IOM Sierra Leone

IOM Sierra LeoneEbola ResponseSITUATION REPORT | Issue 36 | 2-8 August 2015© IOM 2015© IOM 2015IOM Bombali’s Emergency Interim Care Kits Field Monitors– Isatu, John, James, Barrie and Hawanatu (L to R) at the District EbolaResponse Center in Makeni on 6 August 2015. 500 interim care kits have been pre-positioned in 70 primary health units in 11 of 13chiefdoms across Bombali. Field Monitors ensure kits are properly distributed and PHU staff trained on their use.SITUATION OVERVIEWWeekly Highlights The single case reported from Sierra Leone in the week to 2 Augustcame from Tonkolili. The new case is one of over 600 contacts generatedby the case reported in Tonkolili the previous week (the indexcase). The case is a family member who provided care to theindex case, and was considered to be at high risk of an acquired infection.There are over 40 other such contacts considered to be athigh risk of developing EVD because of the nature of their contactwith the index case, and there is a high probability that further caseswill arise. All contacts are currently under follow-up. Investigationsinto the source of infection of the index case, who is thought tohave acquired infection in Freetown before traveling to Tonkolili,are still ongoing. Across the country a total of 811 contacts remain under follow-up in4 districts, with the vast majority (636) located in Tonkolili. All contactsassociated with known chains of transmission in Kambia havenow completed the 21-day follow-up period, although new contactsare likely to be identified during the course of investigations into thecase reported from Ratoma, Guinea, in the week ending 2 August. Laboratory indicators continue to reflect a heightened degree ofvigilance, with 1955 new samples tested in the 7 days to 2 August.Fewer than 1% of samples tested positive for EVD. Most tests (80%in the week to 2 August) are of post-mortem swabs taken to ruleout EVD as the cause of death. IOM monitors together with the Passenger WelfareOrganization (PAWEL) have begun to make routinemonitoring visits to the 47 border crossing pointsmanned by RSLAF personnel along the Guineaborder in Samu, Bramaia and Gbileh Dixonchiefdoms, Kambia district. IOM is sustaining its Magazine Wharf outbreakresponse support to 8 Peripheral Health Units intoweek 7. IOM clinicians in collaboration with the EbolaResponse Consortium are providing InfectionPrevention and Control (IPC) training support atConnaught, Princess Christian’s Maternity and OlaDuring Children’s Hospitals and have now trained416 hospital personnel. In collaboration with MOHS and ERC partners, IOMHealth Screening Advisory Teams (HSAT) havebegun optimizing health screening systems at OlaDuring Children’s Hospital as of 5 August. A secondteam will be deployed to Princess ChristianMaternity Hospital within the next 2 weeks.Follow IOM Sierra Leone on Facebook www.facebook.com/iomsierraleone orvisit www.iom.int/countries/sierra-leone

IOM Sierra Leone Ebola Response Situation Report | Issue 36 | 2-8 August 2015Gibrilla Kamara, survivor, continues to inspireGibrilla Kamara, 43, isan Ebola survivor andsingle parent. He becameinfected in lateSeptember last yearwhile caring for his sickaunt, a nurse workingat the Rokupa Governmenthospital who laterdied. Within twoweeks Ebola rapidlyspread through his© IOM 2015Gibrilla Kamara, HHBM monitorin Suzan’s Bay, 6 August2015.family, claiming the lives of his uncle, his 20 year old son,16 year old daughter, 70 year old grandmother and threeother relatives. 7 other family members were infected andtaken to hospital. Gibrilla, himself spent 11 days at the MacauleyStreet Hospital holding center and was later transferredto the Hastings Treatment Center where he spent21 days before being declared Ebola free and dischargedon 10 November 2014.Upon his discharge from hospital, Gibrilla decided to helpin the fight against the Ebola virus disease.” I couldn’t imaginemyself sitting around and doing nothing” he sayscandidly. “What I went through is so painful that I am willingto help in any way possible to ensure no one else goesthrough what I did. Since I was discharged, I have beenthinking about the suffering and death I saw close to meand the pain I went through during my stay in hospital.Surviving that is a blessing that must have occurred for areason. I feel strongly that I survived so that I could contributeto something larger than myself. So I decided tojoin the fight against Ebola.”"I feel strongly that I survived so that I couldcontribute to something larger than myself.So I decided to join the fight against Ebola."— Gibrilla Kamara, HHBM MonitorIn December 2014, Gibrilla was contacted by a survivor hehad met in the holding center and asked if he would beinterested in working for IOM at the National TrainingAcademy at an expert patient simulator. Without hesitationhe immediately signed up. Speaking about and sharingexperiences with other survivors and trainees to preparehealth care workers for deployment to ETUs.This July, Gibrilla transitioned to the Health and HumanitarianBorder Management project in Freetown at Suzan’sBay as a health screening monitor at the Port Loko Wharf.“Today I am happy. Seeing the number of Ebola cases rapidlygoing down and with treatment centers now virtuallyempty, I feel proud of my contributions to end the worstepisode in our country’s history.”IOM HHBM staff greet High Level PanelThe UN Secretary General, Ban Ki Moon appointed aHigh-Level Panel on the Global Response to Health Crisesin May 2015. On 4-5 August the Panel visited Freetownas part of a wider trip to the worst affected countries toundertake consultations with the President of Sierra Leone,INGOs and local NGOs, survivors and the UN countryteam.The Panel arrived by helicopter from Guinea to Cockerilland was met by IOM’s Health and Humanitarian BorderManagement monitoring staff on the ground to undergo© IOM 2015© IOM 2015IOM HHBM monitors take Ms Joy Phumaphi, ExecutiveSecretary of the African Leaders Malaria Alliancethrough the health screening process on 4 August 2015.health screening procedures before being escorted toState House.Panel members include Mr Celso Luiz Nunes Amorimo,former Minister of Foreign Relations and Defence Ministerof Brazil; Ms Micheline Calmy-Rey, former Presidentof the Swiss Confederation, Mr Marty Natalegawa, formerForeign Minister of Indonesia and its PermanentRepresentative to the United Nations in New York, MsJoy Phumaphi, Executive Secretary of the African LeadersMalaria Alliance and Botswana’s former Minister forHealth and Minister for Lands and Housing and Dr RajivShah, until January this year, Administrator of the UnitedStates Agency for International Development (USAID).Panel members, have been tasked by the UN SecretaryGeneral to make recommendations on how to strengthennational and international systems to prevent andmanage future health crises taking into account lessonslearned from the response to the Ebola outbreak. Thepanel will submit periodic progress reports and presentits final report at the end of December.High Level Panel delegate, former USAID AdministratorRajiv Shah arrives at Cockerill on 4 August 2015.© IOM 2015PAGE 2

Health Screening Advisory Teams deployedSince Wednesday, 5 August IOM is deploying HealthScreening Advisory Teams (HSAT) to Ola During Children’sHospital. 2 additional staff will be deployed to PrincessChristian’s Maternity Hospital within the coming 2 weeks.In collaboration with the Ministry of Health and Sanitationand respective Ebola Response Consortium partner agencies,IOM will optimize health screening systems at OlaDuring Children’s Hospital, Princess Christian MaternityHospital and other medical facilities as required. IOMHealth Screening Advisory Teams (HSAT), one team assignedper facility, will conduct continuous capacitybuildingof the end-to-end health screening system to includehealth screening system layout, health screenertraining, system monitoring, data collection/managementand adherence to health screening standard operatingprocedures (SOPs).IOM HSATs will be comprised of an international clinicianteam leader and national clinician assistant and dedicatedto health screening system optimization for a total periodof four months.Phase I of this component will consist of HSAT deploymentto the facilities in order to conduct a rapid facility screeningassessment in order to identify and resolve existingscreening deficiencies.Phase II will consist of intensive training/mentoring ofhealth screeners and optimization of the health screeningsystem. HSATs will ensure effective and comprehensivemonitoring of all hospital entry health screening points.Phase III will consist of continued screening system monitoringand mentoring by the HSAT national clinician.HSATs will collaborate closely and routinely meet withIOM Sierra Leone Ebola Response Situation Report | Issue 36 | 2-8 August 2015MOHS and respective ERC partner agencies to providetimely information on all activities; and produce bimonthlyreports for the first month and monthly reportsfor subsequent months for distribution to all hospitalstakeholders. HSAT deployment and capacity will be flexiblein order to potentially accommodate the healthscreening optimization of additional facilities as required.IOM participates in Cross Border MeetingThe bi-monthly cross border working group meeting tookplace on 6 August in Forecariah with representatives fromIOM, WHO, CDC, ACF, and UNICEF in attendance. Themeeting emphasized the need to strengthen screening atborder crossing points, effective collaboration betweenRSLAF and the Guinea Gendarmerie and the sharing ofbest practices. Partners were urged to support IOM deploymentsat the BCPs on surveillance and contact tracingsince the emergence of a suspected case believed to haveleft a quarantined area in Guinea for Kambia.IOM, PAWEL work with RSLAF on borderIOM monitors together with staff from the Passenger WelfareOrganization (PAWEL) have begun to make routinemonitoring visits to the 47 border crossing points mannedby RSLAF personnel along the Guinea border in Samu,Bramaia and Gbileh Dixon chiefdoms in Kambia district.Migratory flow data is being collected in samples at thesecrossing points including name, sex, origin/destination,purpose of crossing with the intention of promoting thehealth screening/monitoring process along the border andbuilds staff confidence in their interactions with RSLAF.Cumulative Training Academy/Mobile Training operational data for 01 December 2014– 9 August 2015(weekly numbers in brackets)Course NameNumber ofcourses runTotal number ofNational studentsTotal number ofInternational StudentsCumulativeTotal3 day Ebola clinician IPC2 day Simulated PatientcareIPC support to Gov’thospitals1 day Ebola clinical IPC2 day Simulated patientcare23 589 355 94418 (5) 416 (101) 0 4164 26 59 851 day clinical4 25/65 41/33 164augmentation/ 1 dayclinical pilot/RING IPC3 day basic IPC/PPE/3 66 5,850 51 5,901day WHO Ebola basic IPCMobile Training 3 day 36 1,335 0 1,335IPC/PPE/ClinicalDecontamination/2 daymodified IPC3 day clinical frontline 1 8 2 10IPC (COMAHS)Total 152 (5) 8,314 (101) 541 8,855PAGE 3

IOM Sierra Leone Ebola Response Situation Report | Issue 36 | 2-8 August 2015IOM looks to build community engagement; PSS support within EVD affected communitiesIOM’s current social mobilization project in Bombali whichhas focused on unsafe burials and the re-opening ofschools through implementing partner World Hope Internationalwill look to transition to Phase III of response activitieswith a focus on managing residual risk and providingsupport to survivors. The priority will be community engagementand include psycho-social support and livelihoodselements to re-empower not only survivors but allcommunity members in targeted areas.On 6 August, IOM staff were on hand with NGO Trocairetogether with the Access to Justice Law Center in Makeniarranged for a drama troupe from a local high school toperform an Ebola-themed play in Samaia, acommunity of 150 people on the outskirts ofMakeni in Gbendembu Ngowa chiefdom,Bombali district where at least 10 residentshave lost their lives to Ebola. Three schools in3 districts- Bombali, Kambia and Port Lokohavesimilar drama groups for students thatwork with Access to Justice to provide contentfor their plays. In Bombali they havebeen rehearsing the stage play for about onemonth and are now performing for communitiesas a part of their school curriculum.The intention is to combine a number ofoverriding Ebola-centric themes in the playand publicize them in communities so theybecome more acceptable topics of discussionsuch as signs and symptoms of Ebola, earlyBEST of the WEB (click links for story):© IOM 2015IOM Sierra Leone’s initiatives are supported by:reporting of symptoms and attending to a health facility,psycho-social impacts, stigmatization and finally reintegrationof survivors. The drama was a major hit withthe community residents. However, challenges remain. Amajority of those in attendance were older women andyoung children. Men were away working and younger peopleoften migrate to cities in search of work.Following the play, Access to Justice, asked follow up questionsto the audience providing an open forum for peopleto share their experience and start the healing processthrough community engagement and follow up counselingwith community based volunteers.State of Emergency still in place but no limit on public activities, SwitSalone, 7 AugustEbola survivor meeting explores research priorities, 'biobanking', CIDRAP, 7 AugustEbola survivors face joint, eye complications, CBC, 7 AugustThe fight against Ebola is far from over, researchers say, The Verge, 5 AugustGhana forms national/zonal Ebola response teams, Ghana Web, 9 AugustEbola survivors suffer as epidemic wanes, VOA, 7 AugustA student drama troupe performs an Ebola themed play for residentsin Samaia community, Bombali district, 6 August 2015.Chinese FM visits Ebola-hit African countries, CRI English, 9 AugustNew Ebola vaccine shows promise but there’s good reason for caution, Vox, 3 AugustFor more information on IOM’s Sierra Leone activities please contact:IOM Sierra Leone Response | jbaker@iom.int | Public Information/Project Development | nbishop@iom.intPlease find IOM Sierra Leone on Facebook at www.facebook.com/iomsierraleone &www.iom.int/countries/sierra-leone/PAGE 4