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LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 19 December 2014 Disclaimer: the information presented here is collected for management information.

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Presentation on theme: "LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 19 December 2014 Disclaimer: the information presented here is collected for management information."— Presentation transcript:

1 LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 19 December 2014 Disclaimer: the information presented here is collected for management information purposes only and is not intended for publication. The information included does not represent official statements by either the Government of Liberia or its partners.

2 97% Social mobilisation Required social mobilizers recruited 76/ 650 Case management Occupied beds vs current bed capacity 30% Psychosocial Required psychosocial workers recruited 66% Epi laboratory Available spare capacity 27% Non-Ebola healthcare Triages at regular health facilities open 5 out of 15 Contact tracing Counties with inadequate contact tracing Summary 1 of 3: Medical Response Key outstanding actions 1.Roll out mouth swab to other counties 2.Survivors registration started. Need partners to provide survivors kit 3.Provide awareness (training ) for funeral homes to reduce unsafe burial at the community level 4.Provide psychosocial support services to burial teams 5.To develop food and water supply plan & secure funding for Montserrado ETUs 6.Continue integration of people doing contact tracing, social mobilisation and focus on active case finding 7.Scale up active case search and Rapid Isolation and Treat of Ebola (RITE) Strategy 8.Need a strategy, including particularly for communities, on giving feedback from dead body test results. 9.Develop supply plans for all facilities to allow planning by Logistics (ETU, CCC, regular health facilities) 10.Accelerate roll out plan for triages at regular health facilities 95% Body management Bodies collected within 24 hours Cemetery opening delayed Trend on last week Ok, training ongoing Scale Up Still Awaiting Release of Funding Need to focus on 5 counties with poor coverage Ok Cemetery and test feedback are issues Data still poor on clinic status Ok, launching RITE

3 5 out of 19 Medical planning Key medical supplies with less than 1 week stock/pipeline 80% Finance of ebola response Of Ebola Funding Requirement Committed Summary 2 of 3: Non-medical Support Response Key outstanding actions 1.5 categories of medical supplies needed immediately 2.Need comprehensive picture of who is supplying what, critical for log cluster forecasts and dispatch plans 3.Airport runway tarmac plan critical 4.Ensure real-time information for decision making and improve dispatch plans from partners in order to provide visibility and planning of the supply chain 5.Start using 40 DAF trucks in December 6.Launch package of interventions for desludging of latrines and sceptic tanks at ETUs in Greater Monrovia 6.Airport processes to allow faster dispatch of incoming commodities 7.Address Guinea border problems for ebola cargo 8.Log Cluster to provide county maps showing ETUs, CCCs, and other facilities served by each FLB 9.LogCluster to send information on availability of donated Maersk containers for partner use. 10.LogCluster to provide more detailed information on casevac procedures and procedures/capacity for movement of blood samples. 11.There is an urgent need to dispatch more cargo from the Main Hub to the rest of the country 5 out of 5 Logistics Forward Logistics Bases have land allocated 18% WASH Percentage of Planned WASH activities completed Epi-Data Awaiting indicator

4 3 out of 7 Border controls Regular Airlines Operating 33% Education system Teachers trained in EVD 1 Development projects Health care facility for international project and concession workers 24 Communication Targeted Ebola Daily Press Briefings Held 100% Economic impact Markets allowed to be open Summary 3 of 3: Response to the Consequences of Ebola Stable Security Security Situation Key outstanding actions 1.Food and livelihood assistance needed for EVD affected 2.Identify health support (e.g scale up Aspen Clinic support) needed to encourage concession workers & development project contractor 3.Funding needed for budget shortfall to support short term stimulus activities 5.Continue to hold ebola working session for media managers 6.Ensure all community radio stations are transmitting daily ebola press conference 7.Re-launch critical development projects 8.Develop modules for airing of radio education programs 9.Train teachers in EVD prevention 10.Re-open schools by January % Food security Increase in price of rice since August

5 Annex 1. Social mobilization & communications Plan for achieving objectiveCurrent Status and Actions Underway Establish robust, evidence-based strategic framework for all social mob efforts. KAP: 10-counties approached; Completed qualitative component of field work in all 6 planned counties; 5 of 6 counties-Data analysis to begin parallel; Ongoing quantitative survey work in 4 additional counties to expand understanding Establish ‘single source’ information platform accessible to all partners Health Promoters Network scaling up Anti-Ebola Regulation, Ebola Must Go Strategy, Healthy Christmas and Election Messages. Developed key Message Guidance Package covering: New Vaccine Trials, messages on the “Ebola Must Go” campaign; Safe burial practices, signs and symptoms, Prevention, Available services and treatment at ETUs, Contacts and contact tracing, survivors and stigma, and community engagements. Others include safe transportation, CCCs. Packages distributed nationwide. 1,000 video (DVD) on “Religious leaders Speak on Ebola” being distributed to video clubs through the Ministry of Information and CHTs. Messages on Elections and holidays developed on Ebola prevention. Anti-Ebola Regulation being publicized. Establish coordinated network of at least 10,000 trained social mobilizers 14,731 (chiefs and elders, religious leaders, women and youth groups, peer educators, motorcyclist, survivors including gCHVs) trained and deployed in Social Mobilisation activities in 83 districts in 14 counties. Establish supervisory, reporting & monitoring system Reports from the various communities towns and villages are being collected by the DHOs and submitted to the CHTs on a weekly basics. There is a need for central level supervision and monitoring of those activities. Establish ‘near real-time’ behavioral surveillance mechanism The national strategy “Ebola Must GO” launched and ongoing at the community level. Messages for the restoration of basic health services are ongoing.. sem.edu lahannahvillejawa Date updated: 19/12 Note: the training of GCHVs (10,000 ) is ongoing- this indicator is now gradually rising to meet the target. In the meantime the Social-Mobilisation Committee is thinking of other more suitable indicators. To do this, data management needs to be improved.

6 Annex 2A: Case Management Plan for achieving objectiveCurrent Status and Actions Underway Ensure a total of 29 ETUs with adequate coverage in each county 14 ETUs are functioning in the country. Zwedru ETU opened last weekend. Two ETUs are planned to open next week. Montserrado beds have been scaled down to 430; MSF pulled out of Lofa; Bong 51 beds; Nimba 36; Margibi 51, MMU 22beds, Bomi 20 beds, total beds scaled down to 650, excluding Zwedru, the first in the Southeast of the country. Many beds will be available in the counties soon given many ETUs are coming online soon. Establishment of 78 CCCs, starting with 15 new priorities (UNICEF) 5 CCCs are operational, 8 CCCs are currently under construction by UNICEF, and three CCCs will soon be opened in Montserrado by eHealth. Identify trained staff and essential supply requirements for ETUs and CCCs MoH/WHO/DoD staff being trained per week in cold training, 40 hot training per week at MOD1, 20 hot training at IMC per week. Essential supplies issues are being sorted out for ETUs and CCCs. RITE kits have been set up at central IMS and will now be prepositioned in the counties. Conduct active case finding for hotspotsPreparations for active case findings in hotspots are underway: RITE Strategy has been launched. One rapid response center has been set up in Rivercess by MSF and is functional. Increase number of ambulances43 ambulances have been deployed in the response as at November 28. ( Bomi-5, Gbarpolu-2, Grand Bassa-1, Capemount-5Grand Gedeh-3, Lofa-1,Margibi-2, Maryland-1, Montserrado-15, Nimba-2, Rivercess-2, Rivergee-1, Sinoe-2; Grand kru-1) Updated by Philip Bemah and Dan Gwinnell ntonhealthaccess. org ahoo.com nhealthaccess.org Date updated: 18/12 TARGETS UNDER REVIEW

7 NB: One Sinoe location now changed Annex 2B: Case Management Map

8 ETU data – 18th December 2014 ETU Name Current Capacity Total patients Total confirmed patients Total beds free Partners Potential capacity- all wards New admissions last 2 days Bomi (Tubmanburg)202218IOM1000 Bong (Suakoko)517846IMC719 Lofa (Foya)40closedMSF -> SP140closed Margibi (Firestone)310036Firestone31 Margibi (Kakata)201415IMC708 Margibi (Monrovia Medical Unit) 22No report 22USPHS25No report Monsterrado (Unity Conference Centre) MOHSW962 Montserrado (Chinese ETU)502046Chinese FMT1000 Montserrado (ELWA 2) MOHSW/WHO1002 Montserrado (ELWA 3)602619MSF2509 Montserrado (Island Clinic) WHO/MOHSW1002 Montserrado (MoD) AU / Cuban FMT / MOHSW / MSB1002 Nimba (Ganta United Methodist Hospital) Nimba CHT / PCI361 Total Uneven distribution across the country

9 Annex 2D: CCC Status as of 16 th Dec Date updated: 18/12 CCC Name Current Capacity Total patien ts Total confirm ed patient s Total beds free Partners Potential capacity- all wards Number triage in the last 2 days Notes Grand Cape Mount (Jene Wonde RRC) 8 8MTI, eHealth8 CCC team working on reporting system Margibi (Dolo's Town Clinic) 3000 Save The Children303 CCC team working on reporting system Margibi (Wohrn Clinic) Save The Children301 CCC team working on reporting system River Gee (Fish Town Hospital) 1500 Samaritans Purse150 CCC team working on reporting system River Cess (Gozohn RCC) MSF CCC team working on reporting system Gbarpolu (Chief Jallah Lone Clinic) TBC CCC team working on reporting system Grand Bassa (Quewein) 15 MSF15 CCC team working on reporting system Total

10 Annex 2E: ETUs Planned Date updated: 18/12 NoLocationCounty Partners - construction Planned Date Construction Finished Planned Open datePartners Maximum bed capacity Initial beds 1BopuluGbarpoluDoD/AFL25/12/14TBCPAE/Aspen1050 2BuchananGrand BassaDoD/AFL06/12/1407/12/14IOM1050 3SinjeGrand Cape MountDoD/AFL06/12/1415/12/14IOM1050 4ZwedruGrand GedehGAA01/12/1407/12/14PIH / PAE1060 5BarclayvilleGrand KruDoD/AFL26/12/14TBCPAE / Aspen1050 6ZorzorLofaDoD/AFL16/12/14TBCPAE/Aspen1050 7VoinjamaLofaDoD/AFL14/12/14TBCWAHA /GOAL / PAE / Aspen1050 8KakataMargibiSave the ChildrenCompleted22/11/14IMC /USAID1070 9HarperMarylandGAA20/12/1421/12/14PIH / PAE MoD 2MontserradoWFPCompleted TRAINING SITELetter of Intent from MSB Sweden TRAINING SITE100 11SKD 1MontserradoWFPTBC03/12/14IRC / USAID SKD 2MontserradoWFPTBC25/11/14German Red Cross/Army SKD 3MontserradoPLACompleted03/12/14PLA Unity Conference CentreMontserradoALPHACompleted18/11/14MOHSW GantaNimbaDoD/AFL09/12/14TBCPCI TappitaNimbaDoD/AFL08/12/14TBCHeart to Heart / PAE / Aspen Gbediah TownRiver CessDoD/AFL25/12/14TBCPAE / Aspen FishtownRiver GeeGAA14/12/1422/12/14ARC / USAID GreenvilleSinoeGAA10/12/14TBDPAE/MSB1050

11 Annex 2F: CCCs Planned Date updated: 18/12 NoLocationCounty Partners - construction Planned Date Construction Finished Planned Open datePartners - management Maximum bed capacity Initial beds 1Beh Town ClinicBomiUNICEF14-Dec-14TBCPlan15TBC 2HaindiBongUNICEF14-Dec-14TBCPCI15TBC 3Kpayeakwelleh ClinicGbarpoluUNICEF15-Jan-15TBCSamaritan's Purse15TBC 4Chief Jallah Lone HospitalGbarpoluUNMIL/CHT14-Dec-14TBCSamaritan's Purse15TBC 5Kongbor ClinicGbarpoluUNICEF14-Dec-14TBCSamaritan's Purse15TBC 6John Logan TownGrand BassaUNICEF15-Jan-15TBCConcern Worldwide15TBC 7KeitaGrand Cape MountUNICEF24-Dec-14TBCMTI15TBC 8Gbarzon Health CenterGrand GedehUNICEF31-Dec-14TBCPIH15TBC 9Niplikoi ClinicGrand KruUNICEFTBC Samaitans Purse15TBC 10Konia health CenterLofaSamaritans PurseTBC Samaritan's Purse15TBC 11PleeboMarylandUNICEF22-Dec-14TBCPIH15TBC 12Mount Barclay CinicMontserradoeHealthTBC Concern Worldwide15TBC 13Louisiana ClinicMontserradoeHealthTBC Plan Int.15TBC 14Koon Town ClinicMontserradoeHealthTBC Concern Worldwide15TBC 15Bensonville HospitalMontserradoeHealthTBC Plan Int.15TBC 16Saclepea ComprehensiveNimbaUNICEF24-Dec-14TBCPCI15TBC 17Bahn Health CenterNimbaUNICEF24-Dec-14TBCPCI15TBC 18St.Francis HospitalRiver CessUNICEF24-Dec-14TBCPIH15TBC 19Gbeapo Health CenterRiver GeeUNICEF22-Dec-14TBCSamaritan's Purse15TBC 20Karquekpo ClinicSinoeUNICEFTBC MTI15TBC 21Juaryen ClinicSinoeUNICEF31-Dec-14TBCMTI15TBC 22Nyehn Health CenterMontserradoMOHSWTBC MOHSW15TBC

12 Annex 3. Mental Health/Psychosocial (MH/PSS)1- Updated by eria.org eria.org Updated: Dec. 17, 2014 Plan for achieving objectivesCurrent Status and Actions Underway Provision of Mental Health/Psychosocial services to individuals and communities Current: MHPSS services provided for all patients in ETU and 5 communities in Tubmanburg in Bomi county. Held meeting with 25 survivors, screened and counselled 20 clients, with 3 survivors showing symptoms of anxiety in Bong County. Provided pycho-education to 362 people in 15 communities, reintegrated 64 quarantined individuals in 5 communities in Grand Cape Mont. 28 patients received mhpss services in Ganta ETU. Action: WHO currently training 36 MHCs and social workers on mhpss support services. In community: increase mental health/psychosocial workers focused on affected, hcws, first responders Current: 50 MHCs and 60 SWs in 10 counties; and 15 County SW Supervisors. UNICEF committed to additional 10 social worker in 5 counties. Action: Expand services to burial team. STALLED Identify and appropriately place and support children separated from their families Currently: 583 affected children identified in December. Total of 2,664 affected children (1,264 males and 1,400 females) currently receiving support either through their families and/or are placed at home/or in transitional home. Actions: UNICEF one time grant of $150 USD/child reeived by 385 EVD affected children in 7 counties (Bong 30, Grand Gedeh 18, Nimba 9 and Bomi 33, Bassa 15, Margibi 50, Lofa 230). 130 children from ETUs and ICCs reunified with their families. ICC opening in Bong still pending. Team needs 1,000 available Psychosocial workers overall. (Timing: asap.) Current: Proposed funding for 600 Mental health and Psychosocial workers from World Bank. Proposal developed and submitted. Action: Agreement signed. Release of funds still pending. Working with partners on provision of quality care Current: New system for patients and family feedback whilst in the ETU implemented in Montserrado County. Action: Expand system to other counties. Began initial distribution of 1000 phones donated by UNICEF for ETUs across the country. Implement plan to address survivor needsCurrent: Reunified 5 survivors in Bomi. UNICEF commits to support for survivors coordination. CDC conducted photo voice TOT for survivors. Margibi local chapter of Survivors’ Network elections held Action: Survivors registration started. Final survivors’ meeting for 2014 to be held on Dec. 18. Database has line listed 1328 survivors

13 Annex 4A. Contact Tracing Plan for achieving objectiveCurrent Status and Actions Underway Identified and follow up all persons who came in contact with a case 334 new cases, 1,807 new contacts and 171 new deaths were reported December 1-13, 2014 A daily average of 28 cases, 151 contacts and 14 deaths were reported, 82% of new cases were found in Montserrado (49%), Grand Cape Mt (13%), Grand Bassa (11%) and Bong (9%) Follow-up every ‘contact’ in person, on a daily basis, for 21 days, to check for signs of symptoms. 5,044 contacts are currently under follow-up 97.4% of current contacts are found in Montserrado (72.6%), Margibi (17.9%) and Grand Cape Mt (6.8%) Counties Two-thirds of the counties do not have a confirmed case and contact under follow-up Recruit and train contact tracers at County, District (zonal) and community level responsible for conducting tracing and reporting There are 5,919 contact tracers and active case finders nationwide. Contact tracers are found throughout the country at County, District (zonal) and community level. Mobilize resources to expand the number of contact tracers Approaches Train and deploy contact tracers (World Bank 500; WHO south east) Has kicked off Introduce mobile technology (mobile phone) to facilitate timely reporting and mapping of contacts and cases (UNFPA and UNMEER ) Engage communities to facilitate active case finding and quarantining Introduce performance incentive for active case findings Update: 19/12 # County Contact Tracers and Active Case Finders 1 Bomi150 2 Bong350 3 Gbarpolu121 4 Grand Bassa400 5 Grand Cape Mount247 6 Grand Gedeh42 7 Grand Kru179 8 Lofa138 9 Margibi Maryland96 11 Montserrado3, Nimba1, Rivercess82 14 River Gee Sinoe263 Total5,919 Number of Contact Tracers and Active Case Finders per county

14 Cases and Contacts Trends (July –November, 2014) Annex 4B: Cases and Contacts Update: 5/12

15 Annex 4C. Required # of Contact Tracers & Active Case Finders Number of Contact Tracers and Active Case Finders #County Current Number of Contact Tracers and Active Case Finders # that are PaidGap Partners that are responsible to pay 1Bomi UNFPA, IOM & Bomi Citizens 2Bong Global Community, Save the Children, AFRICARE & World Bank 3Gbarpolu Global Community & LNRC 4Grand Bassa World Bank, WHO & AFRICARE 5 Grand Cape Mount UNFPA 6Grand Gedeh422517World Bank 7Grand Kru WHO and World Bank 8Lofa UNICEF 9Margibi ZOA & World Bank 10Maryland96 0WHO and World Bank 11Montserrado3172 0ACF, WHO & UNDP 12Nimba1, 5741, WHO, PCI, Africare/AML, World Bank 13Rivercess502030DCI, LNRC & World Bank 14River Gee WHO & World Bank 15Sinoe World Bank Total

16 Annex 5A. Epi Laboratory Plan for achieving objectiveCurrent Status and Actions Underway Run other tests along with Ebola increase Health care delivery during the phase of excluding Ebola, All Labs currently have the capacity and are performing to some extend other test but need a request from the Government of Liberia to proceed on a large scale. The deceased samples are now been tested by LIBR, BONG,and Island and the sensitivity is high. Conduct a training Workshop for Medical Laboratory Practitioners on safe blood collection, packaging and transportation. Training of 100 laboratory Practitioner on the safe phlebotomy and sample transportation approved. To start soon Planning additional workshop for 91 Laboratory personnel in the safe blood collection, sample packaging and transportation. Bring in additional staff and resources to maximise laboratory capacity especially for LIBR and to increase the number of phlebotomists LIBR has capacity to train and serve as a training facility. Explore with partners needed resources to expand capacity Review practice to ensure it meets required specifications New desk officers to submit Lab SOPs for review – to confirm labs operate to minimum centralised safety standards (10/10) Updated by Henry Kohar on 10/12 om Date competed: 10/12 Table showing current laboratory capacity Daily Capacity LABS Etu served CurrentProjectedAverage LIBR ELWA LOFA ISLAND BONG TOTAL

17 Annex 5B. Current Laboratories and Possible Relocation 17 LBIR Relocation to Sinje, Cape Mount approved

18 LaboratoryEbolaMalariaYellow FeverLassaOthers ELWA: CDC – NIHPCR Malaria PCR LIBR: CDC-NIHPCR Bong: NavyPCR Island clinic: NavyPCR Sanniquellie –NimbaPCR Zwedrou - Grand GedehPCR Tapita (Nimba)PCR Green Ville (Sinoe)PCR Current Ebola Diagnostics and Technical Capabilities CurrentTechnical Capability but not performing

19 Annex 6. Body Management Plan for achieving objectiveCurrent Status and Actions Underway Train & deploy sufficient safe burial teams across the country to conduct safe collection and burial. Current status: 20 IFRC teams ready to deploy + 6 GC teams in Monts; 51 GC teams across other counties Montserrado teams currently being used and doing training refresh. Plan for expansion: IFRC/GC able to quickly train additional in Monts. 98% body pickups within 24 hours. Ensure adequate supplies and storage facilities for body management teams through dedicated warehouse. Have had problem with body bags /other ad hoc supplies and the ordering/collection system. 19 th warehouses still being made operational. Inventory tracking and assistance required. Develop sufficient crematorium and burial capacity Cemetery plan underway however still awaiting MoJ verification of deed ownership. Draft social mobilisation/messages have been finalised for agreement. Undertake actions (e.g. testing, identification etc) to ensure all collections and burials are happening safely. Swabs being collected by IFRC teams but feedback is a problem. CDC have developed draft guidance but the final feedback and comms strategy needs to be agreed. GC teams being trained in swab testing and will support in all counties. Date competed: 5/12 Burial Teams – by County Maximum Teams 23-Nov29-Nov06-Dec GCIFRCGCIFRCGCIFRC Bomi Bong Gbarpolu Grand Bassa Grand Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Montserrado Nimba Rivercess RiverGee Sinoe Total Percent of Maximum 89% Target/ Percent of Target 6598%

20 Annex 6b. Body Management Date competed: 5/12

21 Hospitals open 131 out of 141 hospitals open (new data submitted this week) 93% Non-ETU Health-workers names submitted to MDFP for Hazard Pay 7,679 out of 8,162 health workers Some health workers have now received payment – see next slide 95% Health facilities open Data being worked on but many geographical challenges 150 out of 869 facilities checked 139 facilities open; 11 closed; 719 unknown TRIAGE system established in health facilities 27% 182 out of 657 facilities (up 7% since 8 Nov) Update on health worker pay: 379 health workers have been placed GOL payroll between October and November 2014 Challenge on hazard pay: Validation of HW lists submitted by counties for hazard payment (Duplication of acc numbers) Action: Fast-track joint MFDP and MOH validation processes Other Challenges: FARA reimbursement ( 2.6 Mil) and Y4 budget support still pending Still awaiting transfer of the 6 million US dollars to MOH for support to partners for restoration activities in the 5 highly affected counties Annex 7. Status of Essential Health Services Date completed: 5/12 “131 out of 141 hospitals open” This stats to be validated

22 Processes involved with preparation for Triage Set Up in Health Facilities a)Conduct practical IPC Training for all HF staff b)Deliver IPC supplies after the training c)Identify IPC Focal point in facility to ensure adherence to IPC standards and protocols for staff and patient safety d)Safeguard HF : ensure 1 entry and 1 exit point in the facility e)Construct and furnish temporary/permanent structure for screening (triage) f) Setup a holding station for isolation of suspected cases g) Set in place safe medical waste disposal system Annex 7B. Update on triage: process and next steps Challenges: Infrastructural challenges for single entry and exit points within the facility Behavior change Inconsistent IPC practices Inadequate IPC supplies leading to poor adherence to IPC protocols and standards and waste disposals Action: Supportive supervision, mentoring and coaching of staff in health facilities Assessment by WASH Consortium to be conducted soon to address waste disposal Address infrastructural challenges in some facilities where needed Updated on: 05/12

23 Annex 8A: Logistics Cluster Main Discussion Points Humanitarian Passenger flights – following a user needs survey with partners, and a UNHAS user group meeting (to be held Thursday 18 December) a new schedule will be drafted and once approved, will be published on the Logistics Cluster website. Forward Logistics Base (FLB) Updates- All 5 FLBs are operational. 3 FLBs have all 6 planned Mobile Storage Units (MSU) erected. Buchanan FLB has now all 4 planned MSUs completed and Harper FLB has 5 out of 6 MSUs completed. Dispatch plans and the Main Logistics Hub – 90% of the storage space in the Main Hub is full. There is an urgent need to dispatch more cargo from the Main Hub to the rest of the country. Rapid Isolation Treatment of Ebola (RITE): WFP has supported the humanitarian community in response to 2 different outbreaks, and so far has provided 3 RITE kits of supplies by air (Grand Cape Mount and 2 X Greenville) Detailed CCC and ETU Mapping: The logistics cluster is consolidating data from all its members to update the Please find in annex a list of zoomed- in maps of ETUs and CCCs for each relevant county. Update on Action Items. Logistics Cluster: Logcluster provided detailed casevac/medevac information for non-Ebola procedures for non-UN staff and all necessary documents are now available on the logistics cluster website. The logistics Cluster proposed an allocation plan for the 20 container donation of Maersk. The logistics Cluster has informed the Swiss government of all received requests regarding their donation of generators and lighting and handling equipment. Outstanding actions: Logistics Cluster to follow up with the distribution of the allocated Maersk containers Logistics Cluster to enquire Maersk if any additional containers can be donated Partners to offer more &detailed dispatch plans to the logistics Cluster to free the main logistics main hub from cargo. Partners interested in OFDA stock on hand should contact Partners to share with the Logistics Cluster their storage locations and capacities across the country. Partners to share any valuable country and county level information for GIS mapping purposes. Updated on: 17/12

24 Annex 8C. Quality of Roads Updated: Nov

25 Annex 8B: Logistics Support by Cluster For each Facility (ETU, CCC, regular health facility), need comprehensive picture of who is supplying what. This is critical for our forecasts and dispatch plans. An excerpt of information we are trying to collect is listed below: Updated on: 10/12

26 Annex 8D. Logistics Hub & Forward Logs Bases Updated: Dec

27 Annex 8F.Regional Port Restrictions Updated on: 4/12

28 Annex 9. Medical Planning: Supplies Gap Updated as of: December 13, 2014 KEY: <1 week (7 days) supply <2 week (14 days) supply ONLY Includes requirements and days of stock for facilities using the MOHSW Supply Chain Tremendous amount of PPE in country and in the pipeline for ETUs and CCCs; currently, the proportion of supplies in country for IPC is a constraint

29 Annex 10: WASH for Ebola Date updated: 18/12 Completed by Steller Makasi, WASH Cluster Humanitarian Response  Two Sludge trucks from US-DART team will be handed over to UNICEF and Liberia Water and Sewer Corporation (LWSC) this week to start transporting liquid sludge being overflowed in Septic tanks in two ETUs to the Fiamah (Monrovia) waste water treatment plant to store and treat infectious liquid waste. These septic tanks were emptied and temporarily stored in UNICEF provided poly tanks. With the funding assistance of USAID, UNICEF will get into an operational plan with Liberia Water and Sewer Corporation (LWSC) to continue emptying and transporting liquid infectious waste from ETUs. UNICEF, in consultation with infection prevention and control (IPC) experts from WHO and ICRC, is organizing a practical training session on handling of Waste by Operators and Drivers of sludge trucks of LWSC Subnational coordination has to be reinforced, and partners working in the EVD response should engage with the WASH cluster coordinators at county level.  The WASH Cluster Coordination group conducted a day long capacity building workshop on Integrated WASH assessment and monitoring for County level WASH Coordinators and other technical staff of MOPW. The main objective of the workshop was “Technical and coordination capacity development of WASH team at sub-national level in support to Ebola response using RITE (Rapid Isolation and Treatment of Ebola) approach”. A total of 35 participants attended including MOH environmental health staff and few NGO staff. Major focus of this workshop was on assessment and monitoring of WASH facilities, before and after installation, by MOPW county technical teams with available INGOs support. It was facilitated by MOPW Assistant Minister, National Cluster Coordinator, MOPW WASH Engineer, Public Health Engineer from OXFAM, UNICEF Cluster Coordinator and two UNICEF WASH specialists. WASH Cluster organized this workshop with financial, logistical and technical support of UNICEF Liberia.  WASH Cluster members have agreed to form five technical working groups (TWGs) in its last weekly meeting with a focal person as chair with an alternative to steer working group work and to report their activities to the Cluster meeting. The TWGs are: ETU/CCC; waste management; Integrated WASH assessment, Hygiene promotion and social mobilization and sub-national coordinator. Each TWGs will draft its major tasks in relation to Ebola response.  The Ministry of Public Works with support from WASH cluster members at county level have begun monitoring the distribution of hygiene promotion kits and their use at household levels. One of the Ebola hard hit communities of Telbormai in Voinjama was monitored during the last week. The first sub- national level coordination meeting for the WASH Ebola Away Response was also initiated during this period  Out of 13 incinerators brought in the country 12 were installed. ICRC is leading the training and technical support for the assembly of these 13 incinerators to be used for bio-med waste at the ETUs in and around Monrovia. UNOPS and WHO organized training for operators from Government counterpart and NGOs who have taken operational responsibility.  WHO, MOHSW, IMC, IOM and MSF are operating and maintaining WASH facilities in ETU for 750 beds capacity in the country (Lofa, Bong, Montserrado, Bomi, Nimba and Margibi counties). IMC with the support of Save The Children open a new ETU in Margibi, and IOM in Tumaburg with the support of USAID/AFL.  The construction of the WASH system for additional ETUs in the country with 16 ETU’s under construction (beds) (Actors: UNICEF, WFP, WHO, AFL, WHH, USAID and WB). These are being assessed by WASH cluster assessment teams to ensure fulfilling minimum WASH requirements with their technical advice and recommendations. As of now 9 of these were assessed for WASH by the Cluster organized teams and schedules for the remaining are being worked out with operating entities. The assessment teams of the cluster also assessed three CCCs in Margibi, Fishtown and in Lofa counties.  As part of UNICEF’s continued support to rehabilitation of the water supply system and sanitation facilities in ETUs, UNICEF provided 12 units of poly tanks and 3 submersible pumps to the unity Centre ETU to pump out waste water from the overflowing tank with proper drainage.  Rehabilitation and upgrade of the water supply system and sanitation facilities in ELWA-2 ETU is almost halfway to complete. The work involves construction of 2 toilets, 2 showers and a storm water drainage system and rehabilitation of pipelines for water supply.

30 Annex 10b: WASH for Ebola Date updated: 09 Dec

31 Annex 11. Finance & Donation coordination Plan for achieving objectiveCurrent Status and Actions Underway Communicate the role of donations coordination to potential donors & establish information & donation point. Currently several donations are made outside the structure and information is not always shared with the donations coordination team To hold a public service announcement with information on where and how to make donations Need for a comprehensive list of immediate needs to share with potential donors Need for a dedicated website for the National Ebola Command Center to facilitate dissemination of donations information There are currently two separate accounts for donations (Ebola Trust Fund and MoHSW Ebola Account). Collate and communicate relevant information (transport, duty and fees) to potential donors Ad hoc submission of various requests from different agencies/organizations for duty waivers, airport handling fees and transportation from airport. Relationship with Liberia Revenue Authority (LRA) established to expedite duty waivers. The new organization of the logistics cluster will address other challenges. Collect, compile and report donation information to relevant stakeholders Donation database currently updated on a daily basis. Reports are produced weekly. Meeting with Ministries of Finance & Development Planning and Ministry of Foreign Affairs and Ministry of Health and Social Welfare to reconcile and harmonize donations. Theo Addey om Date completed: 15/11 *This excludes General Budget Support commitments and includes in-kind donations.

32 Annex 12. Food security Graph of key indicator e.g. food/ commodity prices to be added ObjectivesCurrent Status / Actions Required / Issues to be escalated Provision of Food to affected people In the week 20– 26 Oct WFP Liberia distributed 1, mt of assorted food commodities to 73,355 beneficiaries in the country. [needs updating] By 26 Oct 5, mt of assorted food commodities distributed to 356,469 EVD effected in Liberia since July. Understand situationFAO Rapid Food Security Assessment (Nov 13), for most affected counties: Bomi, Bong, Lofa, Margibi,and Nimba: Rice harvest yield reduction expected. decrease of %, and up to 25% in most affected districts (because of limited markets not production problems) Limited supply of food to markets, main traders not coming, household income reduced, lack cash to buy food. Current needs / challenges Continued food and livelihoods assistance for people affected by EVD; Limited inclusion of local cassava products (gari) in food aid support to ebola affected patients and hhs Need to revitalise Village Savings and Loans Associations (mostly Women) through injection of cash Need Balance between longer-term food/economic security interventions and ebola-related food actions Current status of Ebola impact and potential risks From WFP VAM Nov 2014 “Special Focus Ebola”: Estimate current 480,000 food-insecure people in Liberia with Ebola-driven accounting for 80,000. Predict under Low Ebola Scenario * number of Ebola-driven food-insecure people rises to 380,000 by March 2015 (and total of 840,000). Would see food security worsening in Gbarpolu, Bong, Margibi and Grand Cape Mount in particular. *disease continues to spread at the average rate observed in the previous 42 days and then begins to slow down by January 2015 Emma Fitzpatrick; Food security cluster coordinator Date competed: 4/12

33 Annex 13. Borders Updated: 20/11 BorderStatus Sierra Leone: Bo WatersideClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Sierra Leone: Foya./KailahunClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Guinea: Foua/GueckedoClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Guinea: Voinjama/MacentaClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Guinea: GantaClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Guniea: YekepaClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Cote d’Ivoire: LoguatuoClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Cote d’Ivoire: Janzon TownClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Cote d’Ivoire: Tempo TownClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Cote d’Ivoire: HarperClosed, except for ebola cargo (request via IMS) or trade cargo (request via MoJustice) Senegal (sea)Open

34 Annex 14. Development Projects Current statusActions Required & by whom? RIA runway: project delayed (6 months?) as not confident quality companies will tender for the contract now Need to identify criteria required for contractors, consultants to return to sites. Some indicators include: -lifting of the State of Emergency, -resumption of service of more than one international airline -positive assessment of healthcare risks (e.g. an acceptable hospital is Ebola free and able to treat non-Ebola emergencies) -reduction of the new cases rate to an acceptable percentage of peak (if not 0 new cases), Mount Coffee: on-site construction works suspended until Ebola situation under control; manufacturing, procurement, and other project management activities continue as planned HFO (JICA, WB, GoL): all stalled no work ongoing. Risk of 1 year delay Red light to Gbarnga road: Contractors have envoked force majeure. Risk of loss of dry season and one year delay Fish Town to Harper: Progress has been ongoing to enable works to begin without major further delay Feasibility study for Ganta – Tappita: cannot tender for consultant as quality companies will not bid in current circumstances Agriculture: ? What is the impact of ebola on major development projects? Which major projects have been critically impacted? Most of the crucial development projects have stalled – potential major impact and losing dry season. Contractors and supervising engineers have pulled out. Required financing from GoL budget is at risk due to forecast Budget shortfall. Updated: 27/11

35 Annex 15. Immediate economic issues Specific Objectives to mitigate impactCurrent Status and Actions Required & by whom? The Ebola Private Sector Management Group (EPMSG) are developing a private sector engagement plan that will identify their strengths and abilities as implementing partners for the Ministry of Finance and Development Planning’s Economic Stabilization and Recovery Plan. Ministry of Finance and Development Planning are consolidating the Economic Stabilisation and Recovery Plan into a project by project synopsis and lining up potential partners. Six NGOs and UN agencies have initiated a national social-safety net programme that is led by the Ministry of Gender, Children and Social Protection. Initial ideas and geographic coverage have been proposed and the Ministry and UNDP (co-chair) will evolve the plan. There is strong donor interest. Final mapping of initial proposals needs to be completed to provide an initial picture of social safety net coverage for Liberia in 2015 and how it links into re-investment and livelihoods opportunities for sustainability. The World Bank has confirmed the its interest in supporting social safety net programmes. USAID has also shown significant interest. Both agencies are keeping in close contact with the Ministry and UNDP as the co-chair of the Technical Working Group on Social Safety Net Cash Transfers. The banking infrastructure and mechanisms for making payments is under stress. UNDP is working with the banks and mobile money networks to help them function better in areas outside Monrovia. Longer-term interventions will be needed to overcome the problems that are faced, but some quick fixes may be possible. UNDP is engaged with USAID, NetHope and others that have had this issue on the radar for some years. What is the status of most critical impacts on the economy from the ebola crisis (e.g. concession operations, investment, cross-border trade, government finances etc) -Current growth rate projects are down to 1% (initial estimate of 8.7% at the start of the year) -17 percent increase in prices of essential commodities on year on year basis. -Tax revenues expected to contract by 19% -Hardest hit relating to the labor market: agriculture, fisheries, mining -Montserrado, Grand Kru, Sinoe, and Maryland are the most economically impacted counties according to UNMIL data. -There is a disproportionate number of women affected by the loss of livelihoods according to Liberia’s Association of Marketers -Overall, Ebola is driving communities into higher levels of poverty Stanley Kamara & Stuart Kefford, Coordinator; Early Recovery Cluster undp.org undp.org Updated: Dec. 11, 2014

36 Annex 16. Education Objectives to mitigate impactCurrent Status and Actions Required to & by whom? Strengthen epidemic preparedness and response measures in all schools and communities in 98 Education Districts Completed Ebola Prevention training for 15 CEOs, 98 District Education Officers, 6600 School Principals and Teachers; Completed Awareness in 98 Education Districts by 6600 teachers (each teacher reached over 100 households) over 2 million persons were reached Mobilizing resources for the following: (no committed funded yet) a. payment of teachers for community awareness process b. to conduct additional trainings for up to 6000 teachers and principals c. to assist communities establish Ebola Prevention Structures d. to conduct psycho-social counseling in communities Prepare students & teachers to resume regular schooling Modules for the airing of radio programs developed Programs are being aired on National Radio Stations Mobilizing resources to engage private & community radios for airing of programs in all counties Improve Physical learning environment to prevent the spread of EVD and other diseases Received support from GoL for minor renovation of 500 schools in 15 counties starting December Mobilizing resources to: (no committed funded yet) a. renovate additional 1500 schools in 15 counties; b. clean and disinfect school environment nationwide; c. rehabilitate / construct WASH facilities where needed; d. chlorinate 25,000 wells and hand pumps on school premises and ; e. establish hand washing facilities in all schools What is the impact of school closures? Increase in young children involved in street selling; teen age pregnancy; over aged students; child labor Extreme hardship on private schools teachers due to no salary; condition of school facilities are deteriorating Unavailability of resources for text books, establishment of laboratories, libraries and other items to promote learning The situation may likely have considerable impact on quality and performance of school administrator Elizabeth from Asst Minister Gbormie at Ministry of Education Updates from Minister Gbormie ov.lr ov.lr Date updated: 27/11

37 Annex 17A. ETU Threat Assessment Violence targeting ETU/CCC is extremely low. Most agitation comes when family members are seeking information about their loved one in the facility and the personnel fail to provide an update. As long as facilities are briefing the family members on the condition of their family member, tensions should remain low. Recent demand for dignified burial for victims. Many in the community have expressed concern over cremating the remains and not having a place to go, nor grieve. Reports of affluent members of the community successfully retrieving their loved ones and taking their remains from the facilities to a burial site. Petty crimes and theft are expected around the facilities like any other location. Update: 5/12

38 Annex 17B. Security Assessment The overall security situation in Liberia remains calm but fragile. The border situation with Cote-d’Ivoire (CDI) remains calm. The Government of Liberia (GoL) issued a directive to close all Border Crossing Points (BCP) to contain the Ebola outbreak until further notice. Cancellation of the State of Emergency, markets are reopened in Liberia and the curfew is midnight to 0600 local. The National Election Committee (NEC) submitted a recommendation for Senatorial Election to be held December 16, 2014 and the date was approved. Civilian education began on 17 Nov 14 and campaigning started on 20 Nov 14 and will continue until 15 Dec 14 (24 hours prior to the election). Update: 5/12

39 Annex 18. Wider Communications What is being done to use communications to help fight ebola? NATIONAL CAMPAIGN: “EBOLA MUST GO! STOPPING EBOLA IS EVERYBODY’S BUSINESS~ LAUNCHED 8 DECEMBER Launched in New Georgia by President with partners and UNMEER Campaign will now focus weekly on the 5 priority areas – burials, isolation, reporting, contact tracing, quarantining Implementation: National roll-out of social mobilization materials through IMS and partners (ECAP) – Priority National roll-out of media messaging – national and local radio, GSM and PSAs Media training and message packs Local radio training National roll-out of visual materials – billboards, buttons, bumper stickers Social Media Campaign – Facebook and twitter Ministry of Information briefings focusing on community and traditional spokespeople Presidential activities to promote campaign Media monitoring to track message fidelity Campaign emphasizes Pledge taken by President at the launch: “I, _________________, pledge to protect myself, my family and community, because Ebola Must Go, and stopping Ebola is everybody’s business.” Date updated: 4/12 Completed by Peter for Dep. Minister Jackson at MICAT, secretary of Ebola Comms Committee oo.com Joint Communication Committee (MICAT) Media and major advertising publicity Partners IMS Social Mobilization Leading dissemination and community-level engagement Partners Communities and behaviour Key actors on whom zero-case success depends Key Messages and materials

40 Annex 18. Wider Communications What is being done to use communications to help fight ebola? NATIONAL CAMPAIGN: “EBOLA MUST GO! STOPPING EBOLA IS EVERYBODY’S BUSINESS~ LAUNCHED 8 DECEMBER Launched in New Georgia by President with partners and UNMEER Campaign will now focus weekly on the 5 priority areas – burials, isolation, reporting, contact tracing, quarantining Implementation: National roll-out of social mobilization materials through IMS and partners (ECAP) – Priority National roll-out of media messaging – national and local radio, GSM and PSAs Media training and message packs Local radio training National roll-out of visual materials – billboards, buttons, bumper stickers Social Media campaign – Facebook and twitter Ministry of Information briefings focusing on community and traditional spokespeople Presidential activities to promote campaign Media monitoring to track message fidelity Campaign emphasizes Pledge taken by President at the launch: “I, _________________, pledge to protect myself, my family and community, because Ebola Must Go, and stopping Ebola is everybody’s business.” Date updated: 4/12 Completed by Jonathan for Dep. Minister Jackson at MICAT, secretary of Ebola Comms Committee oo.com General Communications: Continuing regular Information Ministry briefings and engagement with International Media Addressing concerns about Holiday period and elections


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