©2012 International Medical Corps Community Engagement for the Ebola Response: Sierra Leone IAWG Annual Meeting Amman, Jordan February 2015

©2012 International Medical Corps Ebola Crisis Overview

©2012 International Medical Corps EVD Programming Ebola Treatment Centers in Liberia (Bong and Margibi County) and Sierra Leone (Lunsar, Makeni) Multi-Agency Training Collaborative training center in Liberia for healthcare staff from various agencies. Additional training centers in Sierra Leone and Mali. Screen and referral units (SRUs) by setting up triage and isolation units at health facilities and staff training EVD Preparedness and response expansion (Mali, Guinea) Donors: USAID/OFDA (main), Gates, ECHO, DFID, Irish Aid

©2012 International Medical Corps Ebola Related Stressors Communities – Disruption of routines, daily lives, livelihoods – Limited social connections – Fear People with EVD and survivors – Fear and uncertainty – Isolation – Community and family stigma Families of EVD patients – Anxiety, loss, grief – Community stigma Health care staff – Fear related to risks – Being confronted with death and suffering – Community and family stigma

©2012 International Medical Corps Overview of PSS: 1. Staff training; 2. Community Outreach IMC Activities: Community education and raising awareness including what can be done Information about Ebola and ETC (e.g. during ambulance pick-up) ETC tours and information Partnerships with local organizations to reach affected communities with resources and information Promoting community inclusion and community support groups including survivors

©2012 International Medical Corps 3. Reducing transmission of EVD PSS teams communicate with patients and affected families and communities (in ETCs and community settings) to promote well being and emotional support This is also an entry point for explaining how to stop the spread and chain of transmission.

©2012 International Medical Corps 4. Support for vulnerable populations Family tracing Child protection EVD survivors help care for vulnerable children and vulnerable adults in the ETC

©2012 International Medical Corps 5. Discharge: EVD Survivors and Affected Families IMC Activities: Discharge Ceremonies (e.g. singing, drumming, dancing) Provision of Discharge Kits Prepare the family and community for patients return Community liaison (linking patients and families to community supports and working with communities to ensure reintegration post discharge) Follow up (1-2 days, 1 week) Community support groups (including survivors Engaging survivors as staff “Ebola is gone but the pain is still in me” ~Ebola survivor, Liberia

©2012 International Medical Corps 6. Burials Challenges: Cultural practices disrupted, burials done in culturally unacceptable ways IMC Activities: Involve and inform families in acceptable and meaningful practices, e.g. – Bereavement kits (SL, Liberia) Burial of person who passed away from EVD in Liberia

©2012 International Medical Corps Barriers to Access and Use of ETCs Distance and location - political concerns Fear of not returning home Initial messages focused on fatal aspect of Ebola created fear and panic Ebola is seen as a Western disease

©2012 International Medical Corps Barriers to Preventive Behaviors Denial that Ebola exists Link between blood and witchcraft - Preference for traditional healers Lack of knowledge Link with sex – conspiracy theories Fear of chlorine – poisonous substance, soap was available in almost every home but not promoted Lack of knowledge on how to use a condom High teenage pregnancy rate

©2012 International Medical Corps Interventions Engage local leaders, stakeholders, traditional leaders at all levels with positive messages about Ebola Involve survivors in all outreach activities Provide soap and water for hand washing Demystify the ambulance Changing the IPC control strategy at the community level Tailored weekly live phone-in radio programs

©2012 International Medical Corps Outreach Program Launch

©2012 International Medical Corps Presentation Title

©2012 International Medical Corps Presentation Title

©2012 International Medical Corps Weekly Radio Program - SL - Waetin dae happin na we ETC?

©2012 International Medical Corps

Presentation Title

©2012 International Medical Corps Presentation Title

©2012 International Medical Corps Health and Nutrition Program in Four Districts Implemented since 2010 targeting PLW: Care Group Network with Lead Mothers Using Men as Partners (MAP) and Care Group approach, engaged men as Lead Fathers Pamama - Household Husbands Schools - Community MAP strategy was rolled out in collaboration and coordination with Ministry of Health and Sanitation (MoHS), Marie Stopes, UNFPA and community based organizations (CBOs). 610 MAP among 123 PHUs (5MAP/PHU)

©2012 International Medical Corps Household support: “PAMAMA” Community action : “HUSBAND SCHOOL” “PAMAMA“ Versus “HUSBAND SCHOOL”

©2012 International Medical Corps Ebola Response Lead Fathers and Lead Mothers: – Conducted house to house sensitization using standard MOHSW messages to promote essential hygiene and prevent secret burials – Supported contact tracing

©2012 International Medical Corps Conclusions Psychosocial support interventions facilitate community engagement and social behavior change activities Existing Nutrition Food Security Program Lead Mothers and Lead Fathers were quickly mobilized for community outreach and dissemination of key messages EVD Survivors are key actors in community engagement