TIME ebola

Ebola-Stricken Families to Receive Cash Payments

Hawa Musa with her mother and children. Of 25 people living in the house, 17 have died from ebola, including her husband.
Hawa Musa (blue) with her mother and children. Musa used to rent rooms for income, but no one wants to rent her rooms anymore. She previously had 25 people living in her house, but 17 died of Ebola including her husband and a few of her children. She's taken in 10 more kids. Carly Learson—Carly Learson / UNDP

In 2015, the three Ebola-affected countries will start offering cash payments for families hit by Ebola, as well as survivors having trouble re-acclimating to society out of stigma for the disease.

Every aspect of Guinea, Liberia and Sierra Leone’s societies have taken a hit from Ebola, and the disease has shocked what were once fragile but growing economies. Public spaces are now forbidden, so markets are empty, tourists are no longer traveling into the countries and international companies have largely pulled out, including large industries like mining. The World Bank estimates the aftershock of Ebola to already weakened economies will be “devastating.”

“We are seeing a backwards slide of development of about 10 years,” says Boaz Paldi, chief of media and advocacy at the United Nations Development Programme (UNDP). “The outlook is not good. We are fearful for these countries.” That’s why instead of waiting for caseloads to reach manageable numbers, the three countries, with the help of UNDP and other partners, are laying the groundwork now for rebuilding the damaged economies. One of the first major initiatives to be rolled out in the new year are cash transfers and payments to families who no longer have breadwinners and survivors out of work. Many women in the Ebola-affected countries have taken in orphaned children of their family members or neighbors, despite having no steady income.

Dudu Kromah's husband died recently from ebola. She is looking after ten children, many of them orphans including a 3-month-old baby.
Dudu Kromah’s husband died from Ebola. She is looking after ten children, many of them orphans including a 3-month-old baby. She has no income. Carly Learson—Carly Learson / UNDP

According to UNDP leaders, plans for the payment process are still being refined. Lists of names of affected families and survivors are being collected and coordinated for small pilot programs, starting early next year, to test the effectiveness of the payments in preparation for widespread efforts. UNDP has calculated that around $50 will keep a family of five going in the three countries with essential needs for one month, with some variations by country. The group is anticipating making monthly payments to 150-200,000 people in each of the countries.

Ultimately, the payment program may develop into a cash-for-work model, with payments in exchange for work rebuilding communities in an effort to inject cash into the local economy and enable people to earn a living.

Ideas for how to get youth involved are also being considered. In Sierra Leone, Ruby Sandhu-Rojon, the deputy director of the UNDP Regional Bureau for Africa, spoke to young people concerned that since residents can no longer go to their local markets, they are unable to buy the food they need. “So why not start a delivery company to have food delivered to the different communities? How can we provide the start-up capital for young people who want to initiative those types of activities?” says Sandhu-Rojon.

The three countries and the U.N., which launched the U.N. Mission for Ebola Emergency Response (UNMEER) earlier this year, are also looking to the private sector. On Dec. 11 the U.N. held a U.N.-Business Collaboration for Global Ebola Response meeting as a way to get the private sector involved in both the response and recovery. A panel of high-level representatives from U.N. Missions in the affected countries, the U.S., U.K., and France put out a call for help from companies in areas major like logistics. Ultimately, the greatest plea was for companies to return to the countries and invest.

Sadly, all three countries were experiencing high growth rates before the start of Ebola, after coming out of conflicts like civil war. Sierra Leone had only recently launched its “Agenda for Prosperity,” a high-level initiative to become a middle-income country by 2035. High growth rates could largely be attributed to extractive industries like mining, which have now largely decreased their production or shut down, causing a government shortfall in revenue and massive loss of employment. Remaining national resources have been reallocated to the Ebola fight.

“It’s very disheartening, because all three of these countries were on their way up,” says Sandhu-Rojon.

The hope is cash payments will be a boost to help people get by. But increasingly more support and funding will be needed from the international community and private sector to get the countries back on their feet. Whether the countries will make it back to pre-Ebola growth may be a much greater, and longer battle.

TIME ebola

5 Million Kids Aren’t in School Because of Ebola

Schools closed in Sierra Leone after Ebola outbreak
A classroom of a school stands abandoned on Aug. 25, 2014 in Kenema, Sierra Leone. Schools closed and villages quarantined after dozens of its congregation died with Ebola symptoms. Mohammed Elshamy—Anadolu Agency/Getty Images

Children from Guinea, Sierra Leone and Liberia are still out of school. Here's what's being done

Public schools in Guinea have been closed since March. Schools in Sierra Leone and Liberia never opened after the summer holiday. All told, the children’s rights and emergency relief group UNICEF estimates that 5 million children ages 3 to 17 are out of school due to Ebola.

“This Ebola crisis has been predominantly seen as a health crisis but its implications go way beyond health,” says Sayo Aoki, an education specialist for UNICEF working in the affected countries. “It’s time we start looking at it from other perspectives, and education is part of that.”

Some schools were closed out of fear the disease could spread in large gatherings while others had no access to water, making handwashing impossible. But the longer a child stays out of school, the less likely it is he or she will return—which is why UNICEF is working closely with the Ministry of Education and Ministry of Health to come up with protocols necessary to implement in order to let children back into the classrooms. The draft—which calls for measures like Ebola screenings, hygiene requirements and a plan in the event a suspected case—is currently being reviewed by experts at the Centers for Disease Control and Prevention in the U.S. and the World Health Organization.

MORE: TIME’s Person of the Year: Ebola Fighters

In the meantime, UNICEF and partner NGOs have trained out-of-work teachers to act as “social mobilizers,” going door to door to spread messages about how to identify Ebola and prevent its spread. UNICEF and partners are also using the radio programs to offer long-distance learning while kids are kept at home. “We are trying to make [the radio shows] simple and more interesting so children will get some learning,” says Aoki. “If they listen to it at a certain time of the day during the week, it gives them a routine they’ve lost from not going to school. It brings them a sense of normalcy, some sort of stability and hope.”

Stability has been largely destroyed for many children living in Ebola-affected countries. Many have seen family members, friends and neighbors get infected, and many have become orphans as well. Ebola has also changed social mores. “Nobody shakes hands in public,” says Aoki. “It has put a lot of stress on children. There’s no cuddling, no hugging, no kissing. The simple joys of life have been taken away.”

Even before Ebola, Guinea, Sierra Leone and Liberia were economically troubled countries still emerging from conflict and civil war. Guinea and Liberia were in the process of increasing their school attendance numbers—Guinea was at 58% and Liberia was at 34%—and experts worry that Ebola has set progress back. School closures, including private schools, are also a bad economic indicator. Jeff Trudeau, the director of The American International School of Monrovia (AISM) told TIME in August that he lost more than half his expected students for the 2014 school year, many of whom were children of foreign families who moved to the region for jobs in Liberia’s burgeoning business sector. That school’s earliest possible start date is January and for others, there appear to be “moving” deadlines for reopening. Guinea is aiming for January while Liberia and Sierra Leone are hoping for March.

But all the countries will have to patiently wait until their caseloads are under control, since a premature opening may only add fuel to the fire.

TIME ebola

Sierra Leone Has Overtaken Liberia in Ebola

A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone.
A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone, Nov. 22, 2014. Daniel Berehulak—The New York Times/Redux

It now has more cases than anywhere in the world

Sierra Leone has the highest number of Ebola cases of any country, according to the most recent World Health Organization statistics.

Sierra Leone has seen 7,780 cases of Ebola, more than the 7,719 cases in Liberia, WHO figures published on Monday show. Some 17,800 people have fallen ill with virus in those two countries and in Guinea, 6,187 of whom have died.

In the WHO’s latest situation report, published last week, the group said its goal of safely burying 70 % of Ebola victims and isolating 70 % of Ebola patients had been met in “most districts” of the three hardest-hit West African countries. The WHO cited Liberia as a bright point in the global effort to contain the disease, reporting that case incidence was “stable or declining” in the struggling nation, where 3,177 people have died from the disease.

Yet the WHO said that transmission of the virus was still “intense” in Sierra Leone, which at the beginning of the month reported more than 500 new cases over a period of just days.

TIME infectious diseases

Malaria Deaths Have Almost Halved Since 2000 Says WHO Report

But eliminating the disease altogether remains an uphill task

Global deaths from malaria, as well as the number of overall malaria cases, have reduced dramatically in the last thirteen years, the World Health Organization said in a statement on Tuesday.

According to the World Malaria Report 2014, the mortality rate for the disease decreased by 47% worldwide since 2000, and the number of people infected by it went from 173 million the same year to 128 million in 2013.

“We have the right tools and our defenses are working,” said WHO Director-General Dr. Margaret Chan. “But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

The report attributed the progress combating malaria to increased access to insecticide-treated mosquito nets and enhanced diagnostics and treatment, but admitted that there is still a lot of work to be done.

The increased susceptibility to the disease in Ebola-affected countries like Guinea, Liberia and Sierra Leone is an added cause for concern.

TIME ebola

Top U.S. Commander in Africa Is Optimistic on Liberia’s Battle With Ebola

David M. Rodriguez
United States Army General David M. Rodriguez serving as the Commander for United States Africa Command (AFRICOM) meets with Ali Laarayedh (Not seen), the Tunisian PM, on Nov. 21 in Tunisia. Anadolu Agency—Getty Images

“The trend lines are all moving in the right direction,” says Gen. David M. Rodriguez

The top American military commander for Africa on Wednesday gave a vote of confidence to the international effort to halt Ebola, saying that the U.S. mission against the virus might be able to scale back its operations in Liberia by next month.

Gen. David M. Rodriguez told reporters at the Pentagon that U.S. troops deployed in Liberia might be shifted to other hard-hit countries in the region, or even sent back home, if progress reports continue to encourage optimism. The latest status report from the World Health Organization (WHO), released on Wednesday, said that cases in Liberia are “stable or declining,” but was cautious in its assessments for Sierra Leone and Guinea.

“The majority of the big engineering and logistic things in Liberia will probably start to tail off at the end of the year or January,” Rodriguez said. “The trend lines are all moving in the right direction.”

Some 2,900 U.S. troops have been deployed to West Africa to help contain the Ebola virus, which has killed 6,070 people and infected 17,145. The WHO says that while its goals for the region – treating 70 percent of all infected people and safely burying 70 percent of all people killed by the virus – have been met in “most districts” of the three worst-hit countries, “serious shortfalls” persist in other parts of the region.

In its most recent update, the WHO said that transmission of the virus is “slightly increasing in Guinea” and “remains persistent and intense” in Sierra Leone, where 202 new cases have been reported in the capital, Freetown, since Nov. 30.

Meanwhile, Liberia reported just 43 new cases nationwide over a five-day period, down from 78 cases the previous week, the WHO says. The country still overall has the highest number of Ebola-related deaths out of the three countries, with more than 3,000 killed by the virus.

The U.S. mission began in September and is expected to include up to 4,000 U.S. troops and last at least a year.

TIME ebola

The First Attempt to Digitize Ebola Health Records

Ebola treatment in West Africa is going digital

Keeping detailed patient records during the Ebola outbreak can be a nightmare.

Currently, health care workers use very basic methods, ranging from scanning files to writing on white boards to calling results across rooms to simple memorization. But the International Rescue Committee (IRC), a crisis organization, is about to change that by bringing in electronic health records to its new Ebola treatment unit opening the week of Dec. 15 in Monrovia, Liberia.

“There’s a rule in medicine that if it’s not written down, you didn’t do it,” says Dr. Wilson Wang, a senior clinical advisor for IRC’s Ebola response. Wang says the new electronic health record system can be used for health care accountability and to record decisions made, as well as those decisions’ outcome. IRC’s new system can be accessed via waterproof Sony tablets that can be brought into high-risk zones. The devices will still destroyed when the unit is no longer needed, but the actual data will not be lost. The system was developed by IRC’s own technology team with the help of health software company Vecna.

Some of the patient data will be handed over to the Liberian Ministry of Health to aid in contact tracing, but IRC says other data that doesn’t identify patients will be shared publicly in some capacity. That data could consist of what specific Ebola treatments are being provided, how many patients are seen in the unit, what percentage of patients test positive or negative for the virus, how many people survived, and among those who didn’t, where did they go? In the future, this may aid in other outbreaks, and help scientists and researchers understand what went right and wrong in the current outbreak.

“We want to share [the system],” says Wang. “We plan to essentially give it away, but we want to demonstrate that it works.”

It will also enable physician support. Currently, doctors treating Ebola rely on their own experiences and what’s reported to be successful in the past to determine how to treat a person, but Wang says there’s not a single place doctors can go to get the most up to date data on what’s working in the current outbreak. The new system could make it easier for doctors to get directions on how much medication they should provide, for instance, or what to do when someone has a seizure. “When providers are under stress, and even when they’re not, they make mistakes. They’re human,” says Wang. It’s his hope that this technology could help doctors avoid some of those mistakes by giving them a resource to turn to.

IRC has been in West Africa for over two decades often helping hospitals with infrastructure. When the current outbreak is contained, IRC says it plans to find a way to use the system to help rebuild the currently devastated health system in Liberia—even if it’s just to aid in administrative tasks. “Hospitals need a system to manage this type of data and place orders [for resources and drugs],” says Wang. “[Right now] it’s sort of like coming up with a grocery list for a party when you don’t know what people are going to eat.”

In the meantime, IRC plans to roll out the system in its own unit in mid-December, and plans to continue to refine the platform as they go.

“We think this has the potential to really change not only how quality and safety is addressed in an Ebola situation, but it can also be adapted to any health care situation,” says Wang.

TIME Guinea

15-Minute Ebola Test To Undergo Trials in Guinea

The device can diagnose the deadly virus six times faster than methods currently used in West Africa

A rapid diagnostic test for the Ebola virus is about to be trialed at the Ebola treatment center in Conakry, Guinea, The Wellcome Trust announced Friday.

The new test, which can analyze blood or saliva samples, can make a diagnosis within just 15 minutes. Current technology can take anywhere from a couple of hours to four days to yield an accurate result.

“A reliable 15-minute test that can confirm cases of Ebola would be a key tool for effective management of the Ebola outbreak, allowing patients to be identified, isolated and cared for as soon as possible,” said Dr. Val Snewin from Wellcome, the international health charity funding the trials alongside the British government.

The trial will use a “mobile suitcase laboratory” which is solar-powered for use in remote locations with limited power.

Snewin added that a rapid test “not only gives patients a better chance of survival, but it prevents transmission of the virus to other people.”

MORE: Here’s how the Ebola vaccine trial is doing

Also on Friday, French President Francois Hollande visited Guinea, marking the first trip by a Western leader to a country affected by the Ebola crisis. France has pledged $125 million to help the former French colony tackle the epidemic.

The Ebola virus has claimed at least 5,689 lives in the current outbreak in West Africa, and infected three times as many.

The World Health Organization said last week that the situation was “stable” in Guinea, though it continues to deteriorate rapidly in Sierra Leone.

 

TIME ebola

Ebola Cases in Sierra Leone Will ‘Soon Eclipse’ Liberia

Members of the burial team carry a body to his grave at King Tom Cemetery in Freetown, Sierra Leone, on Nov. 19, 2014.
Members of the burial team carry a body to his grave at King Tom Cemetery in Freetown, Sierra Leone, on Nov. 19, 2014. The Washington Post/Getty Images

1,339 cases of the country's 6,599 overall were recorded in three weeks in November

Sierra Leone will “soon” dethrone Liberia as the hardest-hit country in West Africa’s Ebola outbreak, the World Health Organization cautioned Wednesday.

Nearly one-fifth of Sierra Leone’s total cases of Ebola were reported in a three-week period that ended Sunday, according to new figures released by the global health agency. WHO reports that 1,339 of the country’s 6,599 known cases (including 1,398 deaths) were reported in the 21 days prior to Nov. 23.

Six hundred cases were reported throughout the three most-affected countries overall in the past week.

Transmission remains “intense” in Sierra Leone, the assessment states, mostly due to heavy transmission in the western and northern regions. That’s in contrast with Guinea, where more than 2,100 cases (including 1,260 deaths) have been reported, and in Liberia, which is currently the worst-hit, with 3,016 of its 7,168 cases having proven fatal.

The uptick comes after the United Nations recently announced it will not reach its goal of Ebola containment in the three most-impacted nations by Dec. 1.

The U.N. Mission for Ebola Emergency Response (UNMEER) has deployed personnel and resources to West Africa to control the outbreak. Some experts say more mobile treatment facilities are needed instead of large 100+ bed facilities, since many of the countries’ outbreaks are popping up in regions that are more spread out and hard to reach.

In Sierra Leone, however, the capital of Freetown remains the worst-affected area. Overall, more than 15,935 people have contracted the virus, resulting in at least 5,689 deaths.

TIME ebola

The U.N. Says It Cannot Meet Its Dec. 1 Target Date for Containing Ebola

TOPSHOTS-SLEONE-HEALTH-EBOLA-WAFRICA
A cemetery at the Kenama Ebola treatment center in Sierra Leone run by the Red Cross Society on Nov. 15, 2014 Francisco Leong—AFP/Getty Images

"Intense" transmission of the virus in West Africa, especially in Sierra Leone, continues to bedevil efforts

The U.N. mission responsible for responding to the Ebola outbreak will miss its Dec. 1 target for containing the disease because of rising transmission rates in the West African countries of Sierra Leone and Mali.

Anthony Banbury, the head of the U.N. Mission for Ebola Emergency Response (UNMEER), told Reuters that though progress has been made in some areas — including in Liberia, one of the countries hardest hit by the current outbreak — setbacks elsewhere have put the mission off its target.

UNMEER said in September that it hoped to have 70% of Ebola patients in treatment, and 70% of Ebola victims safely buried, by the start of next month. But just 13% of Ebola patients have been isolated in Sierra Leone, according to a UNMEER statement.

“Progress is slow and we are falling short, and we need to accelerate our efforts,” said Amadu Kamara, the U.N.’s Ebola crisis manager for Sierra Leone, in a statement.

The Ebola virus has killed some 5,459 people worldwide, mostly in Liberia, Sierra Leone and Guinea. The most recent World Health Organization situation report, released on Friday, describes transmission rates in all three countries as “intense.”

Mali, which was believed to be Ebola-free after a toddler’s death from the virus there in October, said on Monday that an eighth person in the nation had tested positive for the disease.

Still, UNMEER said that it is hopeful that efforts to stop the virus in Mali will benefit from lessons learned in the three nations still reeling from Ebola.

Banbury also told Reuters that Liberia was a bright point in the mission’s efforts to contain the virus.

Liberia’s President expressed optimism at a ceremony on Monday that her country, whose economy has been gutted by the outbreak, could still reach its goal of no new Ebola cases by Christmas.

“We’ve set a pretty tough target,” said President Ellen Johnson Sirleaf, the Associated Press reports. “But when you set a target, it means that you stay focused on that target and on that goal.”

TIME ebola

U.S. to Grant Temporary Protection Status for People From Ebola-Hit Nations in West Africa

Liberia Battles Spreading Ebola Epidemic
A mother and child stand atop their mattresses in a classroom now used as Ebola isolation ward on Aug. 15, 2014, in Monrovia, Liberia John Moore—Getty Images

People from Liberia, Guinea and Sierra Leone who were in the U.S. as of Thursday

The United States will issue a temporary protected status to people residing in the country from the three nations hit hardest by the Ebola outbreak in West Africa, homeland security officials said in a report Thursday.

Reuters reports that people from Liberia, Guinea and Sierra Leone who were in the U.S. as of Thursday would be eligible for deportation protection for at least 18 months and could also apply for work permits. The 8,000 people estimated to be eligible will be unable to visit home and return in a bid to prevent more Ebola cases arriving in the U.S.

Any extension of the protection will be reassessed after 18 months based on how severe the Ebola outbreak remains in West Africa, the report adds. More than 5,000 people have died from the virus in the worst outbreak in recorded history, the World Health Organization reports.

Read more at Reuters

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