13Th REGIONAL MEETING of the ACP-EU JOINT PARLIAMENTARY

13th REGIONAL MEETING OF THE ACP-EU JOINT PARLIAMENTARY

ASSEMBLY

Freetown, Sierra Leone - 22 to 24 February 2017-Presentation by Red Cross

OPENING COURTESY

My name is Abu Bakarr Tarawallie, I am a member of the SLRCS Senior

Management Team, heading communications and humanitarian diplomacy. I bring you greetings from the Secretary General on whose behalf I stand here as proxy.

Mr. Chairman, Excellences members of the Diplomatic and Consular Corps,

Honourable Members of Parliaments of Member-States of the ACP-EU, respect deserving Ministers of Governments of the Republic of Sierra Leone, esteemed guests, members of the press, distinguished ladies and gentlemen, the Red Cross is honoured to be considered to participate in this all important Regional Meeting of the ACP-EU Joint Parliamentary Assembly in Freetown today.

BACKGROUND TO THE EVD OUTBREAK IN SIERRA LEONE

The unprecedented spread of the Ebola Virus Disease (EVD) in West Africa resulted in one of the most challenging public health crises in recent times. The International

Red Cross and Red Crescent Movement was part of the extensive global effort mobilized to contain the epidemic in solidarity with the affected countries and the

1 international community. At the beginning the Red Cross also had limited knowledge and expertise in dealing with the virus.

With more than 10,000 Red Cross volunteers trained in Guinea, Liberia and Sierra

Leone, supported by the Red Cross Red Crescent’s network of 189 National

Societies worldwide, the Red Cross Red Crescent Movement has been uniquely placed to play a critical role in responding to the outbreak while fostering preparedness in at-risk countries.

The EVD in West Africa was the longest and most widely spread EVD outbreak in the history of the disease, it affected more persons than previous outbreaks. The Red

Cross worked with other stakeholders in the recovery activities as they reviewed their systems and learnt lessons from the outbreak.

Along with other actors, the Red Cross followed the Ebola Response Framework for achieving and sustaining zero cases. The approach incorporated new developments in Ebola control from vaccines, diagnostics, response operations to survivor counselling and care, Safe and Dignified Burial (SDB) and disinfection of houses.

The Ebola outbreak became a public health, humanitarian and socioeconomic crisis with a devastating impact on families, communities and affected countries. Through coordination with other Partners in the recovery phase, the Red Cross recognised the strengths of others, and the need to work in partnership to avoid duplication of

2 resources. Together with partners, the Red Cross continues to engage to re-establish the services, systems and infrastructure which have been devastated in Guinea,

Liberia and Sierra Leone. The Red Cross Post Ebola recovery is country-led and community-based – engaging many partners who have something to contribute; including bilateral and multilateral partners, national and international NGOs, the faith community, and the private sector. A total of 28 616 confirmed, probable and suspected cases have been reported in Guinea, Liberia and Sierra Leone, with 11,

310 deaths towards the end of the Ebola outbreak which created a Public Health

Emergency of International Concern (PHEIC) by March 2016.

Having contained the last Ebola virus outbreak in March 2016, Sierra Leone maintained heightened surveillance with testing of all reported deaths and prompt investigation and testing of all suspected cases.

The Ebola emergency response faced various challenges, starting with fear, rumours, misconceptions, the delayed identification of the unprecedented scale of the epidemic, the challenges within health systems in the affected countries, the lack of knowledge of most responders on handling EVD and the lack of solidarity of other players in the international community. The recovery plans continue to focus on providing support to people affected by the outbreak.

The ultimate goal of post-EVD recovery plans is to re-establish the conditions for a quick return to a healthy society, with viable livelihoods, psychosocial well-being, economic growth, and overall human development. At the same time, the immediate priority is to address the effects of adverse conditions that enabled a localized epidemic to escalate into a national crisis with regional and global ramifications.

Last available cumulative data are provided below for situation and prog. Indicators:

Indicators Operational Countries

Guinea Liberia Sierra Total

Leone

Cumulative cases 3,814 10,682 14,124 28,620

Cumulative health care 115 192 541 848 worker deaths

Cumulative deaths 2,544 4,810 3,956 11,310

Fatality rate 66.7% 45% 28% 40.6%

Trained RC volunteers 1,134 142 4,924 6,200 active in EVD operation

People reached through 2,428,020 2,411,220 3,561,128 8,400,368 face to face social mobilization

People reached through 12,655 8,953 405,030 426,638 psychosocial support

Performance indicators suggest that Guinea, Liberia and Sierra Leone still have variable capacity to prevent (EVD survivor programme), detect (epidemiological and laboratory surveillance) and respond to new outbreaks. SLRCS concluded the process of permitting volunteers who are benefiting from the reskilling and reintegration project to present acceptance letters especially from vocational institutions. The number of volunteers who opted for business after the initial assessment was 508 which is very high considering that only 20 proposals will be supported after the BDS course training. Continued engagement with volunteers through workshops and counselling sessions, has reduced the number from 508 t0

405. Additionally, the education stream has increased from 93 to 108 and vocational skill stream from 210 to 225.

The final breakdown of SDB/IPC volunteers based on the category of streams chosen is as follows:

1. Continue education 108

2. Vocational training 225

3. Business development 405

4. Career Development 62

5. Total 800

A verification exercise has been completed with a total number of 73 Institutions nationwide for continued education and vocational skills. A total of 108 letters were received from volunteers who opted to continue their education and 225 letters received from volunteers who opted for vocational skills.

These acceptance letters were used by the verification team members to access all the institutions. All the indicated institutions were visited and discussions held with the heads/principals/proprietors and other key staff. Verification of the institution was carried out based on the following:

. Existence of the institutions

. Facilities available for the institutions

. Tutors for the training program

. Knowledge of the institutions about the recruited beneficiaries

. Availability of training spaces

. Recognition of the institution by the central government and other agencies

. Type of certificates presented to graduands.

Ongoing follow-up visits are made to volunteers in need of special attention such as those experiencing sleeping difficulties, stigmatization, family pressure and conflict in all districts. Full details of statistical data are available in the office. Individual and group counselling sessions were organised in 10 branches for SDB/IPC volunteers to guide them away from their traumatised state and to progress with their lives and successfully go through their livelihood activities for those who have started and are waiting for payment of their fees.

These activities are ongoing as ‘de-traumatization’ is a process that takes time to completely move people to their normal lives. On-going sensitizations sessions in eight communities from eight district headquarter towns have been organised on stigmatization especially for Ebola response workers, survivors and Ebola affected communities, proper hand washing, and community services such as cleaning campaigns. Coordination meetings are been attended at district level and updates of activities are shared. One survivor was also referred to a government hospital for specialised treatment in Freetown.

EVD EMERGENCY OPERATIONS IN SIERRA LEONE

 Sierra Leone Red Cross Society started participation in the Ebola Virus

Disease Emergency Operations in 2014, after the declaration of its outbreak

by Government, instituting proportional preparedness, vigilance and

appropriate action.

 As an auxiliary to the Government of Sierra Leone, the Sierra Leone Red

Cross Society accepted to participate in the response through all the pillars

established including Safe and Dignified Burial activities. By the way, the

Red Cross was the only organisation that participated in all the pillars of

intervention during the Ebola Virus outbreak in Sierra Leone and covered all

the districts of the country.

 About 1400, volunteers were engaged in the community engagement

activities (Psycho-Social Support, Social Mobilization and Contact Tracing),

while 540 volunteers were engaged in the Safe and Dignified Burial activities.

The presence of these volunteers was felt all over the country.

 Sierra Leone Red Cross was co-chair of the Burial pillar team at the

Emergency Operational Centre.

 Social mobilization volunteers conducted awareness raising at community

level with other partners. PSS and contact tracing volunteers were engaged in

rendering psychological support to community members, survivors and their

relatives.

 The community engagement volunteers participated in all health related

campaigns ranging from birth registration, polio immunization campaign,

distribution of bed nets, identification and referral of pregnant women for ante

natal care and children under five not immunized for age for their respective

vaccines. Their involvement in these activities helped to profile the activities

of the society and also increased collaboration amongst line ministries,

including MSWGCA, MOHS and partners.

 The strategies for implementation included conducting community meetings,

focus group discussions, house to house visits, school visits and other

meetings with stakeholders.

 In order to effectively coordinate and collaborate, District Emergency

Response Centres and a National Emergency Response Centre were formed

by the Government.

 The daily pillar meetings were attended by the respective pillar officers. In

those meetings, successes, challenges were discussed and recommendations

proffered.

 The SDB team was engaged in conducting safe and dignified burials in all the

chiefdoms in the district.

 With the support of the beneficiary communications volunteers, community

members were able to understand and accept the burial process.

 In a bid to promote proper hygiene and sanitation practices in both schools

and community hand washing materials were distributed to schools and

communities.

 The distribution of radios to community members and weekly radio

discussions programmes helped increased community participation as

volunteers in the different pillars were able to reach more people in the

districts and also got feedbacks from community members through the radio

phone-in talk shows.

 The construction and equipping of the information kiosks with WASH and

information materials in all the Branches helped to improve on community

ownership and dissemination of useful life-saving information.

WE HAVE LEARNT A LOT SINCE MARCH 2014

. A localized response to localized epidemics: balance mass communication &

community engagement efforts

. Teach the ‘HOW’ and supervise: Do not only give volunteers standard

messages but teach them how to listen, ask and communicate better/tailor

messages to the local situations

. The fear factor: balance the threat/fear communication with actionable

messages

. Real time knowledge/information management system (socio-

anthropological data & rumour management)

. Take the discussion from a top down “DON’T” to a partnership of “CAN”

with communities. Build TRUST and PARTNERSHIPS

. Two-way communication and feedback loop: solicit continual feedback

from community members and health workers, analyse it and act on it

BE PREPARED:

. Establish coordination mechanisms to be rapidly activated

. Develop tools and workforce skills to conduct needs/capacity assessments

. Build capacities to collect analyse and use real time data (rumours,

feedback, community resistance…)

. Map and keep updated and accessible in-country media channels data

. Improving the evidence base and data sharing

EFFECTS OF EBOLA

The effects of Ebola on the population and the economy are as follows:

 The response helped the Red Cross to make use of the best and most

up-to-date knowledge and material available during the emergency

situation.

 The EVD response through the DFID financial support through IFRC

aided the National Society to recruit a large number of volunteers.

 Experiences gained during the response by Red Cross assisted in

planning and conducting of response plan towards any intervention.

Preparedness plan activities like supporting Health teams in

surveillance, first Aid refresher trainings and mobilizing volunteers

for response were enhanced.

 There were indications of strong concerns held by communities,

volunteers and staff of Red Cross of a persistent impact of the EVD and

its response. These concerns caused SLRCS to extend invitation to

technical teams like the FACT, ERU and RDRTs of the IFRC.

RECOVERY PROCESS

 Our recovery programmes go beyond the provision of immediate relief

to assist those who have suffered the full impact of a disaster to rebuild

their homes, lives and services and to strengthen their capacity to cope

with future disasters.

 British Red Cross Society supported SLRCS in assessing the district

branches for subsequent recovery intervention.

 Based on the vulnerability of the branches, recommendations were

given on which activity was to be implemented in the different district

branches.

 Livelihood and food security, psychosocial support, community Events

Based Surveillance and Disaster Risk Reduction were planned to be

implemented in identified branches.

 In November 2015, there was a report of Ebola Virus Disease surfacing

in the Tonkolili District. This obstructed the recovery plan and made

the National Society to hault their recovery plan and response to the

Tonkolili challenge.

 Volunteers were engaged in the Northern Branches-Tonkolili,

Bombali, Kambia and Port Loko, for a period of three months, causing

the recovery plan to be extended to mid 2016.

 The partner support team (IFRC) was reduced, leaving only the

technical team members attached to the different recovery programs.

 Logistics support in terms of the vehicles was also reduced and most of

the vehicles were returned back to the Regional Fleet base in Dakar.

THE PSYCHOLOGICAL EFFECTS OF EVD ON THE FRONT LINE

WORKERS

 The engagement of youth in burial activities was looked upon as violation of

community culture and tradition as only the aged were responsible for

touching dead bodies.

 Youth engaged in burial activities faced the problem of mental stress.

According to Kalokoh, a volunteer from Western Area: ‘‘The images of

decomposed bodies began to haunt me, even after the day`s work.’’

 Relatives neglected their children that were participating in the EVD response

activities. According to Morqui, a volunteer from the Kailahun district branch,

his parents started feeding him like a dog with food in dirty plates and pushed

unto him to feed.

 Some refused to continue their education for fear of being provoked by their

friends or school mates. According to Elizabeth, from Western Rural

operational area, she deliberately refused to go to school because her

colleagues started calling her the dead man`s friend.

CHALLENGES WE FACED

Lack of timely reliable data, information management and sharing to understand:

. Mistrust, myths, fear, panic + difficult behaviours to adopt in a short period

of time (isolation, burials, no-touching…)

. Stigma hindering people from using the services

. Gaps in knowledge and understanding

. Reasons for people hiding the sick from health personnel.

. Rumors still persisting: man-made disease (government, foreigners)

FUNDING

On behalf of the Red Cross in the Ebola affected countries, and on behalf of the

International Movement of the Red Cross we would like to thank the following for all their contributions to the Ebola Emergency Appeals: American Red Cross and

US government, Andorran Red Cross, Australian Red Cross and Australian government, Austrian Red Cross and Austrian government, Belgian government,

British Red Cross and British government, Canadian Red Cross and Canadian government, Red Cross Society of China Hong Kong branch, Czech government,

Danish Red Cross and Danish government, European Commission – DG ECHO,

Finnish Red Cross and Finnish government, French Red Cross, German Red Cross,

Icelandic Red Cross and Icelandic government, Red Crescent Society of the Islamic

Republic of Iran, Irish Red Cross, Italian government, Japanese Red Cross and

Japanese government, Kenyan Red Cross, Korean Red Cross, Monaco Red Cross and Monaco government, Netherlands Red Cross and Netherlands government,

Norwegian Red Cross, Philippine Red Cross, Portuguese Red Cross, Qatar Red

Crescent, Spanish Red Cross and Spanish government, Swedish Red Cross and

Swedish government, Swiss Red Cross and Swiss government, Taiwan Red Cross

Organization, UNICEF, and the International Committee of Red Cross (ICRC). In addition, the IFRC Secretariat would like to thank the following foundations and corporate partners for their contributions: Bill and Melinda Gates Foundation,

Airbus, International Federation of Freight Forwarders Association, KPMG, Nestle,

Nethope Inc., Shell, Sime Darby Berhad, Tullow Guinea Limited and World Cocoa

Foundation.

WHAT STILL NEEDS TO BE DONE:

 Psychosocial Support (PSS)

 Community Events Based Surveillance (CEBS)

 Community Engagement and Accountability to Beneficiary (CEA)

 The Sierra Leone Health Systems Strengthening – The Red Cross

remains committed to work with the relevant stakeholders, including

Government to support the recovery process and the health systems

strengthening, especially in the area of national emergency ambulance

services where it has huge capacity expertise.

 Strengthening Early Warning Systems (EWS)

Thank you very much for your time. God bless you.

Abu Bakarr Tarawallie, Sierra Leone Red Cross Society