death.

Also known as Ebola hemorrhagic fever or Ebola virus, the disease is spread through direct contact with bodily fluids or objects that have been contaminated by bodily fluids, such as medical needles. It can also be contracted through contact with infected animals, specifically bats and primates.

There have been a number of Ebola cases internationally but the disease has mainly remained in regions of West Africa. The disease originated in 1976 in the Democratic Republic of the Congo, but it was Guinea, Liberia, and Sierra Leone that witnessed the largest Ebola epidemic in 2014 through 2016. An estimated 28,616 people contracted the disease and this resulted in 11,310 deaths.

Fortunately, the presence of Ebola has been contained since the outbreak. In 2015, researchers from the World Health Organization began testing a vaccine in Guinea, which returned with a 100 percent success rate. This vaccine was developed through a “ring vaccination” approach. The approach separated patients and their immediate contacts from the general public.

The vaccination report was released in December 2016. As Marie-Paule Kieny, lead author of the report, states: “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenseless.” Although the vaccine demonstrates progress in eradicating Ebola, it is in need of additional safety research before it can be formally licensed.

Another development in eliminating Ebola comes from a group of Canadian researchers. The group administered a drug known as Interferon Beta-1a to patients infected with Ebola. The drug, which is used to treat hepatitis B and C, had surprisingly effective results. “After 21 days, 67 percent of the Interferon-treated Ebola patients were still alive, compared to just 19 percent of the others,” reports Tom Blackwell from The National Post.

Although more research must be conducted regarding Interferon Beta-1a, findings look promising. The vaccine also demonstrates significant progress in eradicating Ebola, a disease that is now destined to become an element of the past.

– Gigi DeLorenzo

Photo: Flickr

The Coalition for Epidemic Preparedness Innovations

When the Ebola virus broke out in 2014, the world was ill-prepared to respond. In all, there were more than 15,000 confirmed cases and 11,000 deaths. Although the outbreak was concentrated in West Africa, a handful of cases reached the United States and Europe. With the rise of globalization and intercontinental travel, the next epidemic could easily become a pandemic.

To combat this danger, a multinational coalition is needed. The formation of such a group — the Coalition for Epidemic Preparedness Innovations (CEPI) — was announced at the World Economic Forum in Davos earlier this year.

The Coalition for Epidemic Preparedness Innovations is backed by the governments of Norway, India, Japan and Germany. These countries are partnering with the Bill and Melinda Gates Foundation and the Wellcome Trust to invest in vaccines to prevent diseases that have the potential to cause the next great epidemic.

Given the cost-efficiency of immunization programs, the development of vaccines is an effective component of epidemic preparation. With an initial fund of $460 million, CEPI will be well worth the investment. Guinea, Liberia and Sierra Lione lost approximately $1.6 billion in GDP in 2015 alone. A worldwide pandemic would be drastically more costly; the World Bank estimates a flu pandemic would cost $3 trillion globally.

The Coalition for Epidemic Preparedness Innovations will initially focus on three viruses: MERS-CoV, Lassa and Nipah. These viruses are among the diseases identified by the World Health Organization that warrant prioritization. For each virus, CEPI hopes to develop at least two vaccines. This head start is critical, as vaccine development is a long, arduous process. On average, a vaccine takes about 10 years to reach the market, and epidemics take far less time to spread.

Although CEPI is a major step in the right direction, a more comprehensive strategy is necessary to control a potential pandemic. As shown by the Ebola outbreak, a global surveillance system is needed. In addition, vaccines cannot prevent all cases of disease; treatment development is also needed. The current members of CEPI have demonstrated admirable initiative in showing the world that everyone is a stakeholder concerning global health.

– Rebecca Yu

Photo: Flickr

Diagnostic Methods Build the Foundation of Outbreak Control

Disease outbreaks are frequently portrayed by the news and other media as two-step occurrences: disease strikes, then people die. What’s left untold are the in-between moments that are crucial to outbreak investigation and disease outbreak control. Disease testing, the essential step of the diagnostic process, is one of the most useful tools in stabilizing disease outbreaks and preventing them from worsening.

The case of Ebola in Liberia provides an example of how breakthrough disease-testing methods can save thousands of lives. Jude Senguku, one of the leading physicians who treated Ebola patients in Liberia, told BBC that misinformation, panic and misdiagnosis kept people from seeking help at the onset of symptoms.

People knew very little about the deadly disease and feared being sent to Ebola isolation units. Public health workers needed better diagnostic methods to screen people for Ebola in order to obtain medical evidence that would support or invalidate a diagnosis.

For Monrovia’s Redemption Hospital, the solution came in the form of GeneXpert, a machine that rapidly tests for Ebola and provides results within 90 minutes.

At the beginning of the Ebola outbreak in 2014, there were 50 licensed doctors for a population of 4.3 million. To provide each symptomatic person a one-on-one doctor visit was both unfeasible and impractical. During and after the outbreak, GeneXpert allowed health care workers, including volunteers with limited medical training, to accurately test patients for the presence of the Ebola virus and direct them to care in time to receive life-saving treatment.

Senguku says that since 2014, GeneXpert was “very critical” in reducing Ebola scares and restoring Monrovia’s confidence in their doctors.

The technology uses a process called DNA amplification, which tests a human specimen — cheek cells, saliva, etc. — for the disease’s specific DNA sequence. In contrast to other diagnostic methods, the technology can identify extremely low amounts of viral DNA as well as drug-resistant strains, which makes it incredibly sensitive and accurate. The machine, which is used for multiple tests, costs about $17,000. The test cartridge, which is used in every test per person, costs a mere $10.

One of the technology’s most valuable features is its usability. The health care worker administering the test does not need to be trained to identify a specific disease. Rather, they simply need to know how to operate the machine. Moreover, because of its low dependence on electricity, GeneXpert is an ideal diagnostic tool for regions with limited access to power.

The diagnostic process plays a critical role in outbreak control, stabilizing population health and providing a sense of security to an affected community. Events like the Ebola outbreak of 2014 serve as examples of how improved diagnostic methods are helping health care workers deliver faster and more efficient care under strenuous circumstances.

– Jessica Levitan

Photo: Flickr

Foreign Aid Critical to Reducing Poverty in Sierra Leone

As one of the poorest countries in the world, Sierra Leone is ranked 180 out of 187 on the U.N.’s Human Development Index and faces many challenges to creating sustained development. The year 2012, the last year for which official statistics are available, put the proportion of the population below the poverty line at 60 percent.  Since the recent Ebola outbreak, current estimates indicate that 77.5 percent of the population suffers from poverty in Sierra Leone.

Ebola Epidemic and its Consequences

The Ebola epidemic significantly set back the progress made by the West-African nation since the end of its long civil war in 2002. Taking around four thousand lives, and disrupting the country’s health system, the outbreak rocked the developing country.

Until the outbreak, Sierra Leone made numerous strides in multiple aspects of development. The country was cited as a success story of peacebuilding missions and establishing good governance and stable institutions. GDP growth averaged over 7 percent every year for the past decade, but shrank to 2 percent after the West-African Ebola crisis.

Sierra Leone’s Global Reliance

The country is heavily reliant on exports of iron ore to support its domestic economy, contributing to GDP more than all other factors combined. Most of the rest of the country’s revenue comes from agricultural products, which remain at low productivity levels across the board.

Additionally, the country has a high dependence on foreign aid, with more than half of investment coming from foreign sources.

Despite progress, lack of infrastructure and high youth unemployment remain large barriers to the country elevating to a middle-income status. With 70 percent of its youth unemployed, and only about 40 percent of adults able to read, significant investments in economic development and education remain high priorities to eradicate poverty in Sierra Leone.

The poor nation also has one of the highest infant mortality rates in the world, with over 71 deaths per 1,000 live births.

Essential International Aid

Many international groups are engaging in efforts to reduce the level of poverty in Sierra Leone including the International Finance Corporation branch of the World Bank, which is investing in many critical areas to boost economic and private sector development to hopefully make the country a self-sustaining middle-income country.

Additionally, the International Rescue Commission provides humanitarian relief efforts through local engagement to prevent death by preventable diseases. The organization accomplishes such feats through its healthcare and educational assistance which improves future prospects.

While the rise of Ebola may have temporarily derailed development efforts, Sierra Leone continues to march toward improved economic and social conditions with help from international organizations. While challenges exist, the country has been consistently improving since 2002.

The country hopes to bounce back from its recent hiccup as quickly as possible and to begin addressing the issue of poverty in Sierra Leone, which prevents it from becoming a middle income country.

– Adam Gonzalez

Photo: Flickr