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Prevention and Control of Ebola Virus Disease in Kankan Region, Guinea

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Prevention and Control of Ebola Virus Disease in Kankan Region, Guinea Prevention and Control of Ebola Virus Disease in Kankan Region, Guinea AID-OFDA-G-15-00030 Start Date: December 1, 2014 Program Duration: 12 months Period of the report: April 2015 – Jun 2015 Helen Keller International Headquarters Contact: Country Office Contact: Jennifer Nielsen, Sr. Nutrition Advisor Bamba Foungotin Ibrahim, Country Director 352 Park Ave South, Ste 1200 HKI-Guinea New York, 10010 USA BP 6050, Conakry, Guinea Telephone: (646) 472-0321 Telephone: + 224 657 00 44 00 Fax: (212) 532-6014 E-mail:[email protected] E-mail: [email protected] • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Helen Keller International www.hki.org Introduction and overview EVD was first confirmed by the World Health– Organization (WHO) in the Forest Region in March 2014, three months after the first suspected case was signaled. Initially confined to the forest area, it quickly spread to neighboring regions and districts often transmitted during traditional burial rites in which highly contagious corpses were handled. Due to the inadequate initial response, the virus quickly crossed national borders into Liberia and Sierra Leone. An appropriate response requires interventions based on the key levers of control and treatment: identification, referral and effective treatment of cases in Ebola treatment units (ETU) and the effective training and equipment of health workers; tracing and monitoring of every person known to have had physical contact with an infected person and isolation of those who develop symptoms; safe burials; active surveillance to identify new transmission chains; and communications campaigns to raise awareness of the dangers, signs and symptoms of EVD. Community members must be enlisted to support the efforts of the health and sanitation systems. In addition, individuals who may have been infected through close contact and are being held in quarantine require care, including food and moral support, until their status is resolved. HKI will contribute to the control of EVD through its expertise in capacity building and community mobilization, strengthening the capacity of health facilities and community structures to prevent the transmission of EVD and to trace contacts in the health districts of Kankan, Siguiri and Kouroussa At(Kankan the health Region). center level , HKI will collaborate with the Regional Committee for the Fight against Ebola, WHO and other responders to support the training health workers serving in Kouroussa, Kankan and Siguiri on- standard measures for infection prevention and control (IPC). The project will supply all the health centers in these three districts with protective gear, hand washing stations, chlorine, and Atthe thermo communityflash devices level for determining body temperature. vigil committees , surveillance will be strengthened through the training of who will work under the supervision of local partners including the MOH and local government social services. These vigil committees will conduct surveillance and inform authorities as quickly as possible of suspicious deaths and or suspect cases of EVD. Public places in the villages (such as markets, churches and mosques) will be equipped with hand washing stations and chlorine. Counseling cards will be adapted or developed to enable these volunteers to conduct public awareness campaigns in their communities. Voucher or other distribution systems will ensure all community members have access to soap and chlorine for disinfection. Community radio will also be engaged to develop and broadcast programs to raise awareness about Ebola, including precautions for safe burial and stigma Thereduction. contact tracing system - will be strengthened by training additional agents to track down individuals who have had contactcontact with tra thosecing agentsinfected with EVD, and equipping these agents with thermo flash thermometers to monitor the health status of these potential cases during the 21 day period of observation. These will also be equipped with smartphones connected to an interface to allow them to transmit data on their activities in real time to a central, shared server. This will document the time and location of visits to each contact, and any signs of disease presented. Supervisors will monitor and support localtheir efforts.education offices Finally, the project will work with the to train teachers on the prevention and symptoms of EVD as well as the importance of referring cases and the risks of transmission. They will receive the counseling cards to guide their lessons. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Helen Keller International www.hki.org Table 1: Project monitoring indicators Sector 1 : Health Objective: To strengthen the capacity of health facilities and community structures to prevent the transmission of EVD and to trace contacts in the health districts of Kankan, Siguiri and Kouroussa Sub-sect or 1: Health system and clinical support. Indicator Target Quarter Quarter 2 Quarter 3 Quarter 4 Cumulati M F 1 Number of health care providers M F M F M F M F M F trained by type (e.g., doctor, 128 76 99 nurse, community health worker, midwife, and traditional 46 23 4 50 birth attendant), disaggregated 128 97 2 Number of health care facilities supported and/or rehabilitated by type (e.g., primary, secondary, 176 273 tertiary) 100% 3 Number and percentage of 100% 100% Sub-healthsector facilities 2: Community submitting Health Education/ Behavior Change Inweeklydicato surveillancer reports Target Quarter 1 Quarter 2 Quarter 3 Quarter Cumulative 1 Numbers of CHWs trained and M F M F M F M F M F M F supported, disaggregated by sex Total:150 0 0 29 21 29 21 150 Total: Total: Total: Total: Total: 2 Number and percentage of CHWs specifically engaged in 0 50 public health surveillance 3 Number and percentage of community members utilizing 0 0 target health education message Capacity building and Behavior Change Communications During this quarter we trained 27 health agents in the health district of Kouroussa on prevention and control of infections in the context of Ebola. Of the 27, there were 4 women and 23 men; one medical doctor and 26 nurses. We also moved forward on the recruitment of 30 community supervisors and 150 community health workers (CHW), who will be used in community education on the risks and prevention of Ebola. In addition to activities related to Ebola, these agents will address other epidemic diseases, working in close contact with health centers. To support their work we have equipped the CHW with 150 megaphones, 200 job aids and back packs. Supervisors have been equipped with motorcycles, back packs, and protective gear to allow them to reach all target communities. The training of the supervisors and CHW began at the end of this quarter with 50 agents (29 men ; 21 women). The remaining agents are being trained as this report is being submitted, so details will be included in the next report. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Helen Keller International www.hki.org Health centers have been equipped with 600 reusable cotton coats. The project originally targeted 128 health centers, but we are now covering 273. We have included all private centers as well as public clinics in the Kankan region. The number may further increase as the health directorate identifies further sites where there is a risk of exposure. Monitoring and Evaluation All training has been supervised by the project coordinator, the Regional Health Directorate and Prefecture coordinators of the Ebola control efforts in Kankan, Kouroussa and Siguiri. Post training supervision systems have also been established. Challenges For several weeks there have been no new cases detected in the project zone, and consequently the local population and authorities are tempted to relax their vigilance. Thus the challenge is to maintain high alert and avoid complaisance. The appearance of new cases who are suspected to have been infected by survivors suggests that certain assumptions need to be revisited and survivors watched for longer than 42 days, in particular counseled to avoid sexual relations. In response to new directives from the national Ebola coordination body, we have submitted a formal request to OFDA to allow us to expand our training and equipment to cover the entire Kankan region. We have recruited a program assistant who is currently attending a training of trainers offered by WHO. The project will then have a certified trainer in the Prevention and Control of Infections (PCI). There is a shortage of qualified human resources, which has created competition for staff. We have just lost our Project Coordinator to WHO. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Helen Keller International www.hki.org .
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