District Treatment Capacity and Caseload Summary

FMT Treatment capacity and caseload summary 03 March to 08 March

DISTRICT TREATMENT CAPACITY AND CASELOAD SUMMARY

WEEK 10: 03 March to 08 March 2015

Prepared for the FOREIGN MEDICAL TEAMS UNIT

SUMMARY as at 09/03/2015 LIBERIA SIERRA GUINEA LEONE Total new cases in previous 7 days (confirmed) 0 58 56 Districts with new cases in past 7 days 0 5 5 Districts with new cases in past 21 days 2 10 9 Range of beds per case among affected districts No cases From 0.5 From 0.5 beds per case beds per case to 45.8 to 98. Average beds per case (combined ETU and CCC) NA 20.2 8.5 Number of ETUs 18 20 8 Number of districts with an ETU 12 9 7 Average occupancy % (combined ETU and CCC) 3.3% 9% Number of FMTs 19 30 9 FMT Treatment capacity and caseload summary 03 March to 08 March

LIBERIA CASES AND TREATMENT CAPACITY WEEK 10 DATES: 02/03/2015 TO 09/03/2015 NEW DAYS OPERAT POPULATIO CASES INCIDENC SINCE IONAL BEDS PER N (2008 (confirmed E per LAST NUMBER ETU OPERATION CASE OCCUPANC DISTRICT census) ) 100,000 CASE OF ETUs BEDS AL CCC BEDS (ETU+CDT) Y RATE (%) Bomi County 84,119 0 0 99 1 20 No cases 5.00 Bong County 333,481 0 0 73 1 51 No cases 1.96 Gbarpolu County 83,388 0 0 148 1 10 No cases 10.00 Grand Bassa County 221,693 0 0 78 1 10 No cases 0.00 Grand Cape Mount County 127,076 0 0 50 1 20 8 No cases 0.00 Grand Gedeh County 125,258 0 0 190 1 10 No cases 10.00 Grand Kru County 57,913 0 0 169 1 0 No cases 0.00 Lofa County 276,863 0 0 131 2 20 No cases 5.00 Margibi County 209,923 0 0 18 3 73 60 No cases 5.48 Maryland County 135,938 0 0 169 0 0 No cases 0.00 Montserrado County 1,118,241 0 0.00 14 200 No cases 4.50 Nimba County 462,026 0 0 74 2 46 No cases 0.00 River Cess County 71,509 0 0 109 1 0 No cases 0.00 River Gee County 66,789 0 0 154 0 0 15 No cases 0.00 Sinoe County 102,391 0 0 68 0 0 No cases 0.00 total 3,476,608 0 0.000 15 460 83 3.31

NOTES:

Epi: Liberia continues its run of no positive cases. Many of the contacts are finishing up their surveillance times. Cross border surveillance is strengthening with a strong focus on community mobilization and engagement. FMT Treatment capacity and caseload summary 03 March to 08 March

Decommissioning/transition planning

- 13 focused working groups; one concentrating on ETUs. Objectives are to finalize decommissioning and timelines recommendations, adequate partner/stakeholder consultation, provision of technical guidance for various processes and develop long term solutions.

- This group will submit a proposal which needs to be approved by the overarching Advisory group next week.

- MOD ETU is closed to ebola -positive patients but remains in use as a rest house for people under voluntary observation who cannot complete this in their home.

- Island Clinic will not be reopening or renovated.

- The curfew has been lifted and schools reopened from 2nd March 2015, albeit it not all schools opened.

- MSB left 9th March, but have left a small team behind to concentrate on long term planning.

- Cuban Medical Brigade have completed working are awaiting their return home.

- Most FMT parent organisations currently active in Liberia have plans beyond the ebola response.

Essential health services

- 658 health facilities undergoing WASH assessment with support from UNICEF and WASH sector

- AU doctors have been assigned to support surgical, medical and obstetric emergencies at the following hospitals in Monrovia: JDJ (1 OB and 1 GP), JFKMC (1 orthopedic surgeon, 1 general surgeon, 1 obstetrician, 2 internists, 1 psychiatrist and 2 GP), ELWA ( 1 surgeon and 2 GP), Bensonville (1 OB), Redemption (1 OB and 4 GPs)

- Joint verification exercise was carried out by UN agencies and CSO to validate information on functionality of health facilities around the country – Report is being compiled for 150 HFs (hospitals and Health Centers) FMT Treatment capacity and caseload summary 03 March to 08 March

FMT Facility type Composition FMT Treatment capacity and caseload summary 03 March to 08 March

ARC ETU Aspen ETU ETU ETU ETU ETU FMT Facility type Composition AU ETU

Non-ebola China PLA ETU Cuban Medical Brigade ETU 53 total German Army SITTU German Red Cross SITTU GOAL ETU Heart to Heart ETU IMC ETU ETU IOM ETU ETU ETU MSF Brussels ETU MTI CCC

Partners in Health ETU ETU PCI ETU Samaritans Purse CCC Save the Children CCC CCC USPHS ETU FMT Treatment capacity and caseload summary 03 March to 08 March

WAHA ETU WHO ETU

SIERRA LEONE CASES AND TREATMENT CAPACITY WEEK 10 DATES: 02/03/2015 to 08/03/2015 POPULATION (2004 NEW CASES INCIDENCE DAYS SINCE OPERATIONA OPERATIONA BEDS PER DISTRICT census) (confirmed ) per 100,000 LAST CASE ETUs L ETU BEDS L CCC BEDS CASE Eastern Provin ce 1191539 0 0.00 68 32 No cases Kailahun Distri ct 358190 0 0.00 85 0 0 0 No cases Kenema Distric t 497948 0 0.00 15 1 48 0 No cases Kono District 335401 0 0.00 12 1 20 32 No cases Northern Provi nce 1745553 25 1.43 234 427 26.4 Bombali Distric t 408390 6 1.47 0 1 100 120 36.7 Kambia District 270462 7 2.59 2 0 0 98 14.0 Koinadugu Dist rict 265758 0 0.00 11 0 0 76 No cases Port Loko District 453746 12 2.64 2 3 84 29 9.4 Tonkolili Distri ct 347197 0 0.00 12 1 50 104 No cases Southern Provi nce 1092657 0 0.00 120 0 No cases Bo District 463668 0 0.00 53 1 20 0 No cases FMT Treatment capacity and caseload summary 03 March to 08 March

Bonthe District 139687 0 0.00 78 0 0 0 No cases Moyamba Dist rict 260910 0 0.00 16 1 100 0 No cases Pujehun Distric t 228392 0 0.00 100 0 0 0 No cases Western Area Province 947122 33 3.48 216 73 8.8 Western Rural 174249 6 3.44 1 10 202 73 45.8 Western Urban 772873 27 3.49 0 1 14 0 0.5 Total 4976871 58 1.17 20 638 532 20.2

- Epi: Sierra Leone reported its lowest weekly case load for the past month, and also the lowest number of affected districts. Freetown remains the most affected district with numbers tailing off in Bombali after a significant cluster of cases.

- Decommissioning:

o There were no further ETUs closed this week, but a plan for Rationalization of treatment and isolation capacity has been released.

. Current plan is to retain 9 CORE ETCs, plus 6 STANDBY ETCs throughout the wet season (3 ETCs to close)

. Supported by approx. 30 CCCs, lab network and rapid response capability

. CORE=Strategically located ETCs with minimum operational capacity of 30 beds and ability to scale up.

. STANDBY=Will maintain PPE, consumables and pharmaceuticals in order to be operational within 48 hours but no clinical staff on site.

- FMTs

o Cuban Medical Brigade exit planning has been confirmed FMT Treatment capacity and caseload summary 03 March to 08 March

o The FMT unit are holding a Special Meeting for FMTs on Transition planning this Friday (13th March).

- Training

o Double pilot of the WHO/MOHS clinical training curriculum for non-ebola hospitals took place 6-7th March

o Included training the trainer component, and also general training of the curricula.

SIERRA LEONE FOREIGN MEDICAL TEAMS (currently active) Facility Facility FMT name type District Composition African Connaught Union Hospital EHC Freetown Ethiopia Freetown 1 doctors, 5 nurses&0 others Connaught Hospital Non-Ebola Freetown Freetown 1 doctors, 5 nurses&1 others LAKKA Western Clinical Mx Hospital Rural 1 doctors, 6 nurses&1 others ODD Hospital Clinical Mx 1 doctors, 6 nurses&1 others PCMH Clinical Mx Freetown Hospital 1 doctors, 7 nurses&0 others Kissy Mental Clinical Psicol Freetown Hospital Mx 0 doctors, 2 nurses&5 others Freetown Support Freetown 0 doctors, 0 nurses&4 others team FMT Treatment capacity and caseload summary 03 March to 08 March

Epidemiólogi st & Public Diff Places Health Officer 20 doctors, 0 nurses&30 others Facility Facility FMT name type District Composition African Union Diff Places ETC, EHC Nigeria 18 doctors, 27 nurses&23 others African

Union Kenya ASPEN Hastings Western ETC, EHC Australia Airfield Rural 7 doctors, 15 nurses&5 others CAP Ola During ANAMOUR Childrens EHC Freetown (Germany) Hospital 2 doctors, 3 nurses&2 others Chinese Western Medical Jui hospital ETC Rural Team 10 doctors, 18 nurses&11 others Kerry Town - Western Save the ETC Rural Children 22 doctors, 38 nurses&0 others Waterloo - Western ETC MoH Rural 9 doctors, 27 nurses&0 others Cuban Ola During Government Pediatric EHC Freetown Hospital 10 doctors, 11 nurses&5 others Port Loco - Maforki - ETC Port Loko Partners in Health 17 doctors, 25 nurses&0 others Port Loko- Danish Gov. ETC Port Loko GOAL 6 doctors, 15 nurses&5 others LAKKA Emergency ETC Port Loko Hospital 0 doctors, 0 nurses&0 others Port Loko - GOAL ETC Port Loko GOAL 8 doctors, 10 nurses&18 others FMT Treatment capacity and caseload summary 03 March to 08 March

IFRC Kenema ETC Kenema 1 doctors, 6 nurses&6 others (Internationa l Federation of Red Cross Kono ETC Kono Societies) 2 doctors, 10 nurses&9 others Lunsar (Port 8 doctors, 12 nurses&3 others International ETC Port Loko Loko) Medical Mateneh Corps (IMC) ETC Bombali (Makeni) 8 doctors, 6 nurses&11 others Mastaka, Bo, Bo, Western International Western Rural Rescue EHC Rural (Johu Committee Thorpe) 5 doctors, 40 nurses&15 others KING´S Connaught EHC Freetown PARTNERSHI Hospital P Freetown 5 doctors, 4 nurses&2 others Korea ETC Emergency, Western Disaster Goderich Rural Relief Team 13 doctors, 21 nurses&5 others Liberia (ambulance team) First Responder Liberia Inc. 0 doctors, 1 nurses&10 others Marie S. 0 doctors, 0 nurses&0 others Facility Facility FMT name type District Composition MEDAIR Kuntorloh ETC 2 doctors, 4 nurses&9 others Medicos del Moyamba ETC Moyambaa Mundo (MDM) doctors, nurses& others MSF Holland Tonkolili ETC Tonkolili 0 doctors, 0 nurses&0 others MSF Spain Methodists Western 0 doctors, 0 nurses&0 others ETC Boy College Rural NHS STC (KT) IMC ETC Bombali, 10 doctors, 15 nurses&6 others Makeni, Western FMT Treatment capacity and caseload summary 03 March to 08 March

GOAL Port Rural, Port Loko Loko Freetown ? Freetown Norway Moyamba ETC Moyamba 5 doctors, 8 nurses&0 others Partners in Port Loko EHC Port Loko Health Maforki 0 doctors, 0 nurses&0 others Port Loko EHC, non- Government Port Loko ebola care Hospital 0 doctors, 0 nurses&0 others Kambia CCC 0 doctors, 0 nurses&0 others Lunsar, Foredugu, Kamasundu, Kagbantama, CCC Port Loko Lokomasama , Gbanelol, Sumbuyu 0 doctors, 0 nurses&0 others Koidu Overall Government Kono hospital Hospital 0 doctors, 0 nurses&0 others Kayima, Gondoma, CCC Kono Gbane, Njagbwema 0 doctors, 0 nurses&0 others Right to Care Emergency, Western (South ETC Goderich, Rural Africa) 1 doctors, 6 nurses&2 others Save the Western Kerry Town ETC, EHC Children Rural 13 doctors, 4 nurses&1 others UK Military WAHO (West Police African Training Western Health ETC, EHC School 2, Rural Organization Hasting ) 10 doctors, 11 nurses&7 others Welbodi Ola During EHC Freetown 2 doctors, 1 nurses&1 others FMT Treatment capacity and caseload summary 03 March to 08 March

Children´s Partnership Hospital World Hope International (working in CCC Bombali CCCs Bombali) (Source: FMT Sierra Leone Data warehouse ) GUINEA CASES AND 02/03/201 TREATME 5 to NT 08/03/201 CAPACITY WEEK 10 DATES 5

POPULATIO OPERATION OPERATION BEDS PER N (2014 NEW CASES INCIDENCE DAYS SINCE NUMBER AL ETU AL CDT CASE OCCUPANC DISTRICT census) (confirmed) per 100,000 LAST CASE OF ETUs BEDS BEDS (ETU+CDT) Y RATE (%) Beyla 325482 0 0.00 75 1 20 0 No cases 0.00 Boffa 211063 0 0.00 1 0 0 No cases NA Boke 449405 0 0.00 149 0 0 No cases NA Conakry 1667864 13 0.78 0 2 92 0 7.08 16.30 Coyah 264164 8 3.03 0 1 50 0 6.25 50.00 Dabola 182951 0 0.00 73 0 0 No cases NA Dalaba 136320 0 0.00 152 0 0 No cases NA Dinguiraye 195662 0 0.00 NA 0 0 No cases NA Dubreka 328418 5 1.52 0 0 0 5 cases, no NA FMT Treatment capacity and caseload summary 03 March to 08 March

beds Faranah 280511 0 0.00 38 0 0 No cases NA Forecariah 244649 28 11.44 0 0 14 0.50 28.57 Fria 96527 0 0.00 64 0 0 No cases NA Gaoual 194245 0 0.00 NA 0 0 No cases NA No cases, Gueckedou 291823 0 0.00 77 1 98 0 98 beds. 0.00 Kankan 472112 0 0.00 55 0 0 No cases NA No cases, Kerouane 211017 0 0.00 72 0 20 20 beds 0.00 Kindia 438315 2 0.46 0 1 62 0 31.00 1.61 Kissidougo 283609 0 0.00 28 0 0 No cases NA Koundara 130205 0 0.00 NA 0 0 No cases NA Kouroussa 268224 0 0.00 72 0 0 No cases NA Labe 318633 0 0.00 Na 0 0 No cases NA Lola 175213 0 0.00 12 0 0 No cases NA Macenta 298282 0 0.00 9 1 50 0 No cases 4.00 Mali 290320 0 0.00 16 0 0 No cases NA Mamou 318738 0 0.00 NA 0 0 No cases NA N'Zérékoré 396118 0 0.00 43 1 50 0 No cases 0.00 Pita 277059 0 0.00 153 0 0 No cases NA Siguiri 695449 0 0.00 34 0 20 No cases 0.00 Telemele 283639 0 0.00 67 0 0 No cases NA Tougue 122959 0 0.00 34 0 0 No cases NA Yomou 176664 0 0.00 181 0 0 No cases NA TOTAL 10025640 56 0.56 8 422 54 8.50 9.03

- Epi summary: Cases continue to be concentrated within the Conakry, Forecariah and Coyah regions, with the return of activity to Kindia this week. Less than a third of cases were on contact lists were low; with ongoing reticence being implicated in this low figure. FMT Treatment capacity and caseload summary 03 March to 08 March

- FMT& ETU summary:

o FMT Coordination unit held FMT meeting

o The CTD in Forecariah may be transitioned to be a CTE.

o Kindia ETC has admitted its first ebola positive patient

o N'Zérékoré and Geuckedou remain empty. This could be an opportunity to relocate these teams to more active regions.

o Coyah ETC remains at 50% full. With it being the setting for the flavipiravir study, measures are being taken to ensure that extra diagnostic requirements will be met.

- Training:

o There are many streams of technical and psychosocial support training underway in the areas of Surveillance and contact tracing, IPC training, and safe burials. Training support for logisticians has also been requested.

- Research: currently three trials underway in Guinea. Their execution will require ongoing clinical governance to ensuring high standards of care.

- Decommissioning: there is no update available at this time.

- Other: Contact tracing teams in Forecariah have been able to undertake their roles without obstruction from reticence.

GUINEA FOREIGN MEDICAL TEAMS (currently active) Facility FMT Facility name type District Composition Conakry Donka ETU Conakry MSF Belgium Géuckédou ETU Géuckédou FMT Treatment capacity and caseload summary 03 March to 08 March

ETU for health French Military Health Aéroport Militaire care Services (Conakry CTS) workers Conakry French Red Cross Macenta ETU Macenta ALIMA Nzérékoré ETU Nzérékoré 37 total (19 doctors; 18 Cuban Medical Brigade Coyah ETU Coyah nurses) WAHO Coyah ETU Coyah African Union Coyah ETU Coyah 61 Russian team Kindia ETU Kindia WAHA Beyla ETU Beyla