Year 1, Quarter 3, Report: EVD Response, Readiness and Restoration

The program's goal was to reduce patient mortality and transmission of the Ebola Virus Disease (EVD) in the community. The program's objectives included supporting the safe restoration of health care services in Ebola-affected facilities, ensuring safe sanitation and hygiene at Ebola-affected health facilities and schools, and providing psychosocial support services to Ebola-affected communities and health care workers. During Quarter 3 of 2015, the IRC continued to support the safe restoration of services at Redemption Hospital, providing daily coaching and mentoring to Ministry of Health (MOH) staff on delivering care and clinical decision making in the context of EVD. The Adult Emergency department had a total of 638 admissions, the Obstetric ward had 746 admissions, and the Pediatric ward had 379 admissions. These numbers represented a 65-70% decrease in in-patient admissions to the Adult Emergency and Pediatric wards and a 40% decrease to the Obstetric ward compared to pre-EVD. The IRC also supported the decommissioning of the medical waste pits at Redemption Hospital, removing and transporting approximately 55 cubic meters of medical waste to Disco Hill for disposal. The completion of this activity marked the first step in creating a proper waste management system at the hospital. The IRC took over operations of the Ebola Transit Unit, a 10-bed isolation facility built and previously managed by MSF, located adjacent to the hospital. Suspect cases identified at in-patient and outpatient triage were transferred to the Transit Unit, where they could safely receive care while awaiting their test results. Infection Prevention and Control (IPC) activities at primary healthcare facilities around the ETU and Redemption, as well as support to back to school (B2S) activities, came to an end during the quarter. The IRC supported 23 health facilities from January to May 2015 and provided additional training to MTI-supported facilities in Monrovia. Following the initial training for 153 schools in February, the IRC provided additional support to 25 public schools in Paynesville during Q3 to ensure that students could safely return to their studies. On May 9, 2015, the World Health Organization (WHO) officially declared Liberia Ebola-free. At the end of May 2015, since Liberia had reached 42 days without a case, the IRC began the decommissioning process of the Ebola Treatment Unit (ETU) at Samuel K. Doe Stadium (SKD). By the end of the quarter, the IRC dismantled the ETU and worked with the WHO and MOH to distribute the assets and materials to ongoing EVD response and health efforts. However, a new positive case was confirmed in Margibi County on June 30, 2015, underscoring the need for communities to remain vigilant and for health facilities like Redemption to maintain the ability to respond as more cases of EVD are likely to pop up in the coming months. The IRC played a lead role in coordinating external support to Redemption Hospital, supporting the safe restoration of health services. The IRC helped the hospital administration coordinate external support through weekly partner coordination meetings and weekly technical meetings on IPC, lab, and clinical care. The IRC also provided direct health care to patients in the Pediatric, Obstetric, and ER wards and managed operations at the 10-bed Ebola Transit Unit. The IRC procured and delivered essential drugs and medical supplies and provided psychosocial support to hospital staff returning to work at Redemption. The IRC worked with other implementing partners, including the African Union, ACCEL, ICRC, UNICEF/ACF, and Global Communities, to support the safe restoration of health services at Redemption Hospital. The IRC hosted a planning workshop to develop a joint work plan between Redemption Hospital, the IRC, and other implementing partners to more effectively support the hospital through the transition from EVD response to restoration of normal services. The joint work plan will serve as a guide for the responsible handover of activities from external partners to the MOH/Redemption.