Aid agencies must adapt to changing demands of Ebola crisis

19 June 2015

Some of the UK’s leading aid agencies’ prevention work, such as safe burials and awareness raising, in response to the Ebola epidemic in Sierra Leone is “impressive” but must continue to adapt to the changing situation in West Africa, an independent review of the DEC response (pdf) said today. 

The Ebola crisis appeal response review conducted in March 2015 by Pauline Oosterhoff at the Institute of Development Studies for the DEC found that member agencies utilised their existing networks and relationships in Sierra Leone to scale up programmes after the Ebola crisis appeal launched in October 2014. 

Aid agencies used their experience of community-based public health to launch large-scale awareness campaigns, combining their long-term knowledge with new interventions – such as graveyard management, contact tracing and providing food and supplies to quarantined households – to “adapt quickly” to the unprecedented emergency. 

How did the DEC respond?

“The Ebola crisis appeal was the DEC’s first ever appeal for a disease. We knew our members had strong links with local communities that could be scaled up to raise awareness and spread prevention messages. DEC agencies surpassed expectations and developed innovative new approaches alongside their core work. According to the DEC’s chief executive Saleh Saeed. 

“For example one of our members found that imported Community Care Centres, used for treatment and containment, were too hot for Sierra Leone’s climate. Engineers worked with medical staff to create thin and transparent walls to reduce heat and allow family members to see inside.

“Working with local community volunteers to raise awareness and identify cases has proven to be particularly effective. People are much more likely to come forward for testing if they know and trust the health workers in their own community. However DEC agencies will be working for years to come to try and reduce the number of new Ebola cases in Sierra Leone, Liberia and Guinea to zero and help families recover all they have lost.”

Maintaining the momentum

It is all the more urgent to maintain the momentum of ongoing prevention and containment work since the World Health Organisation said the decline in Ebola cases recorded in April and early May has stalled in early June. 

Thirty-one confirmed cases of Ebola were reported in the week ending 7 June, including 15 in Sierra Leone. This is the second consecutive weekly increase in cases and the highest weekly total number of cases reported from Sierra Leone since late March.  

The review showed that the unprecedented humanitarian disaster, and the stigma and fear that goes with it, requires creative solutions. To combat fear of contaminated water, for example, a DEC agency staff demonstrated water was safe by drinking it themselves, while other agencies have sought to overcome fear and break down barriers between responders and those affected by asking community health workers to change in to their protective clothing in public view. 

What can the DEC do better?

However the review said that organisations must make greater efforts to include women and girls, elderly people and people with disabilities in their prevention and recovery work. 

Older people have been disproportionally affected by Ebola due to their caring role in communities, which means they are more likely to wash or tend to those who have died of Ebola. 

In a country with a high number of teenage pregnancies, young girls are particularly vulnerable due to reduced access to sexual and reproductive health services, lack of clarity over the transmission of Ebola through sexual contact and an increased risk of transactional sex as a result of worsening poverty. 

The review recommends that sexual and reproductive health is addressed, including the provision of “gender-sensitive facilities” in schools and advocacy to defend the right of all girls to attend school after a new government law bars pregnant girls from education.

Some women the research team spoke to felt they had been excluded from the aid response in the early phase because communication was often through the predominantly male local leaders. Many DEC agencies are already doing more to make sure women are included in decision-making processes by working with women’s clubs and organisations or designing programmes that respond to the needs of women – for example training healthcare workers on the clinical and psychological management of gender-based violence so survivors can receive the best care.

Many members also planned to prioritise teenage mothers, people with disabilities, the elderly and female-headed households for training, relief supplies or livelihoods support in the second phase of the response. 

Brendan Paddy is the Head of Communications for the Disasters Emergency Committee. He leads the media work of the DEC member agencies in the immediate responses of crises, this includes the Haiti earthquake, Pakistan floods and the East Africa food crisis. 

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