Update on Ebola response from UK

Update on Ebola response

 From:

Britain’s strategy in Sierra Leone has centred on making burials safe, increasing the number of available treatment beds and changing behaviour so people suspected of having Ebola seek treatment early. The UK will continue to ensure sufficient resources are available to tackle the outbreak.

The UK’s updated support will provide:

1. Treatment centres

The UK is currently supporting more than 1,470 treatment and isolation beds in Sierra Leone, including in the UK’s 6 purpose-built Ebola treatment centres. In order to keep these vital centres running, a further £60.5 million has been made available.

2. Western Area Surge

The ongoing Western Area Surge, led by the government of Sierra Leone, has seen a huge effort to track down hidden cases of Ebola and encourage people to present early. As well as logistical support, the UK has provided vehicles to be used by home decontamination teams and has established an ambulance and decontamination cleaning site at Hastings.

There are now enough telephone hotline workers, tracers, laboratory systems for carrying out tests, ambulances, treatment beds and staff, burial teams, as well as people to coordinate, find and fix problems as they arise. £7 million will ensure that priorities such as fleet management and continued surveillance flagged as a result of the surge can be responded to quickly and effectively.

3. Regional preparedness strategy

The international community and region itself would struggle to cope with an epidemic in another African country. To help prevent this, the Department for International Development (DFID) is ensuring that our health programmes in high risk countries such as Ghana and Ethiopia, along with multilateral partners, actively support national emergency planning as part of a £25 million regional preparedness strategy.

This additional £92.5 million takes the UK’s total contribution to £325 million.

  1. The World Health Organisation (WHO) has led preparedness missions to assess the state of preparedness of 14 “at risk” African countries: Benin, Burkina Faso, Cameroon, Central African Republic, Cote d’Ivoire, Ethiopia, Gambia, Ghana, Guinea Bissau, Mali, Mauritania, Niger, Senegal and Togo.
  2. The reports of the missions are published on World Health Organisation Ebola web site: http://www.who.int/csr/disease/ebola/en/

Mass Distribution of Malaria Drugs Starts January 16-19, 2015

Freetown, Jan. 12, 015 (MOHS) – The National Malaria Control Programme, Ministry of Health and Sanitation will be conducting its second cycle of the Mass Drug Administration Campaign from January 16 – 19, 2015 in selected chiefdoms in the Bombali , Kambia, Koinadugu, Moyamba, Port Loko, Tonkolili and in all Wards in the Western Urban, Rural Area.

Addressing a press conference at the National Malaria Control Programme at New England Ville in Freetown, the Programme Manager, Dr. Samuel Smith noted the Ebola emergency situation, and the effect of the outbreak that has created numerous challenges for the continuation of routine health delivery services at all levels. The Ebola outbreak he added is having some adverse effects on the malaria programme intervention if appropriate measures are not put in place to support the malaria activities.

The goal of the campaign is to contribute to the containment of the Ebola outbreak in the country thereby reducing morbidity and mortality, with specific objectives to rapidly reduce malaria related incidence and mortality rates by providing intervalled Mass Distribution Administration using Artesunate/Amodaquine (AS/AQ) targeting all ages including children under five and pregnant women. The campaign also aimed at the rapid reduction of number of febrile Ebola suspected cases that would otherwise have required screening and isolation in the Ebola suspected holding centres to exclude Ebola as the cause of illness; and reduce the risk of Ebola transmission among malaria patients.

Dilating on the criteria for exclusion, Dr. Smith said a total population of 2,386, 968 are targeted to cover all ages above 6 months. Children below 6 months, malnourish children, pregnant women who are in their first three months, and all persons with fever and or looking sick are exempted. “Anyone who has received the AS/AQ drug within the last month, patients taking Zidovudine, Efavirenz or co-trimoxazole, are also exclusion to the drug administration”, said Dr. Smith.

Programme Manager, Dr. Samuel Juana Smith briefing the Journalists

Quarantine houses, the Programme Manager re-emphasized must not be visited for the distribution by the MDA teams, adding that alternative arrangements have been made through Surveillance Officers and Contact Tracers at district level.

Answering questions on the findings for the 1st cycle Mass Drug Administration and the utilization of health facilities, Dr. Smith opined that there has been a significant decline in the utilization of health facilities across the country, with malaria prevention and diarrhea continue to be the primary killers of children under five in Sierra Leone, and will remain the main killers during the outbreak,  that the detection and management of Ebola and malaria has been challenging for health workers as the initial clinical presentation of the two diseases is similar. All the targeted 24 chiefdoms in six districts and 30 zones in the Western Ares (10 zones in rural and 20 in urban were covered with satisfactory implementation coverage.

Other highlights in his presentation include lessons learnt in relation to strength, weakness, challenges, mistrust and misconception.

In his contribution, the Registrar of Pharmacy Board, Wiltshire Johnson dilated on Drug Safety and Monitoring.

He spoke on the side effects of the drug as in any other drugs, pointing out that it has been proven safe in line with WHO standard and protocols. Mr. Johnson noted the misconception, rumours and mistrust, disclosing that no established evidence of death was registered during the 1st cycle MDA campaign as a result of the drug, and encouraged compliance in line with the prescribed dosage and criteria of exclusion.

The Public Relations Officer and Chairman for the occasion, Jonathan AbassKamara said social mobilization and community engagement, use of the media and other approaches heightened awareness about the MDA distribution campaign.

He expressed gratitude and appreciation to both the electronic and print media for the pivotal role played in the sensitization and education on the 1st cycle MDA campaign, encouraged journalists to give the same prominence to the forth coming campaign in January 16, 2015.

Mr. Kamara reiterated that the drugs will be administered FREE OF COST.

KK/MOHS

MASS DRUG ADMINISTRATION FOR MALARIA – 16TH -19TH JANUARY 2015

QUESTIONS AND ANSWERS ON MASS DRUG ADMINISTRATION (MDA)

National Malaria Control Programme and Partners, UNICEF, WHO, Global Fund, MSF, Roll Back Malaria

WHAT IS THE CAMPAIGN ABOUT?

Mass Drug Administration (MDA) is the treatment of a well defined population in a geographic area with a curative dose of an Antimalarial drug without first testing for infection and regardless of the presence of symptoms.

MDA is being considered and tested as a strategy to reduce the burden of malaria with the goal of elimination. It may result in a short-term reduction in malaria parasitaemia among the population.

WHY ARE WE DOING THE CAMPAIGN?

–       To rapidly and significantly reduce clinical malaria and the resultant mortality among highest risk target population children and pregnant women;

–       To rapidly reduce the number of febrile episodes(suspected Ebola cases) that would otherwise have required screening and isolation to exclude Ebola as the cause of illnesses;

–       To improve diagnostic accuracy in diagnosis of suspected EVD cases by reducing the disease most likely to be mistaken for EVD, while reducing the burden on overloaded Ebola Treatment Units and Health Facilities;

WHO ARE THE BENEFICIARIES OF THIS CAMPAIGN?

Target will be populations older than 6 months old including adults

WHO ARE EXEMPTED FROM THIS CAMPAIGN?

  • Children below 6 months
  • Malnourished children
  • Pregnant women who are in their first three months
  • All persons who are ill (looking sick) according to the Ebola Alert Criteria – (cared for someone with Ebola, attended a funeral of someone with Ebola)
  • Anyone who has received AS+AQ within the last month.
  • Patient taking Zidovudine, Efavirenz or co-trimoxazole and
  • Quarantine houses (alternative arrangements are made for them through surveillance officers and contact tracers)

WHEN IS THE CAMPAIGN?

The 2nd Cycle of the campaign will be from the 16th to 19th January 2015

WHERE IS THE CAMPAIGN?

The campaign will be conducted in selected chiefdoms in Bombali, Kambia, Koinadugu, Moyamba, Port Loko, Tonkolili and all wards in Western Area (Urban and Rural)

HOW ARE WE GOING TO DO THE CAMPAIGN?

– The MDA distribution will be held during the high malaria transmission period (November 2014 to January 2015) in two cycles with an interval of 30 to 45 days to ensure therapeutic blood levels of AS/AQ over the targeted period;

– Administration of this regimen would be door-to-door, with Directly Observed Treatment (DOT) for first dose. The client will be educated and encouraged to comply with the treatment regimen by taking the two subsequent doses on the two days following the administration of the first dose.

– Distribution will be accompanied with strict adherence to the “no touch” policy.

WHY AS+AQ FOR THE CAMPAIGN?:

–       AS/AQ has been chosen for the MDA because it is the first line drug for the treatment of uncomplicated malaria in Sierra Leone. It is efficacious, safe, and well tolerated.

–       There is no reported local resistance to AS/AQ;

–       The drug AS/AQ is well known and acceptable to the Sierra Leonean population;

–       Health Workers and Community Health Workers are already trained to administer AS/AQ;

–       Fixed Does AS/AQ is known to be highly effective and acceptable in the targeted areas and is available.

–       Drug will be delivered in age appropriate blister-packs of 3 fixed does.

POTENTIAL BENEFITS OF MDA

–       Reduction in malaria morbidity/mortality;

–       Decreased presentation of febrile patients in the targeted communities and holding centres, resulting in potential decrease risk of transmission of Ebola to malaria patients;

–       Reduction of “Non Ebola” pressure on the health system;

–       Improved community engagement with disaffected population;

–       Improved linkage with other services (integration)

ROLES AND RESPONSIBILITIES OF PARENTS/GUARDIANS

Parents/Guardians and Individuals should Ensure:

  • All members of the household 6 months and above receive AS+AQ tablets
  • To adhere to the prescribed AS+AQ dose according to the age.
  • To complete the three days treatment regimen.
  • To report immediately any side effects observed during the course of taking the AS+AQ tablets.
  • Native herbs must not be taken with the Antimalarial tablets during the three days regime.
  • Never to share the prescribed dose for an individual with someone else.

The selfless efforts in the fight against Ebola

Let us all acknowledge the selfless efforts of the doctors and nurses, and the ancillary staff, involved in the on-going battle against Ebola. Nurse Pauline Cafferkey in the Royal Free Hospital is one amongst many volunteers and is not deserving of the mindless criticism levied by some uncaring and selfish individuals. We must all pray for her and all other victims at this time.

The last checkpoint before Freetown!

Newton checkpoint photo

Umaru Fofana

PLEASE NOTE THAT THIS IS A PRESS RELEASE:
POLICE AIG SLAPS MILITARY OFFICER

Freetown, Sierra Leone, December 21, 2014 – I have been inundated with media enquiries since this evening with regards the slapping of a military officer by the Regional Police Commander, Freetown West, AIG Memunatu Conteh.

As a response, I can confirm that at about 4pm today, AIG Memuna (as she is commonly called) publicly slapped Warrant Officer (Class Two) Alimamy Dura at the Newton Checkpoint and also ordered her body guard to beat up the military personnel.

I can also confirm that the Newton Checkpoint would have become an UGLY SCENE this evening if the Warrant Officer and some other military personnel had not exercised restraint after the AIG Memuna’s body guard (a Police Sergeant) had violently pushed the Warrant Officer.

I can attest that this is not the FIRST TIME that AIG Memuna has successfully carried out public humiliation against military personnel. There are many instances of her NOTORIETY towards RSLAF personnel.

Full Details of the Newton incident and the history of AIG Memuna’s personal vendetta against the military will be published.

Contact: Captain Yayah Brima, Media Operations Cell, Headquarters Joint Force Command, Freetown.

Sierra Leone begins house-to-house searches

Sierra Leone begins house-to-house searches

The authorities want to ensure that anyone who may be displaying symptoms of Ebola comes forward for treatment

Sierra Leone has begun house-to-house searches in the capital Freetown to find hidden cases of Ebola.

President Ernest Bai Koroma said that Sunday trading would be banned and travel between districts restricted.

The president said that as Christmas approached, people would need to be reminded that Sierra Leona was at war with a “vicious enemy”.

Sierra Leone has overtaken Liberia to have the highest number of Ebola cases, World Health Organization figures show.

The virus has killed more than 6,800 people this year, mostly in Sierra Leone, Liberia and Guinea.

Sierra Leone has had more Ebola cases than any other country

In his statement, President Koroma said the searches aimed to “break the chain of transmission”.

He added: “Do not hide the sick.”

The president said that while many districts of the country had made progress in fighting Ebola, challenges still remained in the western part of the country, which for the past two weeks had accounted for 50% of new infections.

He said that he was introducing an action plan, Operation Western Area Surge, to encourage people to come forward if they had a fever or other symptoms of Ebola.

He said it was necessary to introduce such stringent measures even though it was the festive season – a time when people would normally “celebrate with their families in a joyous manner”.

The president also said that:

  • Travel restrictions between districts would be enforced over the Christmas period
  • Christians would be allowed to attend church services, but would be requested to return home immediately afterwards
  • All New Year’s Day festivities including church services and outings would be prohibited or severely restricted
  • In addition to the blanket Sunday trading ban, the new measures would include time restrictions on Saturday and weekday shopping.

The prevalence of the virus in the capital Freetown is thought to be one of the reasons why Ebola is spreading so fast in the west.

Our correspondent in Sierra Leone, Umaru Fofana, said the measures were partly aimed at controlling crowds.

He said people in Freetown continued to gather on the streets or go jogging along the beach despite the Ebola threat.

This is not the first time that Sierra Leone has used stringent tactics to locate Ebola sufferers, but none have stopped the rise in infections.

US Centers for Disease Control and Prevention head Tom Frieden told the AP news agency that “the fight is going to be long and hard to get to zero cases”, and is heavily contingent on sick individuals coming forward to be diagnosed.

From BBC News website

Western Area now has exactly 2,500 Cases of Ebola!

 

Urban = 1553   Rural = 947

Port Loko over 1,000

Bombali is over   900

Tonkolili now at  400

 

15th Dec. Ebola Data:

Total Laboratory-confirmed Ebola Cases

= 6,702 as follows:

Western Urban    =  1,553, Western Rural     =     947

Port Loko        =  1,018, Bombali     =     909

Kailahun     =     565, Kenema     =     495

Tonkolili     =     400, Bo          =       297

Moyamba  =      173, Kono        =      124

Kambia      =        97, Koinadugu  =       89

Pujehun       =       31, Bonthe       =         4

Sensitisation Session Saturday in Newton

The Newton Committee organised an Ebola Sensitization Workshop in Newton, attended by around 200 individuals.  The Western Area of Sierra Leone is still giving great cause for concern, whilst cases in the rest of the country are declining. This effort by the committee has been funded by contributions from supporters of the Olney-Newton Link and is much appreciated.

sensitization group5 sensitization group4 sensitization group3 sensitization group2 sensitization group

These pictures were sent by WhatsApp!

The UN Special Envoy on Ebola Dr. David Nabarro said today that the first area of concern was western Sierra Leone, in particular, the capital Freetown, and Port Loko, where there are high levels of transmission and “a much more intense response” is needed. 

He did say that some of the most experienced Ebola responders in the world were working in that area, together with UNMEER’s “Western Area Surge team,” the Government, the UN World Health Organization (WHO) and partners to ensure there were enough beds and burial teams. The UN envoy explained the logistical difficulty of staffing the Ebola treatment units with 300 beds that require some 300 people. The staff needed to change shifts every three to four hours because of the heat of the protective clothing, and each changeover was a dangerous moment, as was each interaction with patients, particularly with needles.

 

Kerry Town Centre : Save the Children admits lack of capacity

Country Director Rob Macgillivray & Interim Director Michael Von BerteleInterim Director of ‘Save the Children’ UK for Ebola, Michael Von Bertele, yesterday told journalist at the Special Court that they are saddened by the criticisms levied on them for their operations at Kerry Town.
The Interim Director said 10 weeks ago, they were approached by the Department for International Development (DfID) to run the Kerry Town, and they made it clear to them that it was new to them, but however, they will try their level best to bring success to the country.
‘We hope with support from WHO and UK National Health Services (NHS) we will be able to operate fully and help infected victims get proper care and hopefully get patients well and free of Ebola.”
He said the centre was opened on the 5th November and because they lacked the capacity, they had to start from scratch, to recruit staff from all over the world, which made them to start with five patients in the first week.
“Four weeks now, we have 40- beds operating because we have nurses from Ministry of Health and 21 medics from the NHS. We are expecting more nurses from MOHS today, as we are on track to get the 80- beds running.”
Michael Von Bertele averred that they have been discharging patients by the day and today Tuesday, they will discharge another two. We are doing all this quietly, as the lab we have is one of the best and we have started testing 150 samples a day and we will continue the upgrading, until it will increase to 300 a day.”
He said they are the only centre that accepts samples at night, so that the result can be ready by morning.
“Currently we have admitted over 70 patients and presently we have 25 children and the youngest is two years old.”
Also the Interim Director averred that they are building a child care centre that was not part of the program, but they have to because there are many children that are vulnerable who need care during and after the Ebola.
“Let me make this very clear to all that Save the Children is up for the fight and we will succeed as we go along.”
The Country Director of Save the Children UK, Rob Macgillivray, in his own remarks said they have never done this kind of program before, so they had to approach it step by step.
‘Ebola is an unwelcome visitor, so we have to drive it out of Africa and the way we will do it is to do it with care and safely. I want to thank the Kerry Town Community as they have provided us with the highest number of employees.”
‘We should always have it in the back of our minds that Ebola is not the only killer disease, as malaria, diarrhea are all killing people, so we must stand shoulder to shoulder with all to win this fight.”
Speaking about the centre for health care workers, he said the British Ministry of Defence is running it and they have treated over 20 patients from all over the country. We also want to acknowledge the support from other NGOs that have been working with us to win the fight, as 25 patients were admitted on Sunday in the centre.”
The Interim Director Michael Von Bertele said they have 250 local staff employed and they are being paid by Save the Children and also their hazard allowances to be paid by them. “We are on track to get all the 80 beds operational by end of the month as they are still employing local and international staff to work in the centre.”
“I want to make it very clear that we have no regret in taking this challenge and we believe that it is in our own interest to work well and get the experience for the future. Also I want to be clear that DfID asked us to run the centre as well as President Koroma, even though they knew we had no experience before, but I want to appeal to all that we are very effective and we will continue to be until Ebola is kicked out of Sierra Leone”.
Tuesday December 09, 2014

Mass administration of Anti-malarial drug

Mass Drug Administration Campaign Starts Today – Dec 5, 2014

The Mass Drug Administration Anti Malaria Campaign organized by the Ministry of Health and Sanitation National Malaria Control Programme is to kick start in Eight (8) Ebola affected districts in the country. The targeted districts include Bombali, Port Loko, Tonkolili, Koinadugu, Moyamba,Kambia, Western Urban and Rural.

Giving an overview of the Mass Drug Administration, the Programme Manager, Dr. Samuel Juana Smith, described fever as a cardinal symptom for malaria infection and also one of the cardinal symptoms of Ebola viral disease. He underscored the importance in making frantic efforts to reduce the incidence and prevalence of the malaria infection with a view to reducing the strain on the health system and allow what he referred to as the true cases of Ebola to be found and treated. The Ministry of Health and Sanitation and partners WHO, UNICEF, MSF in line with the above poised to undertake a mass distribution of the country’s first line anti-malarial ArtesunateAmodiaquine as a supplement to ongoing routine activities in Ebola hot spots, and areas where high incidence of Ebola Virus Disease cases have been reported.

The administration of the drug would be door-to-door, with Direct Observe Treatment (DOT) for first dose, and client would be educated and encouraged to comply with the treatment by taking the two subsequent doses on the two days following the administration of the first dose.

According to Dr. Smith, distribution would be accompanied with strict adherence to the “No Touch” policy, building on existing District Health Management Teams and Community Health Workers Network would be enforced. “Only antimalarial will be distributed to households over the period December 5-8, 2014, and lessons learned during the first cycle will guide the decision on whether any maternal child health interventions should be added to the second cycle”. Dr. Smith maintained.

“Incomplete households will be revisited by distribution team members to complete administration to any members missed in the initial visit”, he added.

The malaria prevention and control strategies aim to achieve three objectives:

  •    Reduce malaria morbidity
  •    Lower the number of febrile patients with malaria to “unload” Ebola assessment service
  •    Increase the protection of front-line health workers engaged in the fight against these two deadly diseases.

The four expected benefits with ACT Mass Drug Administration:

–   Rapid reduction in malaria morbidity and mortality

–   Decreased incidence of febrile illnesses due to malaria, a reduced presentation of febrile patients at Ebola evaluation facilities, resulting in low risk of transmission of Ebola to malaria patients and lessened workload at these facilities

–  Improve the credibility of health service delivery, including community outreach and

–  The possible delivery in combination with other interventions.

British Engineers Proudly Deliver

Sierra Leone News : British Engineers Proudly Deliver By British Government through Joint Forces in Sierra Leone Dec 4, 2014

THE Royal Engineers who have deployed on Operation Gritrock in Sierra Leone are now into the final phase of their mission.

This week sees the final 5 British military built Ebola Treatment Centre sites transition into a completion and handover phase. The NGO end users have taken ownership of two ETC sites (Goderich and Hastings) over the weekend and the remaining three sites have handed partial occupancy to their respective NGO’s so that they may begin fitting out buildings.  The Goderich site is on the field of Bishop Jane Allen school where Claire Lintern [Mrs Tarawally] taught and close to where she now lives with Mahmoud.

The Royal Engineers from 62 Works Group Royal Engineers, comprising of 522 and 523 Specialist Teams and 34 Field Squadron deployed in late September to Sierra Leone as part of the UK’s response to assisting the government of Sierra Leone; their task was to erect Ebola Treatment Centres in 6 locations.

After a rapid planning and design process co-ordination teams were assigned to their sites.  The Royal Engineers supported by Sierra Leonean Armed Forces and Sierra Leonean tradesmen, set about construction with haste.

Lieutenant Colonel Gavin Hatcher, Officer Commanding 62 Works Group Royal Engineers said: “The tenacity and extraordinary dedication of the teams on the sites has meant that we have delivered facilities that would normally take 4 ½ month to build in just 42 days.”

Since being deployed the Engineers have adapted to the evolving situation in country constructing 6 new build Ebola Treatment Centres with a capacity of 600 beds and assisting in the development of a further 400 beds in community care centres. Lt. Col. Hatcher added: “These treatment centres will be at the frontline on the battle against the Ebola Virus Disease. My teams have worked closely with DfID and the NGO community to give them what they need and worked tirelessly, through the rain, mud and humidity, to complete each site in the shortest possible timeframe – I am immensely proud of what they have achieved”.