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Building Ebola Treatment Units to Foster Hope, Healing in Liberia

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

In the Bomi Hills northwest of Monrovia, in an area that used to be the region’s iron and diamond mining center, it’s hard to miss the new “precious resource” that has become critical to Liberia’s fight against Ebola.

Four stark white tents gleam in the sun, the most prominent part of the new Ebola treatment unit (ETU) in Tubmanburg, which is the first ETU to be built and staffed by the United States in Liberia.

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Construction on the 2-acre site was overseen by the U.S. Defense Department in close partnership with the Armed Forces of Liberia. More than 60 people had to overcome the rain, heat, poor roads and supply shortages to build the site in 35 days, completing the ETU earlier this month.

“Especially in this time of national crisis, it has been rewarding to be out here and assisting,” said Armed Forces of Liberia Capt. Glee Dilliard Dada, who supervised the Liberian military construction crew. “I am very overwhelmed with a lot of pride. In a month’s time we did all of this.”

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

USAID Disaster Assistance Response Team leader Bill Berger called the ETU an extraordinary effort, saying, “It took strong partnership to build this ETU. It will also take strong partnership to provide care to patients.”

USAID partner the International Organization of Migration, or IOM, has stepped forward to manage the ETU under the leadership of the Liberian Ministry of Health and Social Welfare. For the past two weeks, IOM’s medical team—made up of local and international health care workers—received rigorous training on Ebola patient care, safety protocols and ETU management.

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning googles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning goggles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

More than 120 members of IOM’s team are now prepared to care for patients. Tejanie Golafaley, a local resident and Ebola survivor, is especially eager to speak to patients at the ETU about his experience beating the disease.

“When I got Ebola, people didn’t want to come around me. I was stigmatized by Ebola,” Golafaley said. “The best thing I can do is talk to [patients] …. I’m going to tell them I’m a survivor. I want to give them hope.”

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

ABOUT THE AUTHOR

Carol Han is the Press Officer for USAID’s Ebola Disaster Assistance Response Team [DART], which is overseeing the U.S. Ebola response efforts in West Africa. The DART includes staff from across the government, including USAID’s Office of U.S. Foreign Disaster Assistance, the U.S. Centers for Disease Control and Prevention, and the Departments of Defense and Health and Human Services.

Recapturing Growth in Ebola-Stricken West Africa

With funding and support from USAID, construction crews work quickly to build a new Ebola treatment unit in Monrovia, Liberia, in front of the former Ministry of Defense building, Oct. 1, 2014

With funding and support from USAID, construction crews work quickly to build a new Ebola treatment unit in Monrovia, Liberia, in front of the former Ministry of Defense building, Oct. 1, 2014 / Morgana Wingard

Unlike a civil war or natural disaster, an epidemic does not destroy property. But it sharply increases the cost of doing business, with powerful effects on employment and investment.

This is happening in Guinea, Liberia and Sierra Leone where the secondary impacts of the Ebola crisis have been seen in terms of shuttered businesses and closed schools. But just as economies can stall during an epidemic, we also know what expedites their recovery—a robust business climate that encourages private sector investment.

New Ebola cases continue to be recorded in Guinea, Liberia and Sierra Leone, but as health workers have begun to contain the epidemic, we are already turning our attention, in partnership with host governments, to the task of restoring business activity in these countries. Liberia and Sierra Leone had been growing strongly before the crisis, driven largely by foreign direct investment in the mining sector; Guinea’s growth was weaker but had been expected to increase in 2014. All three economies have contracted sharply in the latter half of 2014, with full-year gross domestic products now expected to be at or below 2013 levels.

A first look at a 25-bed critical care hospital—staffed by U.S. medical professionals—in Harbel, Liberia, that will treat all Ebola health care workers in the country, Oct. 15, 2014

A first look at a 25-bed critical care hospital—staffed by U.S. medical professionals—in Harbel, Liberia, that will treat all Ebola health care workers in the country, Oct. 15, 2014 / Morgana Wingard

Public and private investment plans have been scaled back, suggesting that slow growth will linger through 2015 even if the epidemic is contained early in the year. This is actually not driven primarily by the loss of labor to sickness and health care, but rather by what economic epidemiologists call “social distancing”—when people avoid interacting with each other in order to avoid a perceived risk of viral transmission.

The benefits to workers, firms and farms to restoring normal economic activity can provide a powerful counterbalance to the effects of social distancing, suggesting that capacity utilization, employment and income will rebound as the epidemic is contained.  But tomorrow’s economy depends on today’s investment. The pace of economic recovery will therefore depend crucially on how private-sector firms view the evolving business environment.

Containing the outbreak will do much to restore that environment, but firms across the size spectrum—including potential new entrants—will be wary of their exposure to health-related losses even as the overall health system is strengthened. Reforms that enhance the quality of regulation and reduce the costs of doing business are therefore crucial components of the recovery effort.

Pick-up trucks-turned-ambulances drive hours through dirt roads in Bong County, Liberia, to collect patients, Oct. 9, 2014

Pick-up trucks-turned-ambulances drive hours through dirt roads in Bong County, Liberia, to collect patients, Oct. 9, 2014 / Morgana Wingard

The World Bank’s newly released business-climate survey of 189 economies—Doing Business 2015:Going Beyond Efficiency—highlighted sub-Saharan Africa as home to five of the 10 top reformers, four of which are in West Africa. “Doing business” reforms are changes in the procedure, time or cost of conducting business in a country, such as reducing the time it takes to get a construction permit or the number of approvals required to open a business. USAID has supported the Doing Business project since its inception in 2004.

Several of the highlighted business reforms from this year’s top reformers in West Africa (Benin, Cote d’Ivoire, Senegal and Togo) were the result of coordinated harmonization efforts led by the Council of Ministers of the Organization for Harmonization of Business Law in Africa. These efforts encouraged  business-friendly innovations throughout the region such as one-stop shops for registering a business, easier land registry and transfer processes, and improved credit information systems—including in the countries most affected by the outbreak.

Liberia and Sierra Leone took the impressive step of establishing public credit registries in the past year, making it easier to get credit in these countries. The resolve demonstrated by member governments in setting a regional reform agenda and implementing meaningful changes for business also bodes well for increased regional trade, which USAID supports through its regional Trade Hubs in West, East and Southern Africa.

USAID has been working with many of the reformers highlighted in this year’s report and will continue to partner with governments in the region as they tackle both the immediate challenges and the secondary effects of Ebola. Better regulatory environments, supported by governments taking the right steps to attract both domestic and foreign investment, will help these countries recover and prosper in the future.

ABOUT THE AUTHOR

Stephen O’Connell is the Chief Economist for USAID

You Can’t Save Lives if you Don’t Fight Pneumonia

MCHIP immunization work in India.

MCHIP immunization work in India / JSI

For many problems in global health, we struggle to know the solutions.

Pneumonia is not one of them.

Since passing the 500 day countdown in August, the global public health community has talked a lot about what it will take to meet the ambitious Millennium Development Goals (MDGs). And one thing is clear: achieving MDG 4 – to reduce child mortality by two-thirds by 2015 – will not be realized without better addressing pneumonia, the leading killer in children under 5.

The good news is that pneumonia is preventable—and that safe, effective and affordable tools are helping to avoid and treat the disease.

Nepali village health worker counting the respirations of a sick infant

Nepali village health worker counting the respirations of a sick infant / JSI/Nepal Family Health Initiative

Pneumonia can be prevented by feeding children micronutrient rich foods, ensuring proper hygiene, including frequent hand-washing, and improving indoor air quality through well-ventilated cooking areas.

Most of all, the disease can be prevented by ensuring all children are vaccinated on schedule and treated promptly and appropriately if signs of pneumonia appear.

Devoted to combating the causes of under-5 morbidity and mortality, USAID’s flagship Maternal and Child Survival Program (MCSP) is celebrating this World Pneumonia Day by working to ensure that every infant in the developing world is fully immunized.

Health worker in Mali assessing the respiratory rate of a sick child

Health worker in Mali assessing the respiratory rate of a sick child / JSI

In 2013, MCSP’s predecessor program—the USAID-funded Maternal and Child Health Integrated Program—joined USAID and more than 100 partner organizations, along with national and global experts, to express support for WHO and UNICEF’s first-ever global action plan to simultaneously tackle the two leading killers of children—pneumonia and diarrhea. Implementation of this plan, linked with ownership by national governments and partners’ involvement, will make these goals a reality.

The Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPP-D) calls on all parties to coordinate their approach to fighting pneumonia and diarrhea, for which there are complementary interventions to provide protection, prevention and treatment.

Immunizing in Kenya

Immunizing in Kenya / MCHIP

On this day of reflection and action, let us commemorate the brief lives of the children lost to pneumonia—nearly 1 million every year worldwide—by vowing to support and focus on implementing the Global Action Plan and strengthening countries’ routine health systems in partnership with communities.

The fight against this deadly disease can be won. Children are not dying because effective interventions do not exist; they are dying because these interventions are not readily available for all. To dramatically reduce child mortality, we must achieve high and equitable coverage.

Through effective use of pneumococcal (PCV), Haemophilus influenzae type b (Hib), and rotavirus vaccines, vitamin A, zinc, oral rehydration solution, breastfeeding and other interventions, we can address MDG4.

Collectively around the world, we owe it to the future generation to give them the best start in life and protect them from preventable and treatable diseases like pneumonia.

ABOUT THE AUTHORS

Robert Steinglass is the Immunization Team Leader and Katrin DeCamp is the Senior Communications Specialist for USAID’s Maternal and Child Survival Program.

Bill Berger: “There is no book on responding to this Ebola crisis… we’re writing it now.”

Morgana Wingard This is the fifth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
General Darryl Williams, Bill Berger, and U.S. Ambasador to Liberia Deborah Malac.

General Darryl Williams, DART Team Leader Bill Berger, and U.S. Ambasador to Liberia Deborah Malac. / Natalie Hawwa, USAID

“There is no book on responding to this Ebola crisis… we’re writing it now,” says Bill Berger, Team Leader for the Ebola Disaster Assistance Response Team (DART) in West Africa.

A seasoned disaster expert, Bill has responded to more than 30 large-scale emergencies across the globe and led several DARTs for USAID’s Office of U.S. Foreign Disaster Assistance.

But how exactly are Bill and his team fighting this unprecedented Ebola epidemic?

“Day by day, pushing at a maximum speed on all fronts,” he says, and with every ounce of compassion and disaster knowledge they have.

As the DART Team Leader, Bill strategizes alongside the local governments and U.S. Ambassadors in the affected countries, the United Nations and NGO partners on the ground to mount the most effective aid effort possible. With Ebola, there are many complex technical pieces that need to come together to help save lives.

“We know the basic things that need to happen, such as building treatment centers, training health care workers, providing testing capabilities and coordination — but we also have a real opportunity here to transfer that capacity and boost national health care systems in West Africa.”

The DART is working across the region in Guinea, Liberia and Sierra Leone – each a unique country with its own dynamic for responding to Ebola. While there are challenges of navigating unknown territory for this unprecedented crisis, Bill draws strength from having the opportunity to help those affected by this tragedy. He’s also inspired by his team and the chance they have to contribute to such a critical and historic global issue together.

“Every DART is like living a full lifetime; you have many experiences and feelings in a short period, with so much confronting you daily,” he says. “Working with others during a crisis brings about wonderful and special bonds.”

Bill jokes that the DART will be giving each other the ‘Ebola bump’ — the new West African greeting of hitting elbows, adopted in lieu of a handshake due to the ‘no touch’ atmosphere — for years to come.

“Our DART is a very special group of dedicated people bringing in every piece needed for this Ebola response. It’s a great gift to lead this team.”

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

First Look at a New Hospital for Ebola Aid Workers: 10 Photos You’ve Never Seen

Morgana Wingard This blog is part of our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

HARBEL, Liberia—”Where have you done this before?” USAID Administrator Raj Shah asked on October 15, as he stepped through the taupe colored tent flap into the new 25-bed critical care hospital being built to treat all health care and aid workers who fall ill to Ebola. “Nowhere, sir. No one has,” replied an army engineer.

Historically, mobile medical units like this one provide versatile trauma care for military operations. In this case, the Department of Defense (DoD) and the U.S. Public Health Service (USPHS) customized the Monrovia Medical Unit to treat highly contagious Ebola patients.

Once complete, the hospital will be operated and staffed by a team of 65 specialized officers from the USPHS Commissioned Corps – an elite uniformed service with more than 6,800 full-time, highly qualified public health professionals, serving the most underserved and vulnerable populations domestically and abroad.

The Commissioned Corps will deploy clinicians, administrators, and support staff to Liberia to treat health care workers with Ebola, and to continue efforts by USAID, DoD and international partners to build capacity for additional care in Liberia.

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The new 25-bed critical care hospital being built in Harbel, Liberia to treat health care and aid workers who fall ill to Ebola. The new hospital is expected to be online in early November.


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Rear Admiral Scott Giberson (Acting U.S. Deputy Surgeon General and Commander of the USPHS Commissioned Corps Ebola Response) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for all health workers who fall ill with Ebola while on the frontlines of the epidemic in Liberia on October 15, 2014.  


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Colonel Joann Frye, nurse, Officer in Charge, U.S. Air Force Air Combat Command 633rd IPTS and USAID Administrator Raj Shah inside the new hospital.


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Tents are connected by a covered passageway inside the “Hot Zone.”  Soon the only people inside this area will be health workers either as patients or suited up in personal protective equipment.


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Inside one of the patient wings of a new critical care hospital being built by the U.S. Department of Defense and the U.S. Public Health Service in Harbel, Liberia.


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The new hospital’s supply room.


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CAPT Ed Dieser (Engineer, USPHS Commissioned Corps Safety/Facilities Officer) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for health workers who fall ill to Ebola while on the front lines of the outbreak in Liberia.

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

Paloma and Alisha: The Information Gurus Behind the U.S. Ebola Response

Morgana Wingard This is the fourth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

Though Alisha McMichael and  Paloma Clohossey’s jobs on the Ebola Disaster Assistance Response Team (DART) aren’t as high profile as the health care workers who suit up in protective gear everyday, one could argue that their role is just as vital to the U.S. response.

“Alisha and Paloma bring all the threads of the operation together for reporting and information collection — they know the ins and the outs of the response as a whole,” said Bill Berger, the Ebola Disaster Assistance Response Team Leader.

They are the DART’s Information Officers – also known as ‘IOs.’: the information gurus who compile, collate and verify all the information about the U.S. Government’s Ebola response efforts and the crisis at large. After absorbing every last detail and fact, they distribute them to team members on the ground and back to Washington, D.C. so that everyone is on the same page and has the correct information they need, when they need it.

In a disaster response environment – especially one like the Ebola epidemic, where everyday the international community is navigating new territory – information is critical. Alisha and Paloma constantly take in and filter information to ensure they’re up to date on the latest — no easy feat given the ever-evolving situation as the crisis progresses and the U.S. response gains momentum.

In fact, Alisha has been dubbed the DART’s ‘sync-master,’ responsible for tracking daily the progress of Ebola treatment units, community care centers, trainings for health care workers, burial teams, airlifts of relief supplies, and other response efforts – following the military’s Sync Matrix model. Meanwhile, Paloma writes daily updates about the situation on the ground to inform Washington and communicate key gaps, challenges and successes.

Being a DART IO requires a lot of attention to detail and long days, but working 24/7 doesn’t get them down.

“The best part by far,” says Paloma, “is getting to have the opportunity to do work that feels meaningful. I’ve been given a chance to contribute to something that I believe in.”

Adds Alisha, “This is a great team, and I know everyone gives their best everyday. That feels good.”

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

RELATED LINKS

“I’ve Never Had a Job Like This”: Life Inside an Ebola Treatment Unit

Morgana Wingard This blog is part of our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

SUAKOKO, Liberia—”It becomes day-to-day life. You get into your PPE [personal protective equipment] and you go in every day and you feel safe,” explains Audrey Rangel – a nurse at the Bong County Ebola treatment unit run by International Medical Corps with support and funding from USAID.

Before landing at Roberts International Airport in Monrovia on September 8,  Audrey worked on a maternal, child health and nutrition program in Timor Leste. “I always wanted to do disaster relief work. The crisis started to take off. It was in the news a lot. People were talking about it. So I went online. I saw a position for an Ebola response nurse. To me it was just the right time. The description just kind of fit me. I was speaking with my husband and I was saying I can’t not do this. I can’t not do this…. They need people. There was an actual need for me. And I just kind of felt like the description was made for me. It was just perfect. I had to do it.”

The Bong County Ebola treatment unit where Audrey was stationed is a four hour bumpy journey from Monrovia. Bong has some of the highest rates of infection after Lofa and Montserrado Counties. Their two ambulances drive for hours every day to pick-up patients in remote locations like Bong Mines where they picked-up 18-year-old Cephas after his father carried him on his back for an hour to a location where the ambulance could reach him.

Audrey’s days are spent on the front lines of the Ebola response, suiting up in protective gear and caring for patients like Cephas. Even as she roots for survivors, she admits that it’s easy to get attached to her patients: “For some reason you’re sad to see them go.”

“It’s turned out to be an amazing, amazing experience. I wouldn’t take it back for anything.  I guess you can say it exceeded my non-expectations,” says Audrey.

To learn how qualified medical professionals can join the fight against Ebola, visit: www.usaid.gov/ebola/volunteers.

Watch Audrey’s Story

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. All this week she will be guest posting from USAID’s instagram

Justin Pendarvis: “We have to demystify Ebola. It’s not a superhuman and magical thing.”

Morgana Wingard This is the third blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
Justin-Pendarvis

Justin Pendarvis: “We have to demystify Ebola. It’s not a superhuman and magical thing.”

Before the United States deployed an Ebola Disaster Assistance Response Team (DART), there was Justin Pendarvis. As one of the Public Health Advisors at USAID’s Office of U.S. Foreign Disaster Assistance, Justin was the first disaster expert tapped to travel to West Africa and assess the growing Ebola situation for USAID.

In early July, Justin traveled to Guinea – home of the epidemic’s ‘patient zero.’ His mission: to observe and gauge the growing outbreak, understand the coordination at play for the response, and identify key challenges.

In Guinea he observed the protocols required to run an Ebola treatment unit (ETU) at one of Medecins sans Frontieres’ first facilities – an intense operation out of the capital city, Conakry. The following week he headed to Sierra Leone where frightening narratives were emerging from Kenema, one of the country’s largest towns hit hard by the virus.

“People were working around the clock, but more Ebola cases kept popping up,” recalls Justin. Health care workers were also falling ill.

By the time Justin landed in Liberia a week later it was clear that a significant amount of resources were needed to support West Africa and help save lives. Weak public health systems fell prey to the disease, and more help was needed. With key insight provided by Justin, USAID stood up the Ebola Disaster Assistance Response Team (DART) – the team of roughly 30 people from across the U.S. Government leading and coordinating the U.S. Ebola response.

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Patients wait outside the JFK Ebola treatment unit in Monrovia, Liberia on September 15, 2014.


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An Ebola patient rests on his bed inside the patient area at the Ebola treatment unit at Island Clinic September 22, 2014 in Monrovia. With the help of USAID, the Government of Liberia and the World Health Organization opened the facility on September 21. Within one day it was filled to capacity with more than 100 patients. USAID provided generators and other supplies to equip the facility with life saving care.


Since then there has been an “evolution of thought,” says Justin, as everyday USAID, alongside the affected countries and international community continue to learn how best to respond to this unprecedented crisis and fight the world’s largest Ebola outbreak in history.

In Liberia’s capital Monrovia, most residents know somebody who has been affected by the epidemic. Justin, like many West Africans, finds Ebola and this humanitarian response to be very personal. He first arrived in Liberia in 2009 and considers it his second home. His first three-and-a-half years in country were spent working with a Liberian NGO to strengthen and rebuild the country’s health infrastructure — systems that had been destroyed by decades of brutal civil war. But progress was being made.

Five years ago, only 11 percent of women in Liberia were delivering babies at health clinics, putting most — those delivering at home often in unsanitary conditions –  at great risk for complications and death. Liberia had one of the globe’s highest maternal mortality rates.

Fast forward to last year, where more than half of Liberian women were safely delivering at hospitals and clinics – a significant health breakthrough.Although maternal mortality is still high, the numbers have started to fall.

Today, in the face of Ebola, any woman who comes to a hospital to deliver her baby and is bleeding becomes untouchable. Staff hesitate to provide medical care due to fear and risk of  contracting the virus, which is transmitted through contact with infected bodily fluids.

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Midwives at John F. Kennedy hospital now wear extra protective gear when they go to work because of fears of the spread of Ebola.


“We have to demystify Ebola, it’s not a superhuman and magical thing. We know how to control it, and we know how to keep people safe – but there is a crippling fear.”

Justin says that many of the challenges in responding to the Ebola crisis are fighting that exact fear, and arming West Africans with knowledge to understand the virus and learn how to weave protective measures into their daily life and cultural traditions.

As USAID continues to work toward bringing more Ebola treatment units online, the DART is also prioritizing messaging campaigns that educate communities on how to protect themselves. These efforts have already proven to be life-saving.

“Liberia is definitely a special place to me. I feel lucky to be in a position where I can hopefully contribute, and am proud of the momentum we’re now seeing – it’s this impact and the collective commitment alongside the Liberian people to fight Ebola that drives me forward every day.”

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Natalie Hawwa is a USAID Press Officer for the Disaster Assistance Response Team on the ground in Monrovia, Liberia

Calling all Innovators to Help Fight Ebola

Saving lives at birth. Powering clean energy solutions in agriculture. Inventing new tools to teach a child to read. Across development, we’re calling on the world’s brightest minds to tackle our toughest challenges. In the last few years, we have helped launch five Grand Challenges for Development that have rallied students and scientists, innovators and entrepreneurs to tackle some of humanity’s toughest problems.

Today, we face just that kind of challenge—a global health crisis that is in dire need of new ideas and bold solutions. From Guinea to Liberia to Sierra Leone, Ebola is devastating thousands of families, disrupting growth, and fraying the fabric of society. The United States is helping lead the global response to the epidemic, but we cannot do it alone. That is why President Obama launched our sixth Grand Challenge. Fighting Ebola: A Grand Challenge for Development is designed provide health care workers on the front lines with better tools to battle Ebola.

To help kickstart this Grand Challenge, some of our nation’s most innovative problem-solvers will gather in DC today and tomorrow to work on this issue.  We’re also inviting people from all over the country to share their ideas. You can add your thoughts and see what other people saying here.

As the United States and the international community work to contain the worst Ebola epidemic on record, courageous men and women are performing critical tasks every day to save lives and prevent the spread of the virus. Personal protective equipment (PPE)—the suits, masks and gloves the health care worker wears—is their primary protection, but it is also the greatest source of stress. In these hot and uncomfortable suits, health workers must administer to the patients and remove contaminated materials.

Together with the White House Office of Science and Technology, the Centers for Disease Control and Prevention, and the Department of Defense, Fighting Ebola seeks new practical and cost-effective solutions to improve infection treatment and control and provide better care to those who need it most.

The first part of the initiative is an open innovation platform powered by OpenIDEO, one of the world’s top design firms. Through it, the global community can brainstorm, collaborate, and comment on new ideas that generate practical solutions to the Ebola epidemic. The strongest ideas may be encouraged to apply for funding later in the Grand Challenge. Our aim is to begin funding ideas in a matter of weeks.

Over the last several years, we’ve found that Grand Challenges not only generate inventive tools and breakthrough technologies, but inspire us to confront seemingly insurmountable challenges—and succeed.

Get started by joining the conversation. To learn more, please visit http://ebolagrandchallenge.net/

Health workers in personal protective equipment (PPE) wait to enter the hot zone at Island Clinic in Monrovia, Liberia on Sept 22. 2014. PPE is their primary protection, but it is also the greatest source of stress

Health workers in personal protective equipment (PPE) wait to enter the hot zone at Island Clinic in Monrovia, Liberia on Sept 22. 2014. PPE is their primary protection, but it is also the greatest source of stress. / Morgana Wingard, USAID

Standing with Liberia to Reverse Ebola’s ‘Spillover’ Effects

 With funding and support from USAID construction crews work quickly to build a new Ebola Treatment Unit in Monrovia in front of the former Ministry of Defence Building. / Morgana Wingard

With funding and support from USAID construction crews work quickly to build a new Ebola Treatment Unit in Monrovia in front of the former Ministry of Defence Building. / Morgana Wingard

The Ebola Virus Disease, and the pressing need for rapid containment over the next 3 to 9 months, presents the global community with a formidable challenge. More than 7,000 cases have already been confirmed in Guinea, Liberia and Sierra Leone (the three core countries of the epidemic), and more than 3,300 people have already died. The epidemic is strengthening, but so too is the international response.

Ebola threatens not only lives, but livelihoods. The main driver of economic impacts is not the loss of labor to sickness and death, or even the major diversion of resources into health care, but rather the much broader spillover effects from peoples’ fear of contagion.

Isolation of infected persons is critical to controlling transmission, and wider restrictions including land border closings and partial community quarantines can interrupt economic activity on a temporary basis. But in an atmosphere of uncertainty about personal and business risks, activity can decline across the entire economy. Self-protective aversion behavior shuts down businesses, disrupts transportation and agriculture, and sidelines employment-creating investment plans – all of which drives down peoples’ livelihoods by undermining a country’s production and trade.

Liberia, where the outbreak is worst, has been rebuilding its economy since emerging from a long civil war in 2003. While economic growth has been strong in recent years, the country remains one of the poorest in Africa, with a per capita income of only $440 dollars and nearly 60 percent of the population below the poverty line. Liberia remains both institutionally weak and aid dependent, so a swift international policy reaction to this epidemic is crucial.

Food prices have recently begun to rise sharply in urban areas in Liberia, reflecting slowdowns in container shipping and uncertainty about future supplies. Regional trade has been reduced by land border closings. Internal transport has slowed down, reflecting official and unofficial restrictions on movement and higher fuel costs. The expatriate economy – with its incomes and expertise – has thinned out.  Some urban enterprises are shedding workers as many government contracts are being cut back, or put on hold.

The World Bank’s latest estimate of economic losses for 2014, in the three core countries, is $359 million. Under a rapid containment scenario, losses in 2015 are projected to be roughly $100 million, with the bulk of these in Liberia where per-capita incomes are not expected to begin rising again until 2016. Left unchecked, however, this epidemic could grow exponentially and drive up both human and financial costs by as much as 8 to 10 fold.  So the international community needs to act quickly and decisively, along a number of fronts.

Simply put, an Ebola epidemic that is not effectively contained and mitigated could reverse years of development progress for the affected countries, with harsh negative impacts on some of the world’s most vulnerable communities. Failure to contain would also increase the risk of outbreaks in neighboring countries, driving economic losses into the tens of billions of dollars.

 Washing is a vital part of the operation of the Ebola Treatment Unit at Island Clinic in Monrovia. All scrubs worn under PPEs and shoes must be washed thoroughly in chlorine water and then with soap. / Morgana Wingard

Washing is a vital part of the operation of the Ebola Treatment Unit at Island Clinic in Monrovia. All scrubs worn under PPEs and shoes must be washed thoroughly in chlorine water and then with soap. / Morgana Wingard

This epidemic calls for concerted international response including health workers, new treatment facilities, and medical supplies to the health sectors of the core countries, food security assistance to stressed and especially isolated and quarantined areas, and preparedness training for health systems in neighboring countries.

The United States, along with our international partners, is stepping up to this challenge. With Liberian clinics overwhelmed with new patients, we are providing 2,000 new beds, 130,000 sets of personal protective equipment, and 50,000 hygiene kits, along with plans to rapidly construct new health clinics.  To prevent further infections within Liberia, the USG and its partners will also provide 400,000 protection kits to reduce transmission in community settings.

To help offset declining government revenues and skyrocketing health costs, we are providing base salary support for civil servants in Liberia’s Ministry of Health, and working closely with the World Food Program to provide emergency food supplies to 1.3 million people across the region, including Ebola patients and communities under quarantine.

We’re also working closely with President Ellen Johnson Sirleaf to intensify our response across a broad range of areas, including supporting the country’s health system so that the focus on Ebola does not come at the expense of providing care to pregnant mothers or newborn infants.

Additionally, we’re working with the Government of Liberia and partners to mitigate the economic impacts of the crisis outside of the health system. This includes the crucial area of public messaging about the safe resumption of normal economic activities.

We’ve seen outstanding teamwork across our Agency, the U.S. Government, and our Disaster Assistance Response Team on the ground in Liberia, Guinea, and Sierra Leone—but we cannot win this fight alone.

We need qualified health care workers—nurses, doctors, and physician assistants—who could be a part of this historic response. We’re encouraging them to register at www.usaid.gov/ebola, and we’ll put them in touch with a network of organizations that are standing by to train volunteers. We’re also identifying care and evacuation procedures to support these professionals in their heroic humanitarian work.
With the same creativity and rigorous efficiency that we have applied to previous disasters, we can—and will—stop this epidemic. By working together with our partners from government, business, civil society, and the military, we can lay the groundwork for a brighter future in vulnerable communities grappling with Ebola’s devastation.

Stephen O’Connell

ABOUT THE AUTHOR

Stephen O’Connell is USAID’s Chief Economist. He guides the Agency on economics-based decision making and provides expert advice to Agency leadership and staff in the field of economic growth.

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