for the period January to December 2015

Transcription

1 UN EBOLA RESPONSE MultiPartner Trust Fund for the period January to December 2015 The Office of the Special Adviser on the 2030 Agenda for Sustainable Development and Climate Change Multi Partner Trust Fund Office,

2 STEPP Strategy Strategic Objective 1: STOP the outbreak Mission Critical Action 1: Identify and Trace People with Ebola Mission Critical Action 2: Safe and Dignified Burials Strategic Objective 2: TREAT the infected Mission Critical Action 3: Care for Persons with Ebola and Infection Control Mission Critical Action 4: Medical Care for Responders Provision Strategic Objective 3: ENSURE essential services Mission Critical Action 5: Provision of Food Security and Nutrition Mission Critical Action 6: Access to Basic (including nonebola Health) Services Mission Critical Action 7: Cash Incentives for Workers Mission Critical Action 8: Recovery and Economy Strategic Objective 4: PRESERVE stability Mission Critical Action 9: Reliable Supplies of Materials and Equipment Mission Critical Action 10: Transport and Fuel Mission Critical Action 11: Social Mobilization and Community Engagement Mission Critical Action 12: Messaging Strategic Objective 5: PREVENT outbreaks Mission Critical Action 13: Preventing Outbreaks Other: Enabling Support to all Objectives RECOVERY Strategy RECOVERY Objective 1: RS01 Health, Nutrition, and Water, Sanitation and Hygiene (WASH) RECOVERY Objective 2: RS02 SocioEconomic Revitalization RECOVERY Objective 3: RS03 Basic Services and Infrastructure RECOVERY Objective 4: RS04 Governance, Peace Building and Social Cohesion

3 Foreword Executive Summary Report Structure Situation Update: Guinea, Liberia and Sierra Leone Achievements of the Ebola Response MPTF Guinea Liberia Sierra Leone Operations and Governance Structure Contributions Guinea; Mission Critical Actions and Recovery Strategy Objectives Liberia; Mission Critical Actions and Recovery Strategy Objectives Sierra Leone; Mission Critical Actions and Recovery Strategy Objectives Regional; Mission Critical Actions Stories from the Field Financial Information Cover Photo: QIPs Project (UNMEER) West Point School Rehabilitation MPTF Office

4 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Recipient ORGANISATIONS CONTRIBUTORS FAO AUSTRALIA, Government of Bahrain Royal Charity ORG LATVIA, Government of LUXEMBOURG, Government of ICAO BELGIUM, Government of Malaysia, Government of ILO Bolivia, Government of MALTA, Government of BRAZIL, Government of Mauritius, Government of IOM CANADA, Government of MONTENEGRO, Government of CHAD, Government of NEW ZEALAND, Government of UNESCO CHILE, Government of CHINA, Government of NORWAY, Government of Peru, Government of UNFPA COLOMBIA, Government of Philippines, Government of UN HABITAT CYPRUS, Government of CZECH Republic, Government of PORTUGAL, Government of REPUBLIC of KOREA, Government of UNHCR UNICEF DENMARK, Government of ESTONIA, Government of FINLAND, Government of ROMANIA, Government of SWEDISH INTERNATIONAL DEVELOPMENT COOPERATION SWISS AGENCY FOR DEVELOPMENT & COOPERATION UNMEER GEORGIA, Government of The Russian FederatioN, Government of GERMANY, Government of TOGO, Government of UNOPS Guyana, Government of TURKEY, Government of UN WOMEN HOLY SEE UNITED KINGDOM, Government of INDIA, Government of VENEZUELA, Government of WFP IRISH AID Volvo Group WHO ISRAEL, Government of PRIVATE SECTOR JAPAN, Government of Kazakhstan, Government of 2

5 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND FOREWORD While the threat from Ebola to global public health was declared over on 29 March 2016, the epidemic left a reported 11,310 people dead, nearly all in West Africa. As of 19 May 2016, the World Health Organization (WHO) reported 28,616 confirmed, probable and suspected cases, with Guinea, Liberia and Sierra Leone bearing the worst of the epidemic. To date, 11,349 survivors struggle with Ebolarelated health problems and the difficulties of integrating back into society. 1 Many thousands more suffered the loss of friends, family and their support networks to the virus. The World Bank estimated that these three countries lost approximately $2.8 billion in Gross Domestic Product (GDP) due to the Ebola outbreak $600 million in Guinea, $300 million in Liberia and $1.9 billion in Sierra Leone losses that undermined important development gains. 2 In addition to a wakeup call to the international community, the Ebola epidemic was also a testament to the strength of these West African countries. It was their people and communities, who along with leadership from their Governments and the unprecedented support of the international community, including from the United Nations Ebola Response Multi Partner Trust Fund (MPTF), who fought tirelessly and successfully to end the outbreak. The first two phases of the Response to stop and treat the outbreak and bring Ebola transmission to zero have successfully concluded, with Ebola Response MPTF funded projects making a number of lasting contributions. Guinea, Liberia and Sierra Leone are now epicenters of global expertise in Ebola response. Yet, there is no room for complacency. As expected, flares of Ebola have been caused by the reintroduction of the virus from survivors, who need nine to twelve months to completely clear the infection. The emergence of these cases, though anticipated, underscores the importance of raising awareness of the risks of flares, of educating, screening and treating survivors, studying the effectiveness of a vaccination program to prevent the transmission of Ebola from survivors, restoring maternal health services in the most affected areas, and maintaining the capacity to detect and rapidly respond to new cases. Thus far, every flareup has been quickly contained, owing, in part, to the human and physical capacity put in place by the Response, including by Ebola Response MPTF funded projects that focused on, for instance, reinforcing health infrastructure and logistics, and growing local capacity for vigilance and rapid treatment. With an estimated 11,349 survivors in need of continued health care and screenings, and many more, including orphans and widows, left vulnerable by the outbreak, Ebola Response MPTF projects will continue to have an important role to play in With the Ebola epidemic under control, it is possible to reflect on and garner the many lessons learned from the Response, which can be used to strengthen emergency planning and preparedness for public health threats, regardless of where in the world they might occur. The experience of the Ebola Response MPTF can help inform pathways of response and readiness that could minimize loss of life and the devastating impacts of disease outbreaks in the future. To this end, an Ebola Response MPTF Lessons Learned Exercise will be undertaken with the key objectives of identifying best practices and providing greater insight on the design and operation of an effective and efficient UN pooled funding instrument that can be applied in the future. Dr. David Nabarro Special Adviser to the UN SecretaryGeneral on the 2030 Agenda for Sustainable Development and Climate Change 1 World Health Organization (WHO) Ebola Situation Report, 19 May

6 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Executive Summary The UN SecretaryGeneral established the Ebola Response MultiPartner Trust Fund (MPTF) in September 2014 to support the UN System s Ebola Response. The Fund achieved its priority objective to offer all phases of the Response a fast, collaborative and strategic financial mechanism to meet unfunded needs. Since its inception, the Fund provided grants to eleven UN entities, inclusive of UNMEER, WHO, UNICEF, WFP,, UNFPA, UNOPS, UN WOMEN, ILO, UNHABITAT and ICAO. It financed projects contributed to 11 out of 13 Mission Critical Actions (MCAs), the guiding principles of the UN system STEPP strategy for Response: Stop the outbreak; Treat the infected; Ensure essential services; Preserve stability; and Prevent outbreaks in countries currently unaffected. Designed to mobilize funding from a widevariety of stakeholders and to distribute it in response to high quality spending proposals through its Response and Recovery finance windows, the Ebola Response MPTF had one of the highest levels of donor engagement ever seen in a UN trust fund. It received contributions from 43 UN Member States, two foundations, three businesses, and many individuals, including school children. Ebola Response MPTF funded projects had rapid and enduring impacts across Guinea, Liberia and Sierra Leone, the three countries most affected by the Ebola outbreak. As of May 2016, contributors deposited US$161,948,573 million in support of the Fund. The Fund disbursed US$154,602,761 million, and its expenditure as of 31 December 2015 was US$127,607,069 million. Throughout the Response, the Ebola Response MPTF, through its funding to the World Food Programme (WFP), provided a range of common services that enabled rapid response mechanisms and effective containment of new Ebola outbreaks. At the onset of the crisis, WFP s operational readiness helped meet urgent requests and needs across the three focus countries. From January to June 2015, the WFPled logistics coordination mechanisms facilitated the transportation of over 54,000 m 3 of cargo in the three affected countries. WFP also supported the construction of logistical bases and health facilities throughout the three countries at the request of national Governments. The agency established four staging areas, three main logistics hub, and nine forward logistics bases (FLBs) across the region. In addition, WFP supported the construction of seven Ebola Treatment Units (ETUs). With regard to air services, as of 31 December 2015, 31,777 passengers were transported across the three affected countries, Senegal and Ghana. Twentyeight strategic airlifts were organized, which transported relief items of behalf of 37 organizations. WFP also performed 56 medical evacuations of Ebolasymptomatic personnel of humanitarian actors and the UN. In addition to supporting logistics, infrastructure and supply chain operations, Ebola Response MPTF funded projects bolstered human and institutional capacity for surveillance, contact tracing, safe burials and monitoring, activities critical to stopping the outbreak. Grants from the Fund, for instance, supported the employment of over 340 epidemiologists, infection prevention and control (IPC) experts, logisticians and social mobilization officers in the three countries. The Ebola Response MPTF enabled WHO, and UNFPA to recruit over 17,000 Contact Tracers, Active Case Finders, and District Monitors to strengthen surveillance. In Guinea, the United Nations Children s Fund (UNICEF) improved capacity for rapid isolation and case management of patients with infectious diseases by constructing six Community Care Centers and by establishing six epidemiologic units within these health facilities. Through the Ebola Child Protection project implemented in five counties in Liberia, UNICEF in collaboration with development partners, reached 17,318 persons with mental health and psychosocial support, alternative care, and case management for Ebolaaffected children and families. Increased human resource and technical capacities of social workers, child welfare officers, mental health clinicians and data clerks enabled 9,060 Ebolaaffected children to access case management; psychosocial support and reintegration follow up services. Some 7,000 child orphans and survivors received a onetime cash grant to support familybased care and return to school across the country. Social mobilization and health promotion were key pillars of the Ebola response, especially in Guinea. Social mobilizers contributed to the facilitation of contact tracing, safe and dignified burials and behavior change communications. Community radios supported by UNICEF were used to sensitize large numbers of people. In Guinea Forest Region, where community reticence was a challenge, Ebola Response MPTF funded projects mobilized all religious denominations as well as community leaders to spread awareness and initiate behavior change. Ebola Response MPTF funded projects supported 652,258 household visits and continued participation of 4,641 members of 663 of Community Watch Committees (CWCs). In Guinea, funded projects, for example, also helped maintain zero transmission at the country s borders, where partnership with the Manu River Union (MRU) reached 139,928 people. 4

7 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Executive Summary Other projects closed gaps in the Response with regard to healthcare worker payments. With the support of the Ebola Response MPTF, the United Nations Development Program () supported the accurate and timely payment of wages, including danger pay, to thousands of Ebola Response Workers (ERWs) in all three countries, preventing strikes and assuring the continuity of care and operations. On 29 March 2016, the World Health Organization (WHO) pronounced the end of the Ebola threat to global public health. The Ebola Response MPTF successfully contributed to this outcome as well as to the successful conclusion of the first two phases of the Response and the pronouncement that each of Liberia, Sierra Leone and Guinea were Ebolafree. While the virus expectedly reemerged in all three countries due to its persistence in some survivors these flares were all quickly contained. This was a testament to the capacity and infrastructure put into place by the Response. Ebola Response MPTF funded projects not only helped countries to reach the milestone of zero transmission, but their lasting impacts helped communities to stay there. With the epidemic under control, emphasis turned to supporting recovery in the region, and to meeting the needs of the estimated 11,349 Ebola survivors, as well as those left destitute and vulnerable by the outbreak. The Fund s Recovery Window, established in April 2015, commenced finance to projects supporting the achievement of the four Recovery Strategic Objectives (RSOs): Health, Nutrition, and Water, Sanitation and Hygiene (WASH); SocioEconomic Revitalization; Basic Services and Infrastructure; and Governance Peacebuilding and Social Cohesion. Projects funded under the Recovery Window focused on meeting the healthcare and socioeconomic needs of survivors, as well as supporting their reintegration into society; maternal and neonatal health; and the restoration of livelihoods elements critical to a successful third and final phase of UN Ebolarelated operations. The Ebola Response MPTF helped to strengthen the national health system in Liberia. The UN Population Fund (UNFPA) supported project, Restoring Midwifery Services in Post Ebola MostAffected Counties, was to reach nine pilot health facilities in Liberia. Sixtysix staff were trained on integrated, Cultural and Sports activities, Dubreka Mano River Union (MRU) 5

8 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Executive Summary essential reproductive, maternal health and new born care services and infection prevention and control. These facilities were being equipped with medical equipment and supplies. In Guinea, 68 midwives trained by UNFPA were deployed in health facilities to ensure quality maternal and neonatal services. In addition, livesaving commodities were procured for distribution in 20 health facilities in the districts of Kindia and Nzérékoré. In Liberia, a UNICEFled joint project with UNHABITAT and the International Labour Organization (ILO) was set to upgrade water and sanitation systems, and incorporate skillsbased training and employment for youth in Ebolaaffected slum communities in Clara Town and Greater Monrovia. The project aimed to reach about 50,000 people, granting access to water. An Integrated Solid Waste Management (ISWM) System was to be adopted to give access to solid waste services. In addition, groups of youths were to be trained to implement these activities to build skills for future employment. In Sierra Leone, Ebola Response MPTF financed projects focused on supporting the livelihoods of Ebola workers, survivors and those left destitute by the epidemic. UNICEF and WHO supported the Government of Sierra Leone with the registration of Ebola survivors, the provision of psychosocial support by training survivors advocates and the enhancement of capabilities of Ministry of Social Welfare, and with the setup of a system of free medical services to survivors in five districts. In summary, the Ebola Response MPTF successfully contributed to meeting the urgent unfunded needs of Ebolaaffected countries and their partners working to stop the outbreak. The Fund assured fast and flexible finance from the very beginning of the Response, reinforcing collaboration and coordination among UN agencies and all stakeholders. It contributed to the rapid growth of capacity and infrastructure needed to stop transmission, and to maintain zero transmission once it was achieved. Throughout the duration of its scheduled operations, the Fund will continue supporting urgent underfunded priorities with regard to response and recovery in the region. 6 Handover ceremony to Guinean Red Cross Guinea

9 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Report Structure This report presents the progress of the UN Ebola Response MultiPartner Trust Fund (MPTF) since its inception in September After providing a brief situation update for the region, inclusive of Guinea, Liberia and Sierra Leone, the report details how the Ebola Response MPTF has supported the UN Ebola Response and the achievement of Mission Critical Actions (MCAs) as well as Recovery Strategic Objectives (RSOs) in these three countries. The report demonstrates how Ebola Response MPTF funded projects contributed to bringing Ebola transmission to zero and ending the global public health threat. It details Fund contributions towards prevention, response and recovery in the region. The report also summarizes the operations of the Ebola Response MPTF, highlighting the work of its Advisory Committee. It presents a financial analysis, detailing Fund disbursements to close critical financing gaps in the Ebola response across the three most affected countries and expenditures as of 31 December MPTF and the implementation of projects approved for funding as of 31 December In line with the Memorandum of Understanding (MOU), the report is consolidated based on information and data contained in the individual progress reports and financial statements submitted by Recipient Organizations to the MPTF Office. It is neither an evaluation of the Ebola Response MPTF nor an assessment of the performance of the Participating Organizations. However, the report does provide the Ebola Response MPTF Advisory Committee with a comprehensive overview of achievements and challenges associated with projects funded through the UN Ebola Response MPTF, enabling it to make strategic decisions. This consolidated progress report on activities implemented under the Ebola Response MPTF builds on previous Interim Reports. It covers the operations of the UN Ebola Response FLB in Port Loko, Sierra Leone MPTF Office 7

10 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT EBOLA RESPONSE MPTF at A Glance 164 million Contributed 149 million Allocated 11 MCAs Supported 47 donors Including Private Sector 11 UN Entities 4 RSOs Supported Stop 36 million RS01 Health, Nutrition and WASH 1.55 million TREAT 55 million Where the funds CAME from RS02 SocioEconomic Revitalization 0.75 million RESPONSE ENSURE 15 million RECOVERY RS03 Basic Services and Infrastructures 1 million PRESERVE 20 million PREVENT 19 million RS04 Governance, Peacebuilding and Social Cohesion 0.25 million North America $7,154,056 Europe $100,456,604 Oceania $9,924,400 South America $7,101,687 Africa $38,174 Asia $39,081, Member States Contributors *Note: Individuals and Foundations not included in the map Funding per Country as of 31 Dec2015 Funding per MCAs and RSOs as of 31 December % Liberia Sierra Leone Regional Funding per Strategic Objectives Recovery and Response for Recovery under four Strategic Objectives 13% 10% 1% Total Allocation $149 m 13% 27% 2.41% Total Allocation $149 m 37% 37% 24% Guinea $149,158, as of 31 December 2015 RSO1 Health Nutrition WASH RSO2 SocioEconomic Revitalizn RSO3 Basic Service & Infrastr RSO4 Govern PeaceBldg Cohesion SO1 STOP the outbreak SO2 TREAT the infected SO3 ENSURE essential services SO4 PRESERVE stability SO5 PREVENT MCA01 Identify and Tracing MCA02 Safe and dignified burials MCA03 Care for persons MCA04 Medical care for responders MCA05 Food security and nutrition MCA06 Basic Services MCA07 Cash Incentives MCA08 Recovery and Economy MCA09 Materials and Equipment MCA10 Transport and Fuels MCA11 Soc.Mob & Community MCA12 Messaging MCA13 Preparedness RSO1 Health, Nutrition and WASH RSO2 SocioEconomi Revitalisation RSO3 Basic Services and Infrastructure RSO4 Governance, Peacebuilding and Social Cohesion 3.66% 2.81% 0% 3.26% 4.18% 2.74% 5.51% 0.59% 7.09% 0% 1.04% 0.50% 0.70% 0.17% 12.69% 20.62% 8

11 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Situation Update: Guinea, Liberia and Sierra Leone On 29 March 2016, based on the advice of the International Health Regulations (2005) Emergency Committee and her own assessment of the situation, the WHO Director General declared the end of the Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa. At the time of declaration, 28,510 confirmed, probable and suspected cases of Ebola were reported across Guinea, Liberia and Sierra Leone, the countries hardest hit by the epidemic. Over 11,000 people died (reported deaths), the majority between April and December 2014, including over 800 healthcare workers. Figure 1: Confirmed, probable, and suspected EVD cases worldwide Guinea Liberia Sierra Leone Italy Mali Nigeria Senegal Spain United Kingdom United States TOTAL 3,811 2,543 4,809 3,956 1 Case 0 Deaths 8 Cases 6 Deaths 20 Cases 8 Deaths 1 Case 0 Deaths 1 Case 0 Deaths 1 Case 0 Deaths 4 Cases 1 Death 10,675 11,323 14,124 Data up to 27 March 2016 Cases Deaths 28,646 To end the public health threat, an unprecedented global effort to stop the spread of virus was launched in the fall of 2014, at a time when the numbers of newly diagnosed were doubling every three weeks. To support the UN Ebola Response, the Ebola MPTF was launched in September The initial response to the outbreak, to which MPTF projects were aligned, focused on rapidly growing capacity to track and diagnose cases, offer treatment, isolate and triage infections, and change behaviors, including unsafe burial practices, which were fostering transmission. With this global effort, and into 2015, case incidence began to fall across West Africa. Throughout 2015, the Response looked to reinforce and broaden the surveillance, contact tracing, and community engagement interventions that were working, in order to drive case incidence towards zero. As the epidemic waned, it became characterized by limited transmission across smaller geographic areas. Progress was uneven, but caseloads reduced thanks to the diligent efforts of thousands of volunteers, Governments, multilateral agencies and an array of other partners implementing and coordinating various elements of the fight against the disease. Eventually, WHO declared all three countries Ebolafree: Liberia on 9 May 2015; Sierra Leone on 7 November 2015; and Guinea on 29 December Despite these milestones, these countries have each experienced expected pockets of Ebola reemergence, owing mainly to the persistence of the virus in survivors. Before Sierra Leone could complete its 90 day period of enhanced surveillance following its November declaration, two cases were confirmed in the country in midjanuary On 17 March 2016, a cluster of two confirmed and three probable cases of Ebola were reported from the prefecture of N Zerekore in southeastern Guinea, and similarly, a case on 1 April 2016, marked a third such flareup in Liberia. These clusters of cases, while quickly contained, served as stern reminders of the importance of constant vigilance and the mechanisms and infrastructure put into place to enable detection, treatment and contact tracing to contain outbreaks. The capacity to deploy rapidresponse teams following the detection of new cases continues to be a cornerstone of the national response strategy in all three countries, and is why, as the disease reemerges, transmission has been quickly brought to zero. Since the start of the epidemic, substantial progress, through MPTF funded projects, among others, has been made to strengthen local and national health systems and to establish the human capacity, logistics and infrastructure that enable quick, ontheground responses to disease alerts. Many communities, initially wary of the response, have now taken the lead in surveillance, education and awareness raising, and this behavior change, especially knowledge of safe burial practices, hygiene and the use of health facilities, has been critical to cutting transmission and ending the outbreak. There are now thousands of trained responders ready to deploy to stop outbreaks, and their effectiveness has been demonstrated throughout the early months of 2016, as all three countries have effectively contained clusters of Ebola reemergence. 9

12 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Situation Update: Guinea, Liberia and Sierra Leone Through the response effort, advances have also been made in diagnostics and in vaccines. Diagnostic tools and services, which initially took days to use, can now provide test results in hours. To date, at least 15 vaccines are under development, with four in varying advanced stages of human testing (possibly the fastest vaccine rollout in history). The response to the latest outbreak in Guinea, for instance, employed a vaccination cerclage of contacts. As the outbreak has been brought under control, attention has turned more acutely to the rehabilitation and recovery of the communities hardest hit by Ebola. Across Guinea, Liberia and Sierra Leone there are an estimated 11,349 survivors. Many continue to face severe, Ebolarelated health issues, as well as serious mental health issues arising from the loss of many family members, as well as communitybased stigmatization and discrimination. Efforts are underway to increase clinical care for survivors, including mental health and monitoring, as well as to ease their reintroduction into society, end discrimination, and restore their livelihoods. Ebolaorphans and destitute women and families have become priority targets for a number of recovery interventions. Projects and partners are also focused on providing psychosomatic and other support to the thousands of volunteers that must now reintegrate into everyday life, and return to their jobs and schooling. Going forward, the response and the projects that support it will maintain a focus on rehabilitation and recovery, while transitioning from emergency operations to surveillance and vigilance with a view to sustaining zero transmission. While the health infrastructure for response and preparedness has been strengthened in West Africa, there remains a great deal of space for further capacity building and improvement, with the lessons learned from the Ebola outbreak informing the way forward. 10 Logistical support in Liberia MPTF Office

13 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Achievements of the Ebola Response MPTF Response Window Logistics Operations Throughout the emergency and early recovery phases of the Response, the Ebola Response MPTF, through its funding to the World Food Programme (WFP), provided a range of common services that enabled rapid response mechanisms and effective containment of new Ebola outbreaks. At the onset of the crisis, WFP s operational readiness helped meet urgent requests and needs across the three focus countries. From January to June 2015, the WFPled logistics coordination mechanisms facilitated the transport of over 13,000 m 3 of cargo in Guinea, 30,000 m 3 in Liberia, and 11,000 m 3 in Sierra Leone. WFP also supported the construction of logistical bases and health facilities throughout the three countries at the request of national Governments. The agency established two staging areas, one main logistics hub, and five forward logistics bases (FLBs) in Liberia; one staging area, one main logistics hub, and two FLBs in Guinea; and one staging area, one main logistics hub, and four FLBs in Sierra Leone. In addition, WFP supported the construction of two Ebola Treatment Units (ETUs) in Liberia (Samuel Kanyon Doe Sports Stadium, Ministry of Defense) with a total bed capacity of 400, and rehabilitated the Island Clinic with an additional 100 beds. In Guinea, WFP supported the construction of five ETUs (Nongo, Coyah, Nzérékoré, Kérouané and Beyla), with a total capacity of 520 beds. With regard to air services, through the WFPmanaged United Nations Humanitarian Air Services (UNHAS), as of 31 December 2015, 5,473 takeoffs were performed and 31,777 passengers and 202MT of light cargo were transported across the three affected countries, Senegal and Ghana. Some 28 strategic airlifts were organized, which transported 770MT of relief items of behalf of 37 organizations. UNHAS also performed 56 medical evacuations of Ebolasymptomatic personnel of humanitarian actors and UN personnel in Guinea, Liberia and Sierra Leone. The Emergency Telecommunications (ET) Cluster provided internet service to 80 humanitarian facilities and radio service in 17 towns across Guinea, Liberia and Sierra Leone, which allowed more than 3,300 humanitarian responders to remain connected, including in red zones. Since the beginning of the operation, more than 3,300 users have employed the internet service set up by the ET Cluster. WFP also responded to adhoc requests for logistical support. For example, in July 2015 in Liberia, WFP technicians assembled four tents for UNICEF staff that had arrived in an area of Margibi County where new cases were appearing and the local community needed support. WFP also reassembled six Rapid Isolation Treatment of Ebola (RITE) kits at SKD Main Logistics Hub as a preparedness measure. In Guinea, the agency supported the Government s sensitization and early detection campaign in Ebolaaffected areas by constructing and dismantling remote camps for humanitarian responders. In Sierra Leone, in light of the recent outbreak in Tonkolili, WFP deployed two prefabs to create office space for WHO field teams within the framework of the WHOWFP Joint Collaboration and provided connectivity services for the Response. To scaleup logistics networks and infrastructure for the protection of healthcare workers, WFP rehabilitated two UN Clinics for humanitarian responders, one in Conakry (Guinea) and one in Freetown (Sierra Leone), which now offer routine care 40hours per week and emergency care services 24hours a day. In order to consolidate and sustain all logistics premises and storage facilities across the three countries, WFP built the capacity of the national counterparts with regard to logistics and supply chain management, thereby enabling their preparedness for future health emergencies. For instance, WFP, as part of its transition plan, bolstered the capacity of the crossministerial General Services Agency (GSA), to which the agency handed over the management and operation of the logistics bases, the backbone of the Ebola response in Liberia. Similarly, in Sierra Leone, WFP continues to provide medium and longterm support by managing the logistics hub in Port Loko. It provides logistical services for partners, thereby maintaining basic logistical preparedness in the country. The Ebola Response MPTF also financed the supply operation of the UN Children s Fund (UNICEF), which sent more than 8,000MT of lifesaving supplies between August 2014 and June 2015, and maintained a steady stream of airlifts and sea shipments across Guinea, Liberia and Sierra Leone. The shipments included tents, tarpaulins and supplies, including personal protective equipment (PPE), gloves, medicine and body bags supplies that supported over 60 Community Care Centers (CCC). The supply operation also: provided nutritional support for over 7,000 Ebola patients and 2,000 children whose families were affected by Ebola; provided drinking water and sanitation materials for 1,700 nonebola health facilities; and provisioned families in quarantined households with the support they needed for the 21day isolation period. UNICEF supplies ensured the continued delivery of vaccines for routine immunizations; and education materials and infection prevention and control (IPC) supplies to support the safe return of 1.8 million children to school. WHO, with the support of the Ebola Response MPTF, strengthened the capacity of Liberia s Ministry of Health to run logistical operations across and within all of the country s districts. This assured the flow of essential materials and supplies for a multidimensional response. Some 105 containers, 14,896 boxes and 23 pallets, which totaled 116 air and sea shipments of mostly IPC supplies, were dispatched to over 700 health facilities in Liberia. 11

14 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Achievements of the Ebola Response MPTF Strengthened Surveillance In addition to supporting logistics, infrastructure and supply chain operations, Ebola Response MPTF funded projects bolstered human capacity for surveillance, contact tracing, safe burials and monitoring, activities critical to stopping the outbreak. The Fund supported the training and retention of essential staff, critical at the height of the outbreak. In Guinea, WHO, with the support of the Ebola Response MPTF, deployed 95 national and international epidemiologists, 37 IPC experts, over 1,500 contact tracers, 66 supervisors, and 74 district monitors. Between September 2014 and the end of this reporting period, contract tracers traced 27,639 people. In July 2015 alone, in Guinea, contract tracers registered 2,285 people, representing 99% of the total number of people who had come into contact with Ebola victims. In Liberia, WHO provided technical assistance through the deployment of 35 epidemiologists across 15 counties. The agency recruited and trained over 10,090 contract tracers/ active case finders (ACFs) and built capacities of the County Health Teams with regard to surveillance and contact tracing, IPC, social mobilization and community engagement. WHO s technical assistance in the deployment of 14 IPC experts helped stop Ebola transmission and contain the outbreak. The development of healthcare workers (HCW) Precautionary Observation Standard Operating Procedure (SOP), IPC minimum standards assessment tool and the training of HCWs in the Safe and Quality Health Services (SQS) package and the Keep Safe Keep Serving (KSKS) IPC package resulted in a 15% increase in healthcare facilities (HCFs) adherence to selected minimum IPC standards during Strengthened capacities at the district level were also instrumental in bringing Ebola transmission to zero in Liberia. Over 8,000 healthcare workers were trained in IPC and 728 health care facilities were stocked with IPC commodities. Ebola messaging and sensitization campaigns improved community education and actively engaged leaders and the wider community by building trust, ownership, and capacity to take decisions and stop behaviors that spread Ebola. In Sierra Leone, the deployment of 65 epidemiologists and 35 IPC experts boosted the capacity of hundreds of contact tracers and over 12,000 healthcare workers on IPC measures. It also improved IPC protocols implementation in 476 health centers in the country. Projects also bolstered human capacity in the Sierra Leone NERC Secretariat and supported Rapid Response Stabilization Teams (RRSTs) that conducted at least fourteen surge operations. The Ebola Response MPTF was catalytic in its support of the Integrated Disease Surveillance and Reporting (IDSR) system in Sierra Leone. The establishment of the ISDR enabled state institutions to monitor and quickly react to the epidemiological situation in the country. Weekly information on diseases is now provided by most hospitals in the country. Similarly, in Liberia, Ebola Response MPTF funded projects helped reestablish the country s IDSR system and support the rapid containment of Ebola outbreaks. Support to Orphans Through the Ebola Children Protection project implemented in five counties in Liberia, UNICEF in collaboration with development partners reached 17,318 persons with mental health and psychosocial support (MPHSS), alternative care, and case management for Ebolaaffected children and families. Out of these, 16,093 children received mental health and psychosocial support, and case management through oneonone meetings with social workers, structured recreation for resilience activities facilitated by trained staff and case management services. Increased human resource and technical capacities of social workers, child welfare officers, mental health clinicians and data clerks enabled 9,060 Ebolaaffected children to access case management, psychosocial support and reintegration follow up services. Some 7,000 child orphans and survivors received a onetime cash grant to support familybased care and return to school across the country. Social Mobilization Ebola Response MPTF funded projects also met critical needs with regard to social mobilization and behavior change, activities that helped empower communities to take action against the virus and to assume monitoring and surveillance activities. WHO deployed social mobilization experts to Sierra Leonean districts (three funded from the MPTF), and recruited, trained and deployed 32 nationals across all 14 districts to assure the sustainability of social mobilization efforts. Community engagement activities were held at least twice in all 149 chiefdoms with intensified efforts during operational surges, including 52 activities as part of the Tonkolili surge. Furthermore, the enhanced social mobilization and surveillance was supported by the Quick Impact Projects reaching out to more than 80,000 people in the end 2015, when many international partners started reducing their presence in the country. Social mobilization and health promotion were key pillars of the Ebola response in Liberia, with the overall goal of raising community awareness, fostering community participation in the Response, and strengthening community engagement in planning, implementation, monitoring and evaluation of agreed Ebola response activities. In December 2014, UNICEF partnered with the City Corporations of Monrovia and Paynesville to carry out social mobilization and community engagement activities through a three month Operation Stop Ebola Campaign. The campaign targeted two of Liberia s most populated cities in Montserrado County, with a population of 1.4 million, close to 12

15 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Achievements of the Ebola Response MPTF half of the population of the entire country. By January 2015, 990 commissioners, community, zonal, and block leaders were trained and equipped with message dissemination tools (Ebola flip book and megaphones) within Monrovia and Paynesville to raise awareness on Ebola at the household level. For wider coverage, UNICEF partnered with 22 FM radio stations in and around Monrovia and Paynesville, which covered a population of approximately 400,000 individuals. The campaign was effective in bridging the linkages between the Ministry of Health (MoH) community health volunteers and community leadership structures. WHO, in collaboration with Global Communities, the Montserrado Response Team, the Centers for Disease Control and Prevention (CDC) and UNICEF, supported community dialogue meetings to mobilize communities to address safe burial practices. The communities developed action points to promote safe burials and steps to strengthen surveillance of dead body management. In Liberia, through an Ebola Response MPTF funded project, some 500 community leaders, active case finders and district surveillance teams participated in orientation meetings to strengthen their collaboration with communities and their surveillance measures. Social mobilization was a key activity in Guinea. Social mobilizers contributed to the facilitation of contact tracing, safe and dignified burials and behavior change communications. Community radios supported by UNICEF were used to sensitize large groups of people, for instance, in Boffa and Dalaba. In addition, one mobile radio Radio Santeyah supported by the International Federation of Red Cross and Red Crescent Societies (IFRC) through Ebola Response MPTF funding, was used to overcome community reticence in Forécariah. In Guinea Forest Region, where community reticence was a challenge to the Response, a project mobilized all religious denominations as well as community leaders to spread awareness and initiate behavior change. Sensitization initiatives reached 22 districts of the city of N Zérékoré, and members of all faiths gathered 3,500 people to participate in an awareness building campaign. In Kissidougou, one of the most Ebolaaffected areas, five rural communes and 10 villages were targeted. Doortodoor visits reached 3,300 people. Assuring safe and dignified burials was also a lynchpin Operation Safeguard Children Sierra Leone UNMEER UNOPS 13

16 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Achievements of the Ebola Response MPTF to the Response in Guinea, as traditional practices of washing the dead advanced transmission. Given this context, 14,254 safe and dignified burials (SDBs) were provided and 10,760 places, such as houses, were disinfected. To meet the urgent need for community education and outreach, Ebola Response MPTF funded projects supported 652,258 household visits and assured compensation to, and thus continued participation of, 4,641 members of 663 of Community Watch Committees (CWCs). In Guinea, funded projects also helped maintain zero transmission at the country s borders, where partnership with the Manu River Union (MRU) reached some 139,928 people. In addition, the Ebola Response MPTF funded the procurement of hand washing kits to prevent the transmission of Ebola during the presidential elections. 17,500 kits were purchased and made available to the Electoral Commission for distribution. Incentives for Ebola Response Workers Other projects closed gaps in the Response with regard to healthcare worker payments. Ebola Response MPTF funded projects supported the accurate and timely payment of wages, including danger pay, to thousands of Ebola Response Workers (ERWs) in all three countries, preventing strikes and assuring the continuity of care and operations. In Sierra Leone, an Ebola Response MPTF funded project supported the coordination of the payment process, which included setting up a payment list, and coordinating with transferring agents, fiduciary agents, donors, and Government institutions, for over 150,000 individual transactions. In Liberia, the UN Development Programme () facilitated payments to Ebola Response Workers and strengthened the existing payment mechanism including the information management system. The agency supported the Government, which by December 2015, paid an average of 10,000 Ebola Response Workers (ERWs) per payment cycle (for a total of 5 payment cycles), ensuring that more than 95% of ERWs were registered and linked to a payment mechanism. In addition, paid an average of 495 ERWs working for the central Incident Management System directly over two payment cycles. It also supported the Government of Liberia in its efforts to harmonize pay scales, installed a complaint mechanism with a call center, and deployed 17 UN Volunteers in the field to support Ministry of Health teams with the collection, sorting and verification of payment complaints. In Guinea,, funded by the Ebola Response MPTF and the World Bank, paid incentives to ERWs working in Ebola Treatment Units. Approximately, 26,712 ERWs were paid through Government systems and 959 ERWs were paid through a contingency plan. In summary, the Ebola Response MPTF has achieved critical results, contributing significantly to the success of the first two phases of the Response and the pronouncement that each of Liberia, Sierra Leone and Guinea were Ebolafree. While the virus has expectedly reemerged in all three countries due to its persistence in some survivors these flares have all been quickly contained. This has been a testament to the capacity and infrastructure put into place by the Response. Ebola Response MPTF funded projects have not only helped countries to reach the milestone of zero transmission, but their lasting impacts are helping communities to stay there. 14

17 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Achievements of the Ebola Response MPTF Recovery Window Support to Survivors With the epidemic under control, emphasis has turned to supporting recovery in the region, and to meeting the needs of the 11,349 estimated Ebola survivors, as well as those left destitute and vulnerable by the outbreak. Ebola Response MPTF Recovery Windowfunded projects are now contributing to meeting survivors healthcare and socioeconomic needs, the restoration of livelihoods and to maternal and neonatal healthcare. In Sierra Leone, Ebola Response MPTF financed projects have focused on supporting the livelihoods of Ebola workers, survivors and those left destitute by the epidemic. Ebola survivors in the Western Area and Bombali have been identified and a project has commenced to support livelihoods of 2,500 survivors in the country. UNICEF and WHO have supported the Government of Sierra Leone with: the registration of Ebola survivors; the provision of psychosocial support by training survivors advocates and enhancing capabilities of Ministry of Social Welfare; and the setup of a system of free medical services to survivors in five districts. In addition, has commenced implementation of a project that supports the reintegration of 800 Safe and Dignified Burial (SDB) team volunteers into society. It provides psychosocial counselling and develops employment and livelihoods options for them. In Guinea, Quick Impact Projects (QIPs) projects have supported the creation of a National Ebola Survivors Platform, with additional activities ongoing to identify survivors, assess their needs for assistance, and provide legal assistance for the formation of survivor associations. Thirteen associations that were provided Ebola Response MPTF support are now ready to advocate for survivors. Revival of Reproductive Health Services The UN Population Fund (UNFPA) supported project, Restoring Midwifery Services in Post Ebola MostAffected Counties is reaching nine pilot health facilities in three counties in Liberia. Some 66 staff, about three per facility, were trained on integrated, essential reproductive, maternal health and new born care services and infection prevention and control. In addition, 70 Community Health Volunteers were trained to UNFPA Team Liberia UNFPA 15

18 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Achievements of the Ebola Response MPTF identify danger signs, make timely referrals of maternal and new born complications and in the promotion of health care services. In collaboration with the Chief Nursing Officer and the Liberia Board of Nursing and Midwifery, eight midwives were deployed to assist in skilled deliveries at the facility level. Nine facilities are being equipped with instruments and medical supplies, including reproductive health kits and other IPC supplies. In addition, five facilities are receiving delivery beds; and the Foya Bormah Hospital received an operating table, additional hospital beds, as well as medical instruments, supplies and delivery kits to improve the quality of antenatal and postnatal care services. In Guinea, 68 midwives trained by UNFPA have been deployed in health facilities to ensure quality maternal and neonatal services. Lifesaving commodities were procured and will be distributed in 20 health facilities in the districts of Kindia and Nzérékoré. Support to Livelihoods Also in Liberia, a UNICEFled joint project with UNHABITAT and the International Labour Organization (ILO) was launched in March 2016 to upgrade water and sanitation systems, and incorporate skillsbased training and employment for youth in Ebolaaffected slum communities in Clara Town and Greater Monrovia. In collaboration with the local population and Government partners, Liberia Water and Sewer Corporation (LWSC) and Monrovia City Corporation (MCC), a rapid technical assessment was conducted in Clara town on the design, status, access and management of infrastructural facilities for WASH and Sanitation across the slum settlement. The project aims to reach about 50,000 people, granting access to at least 20 liters of water per day and reducing the distance from household to water point. It also aims to build 20 additional latrines and to spread good handwashing practices among the slum communities. An Integrated Solid Waste Management (ISWM) System will be adopted to give access to solid waste services to at least 5,000 households. In addition, groups of youths will be trained to implement these activities to build skills for future employment. Overall, throughout the duration of its operation, the Ebola Response MPTF has successfully contributed to meeting the most urgent needs of Ebolaaffected countries and their partners working to stop the outbreak. The Fund has assured fast and flexible financing from the very beginning of the Response, reinforcing collaboration and coordination among UN agencies and all stakeholders. It contributed to the rapid growth of capacity and infrastructure needed to stop transmission, and to maintain zero transmission once it was achieved. Throughout the duration of its scheduled operations, the Fund will continue supporting urgent underfunded priorities with regard to response and recovery in the region. 16 UNFPA Staff Nurses in Guinea UNFPA

19 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Operations and Governance Structure The Ebola Response MPTF is guided by the five strategic objectives of the UN Response STEPP strategy: Stop the outbreak; Treat the infected; Ensure essential services; Preserve stability; and Prevent outbreaks in countries currently unaffected. In addition, the Fund s Recovery Window, established in April 2015, commenced finance to projects supporting achievement of the four Recovery Strategic Objectives (RSOs): Health, Nutrition, and Water, Sanitation and Hygiene (WASH); SocioEconomic Revitalization; Basic Services and Infrastructure; and Governance Peacebuilding and Social Cohesion. The funding priorities for the Trust Fund are defined by three variables: i) the latest assessment of the evolving epidemiology of the outbreak (from WHO and other sources); ii) priority needs in the Ebola Response, as assessed by regular interaction with all stakeholders in the Response; and iii) the comparative advantage of the UN System, as assessed by the Chair of the Advisory Committee and through his interactions with the UN agencies, funds and programmes. Governance Structure and Procedures The Ebola Response MPTF has a transparent structure, which includes the UN Special Envoy on Ebola 3 serving as a Chair of the Advisory Committee, an Advisory Committee, a Fund Secretariat, Recipient Organizations and a Fund Administrator. The Chair articulates the Ebola Response MPTF funding priorities and makes fund allocation decisions in consultation with the Advisory Committee. Recipient Organizations include UNMEER, UN organizations and departments, the International Organization for Migration (IOM) and NGO Implementing Partners. The Multi Partner Trust Fund Office ( acts as the Trust Fund Administrator and is responsible for Fund design, legal agreements with UN Entities and donors, administration of donor contributions, fund disbursement and consolidated reporting. The Fund Secretariat provides support to the Advisory Committee; supports the fund mobilization efforts led by the Chair; organizes calls for and appraisal of proposals; and monitors and reports on the Fund s programmatic performance to the Chair and Advisory Committee. The Advisory Committee provides guidance to the Chair in the management of the Fund, and its views are sought on the allocation of donor resources. The Committee also serves as a forum for discussing strategic issues and sharing information on key issues. The UN Resident Coordinators in each country prioritize and endorse proposals prior to submission to the Chair and the Advisory Committee. Advisory Committee The Advisory Committee is a unique facet of the Trust Fund that supports and facilitates the dialogue needed to make informed, fast and strategic decisions on how funds should be allocated. It is composed of the Special Envoy on Ebola (as Chair), three representatives of contributing donors, one representative from each of the three most affected countries, and the Special Representative of the Secretary General for UNMEER (serving as an observer). The Advisory Committee met when there was an operational need to do so, in order to evaluate and fund projects as quickly as possible. It has met ten times since the inception of the Fund and has allocated over US$149 million for 66 projects. Each meeting provided an opportunity for substantial discussion on the comparative value of the projects with all the members of the Committee, including the Permanent Representatives of Guinea, Liberia and Sierra Leone to the United Nations. 1 As of 1 January 2016, the new title of the Chair of the Advisory Committee is Special Adviser to the UN SecretaryGeneral on the 2030 Agenda for Sustainable Development and Climate Change 17

20 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT Summary of project approval Meeting 1 30 October 2014 Endorsement of Fund s TOR and Rules of Procedure Approval: WFP Common Services for the Health Response US$8,000,000 Meeting 3 5 December 2014 Approvals: ICAO Regional Aviation Ebola Action US$1,000,000 UNICEF and Social Mobilization in Guinea US$3,948,364 Support to Detention Centers in Sierra Leone US$1,201,725 WHO//UNFPA Interruption of Transmission in Liberia US$11,603,212 UNICEF Ebola Charters US$877,718 Meeting 2 13 November 2014 Approvals: WFP Common Services for the Health Response US$32,023,716 Payment Programme for Ebola Response Workers US$6,235,957 UNMEER Quick Impact Projects US$3,000,000 UNMEER and UNOPS Rapid Response Stabilization Teams and Support to NERC Secretariat, Sierra Leone US$8,323,122* Meeting 4 17 December 2014 Approvals: WHO Epidemiology. District Management US$30,010,04 UNICEF Community Transit Centers in Guinea US$9,813,619 UNICEF Outreach and Awareness Campaign in Liberia US$283,088 Meeting 5 16 January 2015 Approvals: /UN WOMEN Payments to EVD Survivors and Destitute Families US$2,055,470 /UNICEF/UNFPA Support to Mano River Union US$2,836,072 Meeting 7 8 July 2015 Approvals: UN Medical Clinics in Guinea and Sierra Leone US$1,219,800 UNFPA Restoring Midwifery Services in Liberia US$1,000,000 Meeting 9 24 September 2015 and eapproval* Approvals: /UNFPA Guinea Strengthening Community Recovery and Resilience US$748,728 Guinea Establishment of a Financial Mechanism for Ebola Recovery US$247,915 WHO/UNICEF Sierra Leone Ebola Survivors: Needs, Assessment, Psychosocial Support and Reintegration US$1,047,396 UNICEF Guinea Social Mobilization for Achieving and Sustaining a Resilient Zero US$909,500 Meeting 6 9 April 2015 and eapproval* Approvals: GRC//WHO Reinforcement of the Guinean Red Cross US$1,000,000 WHO Sensitization Campaign in Guinea US$400,000 UNICEF Social Mobilization in Guinea US$999,915* Meeting 8 14 August 2015 Approvals: WHO Regional Ebola Response Interagency Stewardship US$119,000 Guinea Preventing EVD Spread during the Electoral Process US$991,467 Meeting December 2015 and eapproval* Approvals: UNHABITAT/UNICEF/ILO Liberia Water and Sanitation Systems in Ebolaaffected Slum Communities Guinea Sierra Leone US$1,810,733 Support to the UN Resident Coordinators for Ebola Response Phase 3 Guinea Psychosocial and Economic support for Survivors US$1,500, * Proposals approved via eapproval procedure

21 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND CONTRIBUTIONS UNITED KINGDOM SWEDEN GERMANY CHINA INDIA REPUBLIC of KOREA BELGIUM FINLAND AUSTRALIA ISRAEL CANADA JAPAN DENMARK VENEZUELA SWITZERLAND NORWAY PHILIPPINES TURKEY IRELAND NEW ZEALAND BOLIVIA RUSSIA LUXEMBOURG BRAZIL CHILE CZECH REPUBLIC COLOMBIA MALAYSIA MALTA GUYANA ESTONIA KAZAKHSTAN LATVIA PERU ROMANIA PORTUGAL GEORGIA HOLY SEE MAURITIUS CHAD CYPRUS MONTENEGRO TOGO $5,940,000 $5,042,695 $5,000,000 $4,927,079 $2,061,147 $2,041,742 $1,500,000 $1,233,100 $1,169,400 $1,000,000 $1,000,000 $902,060 $602,845 $300,000 $205,052 $100,000 $100,000 $62,295 $50,363 $50,216 $50,000 $48,876 $48,479 $40,000 $30,293 $25,000 $20,000 $20,000 $16,593 $6,350 $5,000 $1,580 $13,217,001 $11,606,933 $11,000,000 $10,000,000 $10,000,000 $8,964,918 $8,824,590 $8,755,000 $8,750,000 $7,154,056 US$31,884,000 Total: $163,756,663 Private Sector & Foundations Volvo Group Royal Charity Org. Bahrain UN Foundation/UN Partnershp Office Nonprofit Organization PRIVATE SECTOR TOTAL 1,307,360 1,000, ,682 20,000 10,350 2,628,393 19

22 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT 20

23 MCA 1 Identify and Trace People with Ebola MCA 2 Access to Basic Services MCA 3 Care for Persons with Ebola and Infection Control MCA 4 Medical Care for Responders MCA 7 Cash Incentives for Workers MCA 9 Reliable Supplies of Materials and Equipment MCA 11 Social Mobilization and Community Engagement MCA 13 Preventing Outbreaks RSO 02 SocioEconomic Revitalisation RSO 04 Governance, Peacebuilding, and Social Cohesion

24 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT at A Glance GUINEA SENEGAL MALI 54.9 million Contributed 51 million Expenditures GUINEA BISSAU 50 km Boké Conakry ATLANTIC OCEAN Kindia Labé Mamou SIERRA LEONE Faranah LIBERIA Kankan Nzérékoré CÔTE D IVOIRE Map Sources: ESRI, UNCS. The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Map created in Sep Funding as of 31 December 2015* S01 Stop 12 million RS01 Health, Nutrition and WASH n/a 18 Proposals 6 UN Entities S02 TREAT 22.5 million RS02 SocioEconomic Revitalization 0.75 million RESPONSE S03 ENSURE 2 million RECOVERY RS03 Basic Services and Infrastructures n/a S04 PRESERVE 13 million Funding per Mission Critical Actions & Recovery Strategic Objectives S05 PREVENT 4 million RS04 Governance, Peacebuilding and Social Cohesion 0.25 million Guinea Liberia Total Allocation $149 m Sierra Leone Regional 37% * Allocations are based on approved budget $54,930,971 MCA01 Identify and Tracing MCA02 Safe and dignified burials MCA03 Care for persons MCA04 Medical care for responders MCA05 Food security and nutrition MCA06 Basic Services MCA07 Cash Incentives MCA08 Recovery and Economy MCA09 Materials and Equipment MCA10 Transport and Fuels MCA11 Soc.Mob & Community MCA12 Messaging MCA13 Preparedness RSO1 Health, Nutrition and WASH RSO2 SocioEconomic Revitalisation RSO3 Basic Services and Infrastructure RSO4 Governance, Peacebuilding and Social Cohesion 0% 0% 0% 0.50% 3.98% 4.01% 6.57% 0% 7.25% 0% 1.36% 0% 0.45% 12.21% 9.94% 16.87% 36.85% 22

25 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 1 MCA 1 Identify and trace people with Ebola $6.71 million Allocated COVERAGE: High case load districts:10 Other districts: 19 MPTF Project No: Title: #16 Epidemiology District Management # 35 Campaign of sensitization and early detection of Ebola suspected cases TRANSFER DATE: 19Dec2014 6Feb May 2015 AMOUNT: $6,308,640 $400,000 1 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES 1,511 Contact Tracers 1,511 Contact Tracers Staff Deployment 66 Supervisors 66 Supervisors WHO 74 District Monitors 74 District Monitors Epidemiologists deployed 25 International Staff 95 National and International Staff 2 WHO Number of households visited Number of suspected cases 565, ,606 3, WHO WHO 1 In addition to the contribution of the Ebola MPTF, this project was funded by UNICEF, CDC, and French Cooperation 2 As of 31 December 2015 Achievements and Results Contract tracing was a key factor contributing to the end of the Ebola outbreak in Guinea. It encompassed the identification, assessment and management of people who had come into contact with Ebola and their rapid isolation were they to become symptomatic. At the height of the outbreak, WHO, through Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics Management, Community Mobilization and Engagement, deployed 1,651 people in the field to conduct contract tracing. Since September 2014, they have traced more than 27,639 people who came into contact with the virus. During this reporting period, contact tracers worked mainly at the community level in Ebola hot spots (including Conakry and Forécariah), and were involved in minicerclage campaigns. These campaigns focused on small areas where Ebola remained intractable and where cases continued to emerge even after the outbreak had ended in many other parts of the country. During these campaigns, the population s movement was restricted for a period of 21 days and health workers actively searched for the sick. People who were identified as having been in contact with Ebola victims were given food and cash during the period of the minicerclage. The contact tracers interviewed the local population twice daily about the state of their health, took their temperature and filled out reports, which were sent to supervisors. Using Ebola Response MPTF financing, WHO was also able to hire national Guinean epidemiologists who supervised contact tracers and conducted active searches for undiagnosed Ebola victims at health facilities. International epidemiologists played a supervisory role at the prefectural and national levels. Project #35, Campaign of Sensitization and Early Detection of Ebola Suspected Cases, responded to the difficulty of ending Ebola transmission in Lower Guinea, especially given the persistence of rumors, reticence to care and the continuation of unsafe burial practices. In light of that situation, the Government of Guinea, on 28 March 2015, enforced an emergency health declaration. The declaration put in place measures to assure that proper reporting, treatment, isolation, infection prevention and control (IPC) and safe burial practices were undertaken. To support the implementation of these measures, an awareness campaign for people living in zones with active cases and a sweep for suspected cases were organized between 28 March and 12 May The recommended strategy was doortodoor campaigning by mobile teams in the prefectures of Forécariah, Coyah, Dubréka, Conakry (five municipalities), Kindia (urban commune and subprefecture Friguiagbé) and Boffa (subprefectures of Koba Tamita and Douprou). This comprised a total population of 3,390,155 (565,026 households) that needed to be made aware of the emergency measures. Awareness campaigns and early detection were conducted in Forécariah, Coyah, Dubreka and Dixinn. In addition, quarantine strategies were used in localities (Boké and Ratoma in Conakry) that had more than one case over the course of 21 days. The main objective was to break the chains of Ebola transmission and bring transmission to zero within 45 days of implementing the measures outlined in the emergency health declaration. Activities centered around nine specific objectives: (1) Identify any areas that may contain suspected cases of Ebola; (2) Empower and mobilize individuals, families, households and 23

26 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA communities in the notification of cases (patients, alerts, contacts, suspected cases, and deaths); (3) Identify and notify households with all cases (patients, alerts, contacts, suspected cases, and deaths); (4) Strengthen active surveillance networks in communities; (5) Facilitate the identification of suspected cases in isolated areas (more than six kilometers away from health facilities); (6) Strengthen the capacity of integrated supervision teams; (7) Improve active surveillance and IPC in health facilities (public and private), including traditional practitioners; (8) Disseminate information on prevention and how to deal with suspected cases, linked to the distribution of kits, and disseminate information on the emergency health declaration; and (9) Identify and manage suspected cases of Ebola in homes, and strengthen community participation in monitoring the potential cases around them. During the campaign, in Forécariah, 294,150 people were visited by 506 teams throughout the prefecture. Radio, local elected officials and the Community Watch Committees (CWCs) played a leading role in the dissemination of the different messages. A survey conducted after the campaign demonstrated that the campaign was successful, with 92% of households indicating they would continue to raise awareness on Ebola. In Coyah, the campaign reached 57,627 households, representing a total of 375,037 people. This was achieved 2015 INTERIM REPORT Mission Critical Action 1 through 610 teams comprised of 1,830 awareness campaigners who conducted doortodoor visits in the three subprefectures and the urban commune of Coyah. Supervisory teams were also deployed. A total of 366,030 soap bars were distributed. Several meetings were held in the municipalities with mayors, the heads of subprefectures, heads of districts and religious leaders. In addition, several community meetings were held on the subject of advocacy, which boosted support for doortodoor campaign activities. Local radio, Bamboo, also lent support to the awareness campaign. The station, from 8:00am to 9:00pm, aired spots, roundtables and interactive programs with the population. This messaging helped inform households with regard to upcoming outreach visits, fostering the work of doortodoor campaigners. In Dubreka, 13,117 people were visited by 86 teams. The teams in Dixinn visited 3,859 people. Quarantine strategies were used in localities that had more than one case over the course of 21 days. The quarantine in Ratoma, Conakry involved 154 contacts across 33 households. The surveillance team deployed 18 doctors and performed contact tracing (two visits per day to monitor the temperature, signs and symptoms and reporting). A logistics operation distributed fish, meat and rice, as well as soap and chlorine to the quarantined households. 24 GRC distributing soap

27 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 2 MCA 2 Safe and Dignified Burials $5.46 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #30 Reinforcement of the Guinean Red Cross in the National Response against Ebola (WHO) # 32 Ensuring Safe and Dignified Burials in Guinea (IFRC) TRANSFER DATE: 27 May July 2015 AMOUNT: $1,000,000 $4,458,330 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of meetings organized by GRC team per region per month 15 20* WHO Number of SDB trainings organized by WHO Number of adequate safe burials/body management event per region % of unsafe burial within reported community death Number of Districts with trained SDB Teams which are properly equipped Number of training, workshops and refreshing sessions on IPC % of SDBs conducted within 24 hrs of death notification Number of regional/ cross border meetings % 0% % 99.5% 2 3 WHO WHO IFRC/ IFRC/ IFRC/ IFRC/ IFRC/ * 15 health districts (Fria, Dubréka, Coyah, Forécariah, Kindia, Dabola, Faranah, Kissidougou, Kankan, Siguiri, Boké, Lola, Nzérékoré, Macenta et Guéckédou) and 5 municipalities in Conakry (Kaloum, Dixinn, Matam, Ratoma, Matoto) Achievements and Results Project #30, Reinforcement of the Guinean Red Cross in the National Response against Ebola, was initiated to reinforce the logistics, coordination and human resource capacities of the Guinean Red Cross (GRC) to enable the organization to carry out activities requested by the National Ebola Response Coordination, including safe and dignified burials (SDBs) and community education. The project procured and handed over to the GRC: four vehicles, one truck, 15 motorbikes and helmets, 15 generators, 15 inverters, 15 computers and printers, 15 copy machines, 50 mobile telephones and 40,000 liters of fuel. Given the challenges of the Ebola response in Guinea, especially the need for education to improve community engagement and address reticence, and the need for improved IPC measures for response workers, the WHO and the GRC collaborated to strengthen national capacities at both the central and peripheral levels. Main objectives included strengthening the technical capacity of GRC teams by recruiting specialists to coordinate the response in key geographic areas, and strengthening the early warning system, including through alert teams. In addition, specialists were employed under the supervision of the Ebola coordination of the GRC and in their respective districts (Fria, Dubréka, Coyah, Forécariah, Kindia, Dabola, Faranah, Kissidougou, Kankan, Siguiri, Boké, Lola, Nzérékoré, Macenta and Guéckédou) and a particular area of Conakry. Ensuring that burials were conducted safely was one of the most urgent priorities of the Ebola Response and the GRC. WHO worked with communities to help them adapt burial ceremonies so as to minimize the risk of mourners contracting Ebola. Drawing on its expertise in burial management, WHO also deployed logisticians to support trainings on safe and dignified burials (SDBs). The trainings given to GRC staff consisted of eight days of theoretical sessions and seven days of practical sessions. Trainings were conducted in 20 localities throughout the country s eight regions. The sessions used: brainstorming; illustrated PowerPoint presentations; group work, including discussions and restitution at plenary; question and answer sessions; practical work and simulations; presentation of modules; case studies and field trips; the exchange of experiences; technical workshops; opening and closure evaluations of sessions; and education on personal protective equipment, disinfection of information, education and communication (IEC) materials, and communication equipment and logistics. The trainings helped strengthen the organizational capacity and response of the GRC. In the final week of July 2015, just three unsafe burials were reported to have taken place 25

28 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA in Guinea out of 525 reported community deaths, reflecting not only the success of the safe burial teams in responding quickly to reported deaths, but the subtle shift in the attitudes of communities towards the adaptation of traditional practices in the context of the outbreak. In addition to these activities and outcomes, 15 field supervisors and six logisticians were deployed for six months (JulyDecember 2015) to oversee activities, ensure the quality of reported data, reduce the risks of community reticence and to mentor teams. These activities led to achievements that included: 52 teams trained in SDB; 21 GRC technical managers trained in IPC and new standardized protocols; 15 district supervisors and six logisticians deployed for SDB/IPC activities; 9,904 SDBs performed (in the context of systematic SDB); 9,787 salivary samples post mortem collected; 7,442 places disinfected; and 99% of community death alerts covered during the project period. Project #32 focused on Ensuring Safe and Dignified Burials in Guinea. Countrywide across the prefectures, to address the epidemic, there were 63 SDB teams and 536 SDB volunteers 2015 INTERIM REPORT Mission Critical Action 2 deployed. During the Ebola response, more than 126 vehicles were also deployed in the field. Each prefecture had at least one SDB field supervisor, one WASH delegate and one zone coordinator. Between 29 June 2015 and 31 December 2015, a total of 9,825 swabs were taken to monitor for Ebola, 10,769 places such as houses were disinfected and 14,254 SDBs were undertaken. The International Federation of Red Cross and Red Crescent Societies (IFRC) collaboration with the GRC continued to maintain operational capacity for response in Ebola hotspots, while the IFRC worked on a new Community driven biosafety Approach for SDB Teams. The aim was to reduce reticence in sensitive areas through community empowerment. The approach, piloted in hotspot areas in June and July 2015, proved successful. With the declaration of the end of the outbreak in Guinea, the country entered into 90 days of heightened surveillance, until March During this time frame, swabbing and rapid diagnostic tests (RDTs) were employed as a monitoring tool to quickly detect any case resurgence. SDB teams remained on standby. Throughout the project s duration, the average number of volunteer SDB teams was maintained, though the number of volunteers varied from quarter to quarter due the variations in community deaths throughout the year. PERIOD Average SDB Teams No. of Volunteers in the Teams JanMar AprJun JulSept Oct 29 Dec Jan 2016 and onward 0 0 The number of SDB teams was significantly reduced in the last quarter of the year (October December), with active teams cut by 21.4%. SDB teams shifted from 69 teams (with 549 volunteers) to 59 teams (with 432 volunteers) by 29 December 2015, and then down to zero teams by January The joint IFRCGRC operations in the country also focused on strengthening the Guinean Surveillance National System through the community event based report surveillance approach in cross border areas (mainly Forécariah and Boké), which share the border with Sierra Leone and Guinea Bissau respectively. The goal was to build capacity in local communities to quickly detect and respond to new Ebola cases and to address behaviors that could contribute to its spread. Crossborder monitoring was reinforced through the installation of information kiosks in the Forécariah and Boké Districts; community event based surveillance (CEBS); and hygiene promotion with a focus on hand washing. With regard to communications, 30 Red Cross volunteers from Conakry, Forécariah and Boké were trained in radio broadcasting techniques to provide communities with quality information on epidemics. This was reinforced with the use of a mobile radio unit and the distribution of solar radio sets in areas where communities were particularly reticent. The project also supported nine trainings for SDBs, and six trainings on hygiene promotion and sanitation. The Guinean Government decided to strengthen the country s health system, especially in regard to epidemiological surveillance, and the Red Cross, leveraging its large volunteer network, aligned with this health policy in order to strengthen community surveillance, communitybased health programmes, outbreak alert mechanisms and continued support to survivors. 26

29 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 3 MCA 3 Care for Persons with Ebola and Infection Control $22.93 million Allocated COVERAGE: Country, including district areas MPTF Project No: IPC Experts Title: #23 Rapid Isolation and Case Management through establishing Isolation Units within health centres #16 IPC District Management #1 Transportation of Essential Items #1 Storage Capacity #1 Air Services #1 Establishment of ETUs TRANSFER DATE: 19Dec2014 6Feb Nov Dec Nov Nov2014 AMOUNT: $9,813,619 $1,990,380 $3,780,000 $ 658,902 $4,000,000 $2,687,375 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES WHO FLBs Forwarding Logistics Bases 1 2 WFP ETUs Ebola Treatment Units 2 5 ETUs 520 capacity of beds WFP Jan ,745 m³ Feb ,764 m³ Transportation Essential Items 1,000 m 3 Mar ,091 m³ Apr ,261 m³ WFP May ,390 m³ June ,251 m³ Strategic Airlift 12 Covering three countries 28 Covering three countries WFP Jan ,950 passengers Air Services 1,300 Passengers/months (all three countries) Feb ,094 passengers Mar ,271 passengers Apr ,718 passengers May ,743 passengers WFP Jun ,887 passengers Number of CCC Built Number of Isolation Units 10 6 * 6 In Progress UNICEF UNICEF Transportation Ambulances 13 4x4 Vehicles 9 Motorcycles 112 Ambulances 13 4x4 Vehicles 9 Motorcycles 112 UNICEF * The project was revised to additionally build 6 epidemiologic units Achievements and Results Against the backdrop of reaching and sustaining zero Ebola cases during the last months of 2015 and to meet its partners changing needs, WFP, through Project #1, Common Services for the Health Response to the Ebola Virus Disease Outbreak in West Africa, adjusted the provision of services to enable rapid response mechanisms to quickly and efficiently stop new outbreaks as well as assure surveillance. While the regional Special Operation ended at the close of 2015, WFP continued to leverage the recently established infrastructure and logistics capacity. It ran countryspecific operations tailored to national contexts to provide a highly dedicated rapid response mechanism to deal with potential smallscale outbreaks, while further increasing and enhancing the readiness and recovery activities of partners. WFP also prepared those on the ground for an orderly and effective transition of assets and capacities put in place to support the Government of Guinea s Ebola response, thereby improving the ability of the national government and humanitarian partners to respond to future emergencies using the capacity built during the Ebola operation. 27

30 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA Throughout the Ebola response, WFP implemented an adaptable approach to provide optimal support, while facing unprecedented demands and an evolving epidemic. The agency met critical needs and responded to priority activities identified by health partners. In Guinea, from January to June 2015, the WFPled logistics coordination mechanisms facilitated the transport of over 13,000 m 3 of cargo. It also established one staging area, one main logistics hub, and two forward logistics bases (FLBs), and supported the construction of five Ebola Treatment Units (ETUs) for a total capacity of 520 beds across Nongo, Coyah, Nzérékoré, Kérouané and Beyla. While no funds were specifically allocated by the Ebola Response MPTF to build ETUs in Guinea, WFP prioritized the funding received to respond to urgent requests from the Government. In February and March 2015, WFP in collaboration with the Government and UNICEF supported the safe reopening of schools by dispatching 30,000 WASH kits to 89 villages across the Macenta, Nzérékoré and Lola prefectures. In addition, the WFPmanaged United Nations Humanitarian Air Service (UNHAS) ensured humanitarian access by transporting passengers and light cargo across Ghana, Guinea, Liberia, Senegal and Sierra Leone. As of 31 December 2015, UNHAS performed 5,473 takeoffs, transporting 31,777 passengers and 202 MT of light cargo. This was made possible thanks to the overall coordination of air activities through a regional cell and the setup of a temporary air terminal (terminal H) in Dakar out of which intercapital flights were operated. Additionally, in view of the potential deterioration of road conditions during the rainy season, new helicopter routes were established between Conakry and some of the areas most affected by Ebola in Guinea, notably Forécariah, Boffa, Fria and Kindia. Twentyeight strategic airlifts were organized, nine of which took place in January and February 2015 and transported 770 MT of relief items of behalf of 37 organizations. Airlifts were usually conducted out of staging areas such as the one set up at Cologne Bonn Airport by the WFPled Logistics Cluster in cooperation with UNHAS and UNICEF. Through the Emergency Telecommunications (ET) Cluster, WFP provided internet set up, equipment and services to 80 humanitarian facilities across Guinea, Liberia and Sierra Leone, allowing more than 3,300 humanitarian responders to remain connected at all times. In Guinea, locations included two FLBs and four ETUs. These services helped to ensure that blood sample results were communicated quickly from testing labs to treatment centers and that patient information was transmitted without risk from within the ETU red zones. At the start of the Ebola outbreak, many health workers had insufficient equipment and training to prevent infection and they quickly became ill. The infection of health workers and the fear of more infections had serious ramifications: it reduced 2015 INTERIM REPORT Mission Critical Action 3 the number of qualified staff available to work in medical facilities and provide care to Ebola victims; and it increased fear among the local population, making them less inclined to seek proper medical treatment in health facilities. It was imperative to protect health workers and to provide them with the best medical care possible to improve patient survival. It was critical that health workers improve their understanding of the disease and adhered to best practices of infection prevention and control (IPC) at all times (both during and after disease outbreaks). Over the course of 2015, WHO, through Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics Management, Community Mobilization and Engagement, deployed IPC experts who trained 3,136 people at governmentrun and private health facilities and hospitals in Kindia, Telimele, Gaoual, Mamou and Conakry. In November 2015 alone, WHO trained about 1,090 people. The agency also recruited a total of 37 IPC experts who worked at the district level and supported community care centers and hospitals in all aspects of IPC, including training, onthejob mentoring and daytoday supervision. Ebola Response MPTF funds also contributed to the purchase of 20 vehicles used by IPC staff. WHO also procured $7 million worth of personal protective equipment (PPE), including 16 million pairs of gloves and 1.9 million disposable gowns. Once the country began to implement initiatives to promote the recovery of the healthcare system, WHO looked to build on IPC programmes started during the Ebola outbreak to ensure that all medical workers continued to take proper standard precautions to protect themselves from infectious diseases during the course of their work. UNICEF, through Project #23, Community Care Centers: Care for Persons with Ebola and Infection Control, constructed six Community Care Centers (CCCs) to ensure care for suspect cases and triage at the community level. Full implementation of the health sector recovery agenda shed light on the critical importance of constructing six epidemiologic units in Yomou, Diguiraye, Madiana, Dalaba, Tougue and Fria, which were also supported by this project. In Fria, all work was completed and technical acceptance granted. In Yomu, Dinguiraye and Mandiana, major work related to foundations, masonry, carpentry, roofing and plastering was completed. In Dalaba and Tougue, the following steps were completed: building of the walls in chipboard; roughcasting of walls and substructures; electric system installation and sheathing of electrical wiring; piping for drinking water and disposal of wastewater; and metallic roof framework works. The building companies were slightly behind the estimated schedule of construction for these two sites. The construction of the epidemiologic units will be completed in

31 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 4 MCA 4 Medical Care for responders $2.18 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #1 Rehabilitation of Responders Clinic #40 Essential Service Capability UN Medical Clinics TRANSFER DATE: 6August Dec2014 AMOUNT: $608,518 $1,577,030 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Rehabilitation of Responders Clinic (Level 1) 1 1 WFP Number of hours per week the clinic is open for routine care Number of hours per week the clinic is open for emergency care Achievements and Results Throughout the Ebola crisis, a key challenge was ensuring the safety and security of humanitarian responders, given the nature of the disease and the limited and inadequate facilities available in Guinea. At the onset of the outbreak, the UN medical facility in Conakry consisted of a single room with limited equipment located inside the UN compound. In addition, there were limited international agreements, protocols and procedures addressing the medical evacuation of Ebola Response Workers (ERWs) to adequately equipped medical facilities elsewhere in the world. WFP and partners scaledup logistics networks and infrastructure to, inter alia, protect healthcare workers. Supported by Project #1 Common Services for the Health Response to the Ebola Virus Disease Outbreak in West Africa, WFP established a level 1 UN clinic in Conakry. Following a decision to create the facility in a larger structure, WFP identified a venue and transformed it, by adding electric, plumbing, a water tank and sewage systems, a highpower generator and technical support, into a fullfledged UN clinic. The UN clinic now has standard amenities including a waiting room, diagnostic block, examination rooms, sick bay emergency/treatment room, beds ward, pharmacy and a waste treatment and an incineration area. The facility was further expanded to accommodate Ebola contact cases with a dedicated container set up for triage and isolation. It met minimum operating security standards. In addition, complementary activities were put in place to ensure that health responders would alternate in the workplace to limit the risk of transmission. To achieve this goal, connectivity, telecommunications equipment and networks were made available to ensure operational continuity, and minimum security standards were respected. Further, to ensure that the implementation and monitoring of the emergency response was done in a manner that was safe for staff and beneficiaries alike, WFP, jointly with WHO, developed safe distribution measures that were put in place with the support of health advisors. Health advisors developed the guidelines for the safe distribution of relief items and door to door guidelines for Post Distribution Monitoring surveys. They also trained incoming staff specifically on Ebola awareness. With one specially equipped helicopter for Medevac in Guinea, WFP was the only humanitarian actor to provide this service from remote areas to Conakry through UNHAS. In this framework, simulation trainings were undertaken to familiarize responders, the crew of the dedicated helicopter and staff with the Standard Operating Procedures (SOPs) required to perform this type of technicallyspecific Medevac. Trainings on medical evacuation procedures were also provided to the humanitarian community in Guinea, including for the isolation bubble for the safe air transportation of humanitarian workers with Ebolalike symptoms, and for regular health emergencies. WFP aimed to ensure that these complex procedures were correctly and efficiently replicated to facilitate the handover to national health authorities. Other training provided included a basic first aid course, security awareness training, security and safety briefings, basic and advanced security in the field trainings, which cover common safety and security scenarios, and preparation of staff to respond to such scenarios using the right procedures. With the support of the Ebola Response MPTF, Project #40, Maintaining Essential Service Capability UN Medical Clinics in Guinea, boosted medical capacity and ensured the preparedness of UN System personnel. 29

32 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA 2015 INTERIM REPORT Mission Critical Action 7 MCA 7 Cash Incentives for Workers $2.2 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #7 Payment for Ebola Workers TRANSFER DATE: 04Dec2014 AMOUNT: $2,204,200 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of payments made to ERWs (Ebola Response Workers) through Government systems with support N/A 165,756 1 Number of contingency payments made to ERWs through Contingency Plan , Paid in cycles. 2 Please note that the Government is in the lead in paying ERWs. provides support, either by supporting payments through government systems or through s Contingency plan, when requested by the government. There are payments, especially for pay rolled health workers in the Ministry of Health, that are paid directly by the government with no support. 3 Paid in cycles. Achievements and Results Project #7, Programme for Payments for Ebola Response Workers (PPERWs) in Guinea, aimed to harmonize incentives and assure timely payments to Ebola Response Workers (ERWs) throughout the crisis. Over the course of the outbreak, the eligibility criteria for incentives for ERWs evolved. At first, the project had to provide the same incentives to frontline ETU workers from NGOs as to Ministry of Health employees in order to prevent strikes or health services interruptions. The PPERW team made regular visits to the ETUs to communicate eligibility criteria and solve issues or complaints from the ERWs to avoid strikes. Throughout the entire crisis, not a single day was reported without health services. As the outbreak ended in the Forest Guinea Region and in Lower Guinea (Conakry, Forécariah and Coyah), the National Coordination Cell, in agreement with all partners, decided to reduce the eligibility for incentives to those ERWs working inside ETUs only, and empowered the PPERW team to directly manage all payments until the official end of the epidemic. These payments were managed by until the end of December 2015, with the outbreak declared over on 29 December The project was scheduled to run until the end of June 2016, with maintaining the possibility of disbursing incentive payments quickly in response to any new outbreaks, as requested by the National Coordination Cell. Also towards the end of the crisis, the PPERW team dedicated more resources to strengthening current national payment systems. The team held consultations with main financial actors to evaluate the impact of the crisis on cash transfers as well as to consider early recovery actions to be taken that would support the financial sector, in particular, the transition from physical to electronic money transfers. The Central Bank of Guinea and the Micro Finance Institutions (MFIs) signed an agreement to support the national strategy for the transition to electronic payments by providing training to key employees at the Central Bank and supporting MFIs in their financial data management with a view to assuring a more interoperable and secure financial system. Ministry of Health Workers (Indemnity of motivation paid in addition to salary) Beneficiaries ERWs (CTUs, ETUs, Burial Teams, Coordination Cell and Contact Tracers) Community Community Engagement Beneficiaries 4,939 3,810 17,963 30

33 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 9 MPTF Project No: MCA 9 Reliable Supplies of Materials and Equipment Logisticians deployed $3.61 million Allocated Title: #42 Prevent EVD Spread in the Electoral Process # 16 District Logististical Capacity COVERAGE: Country, including district areas TRANSFER DATE: 18Sep Jan2014 AMOUNT: $991,467 $2,618,660 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES WHO # of sanitary control kits purchased and distributed # of polling stations with sanitary control equipment 7,500 17,500 7,500 17,500 Achievements and Results As was reported previously, WHO, through Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics Management, Community Mobilization and Engagement, recruited 17 logisticians to ensure that Ebola response operations ran smoothly at the prefecture level. Every logistician oversaw activities in two, three or four prefectures (depending on the size of the prefecture or the complexity of the response), and performed a variety of roles. Logisticians tracked vehicles involved in the Ebola response, with some responsible for managing fleets as large as 25 vehicles, including fuel needs. They also tracked staff as they moved by land and air, booked accommodation for teams coming into the field, performed supply inventories, and accepted the delivery of generators provided by WFP, conducting maintenance as necessary. Logisticians also accepted delivery of the prefabs/containers that were converted to office space for response workers, assuring that these spaces had electricity and internet connectivity, as well as office furniture and computer equipment. During the minicerclage campaigns, the logisticians erected tents for use as dormitories and offices and installed toilets. The work done by the logisticians not only benefitted WHO staff in the field, but also the staff of partner organizations, NGOs, and other national and international responders. Given the possibility of Ebola spreading as large masses of people assembled to vote in Guinea s general election, Project #42, Preventing EVD Spread During the Electoral Process, was initiated. In line with the rigor established at the onset of the epidemic, the project assured that voters along with members of the electoral commission and security officers sanitized their hands and had their temperatures taken upon entering polling stations. The aim was to both reduce any risks of an outbreak as well as to reassure the public of their safety while participating in the electoral process. With Ebola Response MPTF funds, the project procured 14,500 thermoflash thermometers and 17,500 sanitary kits used to successfully prevent Ebola transmission in polling stations. 31

34 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA 2015 INTERIM REPORT Mission Critical Action 11 MPTF Project No: MCA 11 Social Mobilization and Community Engagement $9.26 million Allocated Title: # 3 Stop Ebola through Social Mobilization and Community Engagement in Guinea # 16 Social Mobilization # 29 Support to the Confidence Building Unit (CBU) from Mano River Union in the national response against Ebola # 36 Stop Ebola through social mobilization and community engagement in Guinea #47 Social Mobilization for achieving and sustaining a resilient zero COVERAGE: Country, including district areas TRANSFER DATE: 12Dec2014 6Feb Mar May Oct2015 AMOUNT: $3,948,364 $570,788 $2,836,072 $999,915 $909,500 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Recruitment and deployment of midwives Reproductive Health Kits (including Hospital Delivery Kits, CSection Kits, Blood Transfusion Kits, STI Kits, etc.) Hospital beds UNFPA UNFPA UNFPA Gynecologic tables Number of maternal deliveries assisted by skilled health professionals in affected areas CBU (Confidence Building Units) fully functioning N/A 24, UNFPA UNFPA /UNFPA/UNICEF % of targeted reticence localities that accept Ebola prevention activities # of social activities (including sports events, gatherings, village meetings) including EVD sensitization # of radio debates held at rural and prefectural radios including EVD sensitization 75% 90% UNICEF/UNFPA / /UNFPA/UNICEF /UNFPA/UNICEF Radio broadcasts devoted to Ebola response 500 broadcasts 30 broadcasts in 30 days in three prefectures in the intervention area PDLG3 Number of volunteers trained on EVD Number of the 663 CWCs members paid Door to door sensitization on EVD Number Of Hot Spots Reporting and Managing Events/Alerts on a daily basis 12,800 17,213 4,641 members 100% 1 million 1,982, UNICEF UNICEF UNICEF UNICEF 32

35 2015 INTERIM REPORT GUINEA Achievements and Results Bringing social mobilization closer to the population and getting community members directly involved in neighborhood sensitization and surveillance, early alert and referral of suspected Ebola cases and contacts were identified as some of the most critical factors in fighting the virus. Yet, these measures were challenging to achieve in Guinea, where weak health systems, entrenched sociocultural practices (washing of the dead), the frequent movement of people, inadequate understanding and fear, and community reluctance to monitoring and care accelerated the spread of Ebola throughout the country. Community reticence, fueled by rumors and the late arrival of safe burial teams, continued to pose a significant challenge to social mobilization efforts as community members continued to refuse monitoring and contact tracing. Project #3, Stop Ebola through Social Mobilization and Community Engagement in Guinea, sought to address these challenges and assure additional and increased community outreach and mobilization efforts to fight the disease. Over the course of 2015, social mobilization and community engagement helped cut chains of Ebola transmission and stop the epidemic in Guinea. Behavior change seen across all communities, including regular hand washing, greater awareness, use of health facilities, and collaboration with response workers, was observed in all communities and was a critical project achievement. Strong reluctance in urban areas, including the municipality of Matoto (Conakry) gradually changed, given action on the ground to address concerns and provide education. Community police, for instance, integrated awareness raising and monitoring into their daily routine. In Guinea Forest Region, the project mobilized all religious denominations as well as community leaders to spread awareness and initiate behavior change. It carried out sensitization initiatives in 22 districts of the city of N Zérékoré, and members of all faiths gathered 3,500 people (including 2,000 women) to participate in an awareness campaign. In Kissidougou, one of the most Ebolaaffected areas, the project targeted five rural communes and 10 villages around the urban commune, reaching approximately 3,300 people (1,980 women) with doortodoor outreach efforts. With Ebola Response MPTF support, UNICEF and partners aimed to create 2,560 Community Watch Committees (CWCs) linked to both Community Care Centers (CCCs) and community mechanisms of child protection. The CWCs strengthened local communication, contact tracing, and notification of authorities of suspected cases of Ebola and community deaths. UNICEF also helped develop communication plans in Dubréka and Conakry, which ensured better coordination of activities of the UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 11 various organizations operating at the prefectural level. Onehundred twentyeight Community Watch Committees (CWCs) that had regrouped 640 people, were operational in 12 towns of the prefectures of N Zérékoré, Macenta and Lola. These CWCs were equipped with 1,000 handwashing devices, soap and chlorine, and they helped popularize preventive measures against Ebola in the villages covered. The work of CWCs contributed significantly to community engagement against Ebola in the forest area. Also through the project, UNICEF supported the creation of two new rural radio stations in Forécariah and Yomou and provided Radio Mano River in Lola with the equipment it needed to operate. The aim was enable the radio stations to become operational as quickly as possible and to broadcast messages to sensitize the population to Ebola particularly in the most affected areas of Guinea along the border. In the early stages of the outbreak, through the Ebola Response MPTF Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics Management, Community Mobilization and Engagement, WHO focused heavily on social mobilization and community engagement. At that stage, it was essential that communities accepted the need for safe and dignified burials; identified potential cases of Ebola; and helped trace the contacts of potential cases. WHO community engagement teams organized a series of community dialogues to help boost awareness and knowledge of the virus. In collaboration with CDC Atlanta and UNICEF, WHO also supported the Communication Sub Committee at the National Coordination for the Ebola Response in Guinea to develop the overall concept and vision for the community engagement plan as well as to identify more detailed objectives and priority interventions. WHO helped reshape the social mobilization strategy in the country from one of community sensitization to community engagement. As the outbreak evolved, part of the community engagement strategy involved minicerclage campaigns in Ebola hot spots. These campaigns limited the movement of community members to a specific area within which teams intensified their search for the sick. WHO teams, which included social anthropologists, helped build support for these minicerclage campaigns by gaining the trust of communities and convincing them of the importance of adopting safe burial practices and engaging in doortodoor case finding. WHO worked with many local groups in these communities as part of the trustbuilding process, including traditional leaders and healers, members of youth and women s groups, religious leaders and representatives from schools and the transport sector. 33

36 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA Executed jointly between, UNFPA and UNICEF, and in collaboration with government partners, Project #29, Support to the Confidence Building Unit (CBU) from Mano River Union in the National Response against Ebola, supported the Ministry of Health s efforts to boost reproductive, maternal and neonatal health (RMNH) services and assure that pregnant women had access to safe, Ebolafree environments. The collaboration assured the supply of essential lifesaving 2015 INTERIM REPORT Mission Critical Action 11 drugs, equipment and family planning commodities to 34 health facilities in 14 Ebolaaffected districts and deployed 68 qualified midwives. This project led to great improvements in reproductive health indicators, such as use of a skilled birth attendant, overall utilization of health facilities by women, and decreases in maternal and infant morbidity and mortality in targeted health facilities. Date No. of Births Attended by Skilled Health Personnel (Midwives) No. Receiving Antenatal Care Coverage (including 1 of the 3rd trimester) Total No. Receiving Antenatal Care No. Caesarean Sections May 1,244 1,945 6, Jun 1,402 2,255 6, Jul 1,701 2,555 8, Aug 1,723 2,549 8, Sep 1,750 2,575 9, Oct 2,260 2,681 7, Nov 1,820 2,828 8, In addition, the Manu River Union (MRU) carried out social and political elements of the project. The MRU supported the organization of community social and educational activities, including sports events, workshops, trainings and TOTs, village meetings, radio spots, social gatherings and house by house visits, to promote understanding and educate on Ebola transmission and prevention. The project enabled a number of capacity building workshops. Overall, in the field, the MRU, in close alliance with UN agencies and government actors, promoted social cohesion, positive attitudes and behavioral change in communities. In September and October 2015, the MRU supported local NGOs in organizing workshops in the 33 prefectures of Guinea and the five communes of Conakry. The MRU organized two national workshops on Ebola prevention in Conakry, one for traditional communicators and the other focused on traditional healers. The MRU was also key in garnering political leadership and support, preventing political strife and coordinating efforts at parliament and cabinet levels. In addition, it raised recovery funds for the Ebola Recovery Pledging Conference, held 910 July 2015 in New York, US; organized international conferences to share lessons and prevention strategies; organized two cross border meetings in Kindia and Gueckedou; and supported the organization and funding of a Regional Meeting and national crisis meetings in Conakry. As part of the fight against Ebola in the crossborder regions and while still working to maintain trade, economic activities and crossborder movement, the MRU installed three new Confidence Building Units (CBUs) in the prefecture of Gueckedou. In addition, 17 CBUs were equipped with motorbikes and ICT equipment, which increased their efficiency. In July 2015, there was a dramatic drop in Ebola case numbers and a reduction in the geographical spread of cases to Conakry and surrounding prefectures, leading to the declaration on 29 December 2015, of the end of the outbreak. Community outreach and education activities were critical in bringing transmission down to zero and achieving this milestone. The process of helping communities understand the causes of Ebola and how to protect themselves, involved intensive social mobilization and community engagement activities that relied on thousands of individuals and many organizations across the country. In early April 2015, in order to address ongoing transmission, the Government, with support from partners, launched an acceleration plan with the aim of bringing transmission to zero. The plan identified social mobilization and community engagement as priority, yet chronically underfunded action areas. In response, Project #36, Stop Ebola through Social Mobilization and Community Engagement in Guinea, was developed to support the National Coordination s social mobilization and community engagement pillar. Specifically, the project aimed to strengthen interpersonal communication through doortodoor visits and increase community engagement by assuring payments to members of the CWCs. Ebola Response MPTF funding was crucial to continuing the CWC strategy throughout the country as it met the need for continued support to help stop the epidemic. Without Ebola Response MPTF funding, the previous plan to end all payments on 30 April 2015 would have gone forward. Instead, 4,641 members of 663 CWCs were paid and 652,258 households received doortodoor visits, over and above the target of 450,000 planned visits. Though August saw the return of Ebola to Conakry, these achievements coincided with significant progress on the indicator, Zero Ebola Notification: No Confirmed Cases. 34

37 2015 INTERIM REPORT GUINEA Ebola Response MPTF funds also supported Phase III of the Ebola Response. As transmission fell in Guinea, so did surveillance indicators, which showed a decrease in notifications of febrile, suspect cases and community deaths. Given the need for continued surveillance, Project #47, Social Mobilization for Achieving and Sustaining a Resilient Zero, focused on strengthening communitybased surveillance to increase community awareness and developing communitybased early warning mechanisms. UNICEF had an agreement with the Ministry of Youth, which aimed to involve youth at the frontline of communication campaigns during Phase III of the Ebola Response. This partnership strengthened the communication and community engagement system for early warning and rapid control of all potentially epidemic diseases in borders and villages. In December 2015, the Ministry of Youth identified and trained 750 youth mobilizers in communitybased monitoring and the UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 11 use of an early warning system based on new technologies (Rapid pro and U Report), which gathers data and supports realtime monitoring. The youth were to be deployed in 2016 to the eight prefectures of Boke, Boffa, Fria, Télimélé, Dubréka, Coyah, Kindia and Forécariah. In addition, the Ministry of Transport identified 99 transport trade unions in the four prefectures of Conakry, Forécariah, Coyah and Dubrécah. Fifty of the unions were to be trained to report suspected cases to health authorities and support Phase III community awareness building at the border between Guinea and Sierra Leone. Nurses UNFPA 35

38 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA 2015 INTERIM REPORT Mission Critical Action 13 MCA 13 Preventing the Spread of EVD $2.0 million Allocated COVERAGE: Country, including district area MPTF Project No: Title: #11 Quick Impact Project TRANSFER DATE: 3Dec Apr2014 AMOUNT: $1,000,000 $1,000,000 LIST OF QIP PROJECTs IMPLEMENTED IN GUINEA... Implementing organization District Project title Budget Project title Centre Régional de Recherche Agronomique de Bordo (CRAB) Administrative region of Kankan Nutritional support to children and pregnant and breastfeeding women affected by Ebola in 6 rural communities of Kankan region $46,823 The project provided 6 maize and rice processing machines and 42,000 kg of maize to EVD affected communities to improve nutritional conditions of breastfeeding women and Ebola orphans Association des Scouts Catholiques de Guinée (ASCG) Coyah and Forécariah Economic recovery of Ebola survivors, orphans and widows $38,537 This partner assisted Ebola survivors in the two communities of Forecariah and Coyah to run incomegenerating activities. It also sensitized communities on good ways to prevent Ebola. Centre d Ecoute de Conseil et d Orientation des Jeunes de Coyah (CECOJE) Coyah, Dubréka and Forécariah Social mobilization for the prevention of Ebola in the prefectures of Coyah, Dubreka and Forecariah $47,335 The partner ran sensitization campaigns in the three communities of Coyah, Dubreka and Forecariah. Direction Régionale de l environnement, eaux et forêts (DREEF) Administrative region of Kankan Prevention of Ebola among hunters and women local organizations in the prefectures of Kankan, Kerouane and Mandiana $46,986 The project sensitized activities with hunters, and additionally it provided alternate incomegenerating activities as a way to minimize risks of contamination of EVD through illegal hunting. Club des amis du Monde (CAM) Boke region: Sansale, Koumbia, Foulamori, Wendoubour, Kanfarande and Sareboydo Support to the community response to the Ebola virus in Boke $47,597 The partner ran sensitization and social mobilization in localities across the border with Guinea Bissau in the efforts to prevent crossborder contaminations. Cellule nationale de coordination EBOLA (CNCE). Cellule nationale de coordination EBOLA (CNCE). Conakry Provision of soaps and lotion to the NERC $47,597 Conakry Provision of soaps and lotion to the NERC $42,837 The NERC purchased the hand wash kits that it distributed to sanitary facilities across the country. The NERC purchased the hand wash kits that it distributed to sanitary facilities across the country. Commune Rurale de Doko Prefecture of Siguiri: Niagassola, Bankon, Doko and Kourémalé Social mobilization to maintain «zero Ebola» in Doko (Haute Guinée) $41,874 The project addressed issues of lack of hygiene and knowledge on Ebola in mining zones and borders with Mali. Sensitization campaigns were held and hygiene kits were installed in covered areas. Women and Health Alliance International (WAHA) Ignace Deen Hospital (Conakry) Support to the triage system at Ignace Deen National Hospital $44,016 Through this project, an IPC unit was built and maintained at Ignace Deen Hospital in Conakry to prevent risks of infections at the hospital. 36

39 2015 INTERIM REPORT GUINEA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 Implementing organization District Project title Budget Project title ONGDHD (Développement Humain Durable) Administrative region of Kankan Sustainability of good hygiene practices and fight against stigma in the post Ebola phase in 6 rural communities of Kankan $39,390 Sensitization campaigns on good practices of hygiene, as well distribution of food items to most vulnerable Ebola affected populations were conducted in 6 localities. Appui aux Initiatives Communautaires pour le Développement (AICD) Prefecture of Nzérékoré Improvement of hygiene among population affected by Ebola in N Zerekore $44,382 The project contributed to the improvement of hygiene by availing 4 public latrines with running water in 4 public places. Consortium des ONG de Mobilisation Communautaire (COMC) Prefecture of Forécariah and 9 rural municipalities Promotion and reinforcement of hygiene practices $38,709 The project reinforced hygiene and assisted EVD survivors through incomegenerating activities. It also distributed school kits to school aged orphans. Groupe d Encadrement et de Recherche en Milieu Associatif et Communautaire (GERMAC) Revitalization of hygiene practices in Lola $42,970 Lola The project addressed issues of lack of hygiene by putting in place 14 hygiene committees to sensitize on good practices and also provided hygiene kits to communities. Coalition des Femmes Leaders de Guinée (COFEL) Kindia, Coyah and Forécariah Reinforcement of women social mobilization in response to resistance in communities and schools $47,527 Doortodoor sensitization and educative activities by women s associations Unité Conjointe de l Union du Fleuve Mano Establishment of an information and Lola insertion centre for Ebola direct and indirect victims in the most affected $37,249 areas of Lola The project assisted in the reinsertion of EVD survivors by availing 4 reinsertion centers where incomegenerating are conducted by EVD survivors while the rest of the community join in for social events such as educative programs on EVD watched on TV sets offered by the project. Reinforcement of social mobilization Commune urbaine de Macenta Macenta against Ebola and community recovery $40,704 in the urban community of Macenta EVD widows and orphans were supported in the production of vegetables to supplement their income and improve their living conditions. Fédération internationale de la croix rouge et du croissant rouge FICR Renovation of the mortuary of Kindia Kindia $47,597 ALPHA OUMAR DIALLO The project consisted of renovating the morgue of Kindia regional hospital in order to minimize the risks of EVD contaminations. Secrétariat Exécutif du Comité National de Lutte contre le SIDA en Guinée SE/CNLS 20 affected prefectures and 5 municipalities of Conakry Support to 1000 Ebola survivors and 1000 Ebola orphans in Guinea $47,597 The project toured the country to visit Ebola survivors and organize them in legal structure for a better advocacy about their postrecovery needs. SOS Villages d Enfants Guinée Conakry, Kankan and Nzérékoré Reduction of Ebola Transmission through hygiene promotion in SOS schools $43,426 With this activity, three hand wash stations and water fountains were built in the 3 SOS orphans villages. 37

40 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA Achievements and Results Project #11, Ebola Response Quick Impact Projects, was transferred to Guinea in July 2015 after the closure of UNMEER. As of 31 December 2015, a total of 39 Quick Impact Projects (QIPs) proposals were received by and 19 were considered for funding, with a total amount of $875,222 disbursed in grants. By the end of December 2015, sixteen QIPs successfully completed their activities while the remaining three were set to complete them in midjanuary The availability of this flexible funding allowed all benefiting partners to achieve quick results in a short period of time (from one to three months), while also allowing to fill some interventional gaps in some areas of the Ebola Response. With regard to social mobilization, six implementing partners were involved in social mobilization campaigns and their interventions reduced community reticence, mistrust and stigmatization of survivors. Their work contributed to a better understanding of the virus and reinforced social cohesion. Funds also supported the creation of a National Ebola Survivors Platform. Two additional projects conducted activities to help identify Ebola survivors, assess their needs for assistance and 2015 INTERIM REPORT Mission Critical Action 13 organize platforms to improve coordination between recovery projects focused on them. Thirteen associations that were lent support became ready to advocate for Ebola survivors. In addition, legal assistance was given to help survivors form associations, where applicable. The project also funded two QIPs aiming to provide nutritional support to vulnerable and affected communities. Four partners proposed in their projects incomegenerating activities to assist the most vulnerable survivors. Training sessions on small business management were offered before small grants were given out to eligible beneficiaries. The funds enabled beneficiary families to secure some of their basic living needs. In addition, 60 Ebola orphans who had abandoned school because of the outbreak were given school supplies that assisted in their return to the education system. Further, eight projects supported hygiene practices such as education on good hygiene (hand washing), installation of hand washing kits, and the distribution of soap, as best practices in the prevention of infectious disease. Overall, these projects were estimated to have benefited 46,219 people. 38 EVD Sensitization Activities Kissidougou Mano River Union (MRU)

41 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA RECOVERY STRATEGY OBJECTIVE 02 RSO 02 SocioEconomic Revitalisation $0.75 million Allocated COVERAGE: Conakry, Kindia and N zerekore MPTF Project No: Title: #43 Strengthening the Community Recovery and Resilience in Post Ebola in Guinea TRANSFER DATE: 21Oct2015 AMOUNT: $ 748,728 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of households economically reintegrated through an income generating activity Number of community recovery initiatives launched Number of community consultations and orientation sessions on the post recovery strategies and community action plan Number of thematic training sessions on income generating activities, business and financial literacy, creation of jobs Percentage of pregnant women who conducted four antenatal visits, including one in 9th month Number of health workers trained in health related topics like reproductive health, HIV, Ebola virus disease, gender based violence etc. Achievements and Results (1,000 persons) (1,000 persons) 33 85% 73% UNFPA UNFPA Project #43, Strengthening the Community Recovery and Resilience in PostEbola, supported activities that generated income in Ebolaaffected communities and households. It sought to sensitize communities and local authorities on project objectives, including the criteria to select income generating activities as well as ending discrimination and encouraging the reintegration of Ebola survivors. As an initial step, the project registered affected households and applied vulnerability criteria to select households for support. Through the project, targeted households were given information on local markets and how they could generate income. Based on the International Labour Organization (ILO) TRIE (trouver votre idée d entreprise) approach, targeted households selected business activities to pursue individually or in association, and small grants were awarded. Twohundred sixtysix households were selected in two prefectures (N Zérékoré and Lola) for project support and 57 recovery initiatives, individually or in association, were granted. With regard to access to reproductive health services, family planning and social protection plans, UNFPA, in collaboration with the Ministry of Health (MoH), trained 68 midwives in November 2015 with the goal of strengthening their knowledge of and skills in obstetric and neonatal emergency care (EmONC), use of Partogram, HIV prevention, Ebola prevention and treatment, addressing genderbased violence and the management and control of infection. In addition, lifesaving commodities were procured for distribution in 20 health facilities in the districts of Kindia and N Zérékoré. Atelier des Femmes Mano River Union (MRU) 39

42 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND GUINEA 2015 INTERIM REPORT RECOVERY STRATEGY OBJECTIVE 04 RSO 04 Governance, Peacebuilding, and Social Cohesion $0.25 million Allocated COVERAGE: Country MPTF Project No: Title: #44 Support to the government to setup and manage a dedicated financial mechanism to capitalize on New York pledging Conference commitments TRANSFER DATE: 21Oct2015 AMOUNT: $247,915 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of Staff trained from Secretariat and the Thematic Groups 30 8 Training of Technical Core Team* Thematic Groups (TG) and Delivery Units (DU) fully operational TG and 4 DU 2 TG Achievements and Results Project #44, Support to the Government to Setup and Manage a Dedicated Financial Mechanism to Capitalize on New York Pledging Conference Committee, was approved to help better coordinate the multiplicity of financing streams pledged at the International Ebola Recovery Conference held in July It aimed to reinforce the capacity of the Guinean Government to establish a dedicated financing mechanism that would offer coherent, fast, flexible and transparent funding in support of the country s national recovery strategy. Extensive consultations with government officials ensured commitment to this dedicated mechanism. A number of key documents were prepared and shared with the Permanent Secretariat and with major donors incountry, including the draft architecture design of the mechanism, the concept note, the action plan for setup of the mechanism, and the terms of reference (TORs) for the preparation of the Manual of Operations. Initial consultations with partners such as the World Bank, the European Union, the French Development Agency, Belgium and Germany helped identify perceptions of key issues and bottlenecks. The Country Office (CO) also assisted the Technical Cell of the Permanent Secretariat with the preparation of an operational budget and the exploration of additional avenues of support. The CO also shared donor intelligence with the Permanent Secretariat on feedback from countries and signed pledges. * Trainings focused on the following activities: Project Management, Monitoring and Evaluation and Resource Mobilization Strategies 40

43 MCA 1 Identify and Trace People with Ebola MCA 3 Care for Persons with Ebola and Infection Control MCA 6 Access to Basic Services MCA 7 Cash Incentives for Workers MCA 9 Reliable Supplies of Materials and Equipment MCA 11 Social Mobilization and Community Engagement MCA 13 Preventing Outbreaks RSO 01 Health, Nutrition, and Water, Sanitation and Hygiene (WASH)

44 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT at A Glance LIBERIA 40.5 million Contributed 36.9 million Expenditures SIERRA LEONE Voinjama GUINEA 10 Proposals 7 UN Entities 25 km Monrovia Bopolu Tubmanburg ATLANTIC OCEAN Kakata Buchanan River Cess Saniquellie Greenville CÔTE D'IVOIRE Fish Town Harper Map Sources: ESRI, UNCS. The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Map created in Sep Funding as of 31 December 2015* S01 Stop 17 million RS01 Health, Nutrition and WASH 1.5 million S02 TREAT 10 million RS02 SocioEconomic Revitalization n/a RESPONSE S03 ENSURE 6 million RECOVERY RS03 Basic Services and Infrastructures n/a S04 PRESERVE 4 million Funding per Mission Critical Actions & Recovery Strategic Objectives S05 PREVENT 1.5 million RS04 Governance, Peacebuilding and Social Cohesion n/a Guinea Liberia Total Allocation $149 m Sierra Leone Regional 27% * Allocations are based on approved budget $40,521,447 MCA01 Identify and Tracing MCA02 Safe and dignified burials MCA03 Care for persons MCA04 Medical care for responders MCA05 Food security and nutrition MCA06 Basic Services MCA07 Cash Incentives MCA08 Recovery and Economy MCA09 Materials and Equipment MCA10 Transport and Fuels MCA11 Soc.Mob & Community MCA12 Messaging MCA13 Preparedness RSO1 Health, Nutrition and WASH RSO2 SocioEconomic Revitalisation RSO3 Basic Services and Infrastructure RSO4 Governance, Peacebuilding and Social Cohesion 0% 0% 0% 0% 9.89% 5.54% 6.35% 0.80% 2.06% 0% 3.65% 3.84% 0% 0% 0% 26.12% 41.75% 42

45 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 1 MCA 1 Identify and trace people with Ebola $16.9 million Allocated COVERAGE: Country, including district areas MPTF Project No: Epidemiologists deployed Title: #10 Interruption of Transmission #16 Epidemiologist District Management TRANSFER DATE: 23Dec Dec2014 6Feb AMOUNT: $11,603,212 $5,312,789 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES 10,090 Contact Tracers 10,090 Contact Tracers 1,300 Active Case Finders 1,300 Active Case Finders Contact Tracers 2,017 Supervisors 2,017 Supervisors UNFPA,, WHO 106 District Monitors 106 District Monitors 30 County Coordinators 30 County Coordinators WHO Vehicles WHO, Achievements and Results Through Project #10, Accelerating Progress Towards Interruption of Ebola Virus Transmission, WHO, UNFPA and collaborated to support the Government of Liberia in implementing activities across the country s 15 counties. As a Lead agency, WHO supported contact tracing and active surveillance in the eight counties of Grand Bassa, Grand Gedeh, Grand Kru, Margibi, Maryland, Rivercess, River Gee and Sinoe. WHO recruited, trained and provided incentives for 2,877 contact tracers, 575 supervisors, 50 district monitors and 16 county coordinators and provided data processing equipment in these eight counties. It also ensured monitoring and supportive supervision and overall compliance throughout all 15 counties. supported contact tracing and active surveillance in Montserrado County. It provided for the recruitment, training and the provision of incentives for 3,246 contact tracers, 649 supervisors, 22 district monitors and two county coordinators, along with data processing equipment and high quality monitoring and supervision. UNFPA supported contact tracing and active surveillance in the six counties of Bomi, Bong, Gbarpolu, Grand Cape Mount, Lofa and Nimba. Its efforts supported the recruitment, training and the provision of incentives for 3,967 contact tracers, 793 supervisors, 34 district monitors and 12 county coordinators, and provided data processing equipment for these six target counties. Following the detection of a new outbreak in Margibi County in June 2015, after Liberia had been declared Ebolafree, the Ebola Response MPTF released funds to support Liberia s response, in line with the Government s priorities. Project #10 was extended until December 2015 with the primary goal of early case detection and rapid identification of the sick and dead, and their visitors. The revised project included support for response activities in Montserrado (active case finders, community engagement, cash incentives for response teams and operational funds). Through the project, supported the payment of July incentives to 4,171 active case finders in Montserrado. It provided refresher trainings, community engagement activities and operational costs. After a reduction of about 50% in the number of active case finders (AFCs) from 4,171 to 2,146, WHO assumed support for them from August through to December Also via the project, UNFPA supported incentive payments to 123 response teams in Montserrado, and provided operational support to four response teams. UNFPA also supported active case finding in the six counties of Bomi, Bong, Gbarpolu, Grand Cape Mount, Lofa and Nimba, and continued giving incentives to 656 active case finders, 176 supervisors, 42 monitors and 14 coordinators, as well as providing training and operational costs through December Specific project achievements, such as the recruitment, training and deployment of over 10,090 ACFs, helped stop the transmission of Ebola in Liberia. The number of cases fell from over 150 per day to zero across the country. The project also aided in the rapid containment of outbreaks, (including the suspected case in Nedowein community and the prompt support provided by the Project Team to the Margibi County Health Team), which was critical in containing the spread of Ebola. In addition, and another important accomplishment, the Liberian Government maintained a high level of surveillance through the Incident Management System (IMS), and through ACFs, while working towards strengthening the country s health delivery system. This continued, even after the Liberia was declared Ebolafree. Community involvement was also critical. Community and religious leaders helped identify the sick, safely bury the dead, and successfully ran contact tracing and quarantines. Their involvement also reduced the level of stigmatization and 43

46 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA enhanced openness in reporting on Ebola cases. Community engagement interventions for sustained surveillance that were started as part of the project s exit strategy, concluded with community inception meetings, community structure mappings and community mobilization and support activities meant to enhance communityled disease surveillance in the counties going forward. Overall, community outreach activities and cooperation in the fight against Ebola through the ACFs and other field personnel raised the awareness of approximately 1.5 million people in the country. These efforts gave rise to a critical mass of experienced youth community volunteers (for instance, over 10,090 AFCs), who were successfully recruited and trained under the project, and who remained as backup human resources for the country. In order to sustain the project s interventions, WHO along with other development partners, supported the Government of Liberia in streamlining the health care workforce under the country s Investment Plan for Building a Resilient Health System. The revised policy aimed to help develop an incentivized community health workforce to improve communitybased health care service delivery. The 2,146 members of the trained workforce supported by the project were to be subsumed under the broader Integrated Disease Surveillance and Response (IDSR) system and work as general Community Health Volunteer (gchv) to track and respond to 15 priority diseases at the community level. Under the IDSR rollout, the Ministry of Health (MoH) and partners facilitated communitylevel trainings for gchvs on IDSR, including 2015 INTERIM REPORT Mission Critical Action 1 community event based surveillance (CEBS), covering all priority diseases and events. WHO engaged with the MoH to promote curriculum development and training for community health services and county and district level coordination of community health service activities. In addition to project activities in direct response to the Ebola outbreak, Ebola Response MPTF funding provided support to the MoH in building national and district level capacity and reestablishing the IDSR system. As a result, IDSR guidelines were redeveloped in a more practical and usable fashion and nearly 1,500 health care workers were trained to recognize the signs and symptoms of diseases as well as how to report and respond to them. This work was undertaken in partnership with MoH Disease Prevention and Control (DPC) department as well as US Centers for Disease Control and Prevention (CDC). Further, WHO and the MoH coled successful working groups for IDSR implementation at the community level, and designed, developed and rolled out an electronic platform for reporting on priority diseases in four pilot counties. To date, all counties collected IDSR data (except Montserrado) for most priority diseases, with some limitations regarding retrospective data collection. Finally, the WHO and MoH also supported the development of a toolkit to enable MoH and WHO field teams to work with counties to develop county specific epidemic preparedness and response plans. All of these outcomes were meant to speed future responses to epidemic prone diseases, with a view to minimizing their spread and impact. 44 UNFPA Contact tracers MPTF Office

47 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 3 MCA 3 Care for Persons with Ebola and Infection Control $10.58 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #16 IPC District Management #1 Transportation of Essential Items #1 Storage Capacity #1 Air Services TRANSFER DATE: 19Dec Nov Dec Nov2014 AMOUNT: $1,212,945 $3,780,000 $1,592,796 $4,000,000 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES FLBs Forwarding Logistics Bases 3 5 WFP Jan ,055 m³ Feb ,074 m³ Transportation Essential Items 4,000 m 3 Mar ,484 m³ Apr ,291 m³ WFP May ,279 m³ June ,789 m³ Strategic Airlift 12 Covering all three countries 28 Covering all three countries WFP Jan ,950 passengers Air Services 1,300 Passengers/months (all three countries) Feb ,094 passengers Mar ,271 passengers Apr ,718 passengers May ,743 passengers WFP Jun ,887 passengers IPC Experts 6 International Staff 14 WHO Vehicles WHO Achievements and Results WFP, through Project #1, Common Services for the Health Response to the Ebola Virus Disease in West Africa, supported the setup of five Forward Logistics Bases (FLBs) in Liberia. Between January and June 2015, 29,972 m 3 of essential items were delivered in the country. WHO, through Project #16, Strengthen District Level Case Finding, Case Management, Reporting Logistics Management, Community Mobilization and Engagement, deployed 14 infection, prevention and control (IPC) experts and purchased 10 vehicles to support IPC activities and interventions in Liberia. FLB and Transportation MPTF Office 45

48 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA 2015 INTERIM REPORT Mission Critical Action 6 MCA 6 Access to Basic Services $4.0 million Allocated COVERAGE: Montserrado, Margibi, Lofa, Bong, and Bomi MPTF Project No: Title: #4 Ebola Children Protection TRANSFER DATE: 15Dec Apr2015 AMOUNT: $4,007,578 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Increased children s access to basic services 12,600 16,093 1 Nationwide UNICEF ICCs (Interim Care Centres) 3 2 ICCs and 1 Transit Center UNICEF Number of families who received oneoff cash transfers support for caring for orphaned/abandoned children due to Ebola 7,500 6,834 Nationwide 5,083 per the five Counties UNICEF Number of children receiving mental health and psychosocial support (MHPSS) 10,000 16,093 2 Nationwide UNICEF Number of Ebola survivors trained and employed as child carers, foster parents, working with social mobilization teams 1,200 Ebola Survivors 1,200 Nationwide UNICEF 1 Nationwide: 16,093 (7,277m, 8,816f) Per the five counties: 13,950 (6,284m, 7,666m), Bomi 257 (131m,126f), Bong 528 (317 m, 211 f), Lofa 2,303 (950 m, 1,353 f), Margibi 4,436 (1,830 m, 2,606 f), Montserrado 6,426 (3,056 m, 3,370 f) 2 Nationwide:16,093 children receiving MHPSS (7,277 m, 8,816 f) Per the five counties: 13,950 (6,284 m, 7,666 f), Bomi 257 (131m,126 f), Bong 528 (317 m, 211 f), Lofa 2,303 (950 m, 1,353 f), Margibi 4,436 (1,830 m, 2,606 f), Montserrado 6,426 (3,056 m, 3,370 f) Achievements and Results Under Project #4, Supporting the Wellbeing and Protection of Ebola Affected Children in Liberia, UNICEF, through partners, reached 17,318 persons, of whom 16,093 were children, with psychosocial support (PSS), alternative care, and case management for Ebolaaffected children and families. The project targeted the five counties of Lofa, Bong, Bomi, Montserrado and Margibi with some services offered nationwide as the epidemic spread. The project helped the Ministry of Gender, Children and Social Protection (MoGCSP) and the MoH increase the capacity and technical skills of 50 new social workers, 15 child welfare officers and 65 mental health clinicians and 20 data clerks through several trainings on case management, child protection and participation, PSS, alternative care, data base management, family tracing and reunification and basic social welfare skills. This brought the total number of social workers to 120 and the total number of human resources supporting Ebolaaffected children to 220. Standard Operating Procedures (SOPs) were written for the care of children in contact with Ebola, and Ebola survivors were trained to provide the care. Through the project, two Interim Care Centers (ICC) and one Transit Center (TC) were opened and equipped. During the epidemic, they served 146 children. Family tracing and reunification (FTR) services helped to reunify 143 children from the ICC and TC during the epidemic. Social workers provided FTR and case management services to children orphaned by Ebola, in order to avoid their institutionalization. The Hawa Massaquoi Transit Center continued to provide shelter and protection for 25 separated and unaccompanied children as family tracing and reunification services progressed. A total of 16,093 children received case management and PSS through oneonone meetings with social workers, structured recreation for resilience activities facilitated by trained staff, and case management services. Out of the 16,093 children in the five counties, 6,314 were registered as orphans and out of this number, 5,083 benefitted from onetime emergency cash assistance. All have been placed in family based care. Payments continued for 166 children in Montserrado and Margibi. The project helped revitalize and support the National Child Protection Information Management System, which currently stores the data of all children in need of child protection services, especially children affected by Ebola. Records for more than 4,000 Ebolaaffected children were entered into the database. In addition, ten vehicles, five motorbikes, 124 rain gear sets and 100 bicycles were provided to the MoGCSP to help facilitate the work of the social workers in the counties and to fast track the registration of children in remote communities. 46

49 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 6 Further, biweekly technical supervision and coaching sessions for the MoGCSP helped enhance the skills of the supervisors and social workers delivering case management, psychosocial care and reintegration visits to Ebolaaffected children. Across the five counties, 143 national junior volunteers continued to provide sensitization and awareness activities on Ebola prevention and on the prevention of sexual and gender based violence. Some also served as volunteer teachers and nurses, and provided guidance for decisionmaking on children in their communities. Further, 150 adolescent girls and boys in Grand Gedeh continued to conduct awareness and sensitization campaigns to prevent the stigmatization of Ebolaaffected children. They also promoted messaging against sexual exploitation and abuse, and promoted the importance of remaining in school. It was expected that these exercises would be replicated in other counties. UNICEF 47

50 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA 2015 INTERIM REPORT Mission Critical Action 7 MCA 7 Cash Incentives for Workers $2.25 million Allocated COVERAGE: Full, including district areas MPTF Project No: Title: #8 Payments for Ebola Workers TRANSFER DATE: 04Dec Jan2015 AMOUNT: US$1,532,616 US$713,216 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of payments made to ERWs (Ebola Response Workers) through Government systems with support N/A 33,394 1 Number of contingency payments made to ERWs through Contingency Plan Paid in four cycles. 2 Please note that the Government is in the lead in paying ERWs. provides support, either by supporting payments through government systems or through s Contingency plan, when requested by the government. There are payments, especially for pay rolled health workers in the Ministry of Health, that are paid directly by the government with no support. 3 Paid in two cycles. Achievements and Results Project #8, Programme for Payments for Ebola Response Workers (PPERW)Liberia, was established in December 2014 to ensure that all workers received payments for performing essential duties. By the end of December 2015, had supported government payments to an average of 10,000 Ebola Response Workers (ERWs) per payment cycle (for a total of five payment cycles), ensuring that more than 95% of ERWs were registered and linked to a payment mechanism. In addition, paid an average of 495 ERWs working for the central Incident Management System, directly, over two payment cycles. Through this project, also helped support the harmonization of pay scales, installed a complaint mechanism with a call center and installed 17 UN volunteers in the field to support MoH teams in collecting, sorting and verifying payment complaints. By August 2015, a total of 578 complaints were reported by UN volunteers deployed across the country, with 414 of the complaints addressed by the County Health Teams. Approximately 164 complaints were elevated to the MoH central office and resolved. To increase the ability of the Ministry of Health and Social Welfare (MoHSW) to pay workers in remote areas and to strengthen payment mechanisms in Liberia, forged a partnership with USAID to reduce the risk, via a publicprivate partnership, for a digital payments aggregator, Splash Cash, to enter the Liberian market. Because there were a number of residual activities under the project, such as outstanding payments, outstanding grievances from ERWs, and an indepth financial diagnostic of the digital payment sector in Liberia that were underway at the end of December 2015, the project was extended. Overall, the project is estimated to have reached 10,798 beneficiaries. The project had a number of other important outcomes. It strengthened the capacity of the MoH to manage payroll and personnel management. It provided for two liaisons (embedded at the MoH) that helped reduce the lag time between payments and build capacities within the Ministry. An EBillboard was also setup in the MoH to support communication on payment related problems and other related health issues. Payments to all 822 IMS workers through the PPERW contingency plan were made and funds were used to finance a study for the interoperability of the MoH Human Resource (HR) system with the Civil Service and Ministry of Finance human resource systems. The project also sought to analyze and grow capacity that would support financial services functions. Project funds supported a PPERWheld workshop that updated the MoH and paying organizations on the payment mechanism available in the context of the challenging banking footprint in the counties. The PPERW commissioned an initial financial diagnostic review of the financial infrastructure in Liberia and made recommendations. Finally, the PPERW hired a consulting firm to run a diagnostic of the financial systems. A feasibility study analyzing the introduction of a third party cash management partner was ongoing. 48

51 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 9 MCA 9 Reliable Supply of Materials and Equipment $2.57 million Allocated COVERAGE: Full, including districts MPTF Project No: Title: #16 District Logistical Capacity TRANSFER DATE: 22Jan2015 AMOUNT: $2,574,893 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Deployment of logisticians WHO Achievements and Results At the height of the outbreak, the regular public health supply chain in Liberia was not robust enough to provide essential personal protection equipment (PPE) to health facilities, and before Ebola, most of the health facilities did not have essential IPC supplies. Thus, a supply chain for Ebola response in Liberia was established to organize the management of incoming supplies and to ensure that the right quality and quantity of PPEs and IPC supplies were provided to all health care workers in a timely manner. The goal was to protect them while they performed their duties in the fight against Ebola. The WHO Logistics Team was appointed by the MoH to act as the focal point in handling all IPC requests from partners and ensuring its timely fulfilment. MoH along with WHO and other partners (WFP & John Snow Inc.) developed a coordination group to launch a last mile distribution exercise in February Through the project, incoming air and sea shipments (105 containers, 14,896 boxes and 23 pallets), which totaled 116 shipments of mostly IPC supplies were received and dispatched. In addition, the supply chain management team conducted a supplies needs analysis for Liberia, and forecasted and procured IPC through An IPC supply chain transition task force was setup with the leadership of IMS, and a plan was developed to ensure the smooth transition from an Ebola response emergency supply chain to a regular supply chain system. The goal was to assure continuity of IPC/PPE supplies for the health system. An IPC quantification task force was also established, led by a MoH IPC team, and was responsible for revising the IPC commodities item list as well as quantifying IPC commodities based on consumption data. Due to unplanned donations from several partners and countries, medical supplies not relevant to IPC activities accumulated. The supply chain management team (WHO, WFP, John Snow Inc. and MoH) worked along with other partners and County Health Teams (CHT) in each county. They identified the needs in other areas and health sectors, and distributed these supplies to hospitals and health facilities. These actions prevented the waste of valuable medical supplies and helped meet needs in other areas, in addition to the Ebola response. With regard to vehicles and transport, the logistics team also established a fleet management system, developed SOPs for the management of fleet, recruited drivers and repaired dozens of broken vehicles that were then deployed to the field and equipped with tools and first aid kits. The project supported County Health Teams, assuring improved resource management and the utilization of available resources, especially in regard to transport. A sample transport system was setup to transport the semen samples of Ebola survivors from Redemption Hospital in Montserrado County and Phoebe Hospital in Bong to Tappita Lab in Nimba. Other specific project outputs included the completion of several distributions throughout the year, with more than 700 health facilities receiving IPC commodities through last mile distribution efforts. Fourteen Mobile Storage Units (MSU) were installed to improve storage capacity in 14 counties. The project also removed expired medical commodities from supply chains. A supply chain management orientation workshop was provided for 17 supply chain coordinators, 15 county pharmacists and 12 hospital pharmacists. The project also assessed ELWA 3 Lab, assured compliance with required operational standards and supported the cold chain logistics and infrastructure needed for all vaccination campaigns carried out in the country. Figure 8: IPC commodities distributed in 2015 County 1st 2nd 3rd 4th 5th 6th 7th Bomi Bong Gbarpolu Grand Bassa G. Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Montserrado Nimba Rivercess Rivergee Sinoe Total (number) Total (%) 58% 60% 90% 89% 90% 92% 100% 49

52 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA 2015 INTERIM REPORT Mission Critical Action 11 MCA 11 Social Mobilization and Community Engagement $0.84 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #25 Outreach and Awareness Monrovia and Paynesville* #16 Social Mobilization TRANSFER DATE: 19Dec2014 6Feb2015 AMOUNT: $283,088 $552,963 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Social Mobilization Experts 3 5 WHO * The project is operationally closed as of April For the indicators of this project refer to 2 nd Interim Report of the Ebola Response MPTF. Achievements and Results Through Project #16, Strengthen District Level Case Finding, Case Management, Reporting Logistics Management, Community Mobilization and Engagement, WHO worked in collaboration with the MoH, Ministry of Education, UNICEF, CDC, the UN Mission in Liberia (UNMIL), UNMEER and other partners to strengthen social mobilization coordination and partnerships; develop guidelines and training materials; develop messaging and information, education and communication(iec) materials; promote community mobilization engagement; and strengthen social mobilization capacity at all levels. The reemergence of Ebola on two separate occasions after Liberia was initially declared Ebolafree demonstrated the importance of maintaining community vigilance to prevent outbreaks and to control behaviors that could enable the reemergence of the virus. Project #25, Operation Stop Ebola Transmission in Monrovia and Paynesville, supported the Montserrado County response team and the Montserrado IMS community engagement pillar to plan, implement and coordinate partners in response to the Ebola outbreak. In collaboration with communities, the Montserrado response team, CDC and UNICEF, WHO supported community engagement and dialogue meetings to mobilize communities on the issue of safe burial practices and Ebola prevention. The communities developed action points to promote safe burials and to strengthen the surveillance of dead body management. Through the project, 500 community leaders, active case finders and district surveillance teams participated in orientation meetings to strengthen their collaboration with communities and their surveillance measures. Additional outcomes included provisions to 96 block leaders in Montserrado to strengthen their participation in community response. They were provided rain boots, scratch cards and refreshments. A community engagement session was held with community leadership and other stakeholders to discuss triage at the Louisiana Community Health Clinic. Meetings were also held with community leaders in New Kru town and Island Clinic community on the decommissioning of Ebola Treatment Units (ETUs); and about how to pass community concerns onto government counterparts. Zonal coordination meetings were held regularly through which community leaders committed to address community health issues such as unsafe burial practices, body swabbing and early disease reporting. The project also supported a MoH analysis and monitoring report for countylevel social mobilization activities in Ebola response; and updated a standard messaging guide to include communications on postebola vigilance advocacy for ongoing campaigns, including Ebola immunizations. 50

53 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 MPTF Project No: MCA 13 Multifaceted approach to Prevent the Spread of EVD $0.34 million Allocated Title: Ebola Response and recovery positioning Community Quick Impact Projects (CQIPs) for Montserrado County Liberia COVERAGE: Monserrado TRANSFER DATE: 22Jul2015 Community Based Organization County Project Value(USD) Project Title and brief description of activity Community Help Insight Liberia (CHIL) Sean Devereux Children s Education And Agriculture Programme. Babylon Congress For Development (BCD) Monserrado $3, Monserrado $4, AMOUNT: $344,277 Building the capacity of primary and secondary school teachers in Ebola prevention, infection and control in District #2 Johnsonville City. Construction of elevated poly tank water supply facility for use by children and students to properly maintain hygiene in Sean Devereux School Toile and provide safe source of water for school and community dwellers Monserrado $2, Sanitizing school campuses and providing antiebola hygiene materials Total Dignity Institute, Inc. (TDI) Monserrado $5, Survivors Aid International Liberia (SAIL), INC Paynesville SDA Women Ministry Department Monserrado $4, Monserrado $1, Women of Change Monserrado $4, Integrated Livelihood Promotors Inc (ILIP) Monserrado $ 4, United For Humanity (UH) Monserrado $ 4, New Liberia Media Initiative Monserrado $ 4, Global Vision for women and children Monserrado $ 4, Child Equip Inc Monserrado $ 4, Ebola Prevention & Care for Deaf students (EPCaDS), providing specialised services for persons with disabilities Back to School Assistance to Ebola Orphans and Survivors, providing counseling support for return to school along with ebola preventive materials Teaching basic Hygiene in the Schools and Communities to say farewell to Ebola targeting women and children Ebola Survivors Reintegration Programme 1st phase (ESRP); focused primarily on women creating awareness and prevention of Ebola to stay at zero while at the same preventing the resurgence of disease Enhancing good sanitary condition to schools (Construction of hands pumps, hands washing center, renovation of Toilet at the TEEBEY, Memorial high school, point Four, Bushrod Island, Monrovia, Montserrado County) Restoring Trust in the Health Care Delivery System; focused on a multifaceted preparedness to preserve stability of the gains made in the Ebola response Taking stigma and complacency out of minds towards a win against Ebola in Liberia tackled stigma, denial through direct engagement with survivors and families Engaging communities, especially women on stigmatization and complacency on the prevention of Ebola Child Equip unites to fight Ebola focused on preventive care support, messaging, enhanced community engagement & provision of essential equipment and materials and supplies Devcorps Inc. Monserrado $ 4, Strengthening PTA and school partnerships to make schools EVD free zones Initiative for female development (INFED) National Federation of women employees and allied workers (NAFWEA) Community Organization for Reconstruction and development ( CORD) Monserrado $ 2, Monserrado $ Monserrado $ 4, Back to school recreation targeted mobilization at the household level in the context of schools reopening to preserve stability of the gains made Initiative to Reduce complacency and fatigue among market women focused on preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and supplies Community action for sustained Zero Tolerance of EVD in Todee district community mobilization with preventive messages and behaviour change with an objective of preventing the disease from reoccurring 51

54 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA 2015 INTERIM REPORT Mission Critical Action 13 Community Based Organization County Project Value(USD) Project Title and brief description of activity United Youth Social Symposium for Education and Development (UYSSED) God s Anointed Children Club (GACC) Rural Effective Agriculture Program (REAP) Monserrado $ 4, Monserrado $ 2, Monserrado $ Sustaining and accelerating EVD prevention Interventions to achieve Zero New Case in Liberia focused primarily on preventive behaviour change messages Creating Rapid awareness on the spread of the deadly Ebola virus; focused on preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and supplies. Installation of hand pumps in Ebola affected communities and households within Paynesville area Women and Children Development Association of Liberia Monserrado $ 5, Reenforcing compliance to the Health Protocol to achieve zero infection rate in communities focused on teaching behaviour change National Empowerment program for Women and children (NEP) National Health and Prmomoters Association of Liberia NGOs (NAHPLAN) Monserrado $ 5, Montserrado County Sector 3 IMS Monserrado $ 4, Children Empowerment for Future, Inc Monserrado $ 3, Monserrado $ 4, Secure Liberia Monserrado $ 4, Shaul Foundation Monserrado $ 3, Taking action against Ebola Stigma and discrimination focused primarily on fighting stigma especially amongst survivors and familiies Post Ebola rapid assessment of community need to improve quality of life and reduce the transmission infectious diseases behaviour change education Kick Ebola beyond border focus was on preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and supplies. Strengthened capacity for positive guardians focused on a multifaceted preparedness, especially in the context of schools reopening to preserve stability of the gains made in the Ebola response Prevention of further Ebola virus diseasse outbreak in Liberia through the provision of water for handwashing, sensitization and awareness creation in schools Focused on stopping stigmatization against Ebola virus disease survivors and promote livelihood for female headed household survivors project Liberian International Foundation for Education (LIFE) Monserrado $ 4, Restoration of Dixville Public School provided support in the form of hand pumps, sanitary wares and and other preventive materials and supplies Youth for Education and Agriculture International Liberia (YEAILiberia) National Public Health NGO Network (NAPHNET) Afromedical Community Health and welfare services (ACHWS) Monserrado $ 4, Monserrado $ ners Social and Athletics Club Monserrado $ 2, Monserrado $ 4, Bethel National Youth Ministry Monserrado $ 2, Formation and maintenance of Water,sanitation and Hygiene (WASH) clubs in ten high schools Conducted IPC TOT training to 15 private schools in Caldwells with the objective of building knowledge and skills to fight ebola and other epidemics Sporting awareness against spread of Ebola capitalizing on the popularity of football, this project sought to use its platform to mobilize communities bringing people together particularly the youth to fight the virus and to help those living in affected communities. In particular, it used sports and entertainment community stars in spearheading positive message to fight stigma. Reducing stigma and improving hygiene in Freeman Reserved community this was done through provision of engagement and provision of preventive materials Focused on mobilizing and monitoring implementation of safe health and hygiene practices Urban Community Empowerment Monserrado $ 2, Hygiene promotion in schools and its environs via drama this was considered a platform to mobilize communities particularly the youth to fight the virus and to help those living in affected communities. Bilingual Community based organization Monserrado $ 5, Improving livelihoods and income generation for Ebola survivors 52

55 2015 INTERIM REPORT LIBERIA UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 Community Based Organization County Project Value(USD) Project Title and brief description of activity Health Department of Seventh day Adventist Church Young Adults Volunteers Association Soul Clinic Community Development Association (SCCDA) Yarcooper Elementary and Junior High School Monserrado $ 2, Student Reform Initiatives Monserrado $1, Monserrado $ 3, Monserrado $ 5, Monserrado $ 1, Health Department of Seventh day Adventist Church Psychosocial training on Ebola this focused on communities and households especially those known to have suffered most Wait Small more(ya) ; Liberian colloquial this was a palave hut type strategy bringing the youth together to discuss openly and find solutions towards fighting ebola and supporting community recovery Four rooms toilet facility for 2 schools in the community focused on WASH as one of the key areas of improvement in general hygiene Water for health in Block B and H of Soul Clinic preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and sup Yacooper Elementary and Junior High School safe drinking water project construction of water pump and hand washing points Actions for Humanity Monserrado $ 2, Edusport Liberia Monserrado $ 4, Manja Catering and Charity Monserrado $ 4, Taffi Dollar Child Welfare Centre Monserrado $ 5, Islamic Guidance Organization Monserrado $ 5, Strengthening the fight against new outbreak of Ebola through nightclubs and entertainment centres Increasing awareness to reintegrate EVD survivors in the communities and schools without discrimination through sporting events and psychosocial Preventing further Ebola virus outbreak through community water and awareness programmes Right to play: Construction of a recreational facility for orphans at Taffi Dollar Child Welfare Centre Back to school awareness on Ebola WASH using faith a platform, the focus was on encouraging a back to school message and how to ensure safety and security even in doing so Equipping Youth to Help One Another Monserrado $ 4, Strengthening Relationship between Ebola survivors and host community dwellers through psychosocial counseling and sports Women Protecting Female Inmates & welfare (WOPROFIW) Inc. Monserrado $ 5, Youth Crime Watch of Liberia Monserrado $ 4, Youth Looking After Community Affairs Monserrado $ 4, Campaign against Stigmatization of Ebola affected people through community Engagement working with community mobilizers, counselors and psychosocial providers. Nurturing Hygiene Practices to avoid probable illness among Children and Youth in 6 paynesville communities Raising awareness on Ebola for Upper Caldwell Nursery and Elementary School children strategy was preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and supplies Liberians for development and progress Monserrado $ 4, Ebola Prevention awareness to farmers this focused on farmers, and passed prevention messages at the farms without interrupting their work Agape Hill Youth Association Monserrado $ 2, Concerned Women Monserrado $ 4, Reaching out to the unreachable to stop Ebola focus on most affected communities and households with preventive care support, messaging, enhanced community engagement, provision of essential equipment and materials and supplies Construction of 4compartment modern pit latrine with wash panprimarily WASH with a focus on women and girls Common Heritage Foundation Liberia Monserrado $ 5, Community engagement with emphasis in compliance with prevention protocols, as well as fighting denial and stigmatization Women and Adolescent Girls empowerment program Monserrado $ 4, Promoting citizens participation to council, educate and prepare communities to prevent the spread of Ebola virus in Liberia 53

56 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA 2015 INTERIM REPORT Mission Critical Action 13 Community Based Organization County Project Value(USD) Project Title and brief description of activity Women Unite Monserrado $ 5, Women Unite to create awareness Psychosocial in Schools and communities within Mount Barclay area and Johnsonville United Youths for Development Inc. Monserrado $ 3, Reaching Zero infection level through drama in school preventive messages using IEC and targeting schools Swine Producers Association of Liberia Monserrado $ 2, Training swine producers to overcome losses sustained from EVD within the Mount BarclayLower Johnsonville area Sisters in Action Monserrado $ 5, Safe school environment in the Ebola outbreak in 18 schools located at the Peace Island community and its environs Community Youth Empowerment Initiative Monserrado $ 2, Spreading Ebola Messages through custom made copy book targeted young people who can read and write Friends of Success Monserrado $ 3, Psychosocial intervention mainly to fight stigmatization and denial Global Assistance for All People Monserrado $ 4, EVD awareness and prevention project a school environment approach Kriterion Monrovia Monserrado $ 3, Reform Youth network Monserrado $ 2, Sharpe Home Care Services Monserrado $ 4, Education on Ebola in schools and communities in Montserrado county emphasis on making the school environment safe and secure from epidemics with basic knowledge and education Social stigma reduction and Ebola WASH Project focus on young people through mini cash for work programme building latrines and washing areas Deaf people AntiEbola Education project special focus on people with disability Youth Health Initiative Monserrado $ 2, Promoting Community Health through grassroots participation Federation of Chocolate City Youth Monserrado $ 4, Wash your hands, save your health Zero Ebola cases Conscious youth for the transformation of Liberia (COYTOL) Women Empowerment for self Employment Monserrado $ 2, Monserrado $ 5, Livelihood support for Ebola survivors preventive care support, messaging, enhanced community engagement, provision of essential equipment, materials and supplies Mobilizing Women for Sustanable Ebola Prevention Practices specific focus on women and girls within the Rehab, Paynesville community Barkarjoe Youth Association Monserrado $ 1, Counselling the Orphans in the disabled community focus on people with disability Sisters Aid Liberia Monserrado $ 4, Ensuring safe school; building synergy to end Ebola in Liberia focus on behavious chanfe education and counseling along with provision of preventive materials and supplies Liberian Polio Association Monserrado $ 5, Ebola messaging with a focus on preventive care and support enhanced community engagement focusing on people with polio induced disability as well as provision of essential ebola preventive materials and supplies 54

57 2015 INTERIM REPORT LIBERIA Achievements and Results The expected results of Project #11, Ebola Response and Recovery Positioning Community Quick Impact Projects (CQIPs), initiative included: enhanced capacity of the communities to prepare and respond to Ebola and other diseases; and strengthened capacities of communitybased organizations (CBOs) to design, implement and report on project interventions through education, WASH, and Ebola related messaging and multifaceted response/preparedness. This initiative was part of the broader post Ebola recovery effort focused on enhanced community awareness, ensuring that Liberia stayed at zero transmission and that survivors, orphans and health workers were protected from discrimination and treated with respect. Among the 70 approved CQIPs CBOs, 46 focused on preventing resurgence in approximately 62 communities in Montserrado County, while 15 focused on Ebola education in schools. Around nine CBOs were involved with WASH activities, such as the construction of hand washing stations and water towels in designated community centers and school facilities. One of the CBOs also focused on Ebola survivors and their integration into communities, spreading messages to bolster their acceptance and eliminate all forms of stigmatization and discrimination. Initial implementation was slow, with activities commencing in October By the year end, 76% or 55 of the CBOs successfully completed their activities and submitted their reports. During the period under review, the Mother Patern College of Health Sciences (MPCHS) CQIPs applied to for a no cost extension of the project. The request resulted mostly from the CBOs that were delayed in submitting their reports, and 15 CBOs that had defaulted. The projects had numerous important outcomes and results. Due to the intervention of the CBOs with funding through the CQIPs Project #11, approximately 175 speech and hearing impaired children were educated on Ebola and equipped with preventive measures. UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 Nine CBOs were involved with WASH activities. In five of the target communities, the WASH activities included the construction of hand pumps, a water reservoir and stations. Four of the CBOs targeted schools and other community facilities where hand washing stations were also established. One of the CBOs managed an orphanage for Ebolaaffected children. Here, WASH and playground facilities were constructed to strengthen psychosocial support for these children, especially those from the most remote and poorest sections of the counties. Approximately 15 of the CBOs worked on sensitizing target communities to prevent the stigmatization of and discrimination against Ebola survivors in the Robert Field High Communities, one of the epicenters of the disease. The CBOs engaged community leaders who were able to ensure that Ebola survivors were accepted and integrated into normal community activities. The involvement of the community leaders was to help sustain information sharing and the protection of survivors. Of the four highly populated sectors of Montserrado, three were covered by project activities. In the area of knowledge and capacity building, CBOs also leveraged community leaders as well as youth groups that were given psychosocial training to assist in preparedness for any resurgence of Ebola. The trainings focused on the impacts of Ebola on survivors and on families as well as on prevention through hygiene and sanitation. The trainings were delivered across schools, religious groups and other community structures such as women s groups, youth groups and groups of people with disabilities. Most of the CBOs employed nationals who also served as social workers to work as facilitators as well as national trainers, certified through the MoH. The project was estimated to have reached 210,000 beneficiaries. 55

58 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT LIBERIA RECOVERY STRATEGY OBJECTIVE 01 RSO 01 Health and Nutrition and WASH $2 million Allocated COVERAGE: Gbarpolu, Grand Cape Mount, Lofa Counties MPTF Project No: Title: #33 Restoring Midwifery Services in Ebola mostaffected counties #46 Upgrading Water and Sanitation Systems in EbolaAffected Slum UNICEF* TRANSFER DATE: 20 Oct Dec 2015 AMOUNT: $1,000,000 $1,000,000 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES International obstetric teams trained and deployed National midwives trained and deployed UNFPA UNFPA * The project is recently funded Achievements and Results With the overarching goal of reducing maternal mortality in Liberia, the UNFPA implemented Project #33, Restoring Midwifery Services. It aimed to support government efforts to restore and strengthen essential reproductive maternal and neonatal health (RMNH) services, assuring that women and their families had access to quality lifesaving maternal health services, including family planning. It paid particular attention to adolescent girls, given the high number of adolescent pregnancies (32%) among girls between 14 and 19 years old in Liberia. Situated in three border counties, the project also sought to ensure linkages between community and health facility surveillance activities. It aimed to strengthen health and related services relevant to the collection of quality data, including on maternal deaths, which could be used to inform decisions on how to improve services. The project aimed to achieve, through health facility and community interventions, an increase in access to quality, equitable maternal and new born health services that would significantly contribute to maternal and new born survival. It also sought to increase access to reliable data on maternal deaths, which could inform actions to reduce mortality through community engagement and response systems. The project aimed to strengthen information dissemination in order to increase knowledge and potential utilization of sexual and reproductive health services among adolescents in districts and communities in Maryland County. In early January 2016, UNFPA conducted a rapid needs assessment of the facilities. It determined their status and gathered baseline data to support realistic target setting. It also informed the procurement of required equipment and medical supplies, as well as those staff skills in need of improvement with regard to maternal and newborn health services. As a result of the assessment, a procurement and recruitment plan was drafted for implementation. In addition, discussions were initiated to increase existing human resources in each facility in collaboration with the MoH. Eight national midwives were deployed to health facilities in Cape Mount and Lofa Counties. In collaboration with the MoH, contracts were being completed to ensure that new staff was paid through the existing MoH incentive/salary payment mechanism. This approach facilitated a smooth and sustainable transition of staff remuneration into the national system through the MoH. UNFPA was also in the process of distributing medical supplies and equipment to health facilities in seven counties, including Lofa and Gbarpolu, which benefited from the distribution exercise. As a result of the critical needs assessed, UNFPA prioritized three health facilities in Gbarpolu for the initial phase of supply distribution, namely: Chief Jallah Lone Hospital, and Gbarnway and Kungbor clinics. These facilities were to receive delivery beds and other essential supplies to ensure that the procurement of items using project funds was implemented during the first quarter of the year. Other health facilities in Lofa and Cape Mount were expected to receive medical supplies from February to March In late 2015, the MoH with support from UNFPA trained 12 skilled birth attendants in basic lifesaving skills. The attendants came from five health facilities from within Cape Mount and Gbarpolu Counties. Existing staff in project health facilities also received training in family planning service provision. 56

59 2015 INTERIM REPORT LIBERIA With regard to future outcomes, the selection of a suitable vendor to refurbish targeted facilities commenced, with renovation anticipated to be underway by February Also into 2016, international staff was being recruited to mentor local staff, and additional trainings and deployment of national health care providers in collaboration with the MoH was ongoing. UN EBOLA RESPONSE MULTIPARTNER TRUST FUND RECOVERY STRATEGY OBJECTIVE 01 urban slums where the vulnerable communities were severely affected during the Ebola outbreak due to poor hygiene and sanitation. During the implementation that will be completed by the beginning of 2017, youth will be trained and engaged in construction of WASH systems to develop skills for future employment. UNICEF, via Project #46, Upgrading Water and Sanitation Systems Incorporating SkillsBased Training and Employment for Youth in EbolaAffected Slum Communities, prioritized hygiene promotion with a special emphasis on hand washing with soap or chlorine solution as a key strategy for infection prevention at community and household levels. The focus of this project is to work on improving the living conditions in the UNFPA Maternal Health UNFPA 57

60 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT 58

61 MCA 1 Identify and Trace People with Ebola MCA 3 Care for Persons with Ebola and Infection Control MCA 4 Medical Care for Responders MCA 6 Access to Basic Services MCA 7 Cash Incentives for Workers MCA 8 Recovery and Economy MCA 9 Reliable Supplies of Materials and Equipment MCA 11 Social Mobilization and Community Engagement MCA 13 Preventing Outbreaks RSO 03 Basic Services and Infrastructure

62 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT at A Glance SIERRA LEONE GUINEA 52 million Contributed 39 million Expenditures 15 Proposals 7 UN Entities Makeni RESPONSE S01 S02 S03 S04 S05 Freetown Bo Kenema Stop 7 million TREAT 22.5 million ENSURE 6 million RECOVERY PRESERVE 3 million PREVENT 12.3 million 25 km ATLANTIC OCEAN LIBERIA RS01 Health, Nutrition and WASH n/a RS02 SocioEconomic Revitalization n/a RS03 Basic Services and Infrastructures 1 million RS04 Governance, Peacebuilding and Social Cohesion n/a Map Sources: ESRI, UNCS. The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Map created in Aug Funding as of 31 December 2015* Funding per Mission Critical Actions & Recovery Strategic Objectives 35% Guinea Liberia Total Allocation $149 m Sierra Leone Regional * Allocations are based on approved budget $52,063,681 MCA01 Identify and Tracing MCA02 Safe and dignified burials MCA03 Care for persons MCA04 Medical care for responders MCA05 Food security and nutrition MCA06 Basic Services MCA07 Cash Incentives MCA08 Recovery and Economy MCA09 Materials and Equipment MCA10 Transport and Fuels MCA11 Soc.Mob & Community MCA12 Messaging MCA13 Preparedness RSO1 Health, Nutrition and WASH RSO2 SocioEconomic Revitalisation RSO3 Basic Services and Infrastructure RSO4 Governance, Peacebuilding and Social Cohesion 0% 3.85% 0% 1.64% 2.42% 7.84% 3.89% 0.54% 0.91% 0% 0% 0% 2.01% 0% 13.71% 23.72% 39.46% 60

63 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 1 MCA 1 Identify and trace people with Ebola $7.14 million Allocated COVERAGE: All 14 districts of Sierra Leone MPTF Project No: Title: #16 Epidemiology District Management #17 Strengthening EVD Surveillance through IDSR TRANSFER DATE: 19Dec2014 6Feb Aug2015 AMOUNT: $5,065,084 $2,073,205 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Proportion of suspect cases investigated within 24 hours of notification 100% 100% WHO Epidemiologists deployed Vehicles delivered IDSR system is in place (>80% of Health units report weekly on epidemic situation in Sierra Leone) Districts involved into crossborder cooperation Communication events WHO WHO WHO WHO WHO Achievements and Results With persistently high numbers of new cases and cases occurring outside of contact lists throughout the first half of 2015, there was a clear need to expand and improve case investigation and contact tracing activities. Ebola Response MPTF funding enabled WHO to increase the deployment of personnel to the field and to focus on addressing the quality of contact tracing. Through Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics, Management and Community Mobilization and Engagement, epidemiologists, Infection Prevention and Control (IPC) experts, and social mobilization experts were deployed to work closely with the District Ebola Response Centre (DERC), harmonizing the efforts of the Government, WHO and other international and domestic partners, while building local capacity. Based on the challenges identified, some districts went beyond the Standard Operating Procedures (SOPs) for contact tracing and brought in thermometers to assist with active engagement and to complement selfreporting and observation assessment techniques. Improvements in the identification and monitoring of contacts led to a reduction in the number of deaths in quarantined homes and to rapid detection and treatment of new cases from contact lists. Since June 2015, most epidemiologists have doubled as Field Coordinators with oversight for burials, contact tracers and strategic direction. District teams started using an event manager model led by epidemiologists with responsibility for ensuring coordination with partners and across pillars in support of the District Health Management Team (DHMT) response to specific events. Towards the end of the project, as case numbers began to fall with improved contact tracing, rapid isolation and treatment, Ebolafree districts focused on developing more robust district surveillance systems. This helped enable rapid response to and containment of future flare ups. The project s achievements also laid the foundations for Integrated Disease Surveillance and Response (IDSR) for a broad range of health issues going forward. Project #17, Strengthening EVD Surveillance Community Engagement and Response for Getting to and Sustaining Zero Ebola Cases in Sierra Leone, commenced in August 2015, with the goals of revitalizing and building technical capacity for the IDSR system, including revision of the IDSR integrated supportive supervision checklist and book, and development of an eidsr; enhancing Community Based Surveillance (CBS) integration of the International Health Regulations (IHR) 2005; strengthening crossborder surveillance; and building awareness through weekly epidemiological bulletins. The project contributed to the establishment of the robust IDSR system in Sierra Leone. By the end of December 2015, most of the hospitals in Sierra Leone reported on the dynamics of monitored diseases. IDSR technical guidelines, training, documentation and reporting materials were developed and validated. 61

64 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE 2015 INTERIM REPORT Mission Critical Action 1 2,000 Technical guidelines printed and distributed Participants modules printed and distributed 200 Facilitators modules were printed and used in training 1,500 IDSR technical guidelines, training and other materials Case based reporting forms printed and distributed Weekly reporting forms printed and distributed Linelisting forms printed and distributed 1,350 Rumor log books printed and distributed Other specific outputs 144 national and district midlevel managers from all 13 districts trained as TOTs in IDSR 1,442 health workers from health facilities and partner agencies trained in IDSR during cascade training Clinician training materials developed; and 12 clinicians from Connought Hospital in Western area district were trained during the piloting process CBS Standard Operating Procedures, reporting tools and training materials validated and approved An initial CBS implementation framework developed CBS TOT training conducted for participants from six districts IDSR integrated support supervision checklist and book were reviewed and validated 3,000 Standard case definition posters printed and distributed IHR decisionmaking instruments printed and distributed IHR (2005) desk review completed. The IHR work plan under development A crossborder surveillance working group established under MoHS leadership, with WHO technical support Draft RRTs guidelines developed and will be validated. National and district RRT members nominated and will be trained. eidsr user requirements developed. Weekly epidemiologic bulletins were produced and circulated widely 62 WHO Training on Integrated Disease and Surveillance Response (IDSR) MPTF Office

65 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 3 MCA 3 Care for Persons with Ebola and Infection Control $17.8 million Allocated COVERAGE: All 14 districts of Sierra Leone MPTF Project No: Title: #16 IPC District Management #1 Storage Capacity #1 Transportation of Essential Items #1 Air Services #1 Communication Equipment TRANSFER DATE: 19Dec Dec Nov Nov Nov2014 AMOUNT: $1,302,584 $658,902 $11,052,470 $4,675,724 $167,547 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES IPC Expert Infection & Prevention Control deployed FLBs Forwarding Logistics Bases WHO WFP Jan ,344 m³ Feb ,937 m³ Mar ,836 m³ Apr ,396 m³ May ,132 m³ June ,673 m³ 28 Covering all three countries Jan ,950 passengers Feb ,094 passengers Mar ,271 passengers Apr ,718 passengers May ,743 passengers Jun ,887 passengers Transportation Essential Items 2,000 m 3 WFP Strategic Airlift 12 Covering all three countries WFP Air Services 1,300 Passengers/months (all three countries) WFP Achievements and Results From September 2014 through 31 December 2015, WFP rolled out a major systemwide common services platform for the first time in its history, using its significant inhouse logistics capacity to support the Ebola Response and to become an enabling partner for health responders across affected countries. The agency, through Project #1, Common Services for the Health Response to the Ebola Virus Disease Outbreak in West Africa, helped maintain a high level of multidisciplinary services. These included: passenger and light cargo air transport capacity through the WFPmanaged UN Humanitarian Air Service (UNHAS); the setup of emergency telecommunication services; the construction and provision of logistics and health facilities; the provision of access to air, sea and surface transport capacity; and storage capability to ensure the uninterrupted supply of relief items across the region and to the most remote locations in Sierra Leone. Through logistics coordination mechanisms, cargo transport, handling and storage services as a provider of last resort were facilitated as required. In Sierra Leone, from January to June 2015, the WFPled logistics coordination platform facilitated the transport of over 11,000 m 3 of cargo. In the country, WFP established one staging area, one main logistics hub, and four forward logistics bases (FLBs). With Ebola Response MPTF funds, WFP implemented activities beyond its planned indicators, including, the provision of connectivity to seven Ebola Treatment Units (ETUs) in Freetown, Makeni, Moyamba and Port Loko. The agency also provided construction support to refurbish and equip over 20 ETUs across the country through the provision of assets, temporary or prefabricated facilities, logistics and/or engineering support. A decontamination unit was also constructed in Freetown for emergency service vehicles. To fight continued transmission in the north of Sierra Leone (Kambia and Port Loko), the Government launched the Northern Push campaign, which WFP supported with the deployment of light vehicles. WFP also provided support to UNICEF in setting up tents in Kambia as emergency coordination offices. The WFPmanaged UNHAS ensured humanitarian access by transporting passengers and light cargo across Ghana, Guinea, Liberia, Senegal and Sierra Leone. As of 31 December 2015, UNHAS performed 5,473 takeoffs, transporting 31,777 passengers and 202 MT of light cargo. Throughout the Special Operation, 28 strategic airlifts were performed, nine of which took place in January and February 2015 and transported 770 MT of behalf of 37 organizations. Through the Emergency Telecommunications (ET) Cluster, WFP provided internet services to 80 humanitarian facilities across the three affected countries, allowing more than 3,300 63

66 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE humanitarian responders to use a reliable internet connection, enabling communication in and out of red zones. During the last months of 2015, the provision of common services to the humanitarian community and national governments was adapted to the evolution of the outbreak and partners needs. Against the backdrop of reaching and sustaining zero Ebola cases, WFP adjusted the provision of services to enable rapid response mechanisms to control new outbreaks and/or pockets of reemergence. While the regional Special Operation ended at the end of 2015, WFP continued to leverage the recently established infrastructure and logistics capacity through countryspecific operations tailored to national contexts. It provided a rapid response mechanism for potential smallscale outbreaks, working to boost partners readiness and the recovery efforts. WFP also prepared the ground for an orderly and effective transition of Ebola Response assets and capacities to the Government of Sierra Leone, with a view towards improving the ability of the national Government and humanitarian partners to respond to future emergencies. To augment national capabilities to prepare for and respond to future emergencies, WFP started to carry out a series of trainings to build the capacity of ONS, supporting government ministries and development partner staff. The first of a series of trainings took place between 18 and 21 April 2016 in WFP s training facility at the Main Logistics Base (MLB) in Port Loko. The training, which was facilitated by WFP staff, combined classroom lessons, handson exercises and practical simulations on supply chain, logistics planning and assessment, sea and port operations, engineering services, emergency ICT and telecommunications provision and humanitarian air services. Through Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics, Management and Community Mobilization and Engagement, WHO aimed to improve epidemic surveillance and IPC. An IPC expert was 2015 INTERIM REPORT Mission Critical Action 3 deployed in each of the 14 districts in addition to the team at the country office, and an IPC advisor to the newly established Ministry of Health and Sanitation (MoHS) National IPC Unit (NIPCU). This international team of experts provided technical support and mentoring to national staff and to NIPCU. Through monitoring work, 28 Ebola Care Centers (ECCs) improved their quality; and 12,215 Health Care Workers (HCWs) were trained on IPC for Ebola. In collaboration with the MoHS, WHO developed an assessment tool to strengthen the screening and triage process, which was then implemented by the IPC experts and national IPC counterparts in the districts to identify gaps and challenges. To date, 476 facilities, PHUs and hospitals have been assessed, 62 more than once, with a total of 558 assessments for screening and triage completed. WHO also played an important role in developing the standards for decommissioning Ebola Treatment Centers (ETCs). As the outbreak subsided, the focus shifted to sustaining a resilient zero and initiating early recovery. WHO supported the MoHS in the development, review and roll out of national IPC policy and guidelines, setting standards against which all health care providers needed to act. The team facilitated two workshops with the MoHS and partners to validate the guidelines and their roll out. The printing of 300 copies of the national IPC policy and 5,000 copies of the national IPC guidelines in HCFs was scheduled to begin, with copies to be distributed across the country. To consolidate this work, WHO IPC experts conducted a twoday training of IPC technical trainers from nongovernmental organizations (NGOs) and District Health Management Teams on the new national guidelines. This training of trainers (TOT) was cascaded through the districts. Two senior managers trainings undertaken included District Medical Officers, DHS and MoHS program directors, covering their roles and responsibilities to support implementation of the IPC practices and to strengthen patient safety. 64 WFP UNHAS services MPTF Office

67 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 4 MCA 4 Medical Care for responders $2 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #1 Responder Clinic Built #40 UN Medical Clinic Capacity TRANSFER DATE: 23Dec Aug2014 AMOUNT: $1,392,970 $609,900 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Rehabilitation of Responders Clinic (Level 1) UN Clinic is open for emergencies on 24/7 basis (168 hours per week planned) % 100% WFP Achievements and Results At the height of the Ebola outbreak, WFP, through Project #1, Common Services for the Health Response to the Ebola Virus Disease Outbreak in West Africa, rehabilitated the UN clinic in Freetown to treat and care for Ebola Response healthcare workers. At the request of WHO, WFP also rehabilitated a hospital in Kambia to be used as a holding center with a capacity of 40 beds. Specific health safety and sanitation measures were put in place to limit the risk of Ebola transmission to healthcare workers. The agency was also the only humanitarian actor equipped to provide helicopter Medical evacuations in the country, from remote areas to Freetown, through UNHAS. Trainings to staff were conducted accordingly. With support from the Ebola Response MPTF, Project #40, Maintaining Essential Service Capability UN Medical Clinics in Sierra Leone, ensured medical capacity and a level of preparedness for UN System personnel. 65

68 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE 2015 INTERIM REPORT Mission Critical Action 6 MCA 6 Access to Basic Services $0.86 million Allocated COVERAGE: Bombali, Kambia districts MPTF Project No: Health care facilities supported Title: # 48 Social Mobilization and Provision of WASH Services for Achieving and Sustaining a Resilient Zero TRANSFER DATE: 06 Nov2015 AMOUNT: $856,000 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES 7 Recently funded UNICEF Schools with WASH facilities Chiefdoms with established and functional Rapid Response Teams 10 Recently funded 75 Recently funded UNICEF UNICEF Achievements and Results On 7 November 2015, WHO declared the end of the Ebola outbreak in Sierra Leone. Although a positive development, rigorous and continued vigilance and at the community level remained key to maintaining zero cases and ensuring that subsequent flareups were quickly contained. Project #48, Social Mobilization and Provision of WASH Services For Achieving and Sustaining a Resilient Zero, implemented by UNICEF, aimed to build rapid response capacities at the chiefdom/ward level through capacity building of the Village Development Committees (VDC). It also aimed to establish WASH infrastructure in service institutions such as schools, healthcare centers and ECCs. With regard to WASH, the following activities were undertaken: Engagement with implementing partners (IPs) working in Kambia and Bombali districts, who carried out assessments and identified health and school facilities with WASH facilities in need of improvements to be IPC compliant, as set out in the new standards and guidelines for WASH in PHUs. Prioritization of seven health facilities and 10 public schools with the most critical needs to start the implementation of WASH activities at the schools and PHUs by the end of January UNICEF commenced preparatory activities for project implementation in November 2015, with the community engagement strategy serving as top priority. At the national level, the agency collaborated with authorities to advocate for the operationalization of the community engagement strategy. 66

69 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 7 MCA 7 Cash Incentives for Workers $1.26 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: # 9 Payment for Ebola Workers TRANSFER DATE: 04Dec2014 AMOUNT: $1,261,625 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Number of payments made to ERWs (Ebola Response Workers) through Government systems with support N/A 1 149,245 2 ERWs (Ebola Response Workers) registered on the Information management system 100% 100% (36,000 ERWs) 1 15,000 ERWs was used as a planned figure during the height of the EVD epidemic. Starting from April 2015 due to the decreasing number of cases, the total number of ERWs responsible for EVD response in Sierra Leone was estimated up to 10, Paid in 16 cycles. Achievements and Results Project #9, Payment Programme for Ebola Response Workers (PPERW) Sierra Leone, ensured that 100% of Ebola Response Workers (ERWs), the cornerstone of the Response that brought transmission to zero, received timely compensation for their work, including danger pay. During the initial stage of the outbreak, the lack of incentives for ERWs risking their lives was a critical bottleneck in the Response. To address this challenge, this project built a system for establishing and verifying a list of eligible beneficiaries, coordinated the chain of organizations responsible for payments, assured payments and provided for grievance resolution. From November 2014 to December 2015,, through the National Ebola Response Centre (NERC) facilitated 16 cycles (14 monthly) payments to ERWs through the electronic delivery system(mobile money operators) and Banks via the automated clearing house. The project also created an innovative information management system and an online case management database inclusive of 36,000 ERWs. Between February and March 2015, the project team conducted nationwide biometric verification exercises to remove ghost workers. It set up a grievance mechanism using trained graduate interns (two per district) deployed in each of the 14 districts who could resolve compensation issues on the spot. The project also set up a technical coordination group (Cash Transfer Steering Committee/ Board) comprised of the Government, NERC, World Bank, DFID, AfdB, WHO and other UN agencies. The Board revised and oversaw the hazard pay/ risk allowance policy and its successful implementation, and reduced ERW complaints. The policy was reviewed four times over the last 12 months in order to adjust it to the changing epidemiological situation. The project assured that payment services were harmonized across agencies in accordance with the National Policy. To raise awareness of key messages in the National Policy, it produced 40,000 leaflets and 18,000 posters, which were complimented by radio spots and town hall meetings with district coordinators and ERWs. The transition from direct cash payments to the more efficient and effective electronic delivery payment system through mobile wallet, which hitherto was considered a luxury, became an important achievement of the project. It provided for a better, reliable and transparent method of funds transfer. In the final stage of the project, ERWs were able to open bank accounts and their allowances were credited via the automated clearing house. This was the first time such technology was used in the country. In addition, the project supported the registration of almost 15,000 ERWs for National Identity Cards, which were a prerequisite for opening a bank account. The National Ebola Response Centre (NERC) mandate ended on 31st December 2015, and its functions were handed over to the Emergency Operations Centre supervised by the Offices of the National Security and the MoHS. After the declared end of the outbreak, the payment policy was revised from the EVD Zero Resilient Allowance Policy to the EVD Heightened Surveillance Policy, which spanned from 1 January through 5 February

70 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE 2015 INTERIM REPORT Mission Critical Action 7 CASE STUDY A report titled, Saving Money, Saving Lives: A Case Study on the Benefits of Digitizing Payments to Ebola Response Workers in Sierra Leone, published by the Better Than Cash Alliance (BTCA), summarizes the important impacts of the Ebola Response MPTF funded Payments Programme for Ebola Response Workers (PPERW) project. The BTCA, hosted by UNCDF, supported s work with authorities to implement the PPERW in Guinea, Liberia and Sierra Leone. The PPERW coordinated payments for thousands of Ebola treatment center staff, lab technicians, contact tracers and burial teams at the height of the outbreak. In Sierra Leone, the PPERW project brought together public and private sector partners to introduce and implement digital payments to Ebola Response Workers. According to the case study, the PPERW digitized payments, including hazard payments, to over 15,000 Ebola Response Workers (ERWs) in Sierra Leone over the course of just two weeks during the height of the crisis in December 2015, eventually expanding to 26,600 by the end of March The project, according to the analysis, substantially improved the security, transparency, and efficiency of paying ERWs in Sierra Leone. It estimates that the transition from cash to digital payments reduced ERW strikes from an average of eight per month to zero. With an average of 100 ERWs involved in each strike, the case study concludes that the PPERW project prevented the loss of around 800 working days from Sierra Leone s Ebola response workforce. By assuring the continuity of care and service provision when it was most needed and most dangerous, the case study estimates that digitized payments helped save 2,095 lives in Sierra Leone. It also concludes that digital payments delivered a total cost saving of $10.7 million over 13 months from December 2014 to January 2016 savings that came from greater efficiency in making payments and the prevention of doublepayments and payments to fraudulently registered recipients. ERWs also benefited as they did not have to travel long distances to designated cash payment centers to be compensated. Overall, the case study concludes, based on its analysis of PPERW s impacts in Sierra Leone, that the capacity of digital payments to improve response outcomes is highly compelling, and it emphasizes the importance of having a digital payments infrastructure in place prior to a crisis. The report also features challenges and lessons learned from PPERW implementation that can support the development of digital payments infrastructure in other countries, in preparation for future public health emergencies. Saving Money, Saving Lives A Case Study published by the Better Than Cash Alliance (BTCA), summarizes the important impacts of the Ebola Response MPTF funded Payments Programme for Ebola Response Workers (PPERW) project. In Sierra Leone, digital payments implemented through Project #9, Payment Programme for Ebola Response Workers (PPERW) reduced payment times, improved accuracy, generated cost savings, prevented strikes and saved lives during the crisis. ERW strikes reduced from eight per month to zero. The loss of 800 working days prevented. 2,095 lives saved. Cost savings of $10.7 million between December 2014 and January 2016 delivered. 68

71 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 8 MPTF Project No: MCA 8 Recovery and Economy $4.1 million Allocated Title: # 15 Social Rehabilitation and Payments to EVD Survivors and Destitute Families #38 Reintegration of Sierra Leone Red Cross Society (SLRCS) Volunteer Burial Teams COVERAGE: #15: Western Area Urban (Freetown), Port Loko, Bombali, Moyamba, Kailahun and Kenema); #38 All districts of Sierra Leone TRANSFER DATE: 12 Mar Jun 2015 AMOUNT: $2,108,011 $1,975,640 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Survivors and destitute families received solidarity package / UN WOMEN Social safety net arrangements 2,500 List of Survivors and destitute families established / UN WOMEN Skills development and livelihoods support 2,500 Ongoing 1 / UN WOMEN Social reintegration for survivors with psychosocial, hygiene and sanitation measures / Pink Cross 2 Psychosocial support provided for the former members of Burial Teams 800 The psychosocial assessment conducted Reskilling and livelihood restoration for the SLRCS volunteers (former Burial Teams member) 800 Preparatory activities and market assessment on the way /SLRCS Promote financial inclusion and engagement with the financial sector for the SLRCS volunteers 800 Preparatory activities carried out / SLRCS 1 Comprehensive list of Survivors and Destitute families established, coordination and payments mechanism defined and implementing partners identified and market assessment to define viable livelihood options underway. 2 Pink Cross project on Social rehabilitation of EVD Survivors through psychosocial, hygiene and sanitation support for EVD Achievements and Results Project #15, Social Rehabilitation and Payments to EVD Survivors and Destitute Families, focused on supporting the livelihoods of Ebola survivors and destitute women and families through a combination of entrepreneurship training, increased access to extension services, organization of group savings and loans associations and handson training in viable agricultural and small business activities. It gave beneficiaries technical skills, motivation and material support to aid in their rehabilitation and reintegration into the economic landscape. Local communities and beneficiaries have hence commenced a process of building and strengthening good relations that assure collaboration and common economic and social support. With various stakeholders, including civil society organizations that served women, the Ministry of Gender and Children s Affairs Ministry held a consultative meeting to discuss and agree on the criteria for determining destitution and for inclusion into the assistance program. In six chiefdoms in the Kenema district, local authorities committed resources, such as land, for use by the project and its beneficiaries and were working to support local ownership of the project. Ebola survivors in the Western Area have been identified and the project commenced in the Bombali district, however, full livelihood and social rehabilitation activities were not scheduled to start until a complete and verified list of survivors was finalized. In addition, a standard template was shared with the Help Desk Staff in the five target districts to cross check between the Social Welfare Gender and Children s Affairs Ministry s list of survivors and that of other organizations implementing health related projects for survivors. and the Ministry of Education Science and Technology were working to access the national database of educational institutions to determine which skills trainings could be offered to survivors. Appreciable progress was also made in implementing entrepreneurship and other life skills training modules, with one of the districts completing the training using an adapted module. Entrepreneurship training for twentyseven volunteers (10 women from CSOs and 17 female survivors) was also completed. In addition, the Pink Cross, a local nongovernmental organization, launched a workshop on psychosocial counselling, trauma healing, hygiene and sanitation 69

72 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE for 148 Ebola survivors in five communities in Freetown. The organization also mapped and registered 131 Ebola survivors and destitute families. With the declaration of the end of the Ebola outbreak in Sierra Leone on 7 November 2015, the Red Cross and other agencies, including the MoHS, drastically reduced the number of Safe and Dignified Burial (SDB) teams from 143 to 28. Project #38, Reintegration of Sierra Leone Red Cross Society (SLRCS) Volunteer Burial Teams, aimed to support the reintegration of these teams into society. With regard to a livelihood and reskilling assessment, a survey was completed for 800 SLRCS volunteers. The data obtained indicated that the majority of volunteers were interested in starting a business or returning to their tertiary studies. The employment skills and vocational training streams were the two least popular streams. In order to gain additional information, oneonone career counselling sessions were held and communication materials were developed to sensitize and manage the volunteers expectations and to provide information on each reskilling stream. As a result, the roles and responsibilities of the volunteers in each stream were clarified and counseling was provided to aid in their decision making. In the area of psychosocial support (PSS), a psychosocial assessment training was conducted for PSS Officers and SDB team leaders, to help prepare for the entry of 800 beneficiaries into the programme. The trainings focused on data collection and assessment of the level of stress and/ or trauma experienced by the volunteers as well as their respective coping mechanisms INTERIM REPORT Mission Critical Action 8 Following the training, teams composed of one PSS Officer and SDB team leader, conducted oneonone assessments of all 800 volunteers nationally. The assessment included overall questions on mental health, challenges and/or traumas faced and their respective coping mechanisms. The assessment itself was seen as a form of intervention to offer support and comfort to each volunteer individually while giving them an arena to voice their concerns and struggles. The results of these assessments were analyzed to provide a better understanding of the psychological state of the 800 volunteers, and to inform the design and provision of individual and community based psychosocial interventions to aid in the reintegration of the volunteers. During the PSS assessments, the teams took the opportunity to begin discussing the upcoming reskilling and reintegration component of the project. The assessment teams completed assessments in all of the 14 districts and were in the process of analyzing the results to identify the key PSS issues facing the volunteers and how to address them. In the first quarter of 2016, the project focused on discussing emergent issues and rectifying any gaps identified in the assessment; and on ensuring that PSS Officers made appropriate referrals and were doing the necessary followup for volunteers identified as requiring additional PSS support. Though the burial teams were predominantly male, gender mainstreaming was to be incorporated through the Community Based Psychosocial Support (CBPSS) component of the project, and was to be offered to the families and community members of the burial team members. The gender component was meant to reduce stigma and discrimination as well as to promote gender equity. 70 Distribution of hygiene materials to Ebola survivors in Freetown MPTF Office

73 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 9 MCA 9 Reliable Supply of Materials and Equipment $2.0 million Allocated COVERAGE: All districts of Sierra Leone MPTF Project No: Title: #16 District Logistical Capacity TRANSFER DATE: 21 Jan 2015 AMOUNT: $2,026,848 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Deployment of logisticians WHO Achievements and Results With the support of Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics, Management and Community Mobilization and Engagement, a WHO logistics and procurement team grew its capacity to adequately support all 14 districts in Sierra Leone. Each district was equipped with a logistician, through which WHO continued to support the daily needs and requirements of teams across the country, ensuring the transportation of personnel and the availability of goods and equipment. The logistics team supported WHO awareness raising and training events in Freetown and in the districts, including personal protective equipment (PPE) trainings, IPC workshops and Campaigns for World Hand Washing Day. Additionally, the project helped enable the establishment of a National IPC Unit at the MoHS through a preliminary needs assessment and the provision of office equipment. As a pilot programme, WHO and WFP worked together in four districts to build WHO logistics capacity as part of a global collaborative venture. The project continued through 31 December 2015, and the process of handover from WFP to WHO commenced. This project equipped WHO to provide rapid quality logistics support going forward. In May 2015, the logistics and procurement team undertook a pilot study on the procurement, consumption and monitoring of hand sanitizer automatic dispensaries in the main hospitals of five districts. Based on the results, WHO logistics and IPC teams were to support MoHS with the roll out of automated dispensers across the country, including the monitoring and distribution of the sanitizer solution. On procurement, at the beginning of August 2015, WHO centralized the procurement of goods at the countryoffice level to assure accountability. With reduced demand for emergency acquisitions, the procurement of services was to be handed back to unit teams. In comparison, procurement of goods for all districts remained centralized. WHO also managed the procurement process for MoHS lab units, and managed the procurement of swabs and reagents throughout the year to assure that the labs could support critical response efforts and heightened surveillance work. The agency was to continue to work closely with the MoHS, UNICEF and the National Public Procurement Unit as a key partner in PPE procurement. Overall, the agency s focus on monitoring goods received, facilitating custom clearance and ensuring supplies were received by the Central Medical Store for storage and distribution helped create better accountability records for the MoHS and ensured availability of PPE supplies in the country. Leading up to the end of the Ebola outbreak in Sierra Leone, pronounced 7 November 2015, preparations for the transition of national Ebola Response institutions (National Ebola Response Centre and District Ebola Response Centres) commenced. They were completed by the end December The project completed its operations in September 2015, which coincided with the period when the last patient was discharged from an Ebola Treatment Centre (ETC). WHO was to continue to provide logistical support from other financial resources. 71

74 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE 2015 INTERIM REPORT Mission Critical Action 11 MPTF Project No: MCA 11 Social Mobilization and Community Engagement Social Mobilization Experts $0.47 million Allocated Title: #16 Social Mobilization and Community Engagement COVERAGE: Country, including district areas TRANSFER DATE: 6 Feb 2015 AMOUNT: $473,469 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES 3 3 WHO Achievements and Results Project #16, Strengthen District Level Case Finding, Case Management, Reporting, Logistics, Management and Community Mobilization and Engagement, supported the deployment of social mobilization experts to meet needs at the district level and to ensure community engagement in the Ebola Response. This was extremely important to the success of the Response, which was hindered by harmful practices and behaviors that compounded a continually high case rate. Social mobilization and community engagement activities were adapted to target behavior change and emphasize interpersonal communication through face to face dialogue. It was realized that the messenger was as important as the message. In this context, WHO deployed at least two social mobilization experts for each Sierra Leonean district and recruited, trained and deployed 32 national officers across all 14 districts to assure the sustainability of social mobilization efforts. WHO community engagement staff, in collaboration with UNICEF, DHMTs and other partners, also focused on recruiting community leaders (paramount chiefs, traditional healers, religious leaders, town chiefs and councilors) who shared the same sociocultural beliefs and values as the communities and were deemed credible and trustworthy by community members. This approached enabled tens of thousands of Sierra Leoneans to be reached with important messages on, inter alia, Ebola prevention, safe burial practices and reporting on deaths. Community engagement activities were held at least twice in all 149 chiefdoms with intensified efforts during operational surges, including 52 activities as part of the Tonkolili surge. Community engagement and social mobilization officers also worked in partnership with the other pillars of the Response and were an essential element of successful case investigation, contact tracing and quarantine activities. Throughout the year, they supported epidemiologists, worked to dispel fear around quarantine homes and engaged survivors. 72 Meeting with community leaders in Moa Wharf raising awareness on EVD WHO Sierra Leone

75 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 MPTF Project No: MCA 13 Multifaceted approach to Prevent the Spread of EVD $9.52 million Allocated Title: # 17 RRSTs (Rapid Response Teams) ESTABLISHMENT #18 SLE NERC SECRETARIAT #5 SUPPORT TO DETENTION CENTERS COVERAGE: All districts of Sierra Leone TRANSFER DATE: 04Dec Jan Dec Dec2014 AMOUNT: $$7,145,038 $1,178,084 $1,201,725 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES RRST deployment after Surveillance Trigger 6 11 UNMEER / UNOPS Small, Medium and Full Surge Interventions UNMEER / UNOPS Vehicles 23 Pickups, 9 Ambulances, 9 Hearses 100% UNOPS Equipment 60 tents, mattresses, pillows, beds, etc. provided and installed in two camps 100% UNOPS NERC Staff 32 salaries for NERC staff paid 100% UNMEER NERC ICT Infrastructure 59 laptops,32 Mobile phones, District reporting to NERC 100% UNMEER Ebola Holding Units for prisons Detention centres staff trained on EVD Cases handled by legal aid lawyers for prison decongestion Achievements and Results Focusing on enhancing national response capacities, Project #17, Establishing Rapid Response and Stabilization Teams (RRSTs) in the National Ebola Response Centre Secretariat (NERC), enabled UNMEER and UNOPS to deliver fast, flexible financial support to the Ebola Response. Funds helped close human resource gaps in the NERC and supported districtlevel operational surges to fight transmission. Using the fund to build more national human and institutional capacity proved successful, as the NERC s coordination, data management, and overall response capabilities improved dramatically over The surge operations in the districts were equally successful, educating and providing tools and material support to local leaders and communities, and enhancing surveillance and preparedness in rural areas that remained at risk. Deep engagement and education towards the end of 2015 enabled increased community vigilance. The Rapid Response Stabilization (RRST) project, headed by UNOPS and UNMEER, supported the NERC and contributed to at least fourteen surge operations and several trainings. The project duration was extended to enable the RRST surge capability for another five months and also to enable surveillance, isolation and treatment. Over the first six months, project deployedrrsts saw results. Assessments led to surges in target locations that prevented Ebola transmission. Over six months, with the assistance of UNMEER, the project deployed RRSTs in Kono, Western Area, Kambia, Moyamba, and Port Loko, which led to seven full surges and two medium surges. Main support went to the DERC, NERC personnel to enable activities such as case investigation and contact tracing; active case searching; implementation of communitybased surveillance events; border health screenings; and local healer support and alert programs. Complementary support was also offered through the provision of team leaders, working tools, vehicles and tents for team members. Fortyone vehicles (23 pickups, nine ambulances, and nine hearses) were procured by UNOPS to enable rapid response and to fill critical gaps in subdistricts/ Chiefdoms. The vehicles were also used for surveillance 73

76 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE activities, especially contact tracing. With the support provided, assessments of hot spots were conducted efficiently and IPC activities were identified for surges. The second half of the year saw seven RRST funded surges: one in Kambia; two in the Western Area; two in Tonkolili, Bombali, Koinadugu; and an enhanced safe and dignified burial operation. Additional workshops and trainings were conducted for all District Coordinators, District Medical Officers and other stakeholders to support the Ebola in silent time transition, to effectively prepare all silent district plans and reduce the risk of complacency in the fight against the virus. In addition, UNMEER Sierra Leone aligned its plans with the Government s national framework to work diligently in assisting the NERC s response to new events as they emerged, and to prevent larger outbreaks. To this end, UNMEER developed a new approach based on existing approved funds. UNMEER Sierra Leone called this project the Rapid Response Surge Fund (RRSF). RRSF projects supported NERC in assisting districts responses to disease spikes and emergency events. A first $500,000 drawdown was paid to the NERC account to enable faster distribution to the districts when required for a rapid response. Preallocating funds to the NERC ensured money was immediately available when a rapid response proposal was approved. At that point in the Response, time was of the essence, and getting financial support to districts more quickly to contain an outbreak before it spread was an essential component of the Getting to Zero strategy. The NERC Secretariat was supported by UNMEER and UNOPS to coordinate and enable decision makingprocesses to successfully stop Ebola outbreaks, including through the coordination of joint crossborder activities with Guinea. Initially, the Emergency Operations Centre (predecessor of the NERC) at the national level in Sierra Leone, faced human, technical and financial capacity challenges in responding swiftly and efficiently to the Ebola crisis. With phase two of the Response, Project #18, Strengthening the National Ebola Response Centre (NERC) Secretariat, enabled the NERC to hire over 30 core personnel to urgently man the NERC Secretariat and Plans Directorate and to provide support for: NERC implementation: support for the identification of needs and gaps and consequent review and adaptation of plans in collaboration with pillar working groups; Monitoring of NERC implementation: continuation of establishment and monitoring of key performance indicators; 2015 INTERIM REPORT Mission Critical Action 13 Strengthened informationsharing: setup of laboratory and bed management coordination cells linked to the Situation Room; Strengthening of data gathering and analysis; Enhanced information management: setting up guidelines and procedures for information flow from the Situation Room to the Field Operations Directorate and to the pillars. UNMEER worked with the NERC Secretariat to coordinate and enable decision makingprocesses to successfully halt outbreaks of Ebola in most of the 10 out of 12 affected districts. The goal was to ensure coherence between the seven pillars that formed the basis of the NERC s response plan. Currently, and due in part to the project, all the pillars are functional and an integral part of the NERC. The project also increased information availability and flow from the DERCs to the NERC. All documentation and pillar decisions were made available and posted on the NERC Website. Performance indicators were collected, and all national key performance indicators (KPIs) were reported on a daily basis. Information Management Officers (IMOs) were deployed to all 12 DERCs in the country. With regard to strengthened information sharing, all districts were electronically reporting to the NERC. All data collected at the district level and used at the NERC were secured by DERC personnel who were trained by UNMEER/NERC IMOs. The data were collected through web and mobile technology, which brought consistency, removed human transcribing errors, and added automatic validation. As a result, it allowed aggregation of the data into a database. This mechanism became operational in January and was propagated to all the districts. The project was also crucial in providing pivotal operational hardware and ICT support to the NERC Situation Room and Plans Secretariat. With a view to the next phase of operations, UNMEER Sierra Leone partnered with Catholic Relief Services (CRS) to increase the timeliness of support to District Centers and to ensure administrative structure and oversight. To this end, CRS was allocated $671,013 from the project budget to fulfil the request made by the District Officials to fasttrack any request that would directly support the DERCs. With the support of this project, the operational support was thoroughly managed, while providing an accelerated provision of funding to the DERCs in a nonduplicative manner. 74

77 2015 INTERIM REPORT SIERRA LEONE With UNMEER s operational closure date of 31 July 2015, UNOPS Sierra Leone acted as a financial service provider and support system in the role previously provided by UNMEER. Funds were available for UNOPS to support the NERC in three key aspects after UNMEER s departure: salaries for the NERC; operational support; and financial support for surges. Project #5, Support to Detention Centers, played an essential role in preventing the spread of Ebola in prisons, which housed an unprotected and neglected group. Given conditions characterized by extreme overcrowding and a lack of sanitation and medical facilities, prisons were a potential hotspot for Ebola contagion and inmates were vulnerable to an Ebola outbreak. The project worked closely with Sierra Leone Correctional Services (SLCS) to ensure that new inmates were separated UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 and screened before they were introduced to main prison populations. Three Ebola isolation units were built and one fully refurbished in four of the country s most overcrowded facilities, and 201 prison staff was equipped with the skills and knowledge needed to help prevent or identify an outbreak. Each of 17 prisons was provided with necessary hygiene and other materials to prevent an Ebola outbreak in their facilities, including simple WASH facilities. The SLCS is now better equipped to respond to any future disease outbreaks, and as a result of the project, has trained staff and basic IPC equipment. Through the project, emerged with a deeper understanding of the issues facing the SLCS and has entered into a longer term, postebola partnership with the SLCS to support the transformation of prisons from punitive to rehabilitative facilities and to drive up standards of detention. 75

78 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE 2015 INTERIM REPORT Mission Critical Action 13 MCA 13 Preventing Spread $1.5 million Allocated COVERAGE: Country, including district areas MPTF Project No: Title: #11 Quick Impact Project TRANSFER DATE: 03Dec Apr2015 AMOUNT: $1,500,000. LIST OF QIP PROJECTs IMPLEMENTED IN SIERRA LEONE SINCE THE PROJECT WAS TAKEN OVER BY IN JULY 2015; THE FIRST PHASE OF THE QIPs IMPLEMENTED BY UNMEER WAS REPORTED IN THE 2ND INTERIM REPORT Implementing organization District Project title Budget Community Action for Human Security (CAHSEC) Sustaining the fight against the EVD Bombali $42,662 and crossing the last line Project title Monitor the Human Rights situation of Discharged quarantined People, provide psychosocial counselling and monitor Health screening at security checkpoints. United for the Protection of Human Right (UPHR) Port District Children s Advocacy Radio Intensifying the Death and Sick alert Port Loko in the fight against the EVD AND $41,565 REACHING THE LAST LINE Port Loko Media Campaign on scaling down to Zero case Ebola Infection $24,120 Strenghtens the Death and Sick Alerts from EVD high risk communities, provide support and basic livelihood assistance to EVD Survivors, monitor Health screening at Security Checkpoints and Human rights situation of EVD Survivors Sensitization of Community Bye Laws, Pyschosocial support activities, Strategic Pillar engagement in Information sharing, Key messaging and strenthening of referrals pathways. ABCDevelopment Kambia Sella Kafta Emergency road Repairs $47,624 Lion Heart Foundation Tonkolili Improving access, Layout and mobility of the EVD of the Holding Centre $28,792 Enhance free access of human and vehicle movements in and out of EVD affected communities whithin the chiefdom. Contract a local contractor to construct concrete walk paths and contract covered walk ways within the hospital. Archdiocese of Freetown/Caritas (ADDO) Western Area Rural Districts Sustaining the fight against the EVD and crossing the last line $43,314 Monitor the Human Rights situation of Discharged quarantined People, provide psychosocial counselling and monitor Health screening at security checkpoints. Community Sensitization to increase The Needy Today (TNT) Kambia $43,435 attendance at Health Centres (PHUs) Reidentification of target communities volunteers, Enhance effective community engagement., Focus group discussion and house to house engagement, Humanist Watch Sierra Leone (HUWASAL) Kenema/ Kailahun Reenforcing safety practices to maintain a resilient zero EVD case in remote communities. $44,889 Capacity Training for community volunteers, community stakeholders, Orientation meetings for youths, community outreach sessions for secret societal heads, Radio discussion programs for community residents. Mama Cara Pikin Program (MACAPP) Western Area Rural Districts Strengthen community engagement to end Ebola $44,983 Community engagement with stakeholders, Conduct training on community outreach/soc. Mob for the prevention and eradication of EVD, Radio Discussions, House to house sensitization. 76

79 2015 INTERIM REPORT SIERRA LEONE UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 Implementing organization District Project title Budget Movement opposed to Violence &Exclusions (MOVESL) Foundation for Dev. Democracy & Human Right (FoDDHR) Chiefdom level dialogue forum on Bombali Ebola and strenghen Stakeholder s commitment to enforcing chiefdom $36,885 byelaws Border Monitors and Capacities for Kailahun $36,317 EVD Prevention Project title Community Dialogue forum with stakeholders on Ebola and peaceful coexistence among survivors, Training of leadership and monitring skills, establish and train peer group educators on Ebola and other disease prevention measures, conduct Radio Panel discussions with relevant Social Mobilization actors Capacity traning for Border Monitors, community Health committee members, interactive dialogue sessions, Radio discussions to reenforce safe and healthy messages, messaging on sick and death alerts and emergency regulations. Collective Initiative for Development SL (CIFD S/L) Theater for Development on Port Loko $32,445 improving on access to health Theater for development sensitization / performance in schools communities, held radio programmes with stakeholders and school pupils and authorities, identify and rehearse training team on improving access to health facilities. Community Action for the Welfare of Children (CAWeC) Kambia Road Repairs Samu Chiefdom $30,358 EVD Survivors Engagement in Social AIDSIERRALEONE Kailahun $32,916 Mobilization Reinforcing Health Screening Bombali DERC Bombali $14,966 Checkpoints Improve eleven (11) damaged road spots along Samu Road towards Maportolon and Kychum Axis. Training of 60 survivors on Ebola messages especially on EVD transmission through semen. Maintaining the health screening on 5 key checkpoints in the district. Achievements and Results Overall, Project #11, Quick Impact Projects in Sierra Leone, supported 61 projects (46 by UNMEER and 15 microprojects by ) to improve local capacities to respond to the Ebola outbreak. The second phase of Quick Impact Projects (QIP), which was implemented by, was the focus of this reporting period. The QIP programme was taken over by in July 2015, and by August 2015, 35 QIP proposals were received and reviewed by both the QIPs team and the Project Review Committee. Of these, 15 projects from seven districts were funded. Currently, 70% of the Implementing Partners (IPs) completed projects, with both final narrative and financial reports submitted for review by. The QIPs team was to plan a final monitoring, evaluation and closure visit to all implementation sites, to meet with beneficiaries and verify project impacts against activity reports. With its grant, the Lion Heart Foundation eased the movement of patients in a clinic (which had an Ebola isolation unit) by building three walking paths/ramps and one covered ramp. This enhanced the smooth flow of patients and minimized tendencies for body contact and contagion. The facility and services were to be sustained at this health facility over a longer period of time. CAHSeC, in Bombali, engaged ten communitybased mobilizers to conduct housetohouse checks, reaching 700 households in three Ebolaaffected villages. During these visits, mobilizers provided psychosocial counseling and collected data on the sick as well as on deaths. As a result, communities were better prepared to respond to future outbreaks. UPHR, in Port Loko, established 20 community structures in 20 communities and conducted stakeholder meetings in 10 77

80 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE communities, educating a total of 1,200 beneficiaries on safe health practices to fight Ebola. Livelihoods support in the form of solidarity packages were given to 50 vulnerable families and survivors. A wider community stakeholder social mobilization programme commenced in four chiefdoms, targeting about 1,000 beneficiaries. HUWASAL conducted capacity building training for 20 Community Volunteer Monitors (CVMs) (10 men and 10 women) all identified from beneficiary communities. The trained CVMs worked with HUWASAL Community Engagement Officers to educate 25 communities and monitor the maintenance of safe health practices, including sick and death alerts. A total of 208 community stakeholders including town chiefs, religious leaders, women leaders, youth leaders and community headmen completed training on how to follow the best practices for safe and dignified burials. Four orientation 2015 INTERIM REPORT Mission Critical Action 13 sessions were given to 120 men, 88 women and 255 youths on how to raise sick and death alerts in their communities. Advocacy Radio, a media house, hosted 47 recorded radio discussions, aired 20 jingles and produced 40 episodes of radio dramas on IPC, which reached 80,000 listeners across the Port Loko District and beyond. The radio discussions, which were hosted on a daily bases with Ebola pillar heads, had a lasting impact on communities in diverse ways. Some of the discussions brought hope to victims and survivors of the disease, while others created awareness among communities on how to uphold the best health practices. Overall, five QIP Implementing Partners (MOVESL, Mama Care Pikin, Collective Initiative, AIDSL and The Needy Today) undertook social mobilization activities meant to have a longterm impact on communities behavioral practices. 78

81 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND SIERRA LEONE RECOVERY STRATEGY OBJECTIVE 03 RSO 03 Basic Services and Infrastructure $1.05 million Allocated COVERAGE: Port Loko, Tonkolili, Western Rural, Kono and Kambia districts MPTF Project No: Title: #45 Ebola Survivors Database Creation; Needs Assessment & Screening; Psychosocial Support & Reintegration into Society TRANSFER DATE: 13Nov2015 AMOUNT: $1,047,396 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Train advocates in case management, patient advocacy and field screening 100 Senior Advocates Recently Funded WHO Train Health workers and community health workers in CPES and survivor screening Strengthen survivor clinics Establish a comprehensive fully functional, verified and userfriendly database on EVDS Survivors and community members provided with psychosocial counselling 80 health workers and 150 Community Health workers 10 Survivor Clinics 1 list (496 survivors) Recently Funded Recently Funded Recently Funded 496 Recently Funded WHO WHO UNICEF UNICEF Achievements and Results Through the joint UNICEFWHO Project #45, Ebola Survivors Database Creation, Needs Assessment and Screening, Psychosocial Support and Reintegration into Society, WHO continued to provide technical assistance to the MoHS and implementing partners with regard to the clinical care of Ebola survivors. During the month of February 2016, WHO assisted the MoHS and partners in the design of a Clinical Training Programme on Comprehensive Programme for Ebola Survivors (CPES) for Health Care Workers (HCWs). The programme was to enable healthcare workers at community, primary, secondary and tertiary care facilities, case managers, and survivor health advocates to provide clinical and other care to Ebola survivors. The project was to also establish a programme of mentorship and supervision by the MoHS and partners to provide continuous support as it integrated into the national health care system. The CPES training programme s curriculum, part of the broader Clinical Training Programme, was designed to introduce health care workers to the CPES. It reviews the history and structure of CPES as designed by the Government of Sierra Leone as well as the clinical processes that are unique to survivor health care. It also presents the structure of a growing national referral pathway system, inclusive of clinical and community resources. In February, WHO met with clinical care for survivors implementing partners to validate both the Clinical Training Programme on CPES and the associated curriculum. WHO continued to provide technical support on clinical care protocols to partners that were operating clinics. Also during February, Survivor Advocates in the Tonkolili, Kono and Kambia districts received training on peertopeer Psychological First Aid (PFA) from UNICEF. With WHO s support, the MoHS was to roll out counselling on safe sexual practices and semen testing in these districts, to address the risk of Ebola resurgence. To advance the recovery Ebola survivors, WHO supported the MoHS with its plans for improving access to care for all survivors by reducing financial, logistical and psychosocial obstacles. Key barriers to care identified included: the distance to clinic; cost of transport to clinic; fees at clinic; fear of reengaging with the healthcare system; and the lack of knowledge on the need for/availability of care. WHO specifically worked with the MoHS to conduct consultations, and review the status of survivor care, standing capacity of services, and identification of service gaps. Additionally, WHO worked to define referral pathways between levels of healthcare and to identify the most operationally effective referral mechanisms. In order to achieve comprehensive service delivery at proximal care facilities for survivors, discussions were underway regarding the design and implementation of referral transport systems and reimbursements. WHO also continued to support the MoHS and partners in the development of a Partners Consortium for national scaleup of health service delivery for the 3,466 registered Ebola survivors in the country. The following working subgroups advanced tasks in that direction: Training and mentorship for CHOs nursing and medical personnel; Referral pathways; Monitoring and evaluation of CPES; Human resources; Supply chain solutions for essential supplies and medications for free care for Ebola survivors. 79

82 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT 80

83 MCA 7 Cash Incentives MCA 10 Transport and Fuel MCA 13 Preparedness

84 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND at A Glance WEST AFRICA Reference Map MOROCCO WESTERN SAHARA 2.1 million 1.36 million 3 Proposals 3 UN Entities Contributed L I B YA N ARAB J A M A H I R I YA La Youn ALGERIA Expenditures MA U R I TA N I A Tombouctou Kaédi ga l ge ne r DAKAR SENEGAL G A M B I A Tambacounda BANJUL CHAD NIAMEY Gamb ia BAMAKO OUAGADOUGOU BoboDioulasso GUINEA Kankan CONAKRY Lake Chad Birnin Kebi Kano B U R K I N A FA S O BISSAU GUINEA BISSAU NIGER Gao Ni Se CÔTE D'IVOIRE SIERRA LEONE YAMOUSSOUKRO ABUJA TO G O LIBERIA ACCRA Sassandra ABIDJAN Gulf of Guinea Atlantic Ocean PORTOLOMÉ NOVO Bight of Benin Port Harcourt 4,000 5,000 S04 S05 Stop TREAT ENSURE PRESERVE PREVENT n/a n/a 0.5 million n/a 1.1 million RECOVERY CAMEROON MALABO EQUATORIAL GUINEA Bight of Biafra Douala YAOUNDÉ RS01 RS02 RS03 RS04 Health, Nutrition and WASH SocioEconomic Revitalization Basic Services and Infrastructures Governance, Peacebuilding and Social Cohesion n/a n/a n/a n/a Campo LIBREVILLE GABON CONGO Elevation (meters) 5,000 and above S03 NIGERIA SAO TOME AND PRINCIPE 1,000 km S02 Lagos SAO TOME 500 Gombe S01 Be nu e GHANA Kumasi MONROVIA N'DJAMENA BENIN Tamale FREETOWN 0 RESPONSE MALI NOUAKCHOTT BRAZZAVILLE Atlantic Ocean KINSHASA KINSHASA 3,000 4,000 2,500 3,000 2,000 2,500 1,500 2,000 1,000 1, , Below sea level Funding as of 31 December 2015* Legend National capital Populated place International boundary Disclaimers: The designations employed and the presentation of material on this map do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. LUANDA 1% ANGOLA Map data sources: CGIAR, United Nations Cartographic Section, ESRI, Europa Technologies, UN OCHA. Funding per Mission Critical Actions Total Allocation $149 m MCA07 Cash Incentives MCA13 Preparedness Guinea Liberia Sierra Leone Regional $$1,643,300 * Allocations are based on approved budget 82

85 2015 INTERIM REPORT REGIONAL UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 7 MCA 7 Cash Incentives for Workers $0.52 million Allocated COVERAGE: Regional MPTF Project No: Title: #6 Payment for Ebola Workers TRANSFER DATE: 04 Dec2014 AMOUNT: $524,300 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Support to the 3 countryled technical programmes Provided Ongoing Regional contractual services and standardization Provided Ongoing Communication events 2 for Region; 3 for Countries 2 for Region; 3 for Countries Achievements and Results At the height of the Ebola epidemic, the nature and distribution of effective workforces inclusive of contact tracers, staff working in Ebola treatment units (ETUs), and burial teams, among others, were highly dynamic. Personnel grew at 25% every two weeks during this time, while also experiencing a 20% turnover rate. None of the countries had an information management system (IMS) that could be easily decentralized to track workers in real time and ensure the delivery of correct payroll based on eligibility, functional roles, differential contract types, the duration of employment, hiring institutions and national policy specifications. Project #9, The Regional Component of the Payments Programme for Ebola Response Workers (PPERW), was established to address these challenges. It provided technical assistance and coordination support to the Guinea, Liberia and Sierra Leone Payments Programmes so that the UN could assist governments with the timely delivery of incentives to over 72,000 Ebola Response Workers (ERWs). The project aimed to bridge gaps in government capacity through last mile digital technology, policy advocacy and the implementation of more transparent and accountable payment systems. Several important results were achieved by this regional project. First, PPERW Regional s work with PPERW Country components directly contributed to ensuring that all frontline workers risking their lives to fight Ebola were paid on time and paid the right amounts in full. Secondly, PPERW s successful experimentation with digital payments during the crisis contributed to the broader global discussion on how to implement digital payments quickly and effectively, with a preference for the use of systems and processes that promote sustainable financial inclusion (without interfering with response times). Thirdly, PPERW s lesson learned experience with payments advanced regulatory changes that supported the use of sustainable and secure digital payments and longerterm digital financial services (DFS) systems. This outcome ensured an effective response and contributed to future resiliency. Through the setup of the Technical Assistance Units (PPERW country components) in the three countries and the provision of technical oversight and capacity inputs, the PPERW Regional project facilitated timely and correct payments to 72,712 ERWs. Indicator Baseline Guinea Project Outcomes Sierra Leone Liberia Registered Ebola response workers paid on time (%) 70% 80% 100% (26,712 ERWs) 100% (26,712 ERWs) 98% (35,000 ERWs) 98% (35,000 ERWs) 100% (11,000 ERWs) 100% (11,000 ERWs) The % indicated as baseline in the initial ProDoc were 70% and 80% respectively. 83

86 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND REGIONAL 2015 INTERIM REPORT Mission Critical Action 10 MCA 10 Transport and Fuel $0.88 million Allocated COVERAGE: Regional, covering Guinea, Liberia and Sierra Leone MPTF Project No: Guinea Liberia Sierra Leone Title: #22 Ebola Charters TRANSFER DATE: 19Dec2014 AMOUNT: $276,262 $322,898 $278,558 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Flight cargo 183MT 56MT Guinea 60MT Liberia 67MT Sierra Leone 100% UNICEF Achievements and Results With support of Ebola Response MPTF funds through Project #22, Ebola Charters, 300 metric tons of Ebolarelated supplies were sent to Guinea, Liberia and Sierra Leone. This supply response was viewed as one of UNICEF s most successful contributions to the fight against Ebola. This project contributed to an intense UNICEF supply operation that sent more than 8,000 metric tons of lifesaving supplies between August 2014 and June 2015 and maintained a steady stream of airlifts and sea shipments. The shipments included tents and tarpaulins to establish over 60 Community Care Centres (CCC) and other care facilities that offered high levels of infection prevention and protection for family members and health workers. The shipments also included supplies for the safe operation of such facilities, including Ebolaresistant personal protective equipment, gloves, medicine and body bags. The supply operation also provided nutritional support for over 7,000 Ebola patients and 2,000 children whose families were affected by Ebola. It provisioned 1,700 nonebola health facilities with drinking water and sanitation materials and provisioned supplies to families and households that were quarantined for 21 days. UNICEF supplies also ensured the continued delivery of vaccines for routine immunizations; and education materials and infection prevention and control supplies to support the safe return of 1.8 million children to school. The nature of the emergency posed a number of challenges for supply and logistics efforts that required flexible and pragmatic solutions. To ensure efficiency, UNICEF established an air coordination cell that consolidated cargo and offered more than 160 relief agencies space on charter flights. The agency helped ensure there were enough supplies by convening partners and industry to transparently coordinate demand during periods of rapid scaleup and great variation. The agency worked with the vaccine, diagnostic and pharmaceutical industries as a part of the coalition that aimed to ensure an appropriate pipeline of IPC supplies and medicines for prevention, treatment and diagnosis of Ebola. An effort to document the good practices and the lessons learnt from the project, in order to inform future responses to healthrelated emergencies, is underway. 84

87 2015 INTERIM REPORT REGIONAL UN EBOLA RESPONSE MULTIPARTNER TRUST FUND Mission Critical Action 13 MCA 13 Preventing Spread $1.12 million Allocated COVERAGE: Regional MPTF Project No: Title: #2 Aviation Ebola Action Plan TRANSFER DATE: 12Dec2014 AMOUNT: $1,000, #41 Ebola Response Interagency Stewardship 21Oct2015 $119,000 PRIORITY INTERVENTION PLANNED ACHIEVED RESPONDING AGENCIES Training Events State / Airport Assistance Visits ICAO / WHO ICAO / WHO Stakeholders contribute to the formulation of Ebola Response Country Operational Plan 70% 70% participation relevant meetings WHO Cross border, regional and international coordination maintained 70% 70% participation relevant meetings WHO Achievements and Results Much progress was made throughout 2015 with regard to implementation of Project# 2, Aviation Ebola Action Plan. Two regional training events were held and fourteen Assistance Visits (AVs) were completed in countries international airports. Air transport links were, for the most part, restored to the three most Ebolaaffected countries. While the majority of planned activities were successfully executed, some were postponed to 2016 given the length of time and number of actors involved in organizing them. Given the decline in Ebola cases as the year progressed, some States reduced the priority allotted to Assistance Visits, resulting in some scheduling delays. While the reduction to virtually zero in the number of Ebola cases was welcomed, the need for the aviation sector of many countries to be better prepared for a public health emergency and to create intersectoral communication links was made evident from the training events and AVs that were undertaken. In addition, the levels of implementation of the International Health Regulations (IHR) core capacity requirements for airports designated by States as Points of Entry, both routine and for emergencies, were observed during AVs to be much lower than those selfreported by States and included in the annual report presented to the WHO World Health Assembly. It cannot be assumed that these countries would be ready to respond to another threat to public health in an efficient multisectoral manner involving the aviation sector. Some key issues requiring further consideration include: aspects of health screening at airports, procedures and legal basis for denial of boarding of a contact; notification procedures of the airport and airline of contacts identified prior to attempted travel; management of an unwell passenger onboard an aircraft and on arrival at destination; personal protective equipment for cabin crew and postflight cleaning crew; and improved integration of national aviation and public health organizations and their preparedness plans. Improved communication links between the public health and aviation sectors in general would, at least, enable personnel from each sector to better understand the different viewpoints. With the phasing out of United Nations Mission for Ebola Emergency Response (UNMEER), the World Health Organization (WHO) was tasked through Project #41, Ebola Response Interagency Stewardship, to ensure the effective coordination of agencies involved in the Response at all levels. WHO took on the former UNMEER leaders both within countries and regionally in order to ensure: the seamless and successful transition of responsibilities from UNMEER to WHO; and continued strengthening of national capacity to end the present outbreak and to respond to any reemergence. Ebola Response MPTF support covered the period of this activity from August to December The Regional InterAgency Ebola Crisis Lead (RIECL), oversaw coordination across the region, and two Ebola Crisis Managers (ECMs) focused on Guinea and Sierra Leone. This work was referred to as Interagency Coordination on Ebola (ICE). The main functions of the RIECL and ECMs were to ensure that the actions of stakeholders contributed to the overall Response and were coordinated with Ebola Response Country Operational Plans. The RIECL and ECMs worked in cooperation with the UNCT whose capabilities and capacities were essential both to stopping the outbreak and addressing 85

88 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND REGIONAL its broader socioeconomic impacts. The RIECL and ECMs worked closely with all actors in the Response, including national and regional organizations, incountry partners and international nongovernmental organizations to ensure overall coordination of responses to the Ebola outbreak in country, as well across the region. The ECMs chaired weekly meetings of the UN agencies at local and national levels, convened meetings with donors and partners, and represented the UN in national Ebola response coordination meetings. The RIECL chaired the monthly meetings of the Ebola Response Coordination Board: together with the ECMs, he participated in the weekly meetings of the Global Ebola Response Coalition to brief the international community INTERIM REPORT Mission Critical Action 13 Over the course of the five months, ICE staff focused on improving coordination between agencies and support for: addressing the services required by survivors and seeking to harmonize policies and practices and increase availability of services; strengthening rapid response capacity in Ebolaaffected countries and ensuring strong international support; helping to assure the smooth transition of responsibilities for coordinating early recovery from WHO to UNRCs in 2016; and working with all stakeholders towards a smooth transition of responsibilities for addressing Ebola related issues within each government. 86

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90 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT GUINEA It is the first time that we have such a threshing machine in our community. With help, our kids will be able to have a rich and varied meal made of couscous and milk or sauce instead of rice that we were used to in the past. This is a testimony from a resident of TintiOulen in Kankan region whose community benefited from the QIP Program. The site was visited by the QIP team on November 9th, We are very grateful to for having thought of us. Before this project, we were isolated and discriminated by the rest of the community. Now we have this reintegration center where we will be sharing with other neighbors about our past experiences. Now we feel supported, empowered and understood as any other human being. An EVD survivor of Gbakore village in Lola (Nzerekore region) testified during the site visit by the QIP team on November 13th, Because of this project, we are now working together as EVD survivors on some incomegenerating activities. We are hoping that the vegetables that we intend to grow here will increase our revenue and help improve our living conditions. This story was shared by a group of women survivor of EVD in the urban community of Macenta during the QIP team visit on November 14th, We only used to see many visitors coming here to assess our needs but nothing was given to us. But this particular partner came with the help in hands, which is unusual and very good surprise to us. We thank for creating this opportunity for us. Now our association has a field where we intend to grow corn and sell it to gain some revenue. A story from an EVD survivor of Wonkifong village in the Prefecture of Coyah where a QIP partner implemented an incomegenerating activity for local survivors. 88 UNMEER

91 2015 INTERIM REPORT UN EBOLA RESPONSE MULTIPARTNER TRUST FUND LIBERIA Contact Tracer Helps Pregnant Woman Access Care Yabayah is a small, hard to reach community in Fuamah district, Bong county and in late 2015, one of the sixty UNFPA supported contact tracers operating through the REDEP (Reach Every District and Every Pregnancy) system in Fuamah identified a pregnant woman in one of his gazetted households. As required by his training, he offered her counselling on need to attend ANC and encouraged her to deliver at a health facility when the time came. The contact tracer had noticed hesitation from the pregnant woman, but he persisted and continued visiting her household from time to time. her community that were more receptive to maternal health services. During one of their community meetings, she went into labor and with her consent, community members rushed her to a nearby Handii clinic in Fuamah. Unfortunately, she could not deliver naturally, but the community, including the supportive pregnant women, managed to take her to Phebe Hospital where she later underwent a Csection and gave birth to a set of healthy twins. To date, this mother of twins is grateful to the contact tracer for not having given up on her because she realized that she could have lost her life with a home delivery of the twins. The contact tracer also made an effort to influence her decision to attend ANC through other pregnant women in Bendu Sheriff: Age: 9 years: Status: EVD survivor, Student Ma Bendu Sheriff is a nine year old orphan who lost both of her parents to the Ebola outbreak in Liberia. After the death of her parents there were no known adult relatives willing to care for her. Through the support of the Ministry of Gender Children and Social Protection social workers, she was reunified with her grandmother who is currently caring for her and was later referred to the IRCL for further support. I was infected by the same Ebola that killed my ma and pa but I survived. Only my grandmother is now caring for me. She is old and doing her best to care for me. When schools opened I was worried I wouldn t go to school because my grandmother does not have any helper. I used to sit at home and see all my friends going to school and I felt bad and cried for my parents because they always made sure that I was ready for school. Then the IRCL worker came and visited my grandmother to ask about my wellbeing. I told them that I wanted to go back to school. I am now in school and I am grateful to God for the IRCL people who paid my school fees. I am so happy now that I can now join my friends in school. MPTF Office 89

92 UN EBOLA RESPONSE MULTIPARTNER TRUST FUND 2015 INTERIM REPORT SIERRA LEONE Mabinty Bangura, EVD Survivor, Sierra Leone I contracted the virus in November On 18 November, I received confirmation that I was Ebola Positive. The next day, I was taken to the Kenema Treatment centre where I stayed for two weeks before recovering. I was discharged on the 28th of the same month. I m grateful to God for saving my life and also grateful to Pink Cross and for coming to our help when we needed it most. The psychosocial counselling has inspired me to feel like I belong once again, and to have confidence in myself and to move forward instead of giving up. Similarly, the sanitation and hygiene material has helped me to maintain a clean environment that is good for public health and everyone around me, and also for my own personal hygiene. Salifu L Suma RRST Lead NERC Going to the field would look like a picnic, but upon arrival the grim outfit of the quarantined homes would provoke your emotions. The people forced to stay at their homes would look at you as a savior whilst your inner self would keep reminding you of the dangers should you fail in observing basic IPC. People still remained distrustful. In some instances, we were seen as conspirators pushing an agenda of a Western plot, and security personnel had to be present to prevent tensions with angry and traumatized communities. Other times, I felt so empowered to help people to prevent the further spread of the deadly epidemic. Some communities were open so much that they even relied on us as arbiters both in socioeconomic and political issues, as well as in fighting a common enemy Ebola. 90