With Ebola, it was overwhelmed completely.

At a time when rapid diagnosis and case tracking were crucial, such services halted to a standstill. When space to triage and care for patients was at a deficit, health care facilities had no recourse but to shut their doors. And when additional staff were needed to care for a growing influx of patients, supply shortages made working conditions unconscionable.

Ebola has declined sharply since the crisis began more than a year ago, but its consequences are lasting.

As of August 26, 2015, Sierra Leone had confirmed 8,547 Ebola cases. While 3,586 of those cases resulted in death, 5,111 people survived. Among those who survived, many face serious challenges – both physiological and social.

Survivors often experience eye problems, musculoskeletal pain, headaches, neurological issues, gastrointestinal problems and psychological challenges. Socially, they may be stigmatized and left few economic opportunities.

Services for survivors do exist, but not in the amounts needed. In Sierra Leone’s Bombali District, for instance, there is only one survivor clinic for an estimated 659 survivors.

To address this need, Direct Relief and the Medical Research Centre (MRC) — through a commitment announced at the 2015 Clinton Global Initiative’s plenary session  — will establish a new survivors’ clinic in the city of Makeni. Once built, the clinic will accept and care for any Ebola survivor from Bombali and the surrounding districts.

The Ministry of Health and Sanitation (MOHS) has agreed to help staff the clinic. Personnel  will include a supervising physician and medical staff who specialize in eye care and mental health care. In addition to on-site services, clinic staff will conduct community outreach activities. In instances where referrals are necessary, MRC has agreed to establish a referral network between the survivors’ clinic and larger government hospitals. Direct Relief will equip the clinic with sustained donations of medical resources.

In addition to MRC and Sierra Leone’s MOHS, collaborators include:

• Bombali EVD Survivor Association, which will conduct outreach, including through radio dissemination.
• The Canteen of the Midwifery School Makeni, which will provide prepared food for clinic health care workers, staff, and patients, with a focus on patients under observation
• The University of Makeni (UNIMAK) who will deploy psychiatric nurses
• MRC, which will provide non-healthcare related, administrative staff training to employees of the clinic
• Additional health NGOs who will provide specialized or higher level health services

To learn more, the full commitment is available on the Clinton Global Initiative website: Ebola Survivor Services, Bombali District, Sierra Leone

The post CGI Commitment: Ebola Survivor Services, Sierra Leone appeared first on Direct Relief.

As many as one in 30 women will die from complications related to their pregnancy or childbirth.  Skilled birth attendants such as midwives offer the single most consequential intervention for reducing the 289,000 maternal deaths that occur globally each year.  While the global deficit of trained midwives stands at 350,000, even more lack the equipment needed to put their training to use.

“Many competent midwives are unable to use their life-saving skills because they lack the tools to provide the highest standard of care,” said Frances Ganges, ICM’s Chief Executive. “Equipping midwives with a kit of quality and appropriate tools will contribute to keeping mothers and their newborns safe during birth.”

The result of a two-year collaboration between Direct Relief and ICM, each Midwife Kit contains the 59 essential items a midwife needs to perform 50 facility-based deliveries. Items include surgical instruments, sutures, I.V. sets, neonatal resuscitation bags, headlamps, gloves, and cord clamps. The kit also includes pharmaceuticals such as misoprostol to manage post-partum hemorrhage and magnesium sulfate for eclampsia.

A Midwife for Every Delivery, a Kit for Every Midwife

“It is self-evident that educated and trained midwives, as all health professionals, need to be properly equipped to perform their lifesaving role,” said Direct Relief President and CEO Thomas Tighe.  “Direct Relief is deeply thankful to ICM for helping develop a standard kit that will complement the competency standards that ICM has so carefully developed. We want to ensure that each midwife – particularly those in high-need developing countries where women and children are most at risk – have access to this kit.”

The Midwife Kits, valued at $1,250 or roughly $25 per safe birth, are provided free of charge to enable midwives to fully utilize their skills.

In the program’s pilot year, Direct Relief provided more than 400 kits to midwives with partner organizations in the following four countries: Medical Research Centre in Sierra Leone, Africare and Last Mile Health in Liberia, IPI Foundation, Inc. in the Philippines, and Edna Adan University Hospital in Somaliland.

“I can’t afford to buy the instruments and supplies I need,” wrote Filipino midwife, Jessievel Soria, among the first recipients of the ICM-endorsed Midwife Kit. “Thanks to the Midwife Kit, I can continue my services.”

The post A Kit for Every Midwife: International Confederation of Midwives Endorses Midwife Kit as Global Standard appeared first on Direct Relief.

Guinea, Liberia, and Sierra Leone have reported a total of 25,791 Ebola cases since the outbreak began last year, with more than 10,600 deaths reported.

During the visit, the Deputy Minister and Mr. Jalloh outlined the key priorities for strengthening Sierra Leone’s health system. These include ensuring that medical facilities are properly equipped with supplies and staff, that medical professionals have the training and tools they need to effectively care for patients, and that the public’s trust in the health system is reestablished and maintained.

To date, Direct Relief has supplied more than 500 health facilities in Guinea, Liberia, and Sierra Leone with more than $26 million worth (wholesale) of emergency medical aid in coordination with local partnerships. This includes 4.8 million gloves, 22.8 million defined daily doses of essential medicines, and 240,000 gowns and coveralls, among other aid items.

“Were it not for Direct Relief, their timely intervention, and all the support from their donors, we would not be where we are today,” said Deputy Minister Rahman. “We would have lost more lives than we have lost.”

The Deputy Minister’s visit precedes the Ebola Innovation Summit in San Francisco on Tuesday, April 21. Convened by the Paul G. Allen Family Foundation and the Skoll Global Threats Fund, attendees include a mix of tech giants such as Google, household brands such as J&J, and global organizations such as the Bill & Melinda Gates Foundation and Direct Relief.

Alongside the United Nations, African Union, and United States Agency for International Development (USAID), Deputy Minister Rahman will open the event with a discussion of lessons learned and an appraisal of the current situation in her country.

“No one has a better understanding of Ebola’s tragic effects, what worked and didn’t work in responding to it, or has a bigger stake in preventing such future devastation than those in the affected countries,” said Thomas Tighe, Direct Relief CEO.  “It’s an honor to host Deputy Minister Rahman and Mr. Jalloh, whose insights have guided Direct Relief’s efforts, and to join them at this important meeting, urging those whose innovations have so profoundly reshaped countless areas of modern life to do the same in confronting Ebola.”

The post Sierra Leone Deputy Health Minister Visits Direct Relief, Ebola Innovation Summit appeared first on Direct Relief.

Celebrating World Health Worker Week (April 5 -11, 2015), a new story map from Esri, The Earth Institute at Columbia, and Direct Relief, aims to raise support and awareness for the life changing contributions of community health workers.

In dozens of countries, tens of thousands of women and men get up each morning to travel miles over rough roads and across rivers and streams to provide primary health care in some of the world’s most remote, vulnerable, and hard-to-reach places. At any given moment, these people, known as Community Health Workers (CHWs), are monitoring Ebola contacts, counseling an HIV-positive person, surveying basic health needs, or helping a newborn at risk of pneumonia.

On Front Lines of the Ebola Crisis

When the Ebola epidemic swept through West Africa last year, international organizations had difficulty establishing and maintaining community trust. Community Health Workers, many of whom are from the communities they serve, stepped in to bridge the gap. Not coincidentally, the organizations with the most durable results to show also relied extensively on CHWs for case tracking, diagnosis, sensitization, referral, and follow up. Such groups include Partners in Health and Last Mile Health in Liberia, UNFPA in Guinea, and Medical Research Centre (MRC) and Wellbody Alliance in Sierra Leone.

Arguably, CHWs are the key for the countries now rebuilding their health systems to be more comprehensive, effective, and resilient following the shock of the Ebola epidemic. They may also be the best defense against a repeat of these events in the future.

Beyond Ebola: One Million Community Health Workers

While the Ebola epidemic spotlighted the crucial work of CHWs, their value extends far beyond Ebola and West Africa. The One-Million Community Health Workers (1mCHW) Campaign was formed by the Sustainable Development Solutions Network (SDSN) and the Earth Institute at Columbia University to advocate for CHWs and document their far-reaching value.

Direct Relief and Esri teamed up with the Campaign last year to build the Operations Room; a suite of mapping applications that track the scope and enable a detailed comparison of CHW activities.

29 Stories. 24 Hours. 13 Countries

A Day in the Life: Snapshots from 24 Hours in the Lives of Community Health Workers is the latest map in the 1mCHW Campaign. It aims to convey not only the importance of the work that CHWs perform, but the everyday texture and genuine beauty of the lives they improve. This map is a guided tour of 29 CHWs in action during one long day across 13 countries in sub-Saharan Africa. Through the CHW story map, people can learn about and become more deeply engaged in one of the great causes of our time — ensuring that every person on Earth has access to health care.

The post A Day in the Life of Community Health Workers appeared first on Direct Relief.

Restoring Capacity as Ebola Wanes

Today, Andrew (Director of International Programs and Emergency Response) and I visited the Holy Spirit Catholic Hospital in Makeni, a beautiful 85-bed capacity hospital in the third largest city in Sierra Leone.  The facility was clean, spacious, and well-kept.

Infection control procedures prevented us from visiting patient care areas of the hospital without properly donning protective clothing, which we were not prepared to do.

Dr. Patrick Turi told us that the hospital was closed during the height of the Ebola crisis and is now running at about half capacity because of the sharp decrease in patients seeking care at medical facilities. He believed that the hospital would run at full capacity again as the surrounding communities regain trust in the health care system.

In the pharmacy, we took turns identifying items that we recognized as having been donated by Direct Relief through local partner Medical Research Centre.  Noticeably, several Teva drugs were being distributed to patients, such as the antibiotic azithromycin.  Dr. Turi was excited about the prospect of receiving more specialized drugs for cardiovascular disease, diabetes, and hypertension, which could help offset costs, such as rehiring of staff.

Support Continues for Successful Ebola Treatment Unit

Next, we visited the Ebola treatment unit dubbed Hastings II, which still boasts the highest survival rate in the country at about 70 percent.  The unit is operated by the Sierra Leonean military but the hygienic tasks and nursing duties are carried out mostly by volunteers. These individuals choose to work in a dangerous environment in hopes of getting priority for paid work.

When we arrived, there were no less than a dozen men and women in matching blue scrubs cooling in the shade outside the treatment ward.  In the compound that houses the Ebola treatment unit (a converted police training facility), there is an administrative building, a storage unit, and the Ebola ward itself, which is divided into several sections.  The Ebola ward is partially visible from the common area.

Recovering patients watched us as the doctor pointed to the notes stuck on the inside of the plexiglass and explained that this was a form of communication, as no items are physically transferred in and out of the ward.  Direct Relief, through Medical Research Centre (MRC), shipped significant amounts of pharmaceuticals and supplies to Hastings.

Supplies Stocked in Country

Down the street from the Hasting Treatment facility, MRC Director Abdul Jalloh showed us the warehouse rented by MRC to store donated drugs and supplies.  Direct Relief provided a grant to MRC to rent and operate this warehouse as well as purchase a truck to transport the supplies to more than 50 facilities in three districts.

The warehouse was beautifully clean and organized, and stocked entirely with supplies sent by Direct Relief: Ansell gloves, Baxter fluids, We Care Solar panels, and much, much more.  A small team was loading up the truck to take to Bo – the second largest city in Sierra Leone.  Andrew and I were very impressed.

Abdul recalled how Hastings II once ran out of ceftriaxone, which was essential to treat patients with certain types of bacterial infections, and MRC was able to provide the drug immediately because of the donation. He said the Central Stores would have taken two weeks.

Reinstating Maternal & Child Health Services

To end our day, we visited Aberdeen Women’s Centre in Freetown, a facility which we have supported through the Obstetric Fistula Repair Program.  Aberdeen is the only permanent facility providing obstetric fistula repair in Sierra Leone.

Through funding from the United Nations Population Fund (UNFPA) and others, and supplies from Direct Relief, Aberdeen strives to provide at least 200 fistula repair surgeries per year (an incredible number).

Because of reallocation of resources to fighting Ebola, they have not been able to provide fistula repair services since April, but they plan to restart soon and continue to provide birthing services. The facility delivered 1,228 babies in 2014, several by caesarian section.  Painted on the wall toward the entrance is “YU NOR DEY PAY NO MONEY” – all services are free of charge.

Looking Toward Life After Ebola

After only a few days, but endless discussions about Ebola with health authorities, politicians, local leaders, and medical practitioners, it is apparent that the complexity of the issue is staggering—the disease, the politics, the unintended consequences, the international response, the messaging, the historical implications, and on.  Sierra Leone’s history will forever be divided into “before Ebola” and “after Ebola” just as it is colloquially divided by the civil war.

The post From the Field: Health Facilities in Sierra Leone Work to Restore Services appeared first on Direct Relief.

With the substantial decrease in new Ebola cases in recent weeks, the airlift represents a pivot toward helping local health facilities deal with both the pre-existing health challenges exacerbated by the outbreak as well as the still serious threats that Ebola presents.

Dozens of primary care facilities shuttered during the crisis; malaria and other conditions went untreated; vaccination programs were suspended, prompting a recent measles outbreak; and pregnancy-related complications saw an uptick as more women gave birth at home.

“As the focus shifts to long-term health systems strengthening in West Africa, these items will help restore confidence in health care for both providers and people seeking care,” said Andrew MacCalla, Director of Emergency Response and International Programs at Direct Relief.

Each module contains 36 of the essential supplies needed to operate a functional medical clinic for two months, including items such as surgical gowns, gloves, masks, lanterns, medical disposal bins, and non-contact thermometers. The contents were developed in consultation with the Centers for Disease Control and Prevention, the Ministry of Health of Liberia, and Last Mile Health.

The supplies contained in the modules were donated, in part, by the City of Yokohama, 3M, BD, California Nurses Foundation, and One Million Lights. Additional supplies were purchased through a grant from The Paul G. Allen Family Foundation.

Another 17 modules will ship later in the month for a total of 100 modules. In Liberia, 40 modules will be distributed by Last Mile Health. In Sierra Leone, 10 modules will be distributed by Wellbody Alliance and 50 modules will be distributed by Medical Research Centre. Prescription medicines contained on the airlift will also be delivered to all three of these partners, as well as to Africare in Liberia.

The pharmaceutical supplies were made possible by Accord Healthcare, Inc., Actavis Pharma, Inc., Bayer Corporation – USA, Baxter International, Inc., GSK, Hospira, Inc., Mylan Inc., Prestige Brands, and Teva Pharmaceuticals.

Since Direct Relief began responding to the Ebola outbreak last spring, the organization has sent 40 shipments of Ebola relief aid valued at $25 million (wholesale), which have been distributed to more than 1,000 clinics and health centers in West Africa, in coordination with partner agencies.

The post 747 Jets to West Africa as Ebola Response Pivots toward Recovery appeared first on Direct Relief.

The shipments – valued at $4.8 million (wholesale) – contain items urgently requested by health workers in the field such as gloves, soap, IV fluids, and the antibiotic ciprofloxacin to help treat secondary bacterial infections.

The supplies are headed for Last Mile Health and ELWA Hospital in Liberia and Medical Research Centre (MRC) and Wellbody Alliance in Sierra Leone.

While the number of people who have died from Ebola is still rising, Direct Relief continues to hear word from the field that with the right supplies and staff in place, health partners are making a difference.

On Nov. 15, 54 Ebola survivors were discharged from the Hastings Treatment Centre, a facility that receives medical supplies in collaboration with MRC and Direct Relief. They follow 63 others who were discharged the previous week as well as a two week old baby – the youngest Ebola survivor – who was dispatched from the center in early November.

In an update from the Government of Sierra Leone, MRC Director Abdul Jalloh said the continued collaboration with Direct Relief has contributed immensely in complementing government efforts in the fight to contain Ebola.

Additionally, the Sierra Leone Ministry of Health and Sanitation sent a letter of thanks for the support, which was only possible because of people like you. Read the letter: Letter of Appreciation

Direct Relief thanks Airlink and UN Logistics Cluster for getting this shipment to the places where it is most needed.

The post More Ebola Aid Bound for Liberia and Sierra Leone appeared first on Direct Relief.

Hastings’ update today follows last month’s news from the treatment center of the youngest Ebola survivor – a two-week-old girl thought to have contracted the virus from her mother, also an Ebola survivor.

Sierra Leone’s Ministry of Health and Sanitation reports 4,600 cases and 1,149 confirmed deaths in the country since the outbreak began. Today’s update from Hastings and MRC shows that Ebola can be survived and stopped, given the right staff and supplies.

To date, Direct Relief has sent 19 emergency shipments valued at $7 million to more than 1,000 hospitals and clinics in Liberia, Guinea, and Sierra Leone. More shipments of personal protective gear, medicines, and supplies are scheduled to ship next week.

Click here to learn more about the response and how you can help: 2014 West Africa Ebola Outbreak

The post 63 People Survived Ebola Today, a Hospital in Sierra Leone Reports appeared first on Direct Relief.

The shipment – valued at nearly $40,000 – contains more than 5,000 pounds of urgently needed protective equipment like gloves, masks, goggles, and gowns to help prevent health workers from contracting the virus, which is spread through contact with infected bodily fluids such as blood, sweat, and saliva.

In responding to the Ebola epidemic, it is particularly important to keep health workers safe as losing them carries tragic implications not only for the ability to contain the virus outbreak, but also for the future of the country’s health system. Sierra Leone has less than 150 doctors for its six million people, reports Reuters.

This is the tenth emergency shipment of Ebola aid supplies sent to West Africa since the current outbreak – the deadliest in history – began this spring. Urgent requests from health partners continue to come in and Direct Relief is currently preparing more shipments for the affected region.

As of August 31, more than 1,100 cases and 430 deaths had been confirmed in Sierra Leone, according to the World Health Organization.

Join the fight against Ebola. Help airlift more shipments like these when you donate here.

The post Ebola Response: Life-Saving Protective Gear Arrives in Sierra Leone appeared first on Direct Relief.

About 15 percent of all deliveries will be complicated and will require emergency obstetric care. Many complicated cases can be managed at a lower level facility if the skilled birth attendant is trained in the management of basic emergency cases and has the tools they need to do their job. This skilled birth attendant is also trained to recognize the danger signs when a woman does require referral to a higher level of care where cesarean section and blood transfusion are available, and can make that decision promptly in order to save a woman’s life.

Successful emergency obstetric care requires three critical components: trained providers at each level of the health system who know how to manage and when to refer emergency cases; availability of the proper equipment and supplies to manage such cases; and a functioning referral system that can move a woman quickly to the appropriate level of care.

Medical Research Center (MRC), a Sierra Leonean nongovernmental organization and Direct Relief’s key partner in the country, is focused on providing inputs to each of these levels in order to improve emergency obstetric care. MRC has been working in Sierra Leone for more than 30 years and works closely with the Ministry of Health to improve healthcare delivery at the level of Peripheral Health Units (PHU), the health centers closest to the community that provide essential primary care and maternal health services. With support from organizations like Direct Relief, MRC distributes medicines, supplies, and equipment to the health centers that care for women in pregnancy and childbirth. MRC has also trained all healthcare workers that provide delivery services in basic emergency obstetric care and has established an ambulance referral system to transport women in emergencies to the nearest hospital.

But the nearest hospital is often very far away. To witness just how far, I traveled with MRC staff to one of their most remote operational areas, the chiefdom of Sambaia. For more than three hours we bumped over incredibly rough terrain which included a long, steep climb and descent through the hill country, then another hour of travel to reach the village of Bendugu. When we told people at the hospital in Makeni town that we were heading out to Sambaia, they all shook their heads and commented on the long distance and disadvantaged community. Our trip was in the middle of day in the dry season, but emergencies happen at the most inopportune times, like late at night in pouring rain. It’s difficult to imagine a woman in obstructed labor making this treacherous journey in any scenario.

This demonstrates the critical importance for MRC to continue improving quality of services in remote areas so that more woman can deliver safely at the health centers, and when a case requires emergency transport, the health workers are able to identify danger signs early enough to make the call and save a woman’s life.

Yele Community Health Center, also supported by MRC, is down the road in Bo District. Yele CHC has been selected as the basic emergency obstetric care referral center for its chiefdom of over 50,000 people. The community health officer in charge, Peter Konneh, is a dynamic man who is passionate about improving maternal health and proudly recognizes that the health center has had zero maternal deaths in the last few years, thanks to its work to educate the community and ensure that its staff is qualified to manage nearly all obstetric cases.

Peter was a young boy when the civil war broke out and rebels invaded his home village in Kailahun District in eastern Sierra Leone. It was a terrible time for thousands of Sierra Leoneans and Peter was one of many who were forced to flee their homes. After spending 10 years in a refugee camp in Guinea, Peter returned to Sierra Leone and trained as a community health officer, which is just below the level of medical doctor. Upon graduation, MRC employed him in 2006 and he was posted to Yele CHC, where he has committed to overseeing this important work for the long term.

Direct Relief has been working with MRC since 2008 and has provided three donations of medicines, supplies and equipment for the 32 health centers, hospitals, and the School of Midwifery in Makeni. MRC purchases medicines and supplies that are not donated, which is a significant expense. MRC is an excellent partner for Direct Relief; the medical supplies we provide do a great deal to support the primary care system and strengthen emergency obstetric care in Sierra Leone.

The post Improving Services for Obstetric Emergencies appeared first on Direct Relief.