Triangle Smart Talk_Ebola

Bolun Li

Master of Science in Global Health & International Development Policy

CertificateDuke University, Nov.23, 2014

Table of Contents Some facts about Ebola

Key events in the spread of Ebola

Understanding Ebola from a social perspective How do people feel about Ebola in West Africa Health care systems in West Africa Gender and Ebola Tradition: Funerals

International lessons and efforts in fighting Ebola Uganda & Nigeria International aid

Some facts about Ebola

Reported Cases/Deaths

Country Cases Deaths Last update

Liberia 7,069 2,964 15 November 2014

Sierra Leone 6,073 1,571 16 November 2014

Guinea 1,971 1,192 16 November 2014

Nigeria 20 8 outbreak ended 20 October 2014

Mali 7 6 20 November 2014

United States 4 1 16 November 2014

Senegal 1 0 outbreak ended 17 October 2014

Spain 1 0 16 November 2014

Total 15,146 5,742 as of 16 November 2014

Where did the outbreak took place

Widespread transmission: Guinea, Sierra Leone, Liberia Local transmissions - no deaths: Texas, Spain Initial cases - deaths: Texas, Mali Initial cases - no deaths: New York Medically evacuated cases - deaths: Spain, Germany, Nebraska Medically evacuated cases - no deaths: Georgia, Maryland, United Kingdom, France, Norway, Switzerland Previously had cases, now Ebola-free: Senegal, Nigeria

Key events in the spread of Ebola

DEC. 28, 2013

Emile, a 2-year-old boy in Guinean village of Meliandou, dies of a mysterious sickness, becoming West Africa’s first Ebola victim.

EARLY 2014

Amid a multitude of deadly diseases, Ebola spreads without being noticed.

MARCH 23, 2014

The World Health Organization publishes notification of a “rapidly evolving” Ebola outbreak in Guinea involving 49 patients and 29 deaths. Suspected cases in Sierra Leone and Liberia are being investigated.

MARCH 30, 2014

The WHO reports that two Liberians tested positive for the Ebola virus after traveling to Guinea, including a 35-year-old woman who died March 21.

MAY 10, 2014

Dozens of mourners attend the funeral of a traditional healer who contracted Ebola while treating patients. The funeral, in Koindu, Sierra Leone, helps the virus spread and may be linked to 365 Ebola deaths, local health authorities say.

MAY 25, 2014

Sierra Leone health authorities confirm their first Ebola case, a young woman admitted to a government hospital in Kenema after a miscarriage.

JULY 20, 2014

Liberian American Patrick Sawyer ignores the advice of medical officials and flies from Monrovia to Lagos, spreading Ebola to Nigeria. He dies five days later, and the virus goes on to sicken 19 and kill eight, the WHO says.

AUG. 2, 2014

Dr. Kent Brantly, a 33-year-old American who contracted Ebola while working in Liberia, is taken to Emory University Hospital in Atlanta. He becomes the first patient with Ebola to be treated on U.S. soil.

A 21-year-old man who was being monitored by health authorities in Guinea flees to Dakar in neighboring Senegal, becoming that country’s first and only Ebola case. He is released from a hospital Sept. 19.

SEPT. 15, 2014

A 2011 photograph shows Thomas Eric Duncan, who died of Ebola in Dallas on Oct. 8, at a wedding in Ghana.

SEPT. 16, 2014

President Obama says he is sending up to 3,000 military personnel to West Africa, where they will set up 17 treatment centers and train healthcare providers.

SEPT. 18, 2014

The U.N. Security Council declares the Ebola crisis in West Africa a threat to international peace and security.

SEPT. 19, 2014

Duncan boards a plane in Monrovia, Liberia, to visit family in Dallas.

SEPT. 19, 2014

Sierra Leone begins a nationwide lockdown to identify and count cases of Ebola. The country’s residents are required to stay home for three days while healthcare workers and volunteers go door to door searching for Ebola victims and distributing information about the virus.

SEPT. 30, 2014

Tests performed by the CDC and a Texas laboratory confirm that Duncan has Ebola, the first case diagnosed on U.S. soil.

The WHO announces that Ebola outbreaks in Senegal and Nigeria are under control.

OCT. 6, 2014

Teresa Romero Ramos tests positive for Ebola in Spain, becoming the first person known to have contracted the virus outside West Africa in the current outbreak. The nursing assistant had treated two infected missionaries.

OCT. 17, 2014

The WHO declares Senegal to be free of Ebola.

OCT. 20, 2014

The WHO declares Nigeria to be free of Ebola.

OCT. 23, 2014

Dr. Craig Allen Spencer enters isolation at Bellevue Hospital in New York City and is diagnosed with Ebola. He had recently worked with Doctors Without Borders in Guinea.

Understanding Ebola from a social perspective

How do people feel about Ebola in West Africa

In a school building used to quarantine Ebola patients in Monrovia, Liberia, Umu Fambulle stands over her infected husband after he fell

A three-day lockdown in Freetown, capital of Sierra Leone

As in Sierra Leone, the virus marched into the capital city, Freetown, where it took advantage of overcrowded living conditions and fluid population movements to grow in explosive numbers.

Heroes Forever

Mbalu Fonnie

Alex Moigboi

Dr. Sheik Humarr Khan

Alice Kovoma

Mohamed Fullah

"I'm afraid for my life, because I cherish my life. And if you are afraid then you must take the maximum precautions, stay vigilant and stay on your guard." Dr.Khan

Health care systems in West Africa

Understanding the System (source:Lyttelton Braima, Sierra Leone)

PHU (primary health unit/peripheral health unit): lowest tier of health service delivery in rural areas:

1. Maternal and Child Health Post (MCHP): ideally should service 500 – 5,000 people in villages within a 3-mile radius

2. Community health post (CHP) should service about 5,000 – 10,000 people in villages within 5-mile radius

3. Community Health Center (CHC) should service about 10,000 – 30,000 people in villages within 5 – 10-mile radius

CHC at chiefdom headquarters

District hospitals are the main referral centers for the village and chiefdom level facilities.

District Hospitals are Located in District Headquarter towns. ● In big towns and cities, target local council wards or divide the city/town into zones to ease operation (management and

coordination).● Private and faith based health clinics/health centers in big towns/cities.

MCHP and CHP are at village level

Gender and Ebola

• Cultural roles of women in Africacaregiversnurses cross-border traderswho prepare for burial traditional birth attendants

• Female health workers receive less protection than male workers

Casualties & gender

Source: Wolfe, 2014

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Liberia Guinea Sierra Leone

Male

Female

Tradition: Funerals

• Kenema, Serra Leone (mid-May) one traditional healer’s funeral

Mourners came from other nearby towns, to honour her memory by participating in the traditional funeral and burial ceremony.

14 women were infected 365 Ebola deaths linked to this funeral The funeral's role as origin of Ebola in Serra Leone is

confirmed by M.I.T. and Harvard who sequenced the virus found in 78 patients

• In Guinea, 60% of all cases had been linked to traditional burial practices.

International lessons and efforts in fighting Ebola

Lessons from Uganda

• Gulu outbreak in 2000

425 contracted Ebola

more than half died

• Early warning system Village health teams: year-round monitoring Health massages broadcast on over 200 radio stations

• Rapid diagnostic testing center in Luwero district• Emergency-operations center

Lessons from NigeriaMeasures Nigerian teams managed to trace everybody who had

contact with those who later developed the disease. A centralised emergency operations centre A first-class virology laboratory affiliated to the Lagos

University Quickly disbursed government funds TV broadcasts

Lessons Rapid case identification and forceful interventions can

stop transmission.” Persistence, rigorous enforcement of quarantine and

disinfection of premises contribute to a success story for Nigeria

International aid

• http://www.theguardian.com/global-development/datablog/ng-interactive/2014/oct/28/-sp-ebola-funding

MSF(Doctors without Borders)

Medical team, PLA(解放军医疗队 )

US sending 3,000 military personnel to West Africa

UN Chief Board Meeting on Nov.21 after Mali outbreak

Thank you very much!

谢谢！