Year 1, Quarter 2, Report: Montserrado Ebola Prevention and Response

The program aimed to ensure timely case investigation, provide follow-up support and supervision for Ebola infection control and prevention, reduce EVD transmission through tracing and follow-up on all EVD contacts, improve data collection and management, manage dead bodies associated with Ebola infection, and reduce stress, fear, and stigma for EVD-affected families. The program targeted a total of 133,400 beneficiaries, with no internally displaced persons (IDPs) among them. The location of the program was Montserrado County, Liberia, and the duration was from September 1, 2014, to May 31, 2015, spanning nine months. The program was implemented by the International Rescue Committee (IRC) Liberia, in collaboration with the Ministry of Health (MoH), the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and other partners. In early 2015, the MoH established the Montserrado Incident Management System (M-IMS) to improve management and coordination of the Montserrado EVD response. The IRC adjusted to this approach by lending logistics and coordination support to the Sectors, and played a key role in coordinating the new actors who became involved in the response at the ground level. During the second quarter, as cases continued to decline, the shape of the EVD response shifted country-wide, with the last EVD case reported on March 20th, after being triaged at Redemption Hospital, and died on March 27th. The IRC provided improved logistics support to case investigation teams, including renting vehicles to fill the gap and securing a two-month loan of 10 Nissan Patrols from the United Nations Mission for the Ebola Emergency Response (UNMEER). The IRC also increased logistics support to improve management and data flow of case investigation forms, hiring a data courier to retrieve completed forms from designated drop-off points around the county and deliver them to the data team. As a result, the IRC saw a significant improvement in the time it took for the case investigation forms to reach the county data team. The IRC ensured the systematic investigation of every case, finalizing placement of case investigators at Ebola Treatment Units (ETU) and with burial teams. The IRC also supported the continued professional development of case investigators through refresher trainings on key skills and regular supportive supervision in the field. Four Sector Managers were hired to strengthen supervision, improve record keeping and reporting, and ensure more responsive logistical support to case investigation teams at each of the four sector bases. The IRC also supported the Sector bases, coordinating with the MoH and M-IMS to identify suitable facilities and making minor renovations to ensure that there was water, electricity, and secure spaces for case investigation teams to store equipment and rest while on overnight shifts. The IRC also coordinated with USAID's Power Africa project to secure and install two 30 kilovolt amps generators and provided office equipment and supplies, internet service, furniture, laptops for Sector Coordinators, and fuel to run the generators. The program's focus shifted to maintaining capacity to swiftly identify and respond to any suspected EVD cases while supporting a smooth transition of EVD response activities into a sustainable disease surveillance system under the Ministry of Health and Social Welfare (MCHT). The IRC began conversations with the MoH, MCHT, M-IMS, WHO, and CDC to discuss how Montserrado County would leverage the capacity built and lessons learned from the EVD response to expand and strengthen the existing surveillance system.