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[stem-ebola] From Johns Hopkins' Global Health NOW, January 21, 2015


Straight from Liberia’s MoH: Q&A w/ Tolbert Nyenswah - Part I
Tolbert Nyenswah, Liberia’s National Ebola Incident Manager and Assistant Minister/Deputy Chief of the Ministry of Health & Social Welfare, updates GHN on the country’s response. Come back tomorrow for Part II.—Dayna Kerecman Myers
Q. Are you concerned that as Ebola cases fall in Liberia, interest and support from abroad will fade and with it hopes for rebuilding the health system?
We are having these conversations with donors as we speak. We have built very strong relationships with organizations… and they understand that the need for donors during the post-Ebola time of rebuilding will be great.
To ensure that plans are in place … the Ministry of Health, along with other government agencies and partners, is conducting an assessment to review progress toward the 10 Year National Health Policy and Plan established in 2011. The assessment will provide updated objectives and short- and long-term cost estimates in terms of the restoration of essential health services and strategies.
Q. Why did health workers and the public distrust the government at the beginning of the outbreak?
Initially, Infection Prevention & Control (IPC) training and materials were slow to roll out to health facilities, leading to infections among health workers who lacked information—or the proper materials—to protect themselves when an Ebola patient presented. This has been addressed through widespread IPC trainings across the country, and by overcoming logistical hurdles to distribute IPC materials to health facilities. As logistics and training have improved, we’ve seen a significant reduction in health care worker infections, with few, if any, being reported at this stage of the outbreak.
In terms of the public, the outbreak was unprecedented and hit us hard, causing panic; other countries in the world could not have been prepared for what Liberia faced, either. We had to work very hard to engage the affected communities, to educate them and to gain their trust as we scaled up our response. That took time and patience, but now we have a sufficient number of Ebola treatment facilities, beds and laboratory capacity to test specimens more quickly and communities are largely pleased.
Currently are in Phase II of the EVD outbreak in Liberia, emphasizing intense community engagement. We have seen remarkable acceptance and action on the part of the Liberian public. For example, recently we’ve had an average of about 1.4 cases confirmed per day, but an average of about 25 cases reported a day. This is good; this shows that the public is being proactive about reporting illnesses, and that suspected cases are not languishing in communities, potentially infecting others. Now, cases are being isolated sooner, and people are receiving treatment earlier—ensuring a better chance at survival. Thus, I would say at this stage that we have the public’s trust – and are continuing to earn it.
Q. Has the Ebola crisis led to stronger ties with other countries?
To a large extent, the crisis has prompted the development of stronger health communication and surveillance ties with other governments across Africa. With experience in EVD management, East Africa has contributed human resources to Liberia. A Ugandan government team of medical experts has played a key role in the fight against Ebola. Besides the African Union joint support to Liberia, Nigeria, Uganda, Kenya, Egypt, South Africa and Namibia have been tremendously helpful in supporting Liberia.

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