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LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 2 nd January 2015 Disclaimer: the information presented here is collected for management information.

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Presentation on theme: "LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 2 nd January 2015 Disclaimer: the information presented here is collected for management information."— Presentation transcript:

1 LIBERIA COMPREHENSIVE EBOLA RESPONSE DASHBOARD Version of 2 nd January 2015 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 99.8% Social mobilisation Required social mobilizers recruited 68/ 510 Case management Occupied beds vs current bed capacity 30% Psychosocial Required psychosocial workers recruited 70% 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.Coordinated efforts to ensure active case finding, contact tracing and community engagement Urgently needed in G/ Cape Mount- New 2.Workshop for 91 Laboratory personnel in the safe sample collection, packaging and transportation pending-New 3.Survivors registration started. Need partners to provide survivors kit 4.Provide awareness (training ) for funeral homes to reduce unsafe burial at the community level 5.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.Speed up opening of Interim Care Center (ICC) in Bong County 8.Need to release funding for Psychosocial activities 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 92% Body management Bodies collected within 24 hours Cemetery operational Trend on last week Training almost complete Scale Up Still Awaiting Release of Funding Need to focus on 5 counties with poor coverage Ok Cemetery opened Data still poor on clinic status Ok, RITE Implement ation ongoing

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.Launch package of interventions for desloging 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.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 2015 23% 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 study conducted in all 6 planned counties has been completed, results will be ready by January 2015. Establish ‘single source’ information platform accessible to all partners Airing of Ebola Messages in 6 local languages on community radio station; Health Promoters Network conducted Ebola Prevention workshop for community station managers in 3 counties Lofa, Nimba & Bong. Establish coordinated network of at least 10,000 trained social mobilizers 15,175(chiefs, elders, religious leaders, youth groups, woman groups CHVs, peer educators, motor cyclists, survivors including gchvs) have been trained in social mobilization activities in 83 districts in 14 counties. Establish supervisory, reporting & monitoring system Reports from the various communities, towns, villages are being collected by the DHO and submitted to the CHT on a weekly basis. 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”. Current messages on election and healthy holidays; anti Ebola regulations disseminated and printed in booklets for the public; save burial messages updated  National cemetery  Transition away from cremation and vaccine trials in process jsumo001@luther sem.edu lahannahvillejawa ra@gmail.com Date updated: 31/12 # of gCHVs trained # of Chiefs trained 219  570 360  912 315  797 270  684  408  697  345  414 180  5659 225  570 180  366 180  456 270  684

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. Sinje ETU was commissioned. SKD II was commissioned and will be used as severe infection temporary treatment unit. Montserrado beds have been reduced to 300 but can be scaled up significantly when needed; Bong 51 beds; Nimba 36; Margibi 51, MMU 22beds, Bomi 20 beds, Grand Gedeh 10 beds, Grand Bassa 10 beds, and Grand Cape Mount 10 beds total beds available in country is now 510 beds. More ETUS are nearing completion in the counties and will be commissioned soon. Establishment of 78 CCCs,6 CCCs are operational, 8 CCCs are currently under construction by UNICEF, and three CCCs construction in Montserrado has been completed by eHealth. All CCCs to be completed by end of January Identify trained staff and essential supply requirements for ETUs and CCCs MoH/WHO– will now train 60 people per week in didactics and mock ETU Training and 40 people in actual ETU experience training. IMC trains 40 people per week. Essential supplies issues are being sorted out for ETUs and CCCs. RITE kits have been set up at central IMS and are now being prepositioned in the counties. Conduct active case finding for hotspotsRITE Strategy is being implemented, there is an ongoing assessment of counties preparedness. 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 mmassaquoi@cli ntonhealthaccess. org pkbemah2005@y ahoo.com dgwinnell@clinto nhealthaccess.org Date updated: Jan 2, 2015

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8 ETU data – 30 th December 2014 Date updated: 30/12 ETU Name Current Capacity Total patients Total confirmed patients Total beds free Partners Potential capacity- all wards New admissions last 2 days Notes Bomi (Tubmanburg)203117IOM1001 Bong (Suakoko)515446IMC712 Grand Bassa (Buchanan) 1000 IOM500 Grand Cape Mount (Sinje) 10COMMISSIONED 12/29 IOM50 Grand Gedeh (Zwedru)10No report PIH50 Margibi (Firestone)3100 Firestone310 Margibi (Kakata)203117IMC703 Margibi (Monrovia Medical Unit) 223119USPHS252 Montserrado (Unity Conference Centre) 305125MOHSW962 Montserrado (Chinese ETU) 5012338Chinese FMT1009 Montserrado (ELWA 2)50No report MOHSW/WHO100 Montserrado (ELWA 3)60141346MSF2505 Montserrado (Island Clinic) 50191331WHO/MOHSW1006 Montserrado (MoD)408332 AU / Cuban FMT / MOHSW / MSB 1000 Montserrado (SKDII)20COMMISSIONED 12/23 German Red Cross / Army100 Nimba (Ganta United Methodist Hospital) 361035Nimba CHT / PCI360 Total5107340347 Uneven distribution across the country 132930

9 Total patients using ETUs over time Date updated: 23/12

10 CCC data – 30 th December 2014 Date updated: 30/ 12 CCC Name Current Capacity Total patients Total confirmed patients Total beds free Partners Potential capacity- all wards Number triage in the last 2 days Grand Cape Mount (Jene Wonde RRC) 800 8 MTI, eHealth80 Margibi (Dolo's Town Clinic) 302128Save The Children303 Margibi (Wohrn Clinic)3000 Save The Children301 River Gee (Fish Town Hospital) 1500 Samaritans Purse150 Lofa (Zorzor)100015Samaritans Purse100 Lofa (Foya)10 Temporaril y closed 10Samaritans Purse10 River Cess (Gozohn RCC) MSF Gbarpolu (Chief Jallah Lone Clinic) TBC Grand Bassa (Quewein) MSF Total1032198 1034

11 ETUs Planned Date updated: 30/12 NoLocationCounty Partners - construction Planned Date Construction FinishedPlanned Open datePartners Maxim um bed capacit y Initi al beds 1BopuluGbarpoluDoD/AFL12/25/2014Week of 1/10/15PAE / Aspen5010 2BarclayvilleGrand KruDoD/AFL12/30/2014Week of 1/3/15PAE / Aspen5010 3ZorzorLofaDoD/AFL12/19/2014Week of 12/28/14PAE / Aspen5010 4VoinjamaLofaDoD/AFL12/20/2014Week of 12/20/14WAHA / GOAL / PAE5010 5HarperMarylandGAA12/29/2014Week of 1/2/15PIH / PAE5010 6MoD 2MontserradoWFPCompletedTRAINING SITEMOHSW / MSB00 7SKD 1MontserradoWFP12/15/2014TBCIRC / USAID10010 8GantaNimbaDoD/AFL12/18/2014Week of 12/25/14PCI5010 9TappitaNimbaDoD/AFL12/19/2014Week of 12/20/14HHI / PAE / Aspen5010 Gbediah TownRiver CessDoD/AFL12/25/2014Week of 1/10/15PAE / Aspen5010 11FishtownRiver GeeGAA12/20/2014Week of 1/11/15ARC5010 12GreenvilleSinoeGAA12/20/2014Week of 12/29/14PAE / MSB5010

12 CCCs Planned NoLocationCounty Partners - construction Planned Date Constructio n FinishedPlanned Open datePartners - management Maximu m bed capacity Initia l beds 1Beh Town ClinicBomiUNICEF14-Dec-14TBCPlan15TBC 2HaindiBongUNICEF14-Dec-14TBCPCI15TBC 3Kpayeakwelleh ClinicGbarpoluUNICEF15-Jan-15TBCSamaritan's Purse15TBC 4MorlaquilaGbarpoluUNMIL/CHT14-Dec-14TBCSamaritan's Purse15TBC 5Kongbor ClinicGbarpoluUNICEF14-Dec-14TBCSamaritan's Purse15TBC 6John Logan TownGrand BassaUNICEF15-Jan-15TBCConcern Worldwide15TBC 7Keita Grand Cape MountUNICEF24-Dec-14TBCMTI15TBC 8 Gbarzon Health CenterGrand GedehUNICEF31-Dec-14TBCPIH15TBC 9Niplikoi ClinicGrand KruUNICEFTBC Samaitans Purse15TBC 10Konia Health CenterLofa Samaritans 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 16 Saclepea 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 Date updated: 23/12

13 Annex 3. Mental Health/Psychosocial (MH/PSS)1- Updated by wilfred.gwaikolo @cartercenterlib eria.org wilfred.gwaikolo @cartercenterlib eria.org Updated: Dec. 31, 2014 Plan for achieving objectivesCurrent Status and Actions Underway Provision of Mental Health/Psychosocial services to individuals and communities Current: 860 persons received mh/pss services in Bomi, Montserrado, Grand Kru, Nimba, and Grand Bassa including group counseling and individual counseling. Action: WHO trained 14 MHCs and social workers on mhpss support services in Gbapolu and Cape Mont County from Dec. 27-30, 2014. 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. Supported drafting of MHPSS plan for Cape Mont County. Action: Need to fund Cape Mont MHPSS plan Identify and appropriately place and support children separated from their families Currently: 744 affected children identified in December. Total of 2,825 affected children (1,338 males and 1,487 females) currently receiving support either through their families and/or are placed at home/or in transitional home. Joint monitoring and supervision visit conducted by UNICEF and MOHSW in Cape Mont, Bomi and Gbapolu. Actions: UNICEF one time grant of $150 USD/child received by 572 children (Bong-30, Grand Geddeh- 18, Nimba-9, Bomi-33, Bassa-15, Margibi-50, Lofa-230, Montserrado-162 and Cape Mont-25. 154 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. UNICEF to provide additional funding for 10 SWs and 2 supervisors for 3 months. 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. Developed plan with Montserrado County to second a MHPSS lead to work with the SW Supervisor to infuse in contact tracing. Action: Expand system to other counties. Began initial distribution of 1000 phones donated by UNICEF for ETUs across the country. Need ID for case investigation teams. Working to finalize PSS coordination report. Implement plan to address survivor needs Current: UNICEF pick up funding for 2 coordinators of Survivors Network Dec-Feb. Action: Survivors registration started. Database has line listed 1,367 survivors. (see analysis on next slide) Seeking funding for Survivors ID. Currently developing proposals and MOU for action.

14 EVD SURVIVORS ANALYSIS Annex 3.1 Mental Health/Psychosocial (MH/PSS)1-

15 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 591 new cases, 3,251 new contacts and 280 new deaths were reported A daily average of 22 cases, 120 contacts and 10 deaths were reported daily 24.2% (143/591) of EVD cases were confirmed and an average daily confirmed cases of 5.3 55% of confirmed cases were reported from Montserrado County Follow-up every ‘contact’ in person, on a daily basis, for 21 days, to check for signs of symptoms. 4,441 contacts are under follow-up 97.1% of current contacts are found in Montserrado (65.4%), Margibi (26.8%) and Grand Cape Mt (4.9%) 84% of new cases were found in Montserrado (51%), Grand Cape Mt (13%), Margibi (11%) and Bong (9%) Case to contact ratio is 5.5 Recruit and train contact tracers at County, District (zonal) and community level responsible for conducting tracing and reporting There 5,845 contact tracers and active case finders nationwide Mobilize resources to expand the number of contact tracers Approaches Commence contact temperature monitoring this week in Montserrado Introduce the use of mobile phone for contact tracing Update: 29/12 Updated C. Sanford Wesseh Contact Tracing Team 11/14 cswesseh@yahoo.com mfallah1969@gmail.com yeahneebking@yahoo.com IndicatorsBaseline (Status)Targets 1Percent of suspected cases with contact list59%*95% 2Percent of confirmed and probable cases with contact listN/A100% 3Percent of cases and contacts reported within 48 hours59%*75% 4Percent of contacts traced daily92%95% 5Percent of contacts completing 21 days of follow-up74%80% 6Percent of cases not listed on contact tracing list33%**<5% 7Percent of contacts that became cases, reported by tracers6%***<5% 8Average number of contacts per case5.410

16 Annex 4B: Confirmed Cases in December Update: 29/12

17 Annex 4C: EVD Confirmed Cases by County (Dec 1-27) Update: 29/12

18 1 Laboratory confirmed cases (Alive and Dead) by County over the past 21 days 11-31 Dec. total 66 cases 0 5 2 11 0 0 0 0 0 0 1 0 45 Legend- New Cases 11-31 DEC 2014 1 Data from daily confirmed cases reports of aggregated data by County 0 cases 1-9 cases 10-49 cases 50 cases and more Clusters in remote areas 0 Update: 31/12

19 Annex 4D. EVD Confirmed Cases in Grand Cape Mt

20 New confirmed cases (Alive & Dead) the past 21 days 11-31 Dec in Greater Monrovia and Rural Montserrado totally 45 cases 1 Data from daily confirmed cases reports of aggregated data Legend 0 cases 1-3 cases 4-6 cases 7-9 cases 10 or more cases 1 1 7 0 0 1 0 1 4 2 4 0 8 2 3 7 Clara Town Struggle Community Doe Community New Kru Town Paynesville (A1 ) Barnard Farm Soul Clinic 1 1 St Paul River: 0 Todee: 0 Careysburg: 0 Commonwealth: 2 Annex 4E. EVD Confirmed Cases in Montserrado

21 Annex 4F. New Cases

22 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 extent other tests 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. 40 out of 100 Laboratory Practitioners trained on the safe phlebotomy and sample packaging and transportation. Begin second phase January 6 Over 70 burial team members and Laboratory technician trained in swab collection in Bong, Jan 2.2015 Working with restoration on training of Laboratory technicians for 8 referral Hospitals ( JFK, Redemption, Phebe, Tellewoyan, Martha Tubman, JJ Dossen, FJ Grant, ELWA) Planning additional workshop for 91 Laboratory personnel in the safe blood collection, sample packaging and transportation. Pending Bring in additional staff and resources to maximise laboratory capacity especially for LIBR and to increase the number of phlebotomists Capacity to train is improving with the arrival of additional Laboratory equipment 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 thkohar@gmail.c om Date completed: 1/2/15 Table showing current laboratory capacity Daily Capacity LABS Etu served CurrentProjectedAverage LIBR812018040 ELWA2759052 LOFA180906 ISLAND38010060 BONG28010025 TOTAL16395560183

23 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 and performing on limited scale

24 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: 12 IFRC + 6 GC teams in Montserrado; A case investigator is imbedded with each Montserrado based team 48 GC supported teams across other counties plus additional 4 teams at the National Cemetery giving a total of 52 GC teams (Outside Montserrado). 91% body pickup within 24 hours in Montserrado and 92% response rate across the other 14 counties. Ensure adequate supplies and storage facilities for body management teams through dedicated warehouse. 19 th street warehouses now operational. Develop sufficient crematorium and burial capacity National Cemetery open and operational. As of 12/30, 57 burials total at the National Cemetery since opening on the Dec. 24, 2014. Social Mobilization ongoing. National stakeholders forum planned for Saturday, January 3 rd. Undertake actions (e.g. testing, identification etc) to ensure all collections and burials are happening safely. Swabs collected by IFRC and GC teams but feedback is a problem. CDC has developed draft guidance but the final feedback and communication strategy to be agreed upon. GC teams trained in swab testing and will support in all counties, including transportation of swabs to appropriate laboratories for testing. Date competed: 30/12 Current "Burial Teams" for All Counties in Liberia Disinfecti on 27-DecTeams Counties 27 -Dec GCIFRCGC Bomi 2 2 Bong 3 2 Gbarpolu 5 3 Grand Bassa 8 4 Grand Cape Mount 6 2 Grand Gedeh 2 1 Grand Kru 1 1 Lofa 7 6 Margibi 3 2 Maryland 2 1 Montserrado 6127 Nimba 4 4 River Cess 2 2 RiverGee 1 1 Sinoe 2 1 Disco Hill 4 4 Tota l 581243

25 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 8,162 out of 8,162 health workers Some health workers have now received payment – see next slide 100 % 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 52% 348 out of 657 facilities (Source: IPC partners mapping, 4 DEC 2014) 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 account 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

26 Processes involved with preparation for Triage Set Up in Health Facilities 15 embedded TAs (health workers) dispatched to 13 counties to strengthen IPC practices at health facilities 22 national supervisors sent to the 10 counties to conduct supportive supervision on service delivery areas in 20% of health facilities Joint monitoring visit with Liberia Medical & Dental Council (LMDC) on IPC practices in selected clinics & ETUs ongoing in Bong, Nimba, Margibi & Lofa counties Comprehensive IPC monitoring visit at all health facilities in Montserrado county by LMDC Conducted and established Improvement Collaborative Teams at eight (8) major hospitals in Grand Bassa, Bomi, Grand Cape Mount, Gbarpolu, Margibi, Bong, Nimba, Lofa to support quality of care MFDP has disbursed 6million to the MOH to support restoration of essential health services in the five (5) highly affected counties. Contracts to be signed next week Received 2.1MIL from MFDP for FARA re-imbursements for year 4 budget Micro plans developed and approved for Long Lasting Insecticide Nets distribution in February 2015 Received distribution plan for 2800 IPC posters from Unicef to be distributed to health facilities upon receipt of the materials Distributed assorted IPC materials including 15 Toyota Hardtop Double Cabin pick-ups to 15 counties; Trained 164 out of 530 vaccinators in Mont (107) & Lofa (57) counties on intensified routine immunization to conduct round 3 within 3 months Annex 7B. Update on triage: process and next steps Updated on: 05/12

27 Annex 7 C. Restoring Health Services- Planned Activities (Dec 22-26, 2014) Collect non-ETU health workers list from 15 counties health teams to submit to MFDP for hazard payment (October-November) Ongoing training of 366 vaccinators to provide intensified routine immunization INGO contract signing Challenges 1. Could not deployed embedded TAs in Sinoe & Maryland due to broken bridge 2.Compliance to MOH IPC practices due to behavioural change 3.INGO mapping on restoring health services Proposed Solution(s) 1.Identify other transportation means (flight) 2.Continuous supportive supervision & intense monitoring visit 3.Independently collect information from partners during regular NGO partners meeting Updated: Dec. 29 2014

28 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 DARTEbola_Logs@ofda.govDARTEbola_Logs@ofda.gov 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

29 Annex 8B. Quality of Roads Updated: Nov 28 2014

30 Annex 8C: 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

31 Annex 8D. Logistics Hub & Forward Logs Bases Updated: Dec 05 2014

32 Annex 8E.Regional Port Restrictions Updated on: 4/12

33 Annex 9. Medical Planning: Supplies Gap Updated as of: December 28, 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

34 Annex 10a: WASH for Ebola Date updated: 30/12 Completed by Steller Makasi, WASH Cluster smakasi@unicef.org Operational Constraints  According to financial reports submitted by WASH partners to the cluster as of 12th December, only 12.3 million dollars has been received for the EVD response against a cluster need of 85 million, leaving a gap of 72.5 million requirement.  There is a need to reinforce the subnational coordination at county level to increase the response capacity to the new affected communities and ensure the implementation of the integrated WASH national package per county, including the restoring of basic services.  Operation and maintenance of WASH facilities in Ebola Care Center including solid infected waste management sludge treatment, monitoring of WASH services, testing chlorine concentration is a challenge for the cluster to organize with the support of partners especially concerned departments in Monrovia and country administration in each county.  Assessment and provision of WASH facilities in Health Centers to support the essential health services in the country and ensure that Infection Prevention and Control procedures can be implemented safely. This will support also the rapid response mechanisms.  Solid Infectious Waste Management projects in urban and rural areas, to ensure that waste is handling safely until its final disposal.  Assessment and provision of WASH facilities in schools to support the reopening of the school when happening.  Ensure that the WASH services provided by actors met WASH minimum requirement. Funding by Donor & Organisation as Reported by Partners on 12 th Dec The Local Community in Liberia includes individuals who have been donating funds to Local NGOs to support the EVD response. The Int’l Community includes private individual’s donations

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

36 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 addtheo@gmail.c om Date completed: 15/11 *This excludes General Budget Support commitments and includes in-kind donations.

37 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 WFP delivered food to 37,700 beneficiaries in five counties in the last two weeks: Grand Cape Mount, Lofa, Maryland, Nimba and Sinoe. Since August, WFP has provided support to care for more than 200 patients and survivors, to 15,000 isolated households and to 566,700 persons in areas of intense and widespread transmission. FAO Signed an agreement with African Development Corps (ADC) to implement the conditional cash transfer initiative with 20 women associations. Training of women associations in VSLA methodologies and governance. Understand situationJoint Rapid Assessment at National level (MoA, WFP, FAO): The impact of EVD on Food Security is significant in most affected communities and special care should be given to them. EVD had a huge impact on rural economy through the closure of boarders and markets. Saving and loans schemes were affected as well as trading, the second source of income for 73% of affected population. 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 Sayba Tamba sayba.tamba@wfp. org John Emmanuel Paivey JohnEmmanuel.Paiv ey@fao.org Cluster Co-Coordinators Date competed: 23/12

38 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

39 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

40 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 Stanley.kamara@ undp.org stuart.kefford@ undp.org Updated: Dec. 11, 2014

41 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 agbormie@moe.g ov.lr agbormie@moe.g ov.lr Date updated: 27/11

42 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

43 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

44 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 Whiekonblo@yah 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

45 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 Whiekonblo@yah 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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