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The Digital Development Opportunity

Bangladeshi farmer Jalal Kha talks over a mobile phone as he works in his paddy field. / AFP, Farjana K. Godhuly

Bangladeshi farmer Jalal Kha talks over a mobile phone as he works in his paddy field. / AFP, Farjana K. Godhuly

At last month’s Frontiers in Development Forum, we welcomed some of the world’s brightest minds and boldest leaders to discuss how to best partner to end extreme poverty. We not only heard from leaders like Tanzanian President Jakaya Kikwete and Secretary of State John Kerry, but also from innovators who are creating mobile apps to fight human trafficking and using 3-D printers to build prosthetic hands in the field. It was a recognition that we live in a unique moment, one where new technologies and partnerships are redefining what is possible.

Above all, the Forum was a reminder that—as we near the 2015 deadline of the Millennium Development Goals—we must accelerate progress. For our Agency, new technologies and partnerships have created unprecedented opportunities to end extreme poverty and promote resilient, democratic societies.

From GPS to Skype to e-tablets, new innovations are fundamentally changing the way we communicate, work, learn, share and interact. Almost two decades ago, we launched the Leland Initiative, an effort to expand access to information and communication technology in more than 20 African countries. To build on this legacy, we teamed up with the U.K., Google.org, and the Omidyar Network to establish the Alliance for Affordable Internet. Since then, the Alliance has grown to more than 65 members, from Facebook to the Government of Mozambique. Together, they are building global consensus around a set of policy and regulatory recommendations that will lower the cost of internet access—unlocking new opportunities for doctors, entrepreneurs, and local leaders across the developing world.

Much of this progress won’t happen at a desktop; it’ll happen in the palms of billions of hands. Today, farmers are using mobile payments apps to send payments and receive loans; entrepreneurs are selling their goods on the global marketplace; and health workers are treating more patients, at less cost, and without expensive equipment.

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A mobile money user in the Philippines checks her balance on her phone. / USAID, Brooke Patterson

We’re also tapping into affordable, game-changing technologies with the potential to transform the way we work. In Uganda, we’re using mTrac, a tool that enables local health workers to send the government reports via SMS. Recently, the Ministry of Health used mTrac to survey 10,000 health workers on whether their health unit had a fridge that kept perishable drugs and vaccines cold.

The survey cost just $150 and took less than three days—providing the Ministry of Health with information from 1,862 health facilities. As a result, we learned that only about 70 percent of them have working fridges to store life-saving treatments. As Uganda ramped up its national campaign to eradicate polio, it used this information to target the most vulnerable populations and protect more children.

Technology we often take for granted is creating monumental changes in developing economies. In Senegal, rice millers buy expensive Asian imports, while local rice farmers are unable to sell their crops. To build up local supply chains and improve the quality of harvests, we are helping farmers share information through Excel and Dropbox. With this information in hand, rice millers can monitor local crops, schedule shipments in advance, and collect payments online. With 30 farming networks involved to date, this project is helping tens of thousands of smallholder farmers boost their sales and reach new customers.

We’re not creating technology for technology’s sake. There are too many apps that might look sleek, but are not transformative for the people who use them. That’s why we have helped publish a set of guidelines on best practices for development programs that utilize technology.

We call these principles the Greentree Consensus, and they are built on earlier sets of principles that draw on the insight of more than 300 NGOs with expertise in the field. Representing our commitment not only to innovation, but sustainable results, we’re thrilled to be launching these principles in partnership with over a dozen donors and multilaterals, including the Bill & Melinda Gates Foundation, UNICEF, the Swedish International Development Cooperation Agency, the United Nations Development Program and the World Food Program.

This is just the beginning of a conversation. We must do more to take these insights into action.  Over the next year, we want to hear from the development community about your experiences in bringing technology to tackle development challenges—from promoting media freedom to solving water shortages. With our Agency’s new U.S. Global Development Lab at the center of this effort, we’ll be able to create, test, and scale breakthrough solutions like never before. In doing so, we can make strides towards a day when extreme poverty—like cassette tapes and dial-up internet—is a thing of the past.

ABOUT THE AUTHOR

Dr. Rajiv Shah is USAID Administrator. He tweets from @rajshah

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.
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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

An Outsized Problem with a Small-sized Solution

In the lush countryside of Burundi, you wouldn’t expect there to be chronically high rates of malnutrition. But hidden behind the walls of a family’s house, poor feeding practices, compounded by large families with kids close in age, means malnutrition lurks. According to a 2013 IFPRI study, more than 73 percent of the population in Burundi is undernourished, and 58 percent of the population is stunted. These figures are staggering, given the population of Burundi is only 10 million.

That’s where USAID and partner UNICEF come in. Burundi is one of the first countries where U.S.-produced Ready-to-Use Therapeutic Food, or RUTF, is being used to treat acute malnutrition.

A child eats his ready-to-use therapeutic food to treat his malnutrition. / USAID, Katie McKenna

A child eats his ready-to-use therapeutic food to treat his malnutrition. / USAID, Katie McKenna

Why do these small packets make such a difference? Previously, kids with severe acute malnutrition (SAM) had to be treated at the hospital. This meant families’ staying weeks and weeks as the child recuperated. Now, with the advent of products like RUTF, children without any other health symptoms can be treated at home. Imagine you’re a small kid who is sick – which would you prefer? Being at a hospital for weeks at a time, or in the comfort of your own home? It’s a no brainer.

A new food assistance product for the Agency’s Office of Food for Peace, this product is a game changer for tackling severe acute malnutrition. Previously the Agency did not have capacity to purchase this product in the United States for food assistance programs because U.S. suppliers were not producing it. This meant only doing small scale interventions with locally purchased ready-to-use foods, or not being able to treat severe acute malnutrition at all through food assistance.

Starting in 2012, this changed. Currently USAID plans to meet at least 10 percent of UNICEF’s global need for RUTF, and has already provided this specialized product in 14 countries since 2012. In Burundi, RUTF is helping treat 16,500 severely acutely malnourished kids under 5 in nine provinces.

UNICEF staff are working tirelessly to ensure that the Ministry of Health of Burundi is able to treat severe acute malnutrition, and help mothers learn to treat it themselves at home. In villages across Burundi, every week women bring their children to the local health clinic for nutrition training, and to get their kids’ health assessed. In exchange, they receive a week’s supply of RUTF for their kids identified as severely acutely malnourished.

In Burundi, more than 73 percent of the population is undernourished, and 58 percent of the population is stunted. U.S.-produced Ready-to-Use Therapeutic Food is being used there to treat acute malnutrition. / USAID, Katie McKenna

In Burundi, more than 73 percent of the population is undernourished, and 58 percent of the population is stunted. U.S.-produced Ready-to-Use Therapeutic Food is being used there to treat acute malnutrition. / USAID, Katie McKenna

Elias Ndikumana, a father of three, has two children enrolled in treatment for severe acute malnutrition. Twins Alain Don Divin Igiraneza and Alain Bon Idée Ahishakiye, both 1.5 years old, were brought into the health center in Muyange colline, in Makamba Province,  when they started to show some of the telltale signs of being malnourished.

“The children were so weak when I brought them to the clinic. I was so worried about them,” said Ndikumana. For the last six weeks, they’ve been eating RUTF. “Now they’ve been eating the paste, they are livelier and getting healthier. I am so relieved.”

UNICEF and USAID are not stopping there. We are working to build the capacity of the Ministry of Health nutrition office to do outpatient care at the health center level and inpatient treatment of SAM at the hospital level. A first step is helping the government manage the supply chain for RUTF. With funding from both PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) and Food for Peace, warehouses to store the RUTF have been equipped to improve storage space and stock management.

Health workers, nurses and doctors, including those still in medical schools, are also being trained to recognize the signs of acute malnutrition and how to treat it so the problem can be tackled early on, and not once a child gets to a critical stage. It is hoped in the long run that the Ministry of Health will be able to tackle this persistent problem without outside assistance.

ABOUT THE AUTHOR

Jessica Hartl is lead Information Officer for the Office of Food for Peace. Follow Food for Peace @USAIDFFP

Standing with Civil Society

In an effort to advance the Stand for Civil Society call to action, launched in September 2013, the President reminded us at this year’s United Nations General Assembly that “it is our obligation as free peoples, as free nations, to stand with the courageous citizens and brave civil society groups who are working for equality and opportunity and justice and human dignity all over the world.”

He referenced a newly issued Presidential Memorandum that directs U.S. agencies abroad to support civil society in several ways and announced a groundbreaking USAID initiative, in collaboration with the Sweden International Development Agency (SIDA) and the Aga Khan Foundation, to establish Regional Civil Society Innovation Centers that build connections among civil society organizations by providing resources, tools, and knowledge.

Civil society plays an important role in building stable, robust democracies and in protecting the rights of marginalized populations. At the same time, it remains an easy target for governments resistant to change. USAID has become increasingly concerned in recent years as governments adopt more laws that restrict activities of civil society and continue to harass, detain and imprison civil society activists. Tom Carothers of the Carnegie Endowment describes this closing space phenomenon as the “new normal,” which is why the President’s call to action is both timely and necessary.

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By engaging youth in the process of governance, we build a solid foundation for future leaders and contribute to establishing a stable and prosperous future for their countries. / Global Communities

Last month in Jakarta, Indonesia, I attended the Asia Civil Society Experience Summit (CSES), co-hosted by USAID, where the role of civil society and the backlash from numerous governments was the subject of much discussion. At the end of the Asia CSES, the participating activists issued a statement, which called upon Asian civil society, Asian governments and the international community to:

  • Build an enabling environment for civil society;
  • Promote innovative partnerships with diverse actors and change agents:
  • Leverage information and communication technologies to build and strengthen local and regional networks;
  • Explore innovative means to provide technical, institutional and financial support to civil society; and
  • Build and strengthen civil society transparency, accountability and effective governance.

The statement closed with a plea for “donors, governments, and international community to ensure continued financial and political commitment to civil society, particularly in closing and closed environments.”

Having travelled to Jakarta from Sri Lanka, I understood well the tensions and challenges that USAID faces in these environments. Sri Lanka was once a robust democracy but then suffered 25 years of brutal civil war. In the aftermath of the conflict, the government has sought to restrict NGOs they view as “political” by intimidating activists and imposing arduous legal regulations.

USAID’s response applies our three-pronged “prevention, adaptation, and support” approach in closing spaces: prevent the introduction of restrictive legislation; adapt to government efforts that make our existing operations difficult; and commit to continued support, financial or otherwise, for organizations that work in development, reconciliation and human rights.

In Sri Lanka today, many of the organizations that USAID supports are leading the effort to counter government plans to adopt a restrictive NGO law and to highlight concerns about security force intimidation that is affecting their operations. We are also funding programs that work with CSOs to ensure that they can continue serving their communities and advocating for human rights, even as government intimidation increases. And, we intend on continuing to support civil society, even after we transition in 2017 from a full mission to a limited presence country status program.

In Cambodia, USAID’s Development Innovations lab is connecting civil society, technology and social enterprises to provide physical space, expertise and catalytic programming to a number of groups and initiatives. The lab is involved in several activities, including teaching girls to utilize computer code in preparation for an international competition and assisting agriculture organizations to develop better monitoring apps. Via another project in Cambodia, USAID is funding the creation of mobile phone apps that allow Cambodians to read, text and chat in Khmer, their national language, as well as in Cham, the minority language.

The U.S. is the largest supporter of civil society in the world, having invested more than $2.7 billion to strengthen civil society since 2010.

As we continue to face grave challenges around the world, USAID will ensure that, when it comes to civil society, our financial investments are matched by our political commitments, and that we utilize both our presence in the field and technological innovations to support inclusive and accountable democracies that advance freedom, dignity and development.

ABOUT THE AUTHOR

Larry Garber is a Senior Advisor in the Bureau for Policy, Planning and Learning

Reducing Disaster Risk for All Generations

Today is International Day for Disaster Reduction—a day to reflect on the importance of reducing disaster risks around the globe. This year we pay special attention to the global aging population and how we must include all generations in our disaster planning, preparedness and mitigation efforts.

According to the United Nations Department of Economic and Social Affairs, the population age 60 or over is the fastest growing demographic globally, and is expected to more than triple to nearly 3 billion by 2100, representing about 28 percent of the projected 10.9 billion people worldwide.

This trend points, in part, to the many successes of international development, which have helped people around the world achieve longer, healthier lives. It also points to our responsibility to ensure that this population is not ignored when we address disaster risks around the globe.

USAID works steadfastly with our partners to ensure that all of our programs are accessible and inclusive to all people, regardless of age. We recognize that older people may be “hidden” within disaster-affected populations and may face constraints in accessing humanitarian assistance, so we take extra steps to identify them during a disaster response, listen to their views and design targeted programs that meet their unique needs where necessary.

We recognize that having this large and growing population of experienced, knowledgeable leaders and volunteers represents an enormous opportunity for communities, especially in terms of improving safety through disaster preparedness.

Matilda Blake, 85, is a farmer as well as a stand-out participant in the USAID-supported HelpAge International disaster risk reduction program in Jamaica. / Jenny Anderson, HelpAge International

Matilda Blake, 85, is a farmer as well as a stand-out participant in the USAID-supported HelpAge International disaster risk reduction program in Jamaica. / Jenny Anderson, HelpAge International

Take 85-year-old Matilda Blake. She not only single-handedly manages her family farm in Jamaica, she is also a dynamic contributor in her community, serving as an emergency shelter manager when natural disasters threaten the island. She is an active participant in USAID-supported training sessions offered by our partner HelpAge International that help the community better prepare for future disasters.

Stanford Bentley, 84, contributes his energy and experience to disaster preparedness actions in Jamaica while also learning new ways to protect his crops from extreme weather. / Jenny Anderson, HelpAge International

Stanford Bentley, 84, contributes his energy and experience to disaster preparedness actions in Jamaica while also learning new ways to protect his crops from extreme weather. / Jenny Anderson, HelpAge International

Stanford Bentley, an 84-year-old Jamaican farmer, also benefits from HelpAge’s training, learning new ways to protect his crops and livestock from extreme weather, while contributing his own energy, insight and experience to disaster preparedness actions in his community. By ensuring that older people’s knowledge and experience is used to its full potential during the planning and preparedness phase, their specific needs will be capably met when a disaster strikes.

Vietnam Red Cross and local volunteers organize an evacuation of older community members during a flood simulation drill. / Brian Heidel, USAID

Vietnam Red Cross and local volunteers organize an evacuation of older community members during a flood simulation drill. / Brian Heidel, USAID

In Vietnam, USAID has partnered with the American Red Cross to train hundreds of Vietnam Red Cross staff members and community leaders in disaster and risk management. Just as they do in the United States, these Red Cross staff and volunteers in Vietnam respond to disasters that impact their country. They also help people of all generations to prepare for and manage disaster risk. The Vietnam Red Cross uses an intergenerational approach, connecting primary school students, teachers of all ages and older people with information about disaster risk reduction, community resources and practical skills training. By including people of all ages, the program builds and reinforces a culture of safety throughout all generations in society.

These are just two examples that highlight the many contributions of older people. They illustrate how all generations can learn from and support one another, not only once a disaster has occurred, but also before a disaster by working together to reduce risk and prepare for disasters.

USAID has a proud tradition of standing up for the inclusion of older people when providing humanitarian assistance. We are also committed, in both policy and in practice, to helping reduce disaster risk for all generations in all our programs worldwide. On this International Day for Disaster Reduction, we stand together with all of the hardworking people— young and old—who are helping make their homes, neighborhoods, farms, cities, states, and countries safer, secure, and more resilient places for current and future generations.

ABOUT THE AUTHOR

Laura Powers is Senior Humanitarian Advisor and Sara Westrick Schomig is Special Projects Advisor for USAID’s Office of U.S. Foreign Disaster Assistance

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

The Fight on Ebola Continues in the Lab

In a heavily forested area about 65 miles east of Monrovia, Liberia, statues of stone monkeys keep vigil over a sprawling campus of buildings that has seen better days. The Liberian Institute for Biomedical Research (LIBR) was established in the 1970s as a premier research facility to develop scientific breakthroughs for a variety of viral infections, including hepatitis. The rusted, empty animal cages serve as a reminder of the past research conducted here.

Entrance to the Liberian Institute for Biomedical Research -- once a testing facility for Hepatitis B, currently the national lab for diseases like Malaria, Cholera, and now, Ebola.  Entrance to the Liberian Institute for Biomedical Research — once a testing facility for Hepatitis B, currently the national lab for diseases like Malaria, Cholera, and now, Ebola.  

Anthony, a janitor at the Liberian Institute for Biomedical Research, walks past rusted, empty cages that once housed Chimpanzees used for testing.Anthony, a janitor at the Liberian Institute for Biomedical Research, walks past rusted, empty cages that once housed Chimpanzees used for testing.

Now, the facility finds itself drawn into an epidemiological battle against another outbreak, this time, the Ebola virus. LIBR is one of only a few laboratories in Liberia where Ebola specimens are sent to be tested. Due to the spiralling number of Ebola cases in the region, boosting LIBR’s laboratory testing capacity has been a top priority for a team of medical and disaster experts with the U.S. Centers for Disease Control and Prevention, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), the U.S. National Institutes of Health, and the U.S. Agency for International Development (USAID).

“People are dependent on these test results,” said Gary Wes Carter, an emergency management chief with USAMRIID. “The longer a sample sits here, the longer a doctor in the field goes without an answer needed to make critical decisions about patient care.”

Specimens from across the country are delivered to LIBR daily in these coolers.   Specimens from across the country are delivered to LIBR daily in these coolers.   


Since April, American laboratory and disease control experts have been working at LIBR to process Ebola samples and train local technicians. When the rate of Ebola infections spiked in June, more equipment and personnel were brought in. As a result, LIBR’s lab processing capacity almost doubled from 40 specimens a day to more than 70. The goal is to eventually be able to test approximately 100 specimens a day, with assistance from the USAID-led Ebola Disaster Assistance Response Team (DART) and the USAID Mission in Liberia.

USAID’s disaster response and development experts are working to upgrade the laboratory facility by improving specimen containment, providing improved internet access, renovating hygiene facilities, repairing plumbing, and working with contractors to rewire the building so that it receives a steady source of electricity.

“There are a number of projects underway,” said DART Logistics Officer Sergio Solis. “Working together, we could make LIBR not only more efficient, but more sustainable for the Liberian scientists and laboratory technicians who will be running the facility.”

Laboratory experts with the USAMRIID agree that partnerships are the key to combatting the Ebola outbreak.

“We couldn’t have made the lab sustainable in the long-term without the assistance of USAID,” said Carter. “I have never been to an outbreak response where there has been this much intergovernmental collaboration. This has been amazing.”

Dr. Alec Hail, a Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases and his team spend all day from early morning until dark in the lab working on processing samples, documenting results, and sending out reports. Dr. Alec Hail, a Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases and his team spend all day from early morning until dark in the lab working on processing samples, documenting results, and sending out reports.


Before technicians enter the lab at LIBR, they must dress in full protective gear, which is essential to protecting them against the virus. Before technicians enter the lab at LIBR, they must dress in full protective gear, which is essential to protecting them against the virus.  


Dr. Anthony Jones works inside the Ebola testing lab: “This is one of the best labs Africa has ever seen,” says Alec Hail, Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). The lab started off by testing 20 to 30 specimens per day. Just a few weeks later, the it can test up to 80 specimens per day.Dr. Anthony Jones works inside the Ebola testing lab: “This is one of the best labs Africa has ever seen,” says Alec Hail, Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). The lab started off by testing 20 to 30 specimens per day. Just a few weeks later, the it can test up to 80 specimens per day.  


Dr. Jason Kindrachuck inserts the DNA from 47 people into the PCR machine to determine if they test positive for Ebola. This machine can test up to 100 samples at a time.  Dr. Jason Kindrachuck inserts the DNA from 47 people into the PCR machine to determine if they test positive for Ebola. This machine can test up to 100 samples at a time.  


Dr. Jason Kindrachuk (left) and Microbiologist, Dr. Anthony Jones (right) spend four to eight hours of their day in protective space-like suits in a laboratory containment suite preparing samples from potential Ebola patients. Dr. Jason Kindrachuk (left) and Microbiologist, Dr. Anthony Jones (right) spend four to eight hours of their day in protective space-like suits in a laboratory containment suite preparing samples from potential Ebola patients. As the light fades outside, they face the hardest part of their day. After changing back into normal clothes, one reads the list of names of specimens tested that day as the other records the information into a spreadsheet. Each name read aloud is followed by “positive” or “negative.”  “That’s when it gets real,” says Dr. Kindrachuk. Fifty to 60 percent are positive.

ABOUT THE AUTHOR

Carol Han is a Press Officer for the Ebola Disaster Assistance Response Team

Washington Post Overly Alarmist on Liberia’s “Descent into Hell”

The Washington Post’s September 30 story of Liberia’s “descent into economic hell” was overly alarmist and disconnected from that country’s recent history.

Liberia’s descent into hell occurred during the nearly 15 years of civil war that ended in 2003. This was one of the sharpest economic declines ever recorded: between 1988 and 1996, per capita income fell by almost 90 percent.

The legacy of that descent remains. Despite a decade of robust post-conflict progress, Liberia is one of the poorest countries in the world, with an income per capita less than half of what it was in the early 1970s. Educational attainment is growing from a low base, the formal manufacturing sector is tiny, the rural road network is inoperable much of the year because of seasonal rains, and unemployment is widespread. Trust in government is limited.

The U.N. World Food Program distributes USAID-donated rice in West Point, a Monrovian township that has been one of the hardest hit by the Ebola epidemic. / Morgana Wingard

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

But the Ebola crisis has hit a society that is on the rise economically and in the midst of constructing legitimate and effective government institutions.

This is ascent, not descent.

It is the responsibility of the Government of Liberia and its global partners – the World Bank, the CDC, USAID, and others – to consider worst-case scenarios in order to ensure preparedness and underscore the urgency of containing the Ebola crisis. But these are alternative views of the future; it serves nobody to caricature the present.

The World Bank’s latest economic projection suggests that Liberia’s real GDP growth will be less half of what was previously expected (prior to the Ebola outbreak, it was anticipated to be nearly 6 percent), and remain at depressed levels in 2015 even if the international response is adequate and the epidemic is contained within the first half of the year.

This is a severe shock, coupled with deep and lasting tragedy for affected families. But it is not a descent into hell.

President Obama has made the humanitarian and national security case for major U.S engagement to contain this unprecedented outbreak and maintain stability in the region. This whole-of-government response is underway, and it is in fact a whole-of-country response, in partnership with global institutions and the Government and people of Liberia and with vital and acutely-needed contributions from American families, health volunteers, and the private sector. Together we will recapture the ascent.

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.

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.

Andrew Hill: “There’s no standard blueprint for an Ebola treatment unit.”

Morgana Wingard This is the second 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 on Ebola. This series will record 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 offer their reflections on this historic health crisis.
Andrew Hill

Andrew Hill
U.S. Army Civil Engineer

The buzzwords here in Monrovia are “unprecedented” and “exponential.” Everything about the Ebola epidemic in West Africa is unprecedented as it spreads exponentially.

U.S. Army civil engineer Andrew Hill is part of the USAID-led Disaster Assistance Response Team (DART) tasked with implementing an unprecedented response to the Ebola crisis.

An essential part of that response is constructing and staffing new treatment facilities that can isolate and care for the growing number of people infected with the virus.

On the ground in Liberia, one of the first tasks by Andrew and the U.S. military engineers was to conceptualize and design an ETU. Working hand-in-hand with members of the Armed Forces of Liberia (AFL), they consulted the experts with a gold standard ETU model: Médecins Sans Frontières (MSF) and the World Health Organization (WHO). Building off of their expertise, they tailored the designs to create Department of Defense and AFL-specific versions, which could be built and implemented with their resources.

The plans started with a hand-drawn sketch that Andrew created while driving in a car on his way to various sites. That sketch formed the basis for what would become a full concept and material list needed to begin ETU construction.

Photo of Andrew Hill sketching

Photo of Andrew Hill sketching

The U.S. Army Africa engineers, led by Lieutenant Colonel Scott Sendmeyer, pooled their collective professional engineering knowledge and tools in order to continue developing and finalizing the design, and to determine the remaining requirements needed for implementation.

The first site to use the design is scheduled to begin construction imminently — and this model will be replicated and constructed across Liberia by a team of 150 AFL engineers to help save lives and stop the spread of Ebola.

(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

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