Recruiting Infection Prevention and Control (IPC) Mentors for an exciting project!

Welbodi Partnership is recruiting Infection Prevention and Control (IPC) mentors (1-3) for a very exciting project that will kick-off in February 2015 in many government hospitals in Sierra Leone. Join the Welbodi Partnership team and help us roll out this project in 3 hospitals in Freetown to improve infection control measures and ensure staff and patient safety. Please pass this on to others you know who may be interested. Here are some more details:

Position: Infection Prevention and Control (IPC) Mentor

Location: Freetown, Sierra Leone

Start Date: January 1^st 2015

Duration: 6-12 months

BACKGROUND: Welbodi Partnership (WP) is a UK-registered charitable organisation based at the Ola During Children’s Hospital (ODCH) in Freetown, Sierra Leone. For the past five years, Welbodi has worked towards improved paediatric care in the Western Area of Sierra Leone through hospital system development, infrastructural changes, staff training, provision of equipment and community engagement in partnership with ODCH staff, the Ministry of Health and Sanitation (MOHS) and the Sierra Leone Institute of Child Health (SLICH).

Welbodi Partnership continues to support healthcare in Sierra Leone during the outbreak of Ebola Virus Disease (EVD) by providing coordination support to the holding unit at the Children’s Hospital while at the same time strengthening the safe provision of ‘routine’ health services (non-Ebola care) to children in the hospital. WP is working with the MOHS and other partners to roll out a national programme to strengthen Infection Prevention and Control (IPC) in government hospitals and to ensure that hospitals have the water and sanitation infrastructure necessary to adhere to IPC. Welbodi will implement this programme in three hospitals in Freetown.

SCOPE OF WORK: Welbodi Partnership is looking to recruit Infection Prevention and Control (IPC) Mentors to join the team in Freetown to work in collaboration with MOHS colleagues to improve IPC practices within government hospitals. The MOHS is establishing Patient Safety committees in each hospital with an appointed IPC focal person. The IPC Mentor will support this structure and provide mentorship to the committee and focal person.

PLEASE NOTE: Due to the urgency, applications will be reviewed as they are received and suitable candidates contacted on an on-going basis. This position is for 6-12 months. At this time, WP can only accept applications from citizens or permanent residents of North America and Europe due to limitations in the complex evacuation process in case of emergency.

ROLE:

• To work with the hospital patient safety committee to ensure implementation and strengthening of Infection prevention and control (IPC) practices within the hospital
• To facilitate the safe provision of essential health services and support the protection of healthcare workers in the hospital by ensuring that screening and isolation of suspected EVD cases and necessary modifications of routine services are implemented according to the Standard Operating Procedure

RESPONSIBILITIES:

• To mentor and support the hospital Patient Safety Committee (PSC) and IPC Focal Person and ensure that regular meetings are established with appropriate reporting structures to district and national level
• To support the PSC and IPC focal person with the implementation, including training, of the SOP for “Safe Provision of Hospital Services during an Ebola/Viral Haemorrhagic (Fever)” and the Ministry of Health and Sanitation’s “National Patient Safety Guidelines”
• To support the PSC and IPC focal person with the monitoring of staff adherence to the SOP and broader infection prevention and control measures, including the performance of daily and weekly IPC assessments in the facility (e.g. hand hygiene, decontamination, disinfection, sterilization, screening of patients) and addressing incidents or barriers
• To support the PSC and IPC focal person in setting up a system for identifying, reporting and investigating sources of infections (e.g. making departmental rounds, reviewing clinical reports, identifying at-risk patients) and healthcare acquired infections (HAIs) and taking appropriate actions.
• To support the PSC and IPC focal person to systematically collect, analyze and interpret health data in order to plan, implement, evaluate and disseminate appropriate public health practices
• To support the PSC and IPC focal point in planning and delivering ongoing training sessions and holding regular meetings with healthcare staff to disseminate information on infection control practices
• To support the PSC and IPC focal point in ensuring that IPC supplies are available in the hospital and advocate for supplies through MOHS/Central Medical Stores (CMS)
• To develop a report of IPC activities in the facility on a monthly basis for WP
• To support the Project Manager in evaluating the impact of the programme
• To perform any other duties deemed necessary to meet the needs of this project

REQUIREMENTS:

Essential:

• A recognized qualification in nursing, medicine or epidemiology with additional qualifications or significant experience in infection prevention and control
• A minimum of three years recent experience in a hospital setting
• Excellent people skills and the ability to work collaboratively with people from diverse backgrounds
• Ability to self-motivate and work autonomously within the scope of the role
• Excellent computer skills particularly in Microsoft Word, Power Point and Excel
• A good command of the English language (verbal and written) is required
• Flexibility in roles and responsibility is essential

Highly desirable:

• Certification in Infection Control (CIC) is preferred
• A Masters in Public Health (MPH) is an asset
• Experience of working and living in a developing country, preferably in Africa
• Experience in IPC training/mentorship/programme development
• Krio or other local language ability

SALARY/BENEFITS: Based on qualifications and experience, to be discussed with shortlisted candidates.

APPLICATION PROCESS: Interested candidates should email a copy of their CV, cover letter, and a list of three relevant references to jobs@welbodipartnership.org as soon as possible. The job title should be included in the subject line. Your cover letter should include: your country of residence and nationality, your date of birth, dates you are able to commence and duration of availability. Only those applicants shortlisted for an interview will be notified.

Equality and Diversity Statement

The Welbodi Partnership confirms its commitment to a comprehensive policy of Equal Opportunities in volunteering and employment in which individuals are selected and treated on the basis of their relevant merits and abilities and are given Equal Opportunities within the organisation. It is the Welbodi Partnership’s policy as an employer to treat all people equally irrespective of race, ethnic origin, nationality, sex, marital or parental status, sexual orientation, creed, disability, age or political belief.

Applicants for this position should be aware that if successful, they will be requested to complete a Disclosure and Barring (DBS) check, or equivalent in countries other than the UK. The Welbodi Partnership complies fully with the DBS Code of Practice. The entirety of the Welbodi Equality and Diversity statement is available upon request.

PLEASE NOTE: Due to the urgency, applications will be reviewed as they are received and suitable candidates contacted on an on-going basis. This position is for 6-12 months. At this time, WP can only accept applications from citizens or permanent residents of North America and Europe due to limitations in the complex evacuation process in case of emergency.

News from the Welbodi Partnership's Ebola Response Team

In November, scientists and NGO leaders came together in New Orleans for the American Society of Tropical Medicine & Hygiene meeting which is held each year in the US. This year’s hot topic was unsurprisingly Ebola and its impact on health care in affected regions. What might be surprising though is that the keynote speaker, Bill Gates, whose organisation has donated billions to research, saw it not just as a tragedy, but also as an opportunity to focus on health and improve systems that were revealed to be so drastically in need. While listing the top priorities of global health he pointed out that “We really should be investing in the primary health care systems of all countries. In Africa in particular and in Liberia, Sierra Leone and Guinea, those primary health care systems are not very good.”

Welbodi is working hard in Sierra Leone to strengthen the weakened systems by helping people regain trust in the Ola During hospital, medical workers and other health systems in country, a crucial step in rebuilding. After so much fear from Ebola, it isn’t an easy task but dedication to helping the people of Sierra Leone and hard work are overcoming the challenge. The current funds the Welbodi Partnership has for the emergency are not only being used to support the holding unit at Ola During Children’s Hospital, but also to ensure that as children are leaving the hospital they aren’t leaving empty handed. For safety, contaminated clothing must be burned. These are being replaced along with a toy to comfort the children. Other projects include connecting the holding unit to the generator giving it uninterrupted power, providing WASH facilities for staff and setting up a surveillance office to allow vital records to be recorded and managed. These projects are a glimpse into the diverse needs of the situation.

The next few months will be pivotal for Sierra Leone. As cases of Ebola are beginning to go down in Liberia, both Guinea and Sierra Leone continue to see rises. The health care systems are still straining to keep up and while personal protective equipment and beds continue to be shipped in, its funder flexibility that’s needed most. This makes response times quicker and more efficient and with that comes a more rapid end to the crisis. Organisations like MSF are calling for the same flexibility. 

Thanks to generous individuals and funders including Nyawa Funding Group, DIFID and Comic Relief, we've been able to support the emergency response as well as provide vital training to doctors and nurses. We are expanding this training, developing our community response and beginning a round of hospital investment that will address the most pressing needs of the staff, patients and hospital. These projects all fit into a long-term strategic plan to strengthen the healthcare system for years to come.

The Welbodi Partnership will continue to be proactively helping in Sierra Leone. We agree with Mr. Gates in that this crisis is an opportunity to renew our focus on the transformation of the lives of children and mothers in Sierra Leone, to continue to partner locally to create lasting change and to do it all to the highest standard possible.

This report was written by Welbodi's newest team member - Liz Hollenberg. Welcome!

Urgent Recruitment for Welbodi Partnership Team

Welbodi Partnership – Urgent Recruitment

Please distribute this widely to people interested in this opportunity to help ensure the provision of essential paediatric services during the Ebola outbreak, and to improve child health in Sierra Leone thereafter.

Welbodi Partnership is a UK-registered charitable organisation based at Ola During Children’s Hospital (ODCH) in Freetown, Sierra Leone. For the past five years, Welbodi has been working towards improved paediatric care and a reduced child mortality rate in the Western Area of Sierra Leone through hospital infrastructural development, staff training, and community engagement in partnership with ODCH staff, the Ministry of Health and Sanitation (MOHS) and the Sierra Leone Institute of Child Health (SLICH).

Welbodi Partnership will continue to support paediatric healthcare in Sierra Leone during the current outbreak of Ebola and is looking to recruit the following people to join the team in Freetown, Sierra Leone:

• (Paediatric) Nurse Educator
• Community Coordinator/Advisor
• Project Manager

Ebola has a big impact on the public health systems in the country and will lead to a higher morbidity and mortality from other illnesses. Many children will die during the outbreak due to preventable and treatable conditions such as malaria, pneumonia and diarrhoea. While measures to stop the transmission of Ebola are scaled up, there is a need to focus on supporting the hospital to safely provide routine paediatric services.

A partner organization is running an Ebola holding unit at ODCH, which enables Welbodi Partnership to focus on the hospital itself. Our main activities are:

• To support ODCH in strengthening the delivery of essential ‘routine’ health services (non-Ebola care) to children during the Ebola outbreak in a safe manner, by providing training to hospital staff (nurses, doctors, cleaners, porters, laboratory technicians, etc.), with a primary focus on infection prevention and control (IPC); and by providing IPC supplies and equipment needed to ensure a safe working environment. Thorough screening of patients prior to entering the hospital should decrease the risk of exposure of health care workers, but a degree of risk remains, making the need for strict infection prevention and control (IPC) protocols essential. Other training modules will be taught once the IPC programme has been implemented effectively.
• To provide ODCH with an Ebola Response Fund to meet immediate needs for the hospital during the outbreak for projects that have a direct impact on the Ebola response. The projects can relate to infrastructure, equipment & supplies and capacity building
• To play an active role in the Case Management Committee for the Ebola Response, chaired by the MOHS Director of Hospital and Laboratories, which reports to the National Ebola Response Team. This role involves providing input to Standard Operating Procedures (Holding Centres, Non-Ebola Care Units, Infection Prevention and Control, Ambulance/Transport systems, and more) rolled out at national level.
• To provide direct coordination support to the ODCH Ebola Holding Unit, supported by MOHS and a partner NGO, to ensure that laboratory results are obtained quickly and patients are transferred appropriately.

Once the Ebola outbreak stabilizes we will resume our core activity, which is to provide long-term health system strengthening. We will do this in collaboration with ODCH staff, the Ministry of Health and Sanitation (MOHS) and the Sierra Leone Institute of Child Health (SLICH) to address the infrastructure, equipment and capacity building needs of ODCH and surrounding PHUs by using a participatory approach at community, PHU and hospital level. We will also help establish and support training programmes such as in-country postgraduate training for doctors in paediatrics, a diploma course in paediatric nursing management and leadership and continuing professional development for healthcare workers.

We are currently looking for people to fill the following positions as soon as possible. Due to the urgency, applications will be reviewed as they are received and suitable candidates contacted on an on-going basis. All of the positions are for a minimum of 6 weeks, desirable is 6 months with the possibility of extension. Familiarity with Sierra Leone is a great plus.

Job title:	(Paediatric) Nurse Educator
Role:	To support the national nurse educator in the ODCH nurse training office and help ensure the continuous implementation of high quality in-service training for nurses. Initial focus will be providing IPC training and supervision and monitoring on the wards to healthcare workers (nurses, doctors, cleaners, porters, etc.).
Requirements:	Minimum: A recognised professional nurse qualification with additional qualification in paediatric nursing or infection prevention & control or education, with at least 2 years of experience.
Desirable:	Experience of nursing and/or teaching nurses in West Africa.

Job title:	Community Coordinator/Advisor
Role:	To assess the current needs in the communities and Peripheral Health Units (PHUs) in the vicinity of ODCH in terms of social mobilization in the Ebola response as well as access to and availability of child health services. Long term: To support women and children by engaging community groups in participatory learning and action cycles to identify and prioritize challenges in accessing quality care and addressing these issues at community, PHU and hospital levels.
Requirements:	Minimum: Graduate level degree in relevant field or minimum 3 years health sector and project management experience.
Desirable:	Community or project management experience in a developing country.

Job title:	Project Manager
Role:	To manage projects at community, PHU and hospital level approved by the SLICH Board or a designated sub-committee that have a direct impact on the response to Ebola and neonatal and child health. This includes managing financial and material resources as well as ensuring that project objectives and outcomes are well designed, monitored, evaluated and met. To reconvene and facilitate quality improvement groups in facilities when this is feasible and appropriate.
Requirements:	Minimum: Graduate level degree in relevant field or minimum 3 years health sector and project management experience
Desirable:	Project management experience in a developing country

Benefits

We are looking for people to join the Welbodi Partnership team in Freetown as soon as possible. Benefits include a return flight to/from Sierra Leone, cost of visas and residence permits, cost of national professional registration, shared accommodation, emergency medical and travel insurance (including evacuation), transportation to and from work and a monthly stipend. A good command of the English language is required. Flexibility in roles and responsibility is essential. Appropriate training will be provided on arrival in Sierra Leone and personal protective equipment will be provided on site.

Application process

Interested candidates should email a copy of their CV, cover letter, and a list of three relevant references to jobs@welbodipartnership.org as soon as possible. The job title should be included in the subject line. We welcome applicants of any nationality, including Sierra Leoneans at home or in the diaspora. Only those applicants shortlisted for an interview will be notified.

Your cover letter should include:

• Your country of residence and nationality
• Your date of birth
• Dates you are able to commence
• Duration of availability

Equality and Diversity Statement

The Welbodi Partnership confirms its commitment to a comprehensive policy of Equal Opportunities in volunteering and employment in which individuals are selected and treated on the basis of their relevant merits and abilities and are given Equal Opportunities within the organisation. It is the Welbodi Partnership’s policy as an employer to treat all people equally irrespective of race, ethnic origin, nationality, sex, marital or parental status, sexual orientation, creed, disability, age or political belief.

Applicants for this position should be aware that if successful, they will be requested to complete a Disclosure and Barring (DBS) check, or equivalent in countries other than the UK. The Welbodi Partnership complies fully with the DBS Code of Practice. The entirety of the Welbodi Equality and Diversity statement is available upon request.

Emergency Ebola appeal

As you may know, Ola During Children’s Hospital (ODCH) stopped admitting patients on the 18^th of August, when a child that had spent several days on the emergency ward was suspected of having Ebola after the caregivers finally gave the correct history. This patient tested positive. Unfortunately, caregivers frequently hold back information for fear of their child having Ebola, leading to challenges with identification and appropriate isolation of potential cases. Sadly, this breach of protocol on this occasion meant that multiple patients, their families, and the health workers tending to them were exposed to Ebola. The closure of ODCH’s inpatient wards has inevitably had terrible consequences for children seeking care for any number of potentially life-threatening conditions. The consequences of the Ebola outbreak for pregnant women are equally as bad, as women end up giving birth at home for fear of catching Ebola if they deliver in a health facility or because they cannot access health care services because health staff are placed at high risk without proper protective equipment to allow them to safely conduct deliveries or c-sections. 

Currently, the ODCH management, Ministry representatives and partners are working to find a way to reopen the hospital in a manner that will ensure the safety of staff and patients. We are committed to supporting them in that process.

In recent days and weeks, the Welbodi Partnership has had multiple conversations both internally and with ODCH regarding how best we can support them to mitigate the effects of Ebola—including the ripple effects on Sierra Leone’s already fragile health system and on the ability of women to access services for safe labour and delivery and children to access care for preventable and usually treatable conditions. We simply cannot know with certainty what will be needed a few days from now, let alone months down the line, as Sierra Leone works to contain and then recover from this outbreak. What we do know is that the principles by which we have always operated—particularly the principles of partnership, and our recognition that health facility staff are often the best judges of what kinds of support they need—still hold during this emergency and its aftermath.

We are therefore raising an emergency fund to support initiatives proposed and implemented by staff on the ground at ODCH and Princess Christian Maternity Hospital (PCMH). We will also explore whether and how we might open this to peripheral health unit (PHU) staff and community initiatives in the Western Area. We will work with staff to develop and implement these ideas, and will coordinate with the MOHS and with other NGO partners, particularly those with expertise in Ebola prevention and control.  We envision that these initiatives might include efforts to train health personnel in infection control, provide protective equipment, support the re-opening of ODCH, coordinate with other NGOs in other parts of the country, or contribute to the ongoing operational costs of a children’s isolation ward. In the long run, there will be a great need for strengthening health systems and rebuilding trust in the health facilities and among communities. (To read more from some of the Welbodi directors about the links between Welbodi and weak healthcare systems, you can click here or here.)

We would be grateful for your support—whether by donating funds or spreading the word. You can donate online here, or contact us to find out how you can help.

Thank you.

The impact of the Ebola outbreak on child health in Sierra Leone

The worst Ebola outbreak in the world is confirmed to have infected 1,305 people in Sierra Leone to date¹ though the actual rates may be higher. Of the Ebola confirmed cases, around 22% are children between the ages of 0 and 17 years². Children are not only getting infected with this disease, but many have either been separated from their parents or been orphaned due to Ebola and many more children can no longer access basic health services for non-Ebola illnesses.

The loss of over 240 healthcare workers due to Ebola infections in the affected countries of Sierra Leone, Guinea, Liberia and Nigeria, with long-standing shortages of healthcare professionals, has understandably instilled fear amongst hospital staff and has led to a demand for more training, sufficient protective equipment and incentives before they feel confident to proceed with their work on the front line. This, in combination with a fear amongst the general public to report at health facilities and the difficulty in identifying suspected cases when reliable histories are not forthcoming, has resulted in many health facilities closing or only running outpatient services. Amongst these health facilities is the Ola During Children’s Hospital (ODCH); the only government run Children’s hospital in the country, which is now temporarily closed.

At ODCH, which Welbodi Partnership has supported for over 5 years now, preparations were made in collaboration with hospital staff and partnering organisations at the start of the outbreak for the possible arrival of suspected Ebola cases. This included setting up a small isolation unit, ensuring the availability of personal protective equipment in the unit, training of staff and screening of patients at the entrance of the hospital. It also involved the reinforcement of using universal precautions on all of the wards.  

The screening questions are based on the case definition for Ebola, which includes specific symptoms, travel to/from an affected district and contact history with an Ebola patient.  Since the transmission of Ebola is through contact with bodily fluids of an Ebola patient, the contact and travel history are important. It is estimated that prior to the outbreak, 80-90% of children presenting to hospital come with symptoms such as fever, diarrhoea, vomiting, and weakness; symptoms that not only categorize Ebola, but many other common diseases such as malaria, typhoid and gastroenteritis. If the case definition were only to focus on symptoms, this would mean that the majority of children presenting to the hospital would need to be isolated, which with approximately 1000 admissions a month at ODCH, would be a daunting task. It would require a rapid turn around of laboratory results and a large medical and logistics team on the ground, as frequent entry into the unit would be required to assure that infants and young children are receiving adequate hydration and care, particularly as it is not guaranteed that these children could be isolated with a dedicated caregiver.

The agreed procedure at ODCH in dealing with suspected Ebola cases was put to the test in early August: a child arrived at the hospital and was screened at the entrance. The history revealed fever, vomiting, weakness and a positive contact and travel history. Since the patient met the case definition, the child was immediately isolated in the hospital’s isolation unit while testing was carried out. Two days later when the test result came back positive, the child was taken to an Ebola treatment centre in the east of the country. All staff that came into contact with this patient were aware that she very likely had Ebola and took the necessary precautions. Although this case brought up a few challenges in the process, it did go according to plan and the hospital continued with the same procedure.

Only a week later, however, another child arrived at the hospital. This child had symptoms of fever, diarrhoea and vomiting, but the father denied any history of contact with an Ebola patient or travel from an affected district, most likely because he was afraid to hear that his child might have Ebola. For many, the diagnosis of Ebola is seen as a death sentence. Since the father withheld essential information, the child did not meet the case definition and was admitted to the Emergency Room. It was not until two days later that one of the doctors found out from another relative that the child had been in contact with an Ebola case. Alarm bells rang and preparations were immediately made to transfer the child to an isolation unit for testing for Ebola. All other patients were moved onto another ward and the Emergency Room was decontaminated.

As one can imagine, hospital staff was nervous, having cared for this patient for two days on a general ward, using gloves and universal precautions, but not using the full protective suits since the patient was not admitted as a suspected case. It was decided that all staff in direct contact with this case, would be quarantined in their homes where they would sit out the 21-day incubation period with the hope that they had not been infected.  Since that day, ODCH has been closed to new admissions, because without reliable histories during screening it is impossible to identify a suspected case and isolating all cases arriving at the hospital was an impossible task due to size limitations of the initial isolation ward. Over the next few days, most children were discharged from the hospital. Two days later, the result for the child was announced: positive.

Thankfully, 21 days has passed and none of the staff that came in contact with this case have shown any signs of Ebola, but to date, ODCH, the country’s only government-run paediatric hospital, remains closed.

This story is not unique. Many health facilities across the country and in the sub-region are in similar situations. The impact of this outbreak on the already fragile health systems throughout West Africa will be immense. On average, ODCH admits 1000 patients in the month of August. The fact that ODCH was shut for the second half of the month means that 500 children who would normally have access to health care services, did not. What is the fate of these children? Children with diseases such as malaria, pneumonia, gastroenteritis and other common diseases may well die. The implications will also be severe for services such as outpatient paediatric HIV/AIDS and tuberculosis treatment, as these patients are either afraid to come to the hospital to receive their medications, or health staff are placed at high risk without proper protective equipment to allow them to safely conduct consultations. The immunization programmes will be hindered and many children may not be immunized adequately during this outbreak. It is fair to say that we will see an increase in both morbidity and mortality over the next months. Extrapolating data from a Lancet article in 2013^3,4 it is estimated that 2,500 women and children die in Sierra Leone every month. With the current strains on the health care services this number is inevitably going to increase, and this will never be accounted for in national Ebola mortality statistics. The closure of the hospital has also had an impact on the few remaining health facilities in the area, already overburdened by the demands of the Ebola outbreak, and with limited experience in paediatric care.

Efforts are underway to re-open the hospital, but this must be done in such a way to ensure the safety of both staff and patients. An effective screening method needs to be put in place so that the hospital is not, once again, forced to close. With a high level of fear amongst the general public, it could be that other caregivers will not be forthcoming with the actual history, for fear of their child being isolated. Finding a safe way to re-open the hospital potentially means that a large proportion of children presenting to the hospital will need to be isolated and tested prior to being admitted, since the symptoms of Ebola mimic that of other diseases. NGOs currently on the ground at ODCH are working with hospital staff, the Ministry of Health and Sanitation and other agencies to discuss plans to set up a larger isolation unit adjacent to the hospital for this purpose. In the meantime, training of hospital staff is ongoing with a big focus on infection control measures, including the use of personal protective equipment. Welbodi Partnership is currently providing advice from afar but hopes to return soon to support the efforts at ODCH.

In itself, Ebola is a terrible disease, causing suffering and death, but the impact on the fragile public health systems in the country means that the morbidity and mortality from more common illnesses will be on the increase. Measures to stop the transmission of Ebola need to be scaled up to control this outbreak.  At the same time, and continuing into the future, the current health systems need to be strengthened to ensure the availability of high quality health care in Sierra Leone, as well as to prevent and control such outbreaks in the future.

¹ MOHS Sierra Leone Situational Report - 9 September 2014 http://health.gov.sl/?p=537
² UNICEF Sierra Leone - Ebola Virus Disease - Weekly update (1-7 September 2014)

³ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60497-9/fulltext

⁴ http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60696-6/fulltext

Written by: Sandra Lako, Welbodi Partnership

New Intern in London Office

We are very pleased to welcome Gloria to the team in London - if you want to get involved please send us an email. Without volunteers and interns like Gloria we could not do the work that we do, thank you! - The Welbodi Team

Hello all, my name is Gloria and I started my voluntary placement on Monday 11/8. I’m particularly excited about this placement because I will gain insight into the various operational facets and functionality of an international development organisation. International development is my new career! Although I haven’t decided on the thematic area that I want to focus on, I’m happy to be working within an organisation that focuses its efforts and resources into child health.

An update on Ebola, our team, and our work

Dear friends and supporters,

We want to update you about the Ebola epidemic in Sierra Leone and how it is affecting our work.

As you have likely seen on the news, the virus continues to spread in Sierra Leone and in neighboring Guinea and Liberia. As of August 17, the government had confirmed 775 cases in Sierra Leone, including 297 deaths and 215 patients who survived and were discharged. One of the confirmed cases was a child who was initially placed in isolation at ODCH.

Tragically, health workers continue to be hard hit by the epidemic, with many nurses and doctors succumbing to the disease, most recently Dr. Modupeh Cole from Freetown’s Connaught Hospital. Several airlines have cancelled flights to Freetown, the CDC has advised Americans to avoid nonessential travel to the region, and many international organizations have decided to suspend operations and send international staff back to their home countries. Most organizations staying in Freetown are refocusing their work around the Ebola response.

In this challenging and rapidly-changing situation, we took the very difficult decision to ask all the Welbodi staff to work remotely for the time being, away from ODCH. Our international staff and volunteers have travelled to their home countries, some cutting short their planned time in Sierra Leone while others intend to return once the situation in Freetown has stabilized and we are able to identify the right way for Welbodi to support the health system during this time. Unfortunately, as a small organization, we were not equipped to ensure the safety of staff in Freetown if the situation were to deteriorate further, and given all the current uncertainties, we could not rule out this possibility.

We will continue to closely monitor the situation in Freetown, and we plan to return to the hospital as soon as our staff can do so safely. We are heartened by the fact that the government has declared a state of emergency and is taking important steps to stem the spread of the virus.

In the meantime, we will do everything we can to support our partners remotely during this difficult time. We also know that the epidemic will have a lasting effect on the health system and on affected communities, and there will be an urgent need for support once the immediate crisis has abated. Our long-term commitment to Sierra Leone has not diminished, and we will be there to help the government and the people of Sierra Leone rebuild and recover from these tragic events. 

Ebola: A double tragedy

To all our supporters,

We are sure you have seen media reports about the Ebola outbreak in Sierra Leone, Guinea and Liberia and we want to update you on how the outbreak is affecting our work and how we are responding as an organization.  The outbreak of Ebola is, in many ways, a double tragedy for a country besieged by unmet needs for healthcare.  Firstly, Ebola is a direct tragedy for the people who have died and their families.  We were all devastated by the news that Dr Sheik Umar Khan, who was at the forefront of tackling the Ebola outbreak, had contracted the disease and died last week.    Secondly, the outbreak will put further strain on Sierra Leone’s fragile healthcare system, resulting in excessive deaths from causes much easier to treat than Ebola, such as malaria and pneumonia. 

Ebola is a rare viral disease, first described in 1976 following an outbreak near the Ebola River in Zaire (now part of the Democratic Republic of Congo).  Initial insidious symptoms of fever, malaise and diarrhea are superseded by an inability of blood to clot and internal bleeding.  In that initial outbreak, 90% of people infected died.  Thankfully, subsequent outbreaks of Ebola have been rare events and the mortality rate varied between 60 and 90%.   There is no vaccine for Ebola and few effective treatments.  The current outbreak in West Africa is the largest ever recorded.  Since the first cases were identified in the end of May, there have been 533 cases confirmed and 233 deaths in Sierra Leone.[1] 

Meanwhile, Sierra Leone remains one of the most dangerous places in the world for an expectant mother or child to live. The Lancet estimates that 28,000 children under the age of five and 1399 pregnant women died in 2013 in Sierra Leone, largely from preventable or easily treatable conditions.[2] [3]   Assuming that the mortality rates have not dramatically changed this year, almost 5000   women and children will have died from conditions other than Ebola, during the outbreak.   The Welbodi Partnership's purpose is to help reduce the number of women and children who die by improving the healthcare system. 

Why does the relatively small number of people dying of Ebola occupy the world’s media while the thousands of faceless women and children barely get mentioned?  Some might say it is empathy fatigue, that children dying in Africa is old news and an Ebola outbreak sounds like the setting for a Hollywood action film. An alternative explanation is the nature of epidemics, in which the number of people infected increases exponentially.  Therefore, if the Ebola epidemic is not tackled quickly and effectively, we may soon see more people dying of Ebola than of more common diseases.  The true explanation for the media attention is probably a combination of these factors.

How are we responding to the Ebola outbreak?   Thankfully, there have been no confirmed cases of Ebola at the two hospitals we work at, Ola During Children’s Hospital and Princess Christian Maternity Hospital.  We are certainly not complacent and we are actively engaged in supporting the government of Sierra Leone in tackling the crisis.  Our country director, Sandra Lako, is a member of both the national Ebola Task Force and the District Health Management Team, providing support to healthcare facilities in the Western Area District (Freetown) of Sierra Leone.  Sandra also works closely with the hospitals’ medical superintendents and Ebola coordinators to support the set up and running of the isolation unit and ensure that the hospitals are up to date with the latest information from the Ministry. You can read more about Sandra's work on her blog 

  

ODCH hospital is much better prepared to respond to an Ebola outbreak than it would have been six years ago.  As an example, in 2009 we developed a triage system to help doctors and nurses recognize the sickest children as they arrived at ODCH.   Our nurse educator, Dickya Labicane has been providing additional training to the nurses working in triage to help them recognise suspected cases of Ebola.  With subtle modification, the triage system designed to save the lives of children with malaria and pneumonia is now at the forefront of the fight against Ebola. 

Meanwhile, we are trying to ensure our long-term commitment to the women and children of Sierra Leone is not derailed by the Ebola outbreak.   We continue to believe that training of healthcare workers holds the greatest promise for the wellbeing of women and children in the future.  Specifically, we are focused on training Sierra Leone’s first paediatricians. We are also about to start a new maternal and neonatal health project based at PCMH but also focused on  working with community-based women’s groups.

Finally, to our team working in Freetown.  As an organisation we take the safety of our staff and volunteers extremely seriously.  Several organisations have already evacuated their teams, an option we have considered. The Welbodi board continue to monitor the situation closely.  We have offered our team the option of leaving, an option that remains open to them at any time, and we will support them completely if and when they decide to take that step. We are also actively supporting those Welbodi staff members who choose to remain at work.  These staff  are incredibly valuable in supporting the response to Ebola, as well as enabling the hospitals to continue to provide life-saving care during this emergency. The dedication of all of our team members is inspirational, and we are sure you would like to join us in thanking them.

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[1]  http://www.who.int/csr/don/2014_07_31_ebola/en/

[2] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60696-6/fulltext

[3] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60497-9/fulltext