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ADRA started responding to the Ebola crisis in West Africa in July of last year by distributing personal protective equipment to hospitals in Liberia. Over the past year we have implemented a number of projects in both Liberia and Sierra Leone that have focused on Ebola awareness and prevention, Ebola treatment, and recovery from second-order impacts. Over the next few minutes that I have here I’ll share with you some of those approaches and projects, how partnerships played a role, and what our Liberia and Sierra Leone staff have learned so far through this experience. And I have lots of photos, so I hope you like photos =) Before I go too much further though, I want to introduce you to Henry Tony.

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That’s him in this picture here. This photo was taken by a colleague of mine at the ADRA Liberia head office in Monrovia in March of this year. Last fall, Henry and his wife were excitedly expecting their first child – a son – and they were making preparations for his arrival. But Henry’s wife became infected with Ebola, he says from nurses that were providing her obstetric care. We will probably never know for sure where she got it. Henry’s wife died from Ebola on October 13, along with their unborn son. A week later Henry started to experience the classic Ebola symptoms – vomiting, diarrhea, and a fever. He turned himself in to the health authorities, was placed in quarantine, and received treatment for Ebola. He was released two weeks later and declared an Ebola survivor, one of an estimated 5,000 survivors now living across Liberia and 16,000 living in West Africa. Henry is 31 years old. In addition to losing his wife and son, his mother and grandmother also died from Ebola. He still suffers from some little-understood post-Ebola symptoms, like numbness of the feet, which makes it difficult for him to walk sometimes. But I’ll come back to Henry’s story shortly.

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Early in the global Ebola response, ADRA was focused on preventing the spread of Ebola through awareness and WASH infrastructure. Let me share with you some of ADRA’s Ebola response activities. This is one of six 40-foot containers of supplies that ADRA was able to ship and distribute during the crisis. This one is filled with latex gloves, face masks, disposable gowns, face shields, disinfectant, and other supplies to keep medical personnel safe. ADRA does not run clinical facilities in either Liberia or Sierra Leone, but we do partner and support a number of hospitals.

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At one hospital in Monrovia that was not treating Ebola patients and that remained open for the general public, actually for a while it was the only hospital in Monrovia accepting non-Ebola patients, they faced the unique challenge of remaining open while still keeping everyone safe. This photo shows the hospital staff, ADRA staff, and our partners Global Medic from Canada setting up one of five 16x16 tents by the hospital entrance.

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The tents provided a waiting area, a triage area, and a quarantine area should any suspected Ebola patients arrive to the hospital. In total so far we’ve been able to support over 30 hospitals and clinics in Liberia and Sierra Leone with PPE supplies and equipment.

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One of the other main activities was with community awareness and sensitization. The global community at several times throughout the response emphasized how education, and not just clinical treatment and contact tracing, was a key part of the response, and this is one area where ADRA has been able to contribute. In Liberia, ADRA worked with communities to conduct mobile audio-visual awareness campaigns that reached over 14,000 people to learn about Ebola and how to protect themselves and their families.

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Sometimes they were conducted at night so that different people and different ages could attend. They had a video that was played that really caught the community’s attention and helped them to understand the facts about Ebola.

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In addition, hundreds of handwashing buckets and bottles of chlorine were distributed

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and set up as hand-washing stations in public areas.

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In the communities, Health Committees were formed and trained on the prevention and care of Ebola-affected communities and people. Each committee had representatives from youth organizations, the business community, health workers, teachers, and women’s groups. The committees were in charge of maintaining the handwashing stations, sharing what they knew with others, and passing out other informational materials.

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Our Sierra Leone staff conducted similar education and awareness initiatives, targeting public places such as streets and markets.

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ADRA Sierra Leone was also involved in a very interesting project with Plan Sierra Leone to operate a decontamination center, and deploy decontamination and replacement teams. The teams were contacted by the National Ebola Response Center (NERC) whenever an Ebola patient was taken from their home for treatment or passed away in their home. The teams had the task of decontaminating the home with chlorine solution and removing soiled mattresses, bedding, mosquito nets, or other potentially infectious items that couldn’t be easily sprayed down.

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This is a homemade sugar sack mattress that an Ebola patient was on in a home, being sprayed down with chlorine.

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This is unfortunately some of the aftermath of the decontamination work, taking away soiled mattresses and items to a secured dump site. Waste disposal was a big problem faced by a lot of organizations responding to the crisis.

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The replacement teams would come after to provide a replacement mattress, sheets, mosquito net, and pillows to the families. Around 3,000 homes were visited by the decontamination and replacement teams. This project currently is not as active as they were a few months ago when cases were higher but they are still able to be deployed as needed.

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This photo here is in Lofa county in the north of Liberia, at an emergency food distribution with the WFP. These distributions took place over 7 months in 3 counties and reached 134,000 beneficiaries who were facing food insecurity due to the crisis. The ADRA Liberia project team also used the feeding program to carry out Ebola sensitization and awareness messages.

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ADRA Liberia also focused on supporting Ebola survivors and working with the local survivor associations and county health teams to identify and help meet the basic needs of individuals who survived the virus but lost their families, homes, or livelihoods. Many survivors are unemployed and many have lost their homes, belongings, and social supports due to fear and stigma.

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With support from one of our partners, ADRA Liberia provided survivor kits to over 800 Ebola survivor households. These consisted of mattresses, bedding, food rations, and hygiene supplies and buckets, soap, and chlorine.

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One of the more recent projects ADRA has done in Liberia has been to support the re-opening of the schools with necessary supplies like hand washing stations, infrared thermometers, and school meals, and to support affected students with back to school kits, backpacks filled with school supplies that they can use. The schools in Liberia were closed for seven months and it’s been a big effort to reopen them.

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This photo here shows Henry Tony, who we met at the beginning of this presentation, at a project launch at one of the partner schools. Henry was a beneficiary who received a new mattress and survivor’s kit from ADRA Liberia. He is now an ADRA employee working on other community projects. Apart from having the skills that the project needed, Henry is able to serve as a role model for other survivors and to help restore hope to those who have lost hope. In the context of post-Ebola stigma towards survivors, employing survivors is one way to show communities that they’re not a threat to society but rather an asset. Henry Tony says that ADRA has given him a start at a new life, and that the most important thing is getting rid of discrimination.

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My role throughout the Ebola crisis has been stateside but has involved a lot of coordination with our staff and country teams on the ground in Liberia and Sierra Leone, who were the ones reaching out, the ones putting themselves on the line, the ones with the cultural and contextual expertise, and the ones helping to stop the effects of Ebola in their countries and communities. I asked the offices last week some of the things they’ve learned so far from the Ebola crisis – I said I’m doing this presentation, what would you like me to share from your perspective - so to end here’s some of what they shared. 1. Ebola cannot be tackled by health professionals alone. In Liberia and Sierra Leone, ADRA’s strengths are in community-based projects and partnerships, and they were able to draw on that for their response activities to involving and engaging the communities where they work. 2. Survivors need to help with the response, not just be responded to. Our Liberia office has employed survivors working as mobilizers, interpreters, and with the awareness campaigns. The Ministry of Health in Liberia has asked agencies to employ survivors as a step towards restoring their livelihoods. Involving survivors helps to

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restore hope and self-esteem among survivors and is necessary to address where the second-order impacts of Ebola have been most felt. 3. And the last comment they made that I’ll share is “No panicking”. The culture of fear that dominated during the beginning of the crisis did not help with the response. Fear instead of facts drove dramatic actions by individuals and governments that did not make the best use of resources and that did not demonstrate confidence. A “keep calm” approach was recommended instead.

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