Building on Community Responses to the Ebola Crisis in Monrovia

By Mara Forbes, SDI Secretariat

Liberia has a unique history compared to other African countries. Monrovia, the capital of Liberia was founded in 1822 by freed slaves from the United States of America and was named after the U.S. president James Monroe. The current population of Monrovia according to the 2008 census is around 1 million people, of which 70% live in informal settlements. 

Since the late 1980’s the country has faced three civil wars. Years of conflict have devastated the infrastructure. An estimated 80% of the housing stock was destroyed. However, the central role played by women in the aftermath of the conflict was internationally recognized in 2012, when two of the leading women received the Nobel Peace prize. This recognition of women as central players in the development of the country has continued with the election of a female president in 2006, Ellen Johnson Sirleaf, and the current Mayor of Monrovia, the Honorable Mayor Clara Mvogo.

In 2014, Liberia was hit with another outbreak – Ebola. Again, much of the development that was achieved over the past decade is now being undermined by the spread of the outbreak. Ebola has not only affected people’s health and lives but also has social and economic consequences. Inadequate basic services and infrastructure aided in the rapid spread of the disease. Liberia was one of the hardest hit countries with 9,238 reported cases and 4,037 related deaths (WHO, Feb. 2015). The majority of those affected have been women and those living in informal settlements.

SLUMDAL with the support of YMCA Liberia, the local SDI affiliate in Monrovia, took it upon themselves to develop, implement, and monitor a community Ebola emergency response project for some of the hardest hit informal settlements. The goal of the project was to conduct awareness and sensitization training on Ebola and provide preventative hand washing buckets and chlorine to some of the poorest of the poor living in these slums.

In total SLUMDAL provided 650 hand washing buckets and chlorine to 11 informal settlements (WestPoint, Clara Town, Slipway, S.K. Doe, Logan Town, New Kru Town, Jallah Town, 12th Street, Peace Island, Rock Spring Valley, and St. Paul Bridge).

 

SLUMDAL begins distribution of Ebola response materials

During this time SLUMDAL stepped up and played a key role in bringing the Government of Liberia’s Fight Ebola Campaign into the slum communities through sensitization and distribution of hand washing materials and has been recognized by Monrovia City Corporation (MCC) and other stakeholders for their active and vital role with organized communities of the urban poor.

The role of urban poor communities and local authorities in Monrovia in response to the Ebola crisis helped turn the trajectory on new Ebola infections. Monrovia was the hardest hit area in Liberia and had the most fatalities in the region. Liberia is now seen as a success story compared to neighbouring countries due to a shift of approach on behalf of the government. Investments to the national government were decentralized to local authorities and community groups for implementation. Liberia now has the least outbreaks of new cases each week and curfew and land border lock downs have recently been lifted. 

From 1-6 of February a team from SDI visited Monrovia to get a deeper understanding the organization and the work of SLUMDAL and YMCA Liberia. We visited 5 settlements (WestPoint, S.K. Doe, New Kru Town, 12th Street, and Peace Island) and met with 13 savings groups. Federation leaders from Uganda worked with SLUMDAL and the savings groups to better understand the role of the federation and the rituals it practices, particularly the importance of savings. These peer-to-peer exchanges help emerging federations like in Liberia better understand and see the power and importance of federated communities from their more mature affiliates. Ideas are shared and then discussed and adapted to fit the local context.

Members of the Uganda Federation share their experiences with savers in S.K. Doe settlement

The key role of SLUMDAL now will be to move beyond crisis response to a sustainable community development approach by continuing to build on their relationship with local government, expand federation membership, and governance structures.

Cities Alliance is working with SDI and the Monrovia City Corporation (MCC) to develop a joint local government/community led Monrovia City Programme, modeled on country programmes that have been implemented in Uganda and Ghana. The programme seeks to support the resilient social and economic recovery of slum dwellers in Greater Monrovia in response to the Ebola crisis while also improving the living and working conditions of the urban poor. Through this programme organized communities of slums dwellers will work with local government to profile and map all settlements within Greater Monrovia. Communities collect and analyze data about their settlements to inform dialogue with authorities on resource flows and development priorities, to mitigate against disaster and conflict and to make poor communities vocal and visible. This is a critical next step in the development of the Liberian affiliate to demonstrate the potential of community driven solutions in partnership with local government.

 

Ebola Response from the Sierra Leone Alliance

By Samuel Sesay, CODOHSAPA

The current Ebola outbreak in West Africa is the most severe outbreak of the disease in history and has now resulted in over 4,960 deaths and 13,268 cases as of November (WHO, Nov. 2014) across the 6 affected countries (Sierra Leone, Liberia, Guinea, Mali, Spain, United States of America). In Sierra Leone, the second hardest hit country, there have been 4,862 cases and 1,130 deaths (WHO, Nov. 2014). The country of Sierra Leone declared a state of public health emergency on 30 July 2014 and plans to continue enforcing three-day lockdown from time to time as part of government effort to reduce the spread of the virus.

The outbreak is affecting development activities, humanitarian programmes, and the healthcare infrastructure throughout the country. It is also inhibiting local and international investments in Sierra Leone. There is a continued lack of trust in external and Government interventions aimed at reducing the transmission of Ebola. The Sierra Leone Federation of Urban and Rural Poor (FEDURP S/L) and their support NGO, Centre of Dialogue on Human Settlement and Poverty Alleviation (CODOHSAPA), are vital to supporting the Government and other agencies to reduce and ultimately prevent the spread of this outbreak given their position and trust within slum communities across Freetown and other cities. FEDURP has suffered 2 fatalities in the city of Makeni where 2 FEDURP members died of the Ebola virus. One of the fatalities was the first collector from when the Federation process was introduced in Mankeni.

FEDURP Core Team preparing for Ebola sensitisation trainings

Given the continuing impact of Ebola on communities in Freetown and other cities, FEDURP and CODOHSAPA developed an emergency response project together with consultation from other development partners.

105 FEDURP and non-FEDURP community volunteers have been identified and trained, and together they form the Welfare Community Disaster Management Committee on Ebola (WCDMC). These volunteers teamed up with other community stakeholders to establish a community coordinating team (CCT) with the responsibility to enlist community support and cooperation in responding to Ebola.

Margaret Bayoh, a trained and qualified nurse and head of the FEDURP Welfare Committee demonstrates proper hand washing techniques in Makeni 

These volunteers and CODOHSAPA programme staff received training conducted by the Ministry of Health and Sanitation on Ebola response pillars (social mobilisation, community sensitisation, surveillance, case management, psychosocial support, and contact tracing) developed by the Government of Sierra Leone through the Emergency Operation Centre (EOC), now the National Ebola Response Committee (NERC). 

          

FEDURP and WCDMC volunteers accompanied by officials of the Ministry of Health showcasing the use of personal protective gears such as gloves, facial mask  

FEDURP S/L National Chairperson, Yirah O. Conteh, handing over sensitisation equipment to community volunteers to be use in Ebola education

We have customised (with FEDURP, CODOHSAPA, and SDI logos) and produced our own IEC materials from the Ministry of Health and Sanitation. These IEC materials are currently being distributed in all areas of Freetown and Makeni as part of our sensitisation exercise in hand washing, avoiding body contact, and safe burial practices.  

Veronica hand washing buckets, chlorine, soap, and sanitizers have be provided and strategically placed in key places within target communities and managed by the volunteers.

From the initial target of 37 slum communities in Freetown to roll out this project, 16 slum communities have been reached. The remaining communities are either sealed off (hotspots of Ebola) or are packed with security personnel due to houses being quarantined. In these quarantined or sealed areas only health workers and food distribution team are allowed.

In Makeni, the Federation was hit the hardest when a few FEDURP members lost their lives and some were in quarantine. Currently, Makeni is still under lock down. Therefore, a one-day training session was done and distribution of hand washing materials was given to the communities.

A volunteer demonstrating hand washing during the training in Makeni

The volunteers or peer-educators of WCDMC meet weekly to update CODOHSAPA and the FEDURP core team on the community status and response to the Ebola outbreak in each community. In few new communities, the FEDURP core team has been able to establish new groups during the sensitization trainings.