Fighting the Ebola Virus in Liberia

“The fight against Ebola was perhaps the most important work I have ever done in my life.”

—PCI Country Director in Liberia

Fighting the Ebola Virus in Liberia

“The fight against Ebola was perhaps the most important work I have ever done in my life.”

—PCI Country Director in Liberia

Overview

In March of 2014, the Ebola virus struck West Africa, resulting in over 28,000 infections and 11,000 deaths. Nearly half of all the Ebola virus victims lived in Liberia, but the disease also devastated the health of families and communities in Guinea and Sierra Leone.

The Ebola virus spread in West Africa as a “perfect storm” of converging factors: poor countries with a history of conflict, political unrest, and mistrust of the government including the healthcare system; densely populated cities; limited healthcare infrastructure; and deeply rooted cultural practices that increased the risk of contracting the virus.

The outbreak took a significant toll on Liberia’s health systems, economy, and infrastructure. Many hospitals and clinics closed completely or refused to treat patients suspected of having Ebola. Communities also lost faith in health service providers and avoided health facilities for fear of contracting the virus.

Because of the remarkable local and international response, the outbreak was officially contained and declared over in May of 2015.

Stopping the Spread of the Ebola Virus

When the Ebola outbreak began, PCI was already on the ground operating food, nutrition, and health programming in Liberia that engendered deep ties and established trust within local communities. At that time, PCI gave its staff, comprised almost entirely of Liberians, a choice to stay and continue working or take leave with their families. Without exception, knowing the risks, these brave men and women chose to stay and diligently fight against the epidemic.

At the peak of the Ebola virus outbreak, PCI reached over 500,000 people with Ebola-related interventions, responding to the crisis by equipping communities and health professionals with the knowledge, infrastructure, and supplies necessary to prevent the spread of Ebola.

PCI implemented and expanded community education campaigns; training health care providers; contact tracing and case investigation; constructing infrastructure for the isolation of suspected cases; and providing supplies such as personal protective equipment and sanitation necessities to minimize the spread of the virus.

PCI also supported the Government of Liberia by managing the Ganta Ebola Treatment Center, the country’s only site primarily staffed by the Ministry of Health and Social Welfare. More than 90 percent of PCI’s 700 communities remained Ebola-free throughout the outbreak.

The Foundation of PCI’s Successful Ebola Response

PCI’s work in Liberia began in 2010 with the implementation of the Liberian Agricultural Upgrading, Nutrition and Child Health program aimed at supporting health, nutrition, education, and reducing disaster risk.

PCI connected lead mothers, general community health volunteers, trained traditional midwives, and community health committees with community stakeholders, such as Ministry of Health staff, at county and district levels. In total, PCI established 158 care groups and a core group of over 1,600 lead mothers. Every month, lead mothers provided health and nutrition education to more than 15,000 neighborhood women.

With the onset of the Ebola virus disease, PCI gathered its existing program resources and managed over $19 million in additional funding to mobilize a response. PCI provided technical and logistical support to the Ministry of Health, trained Ebola health workers and other health facility staff on infection control and case management, and provided life-saving protective gear to health workers.

In the first six months alone, PCI reached over 60,000 Liberians with Ebola prevention programming.

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Establishing Ebola Care Centers and Treatment Units

PCI expanded its Ebola virus response in September of 2014 through the Rapid Ebola Awareness, Communication, and Training program. The expansion included disease education, behavior change communication, contact tracing and surveillance efforts, clinical support and restoration, provision of critical non-food items, and overall health care strengthening.

Working in partnership with County Health Teams, PCI mobilized community health workers and used mass media campaigns, including radio public service announcements and educational films, to reach an estimated 537,907 direct beneficiaries with Ebola prevention education.

PCI also established and managed three Ebola Community Care Centers—the only fully Liberian-staffed Ebola Treatment Unit in the country. These centers managed both the clinical and non-clinical components of Ebola virus treatment operations. Given its location on the Guinea border, PCI’s Ebola Treatment Unit became a hub for government, bilateral organizations, and partner representatives working on cross-border surveillance and safe transport for patients and laboratory samples.

By the end of the project, PCI fully transitioned the Ebola Treatment Unit to Liberia’s Ministry of Health and Social Welfare and supported the planning and launch of epidemic preparedness and response activities throughout the county.

PCI’s support to these and other facilities directly benefited nearly 850,000 individuals.

Strengthening Health Systems

While responding to the Ebola virus emergency, PCI helped strengthen the ability of Liberia’s Ministry of Health and Social Welfare to deliver high quality healthcare services. PCI trained health care workers in regional health facilities on topics such as triage and isolation, laboratory safety guidelines, waste management, and proper use of Personal Protective Equipment.

  • In total, PCI provided:
  • Emergency temporary triage and isolation units at 25 health facilities in four counties
  • Training for 1,241 health care providers from 65 health facilities on infection prevention and control
  • Regular on-site infection prevention and control mentoring for healthcare providers at 78 health facilities along with supplies, before and after the response
  • Infrastructure support and need-based training for 112 health facilities in four intervention counties
  • Training for 1,050 community health volunteers in public health surveillance and ongoing support and mentorship throughout the response

Mobilizing Communities to Prevent the Spread of Ebola

In addition to national-level surveillance and contact tracing, PCI worked with Ministry of Health teams on case management and community mobilization.

PCI engaged mothers; community health volunteers; agriculture extension groups; disaster management committees; care groups; water, sanitation and hygiene committees; traditional chiefs; religious leaders; and trained traditional midwives in comprehensive education and social and behavior change efforts.

Information included key messages on how transmission occurs, how to prevent transmission, and what to do in case of infection which these groups then shared with neighbors, peers, colleagues, family, and community members.

To manage misinformation and rumors, PCI helped to develop and utilize the DeySay Rumor Tracker—an SMS system created to track, identify, and respond to information gaps that fed the rumors originating at the community level. Used the DeySay Tracker data, PCI worked closely with community health volunteers and community leaders to address and dispel myths and reinstate trust in the healthcare system.

These approaches were critical component of PCI’s efforts to halt the spread of the Ebola virus.

Partnership in Action

PCI’s successful fight against the Ebola virus was made possible by partnerships with Government of Liberia, Liberia’s Ministry of Health and Social Welfare, the Center for Disease Control, USAID/OFDA, and the World Health Organization.

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