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At a glance: Sierra Leone

In Sierra Leone, bringing isolation closer to home

By John James

Instead of sending Ebola patients sometimes hundreds of miles away, treatment and care are being established in the hardest-hit areas of Sierra Leone through construction of dedicated facilities and training of health workers.

BOMBALI DISTRICT, Sierra Leone, 20 November 2014 – “Well, we thank God for the Community Care Centres, but it’s not easy working here,” says nurse Josephine Conteh as she waits for the first patients to arrive at the new eight-bed care unit, known as a CCC, in the village of Pate Bana Mara in Bombali District, northern Sierra Leone.

© UNICEF Sierra Leone/2014/James
Nurse Josephine Conteh at the new Community Care Centre in Pate Bana Mara, Bombali District, northern Sierra Leone.

Until a few days ago, the village was quarantined; construction workers getting to the CCC site had to pass a red ribbon put up around the village after as many as 100 Ebola cases were reported there.

“We are expecting patients to come in, and we are ready to receive them and care for them, give them the best treatment that we can provide as nurses,” says Ms. Conteh. “We don’t want to see anyone die in this community, especially Pate Bana, because they have suffered a lot, so we are fighting hard so that it does not occur again.”

More than 200 clinical health workers and hygienists have been trained to work in the 10 new CCCs established by UNICEF in Bombali District. Many workers come from the same communities they work in, part of an effort to bring isolation treatment and basic care closer to the village level.

New Ebola cases continue to be reported in Bombali District, one of the most heavily affected parts of the country, with 709 confirmed cases, out of Sierra Leone’s 5,056 cases, according to government figures (as of 17 November).

Community owned

At a nearby CCC in Mapaki, site manager Kamel Sesay says the new centre will reduce delays and make care more transparent. He said villagers didn’t really understand what was happening when sick people were sent hundreds of miles away for treatment.

“But now, we are here, you can see, you can pay a visit, the patient can talk to you and there are community health workers who are our brothers, so these are the differences,” he says.

© UNICEF Sierra Leone/2014/James
The CCCs are run by the Government’s District Health Management Team, with supplies and support from UNICEF and local partner World Hope International, and funding from the UK Department for International Development.

The centres are run by the Government’s District Health Management Team, with supplies and support from UNICEF and local partner World Hope International, and funding from the UK Department for International Development (DFID).

“This is really community owned – you just have to look at the architecture of it,” says Shanelle Hall, head of UNICEF’s global supply division, who visited the sites. “You can see that the facilities are such that people can come visit their loved ones that are in isolation and are being care for. It’s staffed by people from the community, so it really is supposed to build trust, provide a service and help change behaviour.”

Huge difference

The initial CCC pilots were set up by the World Health Organization in Port Loko District and other agencies, and partners are now looking to expand units across the country.

Working with communities is a key part of the process. Ahead of construction, there were extensive consultations with local authorities and traditional chiefs to determine the most appropriate sites.

That process is now being replicated in Phase II of the project, which will see more than 10 sites set up in neighbouring Tonkolili District, as well as five more in Bombali District.

“I think it makes a huge difference,” says Patrick Umarau Koroma, representing Mapaki’s Paramount chief during a visit to the site. “Our people up to this point did not believe that Ebola is real, but seeing a place like this convinces them that this is a dangerous disease that has entered our communities. The centre alone tells them ‘Yes, indeed – Ebola is real.’”



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