Decent work ILO Decent Work Team for West-Africa and ILO Country Office for Senegal, Cabo Verde, the Gambia, Guinea, and Guinea Bissau (DWT/CO-ILO/DAKAR)
A quarterly information magazine on Decent Work in West Africa
Volume 1 - N째 03 / December 2015
EBOLA and the World of Work INTERVIEW
PERSPECTIVES
CURRENT EVENTS
Gilbert Houngbo
The Informal Economy
Senegal
ILO Deputy Director General for Field Operations and Partnerships
Views and experiences of five experts
Adoption of a strategy for the promotion of green employment
INTERNATIONAL LABOUR ORGANIZATION groups in society and to improving working conditions and safety at work.
Promoting Jobs, Protecting People
ENSURE SOCIAL PROTECTION FOR ALL 01 02
Lack of access to social protection is a major obstacle to economic and social development
03
A social protection system well designed is an important tool to reduce poverty and inequality and contribute to inclusive development and social justice
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DWT/CO-ILO/DAKAR www.ilo.org/dakar ; dakar@ilo.org / Tel : +221 33 869 92 00
Decent Work
Sommaire CONTENT
©Simon Davis/DFID
5 Editorial
59 READERS’ CORNER
Join forces to bridge the gaps highlighted by Ebola
Director General’s Report: the Role of ILO in the Post-Ebola Recovery Efforts
6 INTERVIEW
Guinea: Post-Ebola Socioeconomic Recovery and Resilience Strategy 2015 – 2017
Gilbert Houngbo, ILO Deputy Director General for Field Operations and Partnerships: “For each country affected by Ebola, we will build a consensus on national priorities for decent work”
56 PORTRAIT 10 FOCUS ON Ebola and the world of work
“Overcoming the Ebola crisis”. Report proposed by the United Nations, the World Bank, the European Union and the African Development Bank
62 CURRENT EVENTS Transition from informal to formal economy: Frenchspeaking Africa lays the bridge Promotion of green employment: Senegal validates its strategy
66 PERSPECTIVES Informal Economy Five experts express their views
Hadja Rabiatou Sérah Diallo
December 2015
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Decent work © photo UNMEER/Martine Perret
Copyright © International Labour Organization 2015 First published in 2015 Publications of the International Labour Office enjoy copyright under Protocol 2 of the Universal Copyright Convention. Nevertheless, short excerpts from them may be reproduced without authorization, on condition that the source is acknowledged. For reproduction rights or translation, applications should be made to ILO Publications (Rights and Permissions), International Labour Office, CH-1211 Geneva 22, Switzerland, or by email: pubdroit@ilo.org. The International Labour Office welcomes such applications. Libraries, institutions, and other users registered with reproduction rights organizations may make copies in accordance with the licences issued to them for this purpose. Visit www.ifrro.org to find rights organizations in your country.
ILO Cataloguing data before publication Decent Work: information magazine on labour in West Africa / International Labour Organization, ILO Decent Work Team for West-Africa and ILO Country Office for Senegal, Cabo Verde, the Gambia, Guinea, and Guinea Bissau - Dakar: ILO, 2015 (Decent Work: Vol.1, No 2/July 2015) ISBN: 978-92-2-230605-3 (print); 978-92-2-230606-0 (Web pdf ) ILO DWT for West Africa and ILO Country Office for Senegal, Cabo Verde, the Gambia, Guinea, and Guinea Bissau Decent work/Ebola/occupational safety and health /social protection/outbreak/West Africa 13.01.1
COVER
Abdoulaye NDAO (layepro.com)
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DIRECTOR OF PUBLICATION
François MURANGIRA, Directeur ETD/BP-OIT/Dakar
EDITOR IN CHIEF Djibril NDIAYE
EDITORIAL BOARD
Djibril NDIAYE, Caroline KANE, Mohamed Elimane LÔ, Fatime Christiane NDIAYE, Pius UDO, Yusuf AIYELABEGAN.
CONTRIBUTORS TO THE PRODUCTION OF THIS ISSUE:
Gilbert HOUNGBO, François MURANGIRA, Djibril NDIAYE, Caroline KANE, Fatime Christiane NDIAYE, Pius UDO, Yusuf AIYELABEGAN, Mohamed Elimane LO, Dr Rosnert Ludovic ALISSOUTIN, Dr Khai TONTHAT, Xenia SCHEIL-ADLUNG, Theopiste BUTARE, Victoire UMUHIRE, Odile FRANK, Hadja Nantenin DIOUMESSY, Dr El Hadj Ibrahima BAH, Angéline TINGUIANO, Damantang Albert CAMARA, Sanaba KABA, Sophie Danielle KOUROUMA, Ansoumane CAMARA, Abdou Amy DIENG, Hadja Rabiatou Sérah DIALLO, Pr. Ahmadou Aly MBAYE, Hamidou SAWADOGO, Edmond Comlan AMOUSSOU, Coumba DIOP, Fréderic LAPEYRE, Abdoulaye NDAO, Mamadou NDAW.
Decent Work
DWT/CO-ILO/DAKAR ILO Decent Work Team for West Africa and ILO Country Office for Senegal, Cabo Verde, the Gambia, Guinea, Guinea Bissau (DWT/BP-Dakar) www.ilo.org/dakar ; dakar@ilo.org ; Phone : +221 33 869 92 00
Join forces to bridge the gaps highlighted by EBOLA
EDITORIAL
The lesson to be drawn from this painful experience caused by the Ebola outbreak is the fundamental role of social partners (workers and employers) and the civil society in the promotion and effective realization of good political, economic and social governance.
I
n the past two years, three countries of our West African sub-region (Guinea, Liberia and Sierra Leone) were shaken by an unprecedented crisis due to the Ebola outbreak. This health crisis “is the largest, longest, most severe and most complex in the nearly four-decade history of the disease.” (Guy Ryder, Director General of ILO)1. At the economic level, the Ebola outbreak reduced investments in the affected countries and had a severe impact on the key development sectors. Agriculture, mining industries, services, public works and the food industries, which are engines of growth, bore the full brunt of the crisis. The informal economy which employs the most vulnerable populations was not spared either. In fact, the many deaths, the inactivity of people affected and/or related to patients and victims, just like the closing of the affected countries’ borders have exacerbated poverty, unemployment and underemployment. In terms of health, the outbreak has led to the loss of many lives and an emotional and social disaster for victims and their families. “Health care workers have paid a heavy price to save lives in the fight against Ebola, with a confirmed total of 513 health workers losing their lives from the start of the outbreak representing 5 per cent of all reported EVD deaths in Guinea, Liberia and Sierra Leone.” (Guy Ryder, ILO Director General)2. The significant number of people who suffered and lost their lives in Liberia, Guinea and Sierra Leone brings to light the serious shortcomings and defects in health coverage and access to essential services of social protection systems in the region.
At the social level, habits were upset by the disease. “People who are used to spending a whole week with a family which is said to have registered a death are urged not to come, when a close relative dies, you should not touch the body, you should not attend the funeral to mark a sacred departure, you should not go to the cemeteries, you should not pray on the body of your close relative.” (Sanaba Kaba, Guinea’s Minister of Social Action and the Promotion of Women and Children)3. In the face of this dire human distress, social trauma and economic misery caused by this outbreak, ILO contributed to the efforts deployed by the international community and affected countries to rebuild and rehabilitate the social and economic fabric. In this regard, the Board of Directors, in its session held in October 2015, adopted the following lines of action for ILO: a) for each country, build a consensus on the national priorities with regard to decent work through an inclusive social dialogue and the strengthening of the role of public sector workers; b) create decent jobs and improve skills through labour-intensive programmes; c) reinforce the social protection systems to gradually arrive at a universal coverage; d) improve the protection of children within the framework of activities aimed at abolishing child labour; e) promote the recovery of the private and public sectors by developing the culture of prevention through Occupational safety and health (OSH) Programme; f ) promote a post-Ebola integrated regional process within
ILO. - The role of ILO in the post-Ebola recovery efforts: Director General’s report: third additional report: fifteenth item on the agenda. - October 12, 2015. - 9p. - (GB.325/ INS/15/3) 2 Idem 3 Discussion with Sanaba Kaba, Guinea’s Minister of Social Action and the Promotion of Women and Children (page 48)
the framework of the Mano River Union (MRU) and the Economic Community of West African States (ECOWAS). To ensure functionality and effectiveness of these recommendations, the Dossier published in the third edition of the Decent Work magazine proposes various measures which focus on the following issues: • the effects of the disease on the economic and social situation of the affected countries; • measures to be taken to improve hygiene, occupational safety and health (OSH) in the workplace in order to maintain the operational continuity of businesses and protect workers; • the consequences of social security shortfalls on health and measures to be taken to establish and/or improve social security systems, particularly, the promotion of universal health that will help deal with serious health problems such as Ebola. As was the case in previous issues, we have provided ILO constituents (government, employees and workers) with the opportunity to share their views on the matter. Media reports were prepared to enlighten people on the situation and give voice to the populations at the grassroots. The lesson to be drawn from this painful experience caused by the Ebola outbreak is the fundamental role of social partners (workers and employers) and the civil society in the promotion and effective realization of good political, economic and social governance, because the outbreak and acuity of this pandemic is rooted in the shortcomings noted in these areas. Enjoy reading!
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François MURANGIRA Director, DWT/CO-ILO/DAKAR
December 2015
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INTERVIEW
Mr Gilbert HOUNGBO ILO Deputy Director General for Field Operations and Partnerships “For each country affected by Ebola, we will build a consensus on national priorities for decent work�
Previously Prime Minister of Togo (September 2008 - July 2012), Mr. Gilbert Houngbo joined the International Labour Organization (ILO) in 2013. In this interview, ILO Deputy Director General for Field Operations and Partnerships, among other issues, outlines the missions entrusted to him; the results of the reform of ILO field activities and the support that our Organization intends to provide to the three West African countries that have just experienced an Ebola outbreak (Guinea, Liberia and Sierra Leone).
You are ILO Deputy Director General for Field Operations and Partnerships. What does your mission entail? The DDG/FOP supervises the operations of the ILO and ensures that ILO activities in Member States reflect the values of the Organization, address the priorities set by the constituents and attain a high level of effectiveness and efficiency. It provides operational guidance to the regions and is in charge of optimizing co-operation between the regions and the head office. It is also responsible for coordinating the allocation of resources to regions, harmonizing the mobilization of resources with the priorities of the ILO programme and establishing external partnerships, in particular within the framework of the Sustainable Development Goals (SDGs). Decent Work
It goes without saying that as part of his responsibilities, the DDG/FOP works in close collaboration with his peers, in particular the Deputy Director General for Policies (DDG/P) and the Deputy Director General for Management and Reform (DDG/MR). The International Labour Office has initiated an in-depth reform of its field activities. What are the results of this reform and its impacts on ILO policy and intervention strategies in Africa? I am sure you are aware of the periodic communications issued by the Director General on this matter. The initiative to reform field operations has achieved tangible results. A relevant
example is the mobility policy implemented for almost a year, the reallocation of resources (so far assigned to administrative functions) to technical positions, an enhanced realignment of the geographic coverage (IGDS Number 442, Version 1, of November 11, 2015), an improved modus operandi between the technical teams in the fields and their counterparts at the head office, decentralizing the management of projects from the head office to the field, a better repositioning of our regional offices within the framework of the role that ILO is expected to play through the implementation of the SDG, etc. Africa is composed of several low-income countries and some countries are in a fragile state (for economic, security reasons and/or for lack of health care). Due to the manifold constraints, particularly those relating to their budgetary capacities, these countries have enormous difficulties to successfully and fully carry through the initiatives they take to implement the Decent Work Agenda. How does ILO intend to support these countries in their efforts to implement policies and strategies to mobilize the
resources necessary to achieve their goals? The review of ILO field activities has highlighted the need for ILO to align its interventions to the typology of the countries. ILO expertise at the normative as well as the operational level must be made more available to the constituents. I am convinced that ILO interventions in the situations you have described will be increasingly focused. The PPTD preparation processes should be more aligned to the national development plans which must integrate the necessary tradeoffs in resource mobilization and allocation. The initiative of the five flagship programmes (Better Work; Revised international programme for the abolition of child labour and forced labour-IPEC; World initiative for preventive action in the field of occupational safety and health; Employment at the service of peace and resilience; The social protection floor) will also make it possible to address emergencies such as
those experienced recently in various countries. We will also draw lessons from the recent evaluation of ILO technical assistance to better assist our countries. In short, we would need to strike the right balance between, on the one hand, the dire necessity to galvanize the role of ILO within the framework of global public goods related to the world of work, and on the other, a greater flexibility that would enable us to rapidly meet the pressing needs on the ground against a background of capacity building for our constituents.
“The initiative to reform field operations has achieved tangible results.”
Today, taking into account your experience in government and your position as key collaborator of ILO Director General in charge of interventions in the field, what role do intend to play to maintain and/or improve the quality of relations between government partners and social partners of African countries? Social dialogue is still a very important goal for ILO. Our
Department of Governance and Tripartism contributes a lot in this field, with the assistance of specialists. My role is to encourage them further to help to improve the quality of relations between governments and social partners. Labour legislation, professional relations and social dialogue are essential for the economic and social organization of African States. Solid professional relationships and an effective social dialogue are means of promoting better wages and better working conditions, as well as peace and social justice. As instruments of good governance, they promote co-operation and economic performance while contributing to the creation of an environment conducive to achieving the decent work objective at national level. What do you intend to do to strengthen the capacities of African countries to address the challenges of the world of work? As Deputy Director General, I work within a team directed by the Director-General, I can therefore answer your question on behalf of the Office because our work is collective and involves several departments and units. We act as “one ILO”. The challenges of the world of work in
December 2015
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INTERVIEW
African countries will be given pride of place in the discussions at the next African Regional Meeting scheduled from 30 November to 3 December, 2015 in Addis Ababa, Ethiopia. The Director General’s report to this meeting, “Towards an Inclusive and Sustainable Development in Africa thanks to Decent Work”, notes that the continent has registered significant economic progress these past years but that social progress is uneven. Admittedly, extreme poverty has globally followed a decreasing trend, but the same cannot be said about social inequalities. Africa has high demographic growth rates, which creates an immense need for decent work opportunities for young women and men. In 2003, Africa had a birth rate of 33.9%, i.e. 33.9 children were born for 1 000 inhabitants. It is, by far, the continent with the highest
birth-rate. The generations joining the workforce by 2030 represent an immense potential but if their expectations are not met, Africa might have to face an aggravation of all its social problems. Social cohesion is at stake. ILO is ready to shoulder its responsibilities within the United Nations family to «promote a strong, inclusive and sustainable economic growth, full and productive employment and a decent job for all» as recommended by the 2030 Programme pursuant to its objective 8. We provide our conception of decent work at the service of this objective and other sustainable development goals. In tandem with the issue of employment and rights, this conception also includes social protection, whose mission is twofold: cushion the shocks for those who are unable
“ILO expertise at the normative as well as the operational level must be made more available to the constituents.”
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to work and earn adequate income to lead a decent life, on the one hand, and, on the other hand, constitute a bedrock that prevents the resurgence of poverty. To this end, ILO intends to use its new technical cooperation strategy adopted by the Board of Directors in November 2015. One of the four pillars precisely consists in strengthening the capacities of our constituents to further influence the decision-making processes at national and international levels. We had, earlier on, mentioned the existence of fragile countries in Africa. The EBOLA outbreak has led to the deterioration of the socio-economic conditions of three African countries (Guinea, Liberia and Sierra Leone), thus worsening their fragility. Can you tell us how the ILO intends to assist these countries to recover and develop resilience to EBOLA and similar outbreaks? The Ebola outbreak in these three countries was the most widespread, the most severe and the most complex that West Africa has ever experienced over the last decades. In September 2014,
the United Nations Security Council considered this outbreak “as a (global) threat for international peace and security”. This epidemic exposed the precariousness, if not the absence of a minimum level of social protection and unreliable health care system. In January 2015, ILO participated in the United Nations system-wide evaluation mission, to assess post-Ebola recovery activities, based on its areas of expertise. We intend to intervene in the following five axes: - on the basis of lessons learnt from the Ebola outbreak, ensure that for each country, a consensus is reached on the national priorities for decent work through an inclusive social dialogue and the enhancement of the role of public sector workers; - create jobs and improve skills through labourintensive programmes that will help establish productive and sustainable infrastructure to increase the number and quality of essential public services, with special attention to female workers; - strengthen the social protection systems to gradually achieve universal coverage; improve the protection of children within the framework of activities for
the elimination of child labour; - promote the recovery of the private and public sectors by developing the culture of prevention through occupational safety and health (OSH) programmes implemented throughout the supply chains, in collaboration with the representatives of governments, employers and employees; and - promote a regional integrated post-Ebola recovery process within the framework of the Mano River Union (UFM/ MRU) and at the level of the Economic Community of West African States (ECOWAS). ILO intends to carry out these activities in partnership with the United Nations, the European Union, the World Bank and the African Development Bank.
We have reached the end of this interview. What do you wish to add? As we embark on the implementation of SDGs by 2030, the challenge facing Africa, in general, and each of its countries, in particular, lies in the need to simultaneously pursue the three major pillars of the SDGs i.e. the economic, social and environmental pillars. According to the IMF report, economic growth in Africa has averaged 5% since 1999. This is highly commendable! Even though it is below the 7% considered as a minimum rate to be attained if we want to truly and sustainably reverse extreme poverty. But let us not deceive ourselves. What use is economic growth primarily
“Admittedly, extreme poverty has globally followed a decreasing trend, but the same cannot be said about social inequalities.�
based on GDP or GDI if it does not go hand in hand with effective poverty reduction and a decisive reduction of the inequalities? What use is economic growth if it does not allow young people to raise their self-esteem through decent work, an enhancement of their existence? We need more than ever to pursue our efforts for greater social justice without which there can be no sustainable development (I was going to say peace)!
December 2015
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EBOLA and the world of work The Ebola spectrum is increasingly dissipating, much to the relief of the three most affected countries (Guinea, Liberia, Sierra Leone) and of the rest of the world. Now that terror has given way to certainty, it is time to take stock in terms of losses in human lives, good practices, the consequences on all sectors and shortcomings, notably in the health and social security systems. As from 1st November 2015, the number of deaths due to the Ebola disease in each of the three countries was as follows: 4808 in Liberia, 3995 in Sierra Leone, 2536 in Guinea (WHO data). The number of deaths among health practitioners infected by the virus, was as follows, as of 21 October 2015: 4808 in Liberia, 3995 in Sierra Leone, 2536 in Guinea (WHO data). i.e. about 5% of all deaths caused by the disease. How did the world of work fare during this painful ordeal? Which post-Ebola strategies were prepared to bring the aggrieved countries up to par?
Decent work keeps you informed. Decent Work
In focus • The impact of Ebola on the economic and social situation of affected countries • Fight against Ebola: Maintain operational continuity and protect workers and businesses • Protection of universal health in the Ebola context: The ILO Strategy • Prevention and fight against the propagation of the Ebola disease: Focus on response measures • A national dialogue for the implementation of a social protection floor and the strengthening of social protection institutions • Workers of the public health sector at the heart of the Ebola crisis • List of health workers who died as a result of Ebola infection • Media reports in Guinea - Dr El Hadj Ibrahima BAH, Infectious Diseases Unit, Donka University Hospital: “There was mistrust even among us doctors» - Agriculture resilient to Ebola - Dealing with Ebola as a working woman: when the choice is difficult - Damantang Albert CAMARA, Minister of Employment, Labour, Technical Education and Vocational Training, Government spokesman: “80 companies have submitted economic lay-off plans” - Sanaba KABA, Guinea’s Minister of Social Action and the Promotion of Women and Children (page 48). “52% of the victims are women” - Sophie Danielle KOUROUMA, National Confederation of Guinean Workers (CNTG): “We hope that the support will arrive soon” - Ansoumane CAMARA, National Council of Guinean Employers: “Sectors have seen their turnover decline by up to 75%” - Abdou Amy DIENG, Head of Mission of the United Nations for Emergency Action against Ebola in Conakry: “I call on the population to adhere to the rules enforced by the government to eradicate Ebola”
©UNMEER/Martine Perret
December 2015
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The impact of Ebola on the economic and social situation of the affected countries by Dr. Rosnert Ludovic ALISSOUTIN, expert in planning, monitoring, results-based evaluation
This article is essentially based on a mission in Guinea sponsored by the International Labour Office, in prelude to the preparation for a PostEbola Recovery Plan in this country. It seeks to show how Ebola devastated and wreaked havoc in the economic and social life of the affected countries, and how the affected people, transforming the constraint into recovery opportunities, valiantly departed on an equal footing, to defy and overcome the disease.
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The Ebola outbreak in West Africa, the most severe since the virus was first identified in Central Africa in 1976 and spread to South Guinea in December 2013. It caused more than 11,200 deaths out of some 27,700 cases, according to the World Health Organization. More than 99% of victims are concentrated in Guinea, Sierra Leone and Liberia, where the disease disorganized the health systems, devastated the economies and scared investors away.
A profound and devastating trauma. The Ebola virus is one of the
most dangerous viruses known. It causes internal and external bleeding in humans leading to death in 60 to 90% of cases. It is transmitted among humans through direct contact with body fluids (blood, saliva…) and through the consumption of infected meat. The Ebola Virus Disease (EVD), with its spectacular symptoms and its high contagiousness, caused widespread panic even beyond its habitual borders, to such an extent that the «Science and Health Review, in its issue of May 2014, carried an article written by a concerned Andréa Fradin who, expressing his fear of a “cataclysmic pandemic” asked: “Ebola: and if an infected person arrived in Paris
Charles-of-Gaulle tomorrow? ». The tragedy of such a psychosis is that it is perfectly justified because everywhere Ebola has emerged; it caused economic distress and social stupor.
A social storm. Officially declared in
Guinea in March 2014, then spreading very quickly in Liberia and in Sierra Leone, the Ebola outbreak profoundly destabilized the respective economies of these countries, by instilling panic among actors and causing the decline of the activities of foreign companies, in particular in the mining, public works and food processing sectors. All these consequences aggravated poverty and vulnerability and are likely to delay the much awaited development dividends. The outbreak has thus worsened an already difficult social situation. It decreased investments and growth, led to the closing of companies, affected the livelihood of populations in the poorest communities, and gave rise to revenue losses at the economic level. In 2014, Guinea’s growth declined to 0.5 %, against 4.5 % before the outbreak. According to last estimates of the World Bank Group, growth losses due to the outbreak will amount to more than five hundred million dollars for Guinea in 2015.
Š LayeproPhotos
The Ebola outbreak was a surprise to Guinea which, obviously, did not have the means to respond effectively as only 3% of its national budget is devoted to health, while the WHO standard recommends at least 15%. It thus discovered the shortfalls of the social protection system, namely: incipient national social protection policy, weak institutional capacities required for the implementation of this policy, very weak social protection; etc. Ebola even shook the bases of African societies founded on the values of solidarity and mutual assistance. Indeed, the survivors of the disease narrated how the fear of contamination pushed the society to turn its back on them. The people simply suspected of being infected were physically and socially isolated. Everyone, including close relatives, avoided them. In the past, such a reaction was unthinkable in African communities which, though poor, are known for their spontaneous interdependence.
Ebola: an economic inhibitor. Before the Ebola crisis, the Guinean economy was expanding, with a real GDP growth rate rising from 1.9% in 2010 to 3.9% in 2012. The incidence of poverty grew by 2.2 points at the national level, from 53% in 2007 to 55.2% in 2012, with contrasting effects between the cities where poverty worsened by 4.9 points and the rural zones with a decline of only 1.9 point.
The World Bank reveals that the Ebola outbreak has seriously deteriorated the economies of the three most affected countries, Guinea, Sierra Leone and Liberia. It is estimated that their GDP suffered a loss of 2.2 billion US dollars in 2015: 240 million US dollars losses for Liberia’s GDP, 535 million for that of Guinea and 1.4 billion in the case of Sierra Leone. Countries react differently. Liberia is gradually finding its way to normalcy. The Guinean economy is trying to set out again. Sierra Leone is suffering and has difficulty to recover from the collapse of the mining sector. The outbreak has had a huge impact in the affected zones and, in particular, on markets, the agricultural and animal sectors as well as on sources of income such as farming, petty trade, hunting and the sale of bush meat. In the three affected countries where the economy is primarily informal, wholesale fish merchants, food vendors along the mining areas and restaurant managers strongly felt the crisis, as their turnover abruptly and drastically declined. Ebola had harmful consequences in all sectors of the economy. Many countries in Africa had closed their borders to nationals of affected countries and most airlines had suspended their flights to these countries. Visitors from Africa or elsewhere avoided the affected region for fear of contamination.
This led to a decline in the demand for hotels, airlines and providers of services connected to international activities. Only harsh recovery efforts can make up for such a loss of economic and financial earnings, which lasted more than a year. The results of the rapid evaluation show that the next crop year will register a decline of about 4% for rice production, the main staple food of the Guinean population. The contribution of agricultural production to GDP is slated to drop from 5.3 to 3.3 percent. According to the World Food Programme4, in areas affected by the Ebola disease, agricultural production for the 2014-2015 crop season was strongly hit by a shortage of labour. The agricultural chains are severely affected by a disruption in the operation of markets. Thus, farmers throughout the country have enormous difficulties to sell their stocks. The prices of local rice, market-gardening and animal breeding products have fallen in the affected zones where these food products are produced, resulting in the drastic decline of the farmers’ income. Survival strategies are increasingly used in the most affected zones, in particular in Guinea Forest Region. The reduction of the number of meals and the consumption of seeds were respectively reported at 74% and 59% in the communities affected by the Ebola disease. The food security of households, which
December 2015
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FOCUS ON CONTRIBUTIONS
depend on agricultural wageearning, petty trade, hunting and the sale of hunting products, has deteriorated significantly in the most affected zones, following a reduction of their income coupled with a decline in their purchasing power. As regards employment, Guinea is characterized by a predominantly young population most of whom are unskilled and unemployed. Only 66.5 % of the working population were engaged in an economic activity in 2012, against 74.3 % in 2007. This situation is aggravated by the abovementioned cumulative impacts of the outbreak in the various sectors and their consequences on the employment and living conditions of households. According to data received from a sample of private sector companies in September 20145, employment was thought to have declined by about 8.6 % in the hotel industry, 3 % in the transport sector and 22.9 % in the construction and public works industry compared to the situation in 2013. Job losses among farm workers of the potato sector could represent 500 000 men/month in 2015, which corresponds to 42 000 full-time jobs. Prior to the Ebola crisis, the government had launched initiatives for economic development, in particular, investments commitments of close to 7 billion USD in Guinea, including private investments of 5 billion in the mining sector. Along the same lines, at the end of several years of negotiations, it signed, in May 2014, the investment plan of the Northern Simandou iron project globally estimated at approximately 20 billion US dollars. It will be the largest integrated project ever undertaken in Africa, combining an iron mine and major rail and port infrastructure. It was initially scheduled to start production in 2018 with a prospect for doubling the country’s gross domestic product, creating about 45 000 direct and indirect jobs in the production
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“In September 2014, employment was thought to have declined by about 8.6 % in the hotel industry, 3 % in the transport sector and 22.9 % in the construction and public works industry compared to the situation in 2013.�
phase, and launching the process for the structural transformation of the national economy. The Ebola disease swept all these prospects under the carpet while scaring investors away and causing panic among workers.
A health system in an in-bed state. The already ineffective health
system weakened considerably with the Ebola crisis, which affected both the safety of workers and the continuity/quality of the service. The Ebola crisis exposed the weaknesses and dysfunctions of the health sector, in particular, from the viewpoint of the hygiene and the safety of workers. An employee of Donka University Hospital in Conakry explains that the arrival of a patient with symptoms close to the Ebola disease always caused psychosis among medical professionals, inadequately equipped to ward off any contagion. Ethically, this employee was obliged to care for the patients; but humanely, he was afraid of being contaminated like some of his colleagues. At the beginning of the crisis, it was noted that health workers were not familiar with the modes of transmission of the Ebola disease. The prevention of infections, control activities as well as support and safety measures led to deviations in the implementation of Ebola prevention measures among health workers. The weakness of the monitoring system, human resources, logistic capacities as well as the nonexistence of units for the management of the consequences of the outbreak were noted, with the closure en masse of governmental and private institutions during the Ebola crisis. Even in the combat against HIV/ AIDS, a disease that spreads less rapidly than Ebola, the gaps existed already. The social protection
cover is very weak with regard to health care provided to affected and infected workers. The existing legislation on the fight against HIV/AIDS in the workplace is ignored and the informal sector is not taken into account in the provisions for the management of the disease. The current fund, which has been in existence since 1960, has never succeeded in providing a comprehensive national health cover, since less than 3% of the population benefit from its services6.
From dynamite to dynamics.
The fever subsides, the countries are recovering. After the effect of surprise which was reflected by the torpor of the first months of Ebola devastation, the populations gradually recovered and organized
© LayeproPhotos
themselves in villages and districts to roll back the disease, in particular by observing the rules of prevention and hygiene. Governments played a key role. Like his Guinean and Liberian counterparts, the President of SierraLeone, Ernest Bai Koroma, announced in mid-2015, the post-Ebola recovery plan to reactivate the economy, health and education and eradicate the virus from his country. The battle plan to overcome Ebola and set the country back on its feet, announced by President Koroma, targets the country’s recovery, in the first nine months and beyond that period, for the following two years, to ensure that Sierra Leone is back on the path of growth, according to an official statement issued by the Office of the President of the Republic. «We will strive to reinvigorate the private sector, turn it into a source of growth, transform our road network, improve access to markets and reduce the operating costs of major companies. Access to energy and water will be among the priorities».
The invaluable support of the international community. Under the
aegis of the World Bank, a donors’ round table conference on Ebola held a meeting with the President of Guinea, Alpha Condé, the President of Liberia, Ellen Johnson Sirleaf, and the President of Sierra Leone, Ernest Bai Koroma. Each President presented his country’s recovery plan. ILO initiated a Post-Ebola Recovery Plan in Guinea. The development objective of the programme is to contribute to the implementation of the national strategy for socio-economic Recovery and Post-Ebola Resilience (SRRPE) intended to revive the Guinean economy. The idea is to reactivate the levers of decent work, revive economic activity in Guinea, in relation with the ILO tripartite constituents. It involves promoting decent work through public works envisaged within the framework of the Socio-economic Recovery and Post-
Ebola Resilience Strategy (SRRPE), widen social protection by drawing lessons from the consequences of the Ebola disease, promote a preventive culture through Occupational safety and health (OSH) and remobilize the constituents around the urgent need for revival by stimulating social dialogue.
PAM, 2014, Impact de la MVE sur l’Agriculture et la Sécurité Alimentaire en Guinée. (WFP, 2014, Impact of the Ebola disease on Agriculture and Food Security in Guinea.) 5 This collection was undertaken by the National Department of Economic Studies and Forecasting within the Ministry of the Economy and Finance. The data was collected from a sample of companies selected within the framework of the evaluation of the macro-economic and sectoral impact of the Ebola outbreak 6 National Directorate of Hospitals and Health Care, 2007, the need to establish a National Health Insurance System in the Republic of Guinea. 4
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Fight against Ebola Maintain operational continuity and protect workers and businesses
by Dr Khai TONTHAT, Chief Occupational safety and health Specialist, ILO/DAKAR
The outbreak of the Ebola disease in the Guinea Forest Region led to a high rate of infection and death in neighbouring countries. It is worrying to note that a significant proportion of doctors, nurses and other health staff are among the victims. The impact that the outbreak had on the national health system prevented the latter from responding effectively to the other diseases. Moreover, the Ebola disease is not only a problem of health and safety; it is also an economic and social problem. The most important aspect is the problem of the workplace.
W
hile dealing with this problem, the Government of Ghana realized that the outbreak of the Ebola disease has had a tremendous impact on the economies of the affected countries. The Ebola disease has caused exceptional social and humanitarian damages, combined with serious economic
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consequences. Workers, farmers, traders, investors and a series of economic actors in small and medium-sized enterprises (SMEs), and the informal economy are severely affected by the epidemic. The disruption noted in the key economic activities, including agriculture, trade, transport and tourism, increased the national unemployment rate. Many
“The Government of Ghana realized that the outbreak of the Ebola disease has had a tremendous impact on the economies of the affected countries.�
employees no longer work because their businesses or the public services are closed, and very few were able to resume their activities or find another job. The most significant and most sustained impacts were noted on those who are selfemployed in the agricultural sector. Recent studies in the three most severely affected countries (Guinea, Sierra Leone
High-level round table discussion of the UN project on the response of the workplace to Ebola in Accra, Ghana.
and Liberia) have confirmed the seriousness of the impacts of the outbreak on the sectors of agriculture, services and factories. Small shopkeepers were seriously affected; with the closing of markets and the isolation of areas leading to the loss of to their sources of income. The impact of the Ebola outbreak was also direly felt in the private sector, including the major multinationals, SMEs and the informal sector. The indirect effects of the preventive measures, attitudinal changes, travel restrictions, the increase in insurance premiums and transportation costs are among the sources of disruptions of private sector activities attributed to the outbreak. About half of the jobs existing prior to the crisis have been lost, despite the improvements in the health situation. After a debriefing, on 30 January, 2015, during which the post-Ebola recovery evaluation mission shared its results, ILO Director General requested the Organization to formulate an action plan in response to the Ebola outbreak. Within this framework, the Abuja Office had taken initiatives, relating mainly to the health and safety of workers, to draw up a response programme in the workplace in Ghana, in collaboration with U.N. agencies and
“On 30 January, 2015, ILO Director General requested the Organization to formulate an action plan in response to the Ebola outbreak.” development partners (GHA/15/01/UND). The project targets specific results such as the mobilization and sensitization of social partners and the Ebola focal points. It will be based on a series of past and current experiences to define the most effective
measures, in order to improve hygiene as well as occupational safety and health (OSH) in the workplace. In fact, there are several ways of assisting businesses, in the public and private sectors, to promote the improvement of their practices. Small and medium-sized enterprises, the informal economy and the agricultural sector have become a significant bedrock for the sustainable development of the economy and a vital means of absorbing surplus labour forces. However these sectors still face several challenges, one of which is how to increase productivity following the improvement of occupational safety and health and the working conditions. At the end of the 1980s, ILO had developed a training manual entitled “Increasing productivity and improving the quality of life at work” to encourage the full participation of SMEs in the improvement of working conditions. In 1982, a pilot training programme, based on a training approach focused on participatory action, was launched with the collaboration of ILO/ PIACT activities. This programme presented a systematic approach for a simultaneous improvement of the working conditions
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and productivity in SMEs. This approach was launched to encourage and support SMEs to take measures voluntarily and at least cost, to improve working conditions and increase productivity, at the same time. The participatory action-oriented training (PAOT) has, since then, been widely applied in Asia and in other countries throughout the world. The WISE (Work Improvement in Small Enterprises) and WIND (Improve the working conditions in the development environment) are typical examples to help workers, employers and farmers to take simple, effective and lowcost actions to improve productivity and the working conditions. These ILO participatory programmes were successfully integrated into the OSH programme of several countries as a practical method to adequately extend the protection of OSH in the vulnerable sectors. One can find typical examples in Asia, with participatory training materials in the workplace developed during the avian flu epidemic in 2007-2010. ILO had developed a checklist of control action and a practical handbook to help employers and workers to reduce their risk of infection and protect their businesses in pandemic situations. Training materials that are easy to use, even in small workplaces, covering the networks of workers, employers and government and supporting national policies, were developed and used widely in Asia during the pandemic. In November 2014, the ILO Office in Dakar drew up a checklist of Ebola control actions introducing the PAOT approach in medical facilities (hospital, Community basic health care units). This checklist of Ebola control actions
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was tested and applied successfully in Fann Hospital, in Dakar, on 5 December, 2014, with the technical support of the ILO Dakar Office. In response to the emerging OSH problem for the protection of workers against contamination from Ebola and other infectious diseases in the workplace, several activities were undertaken with the close collaboration of ILO and Ghanaian actors. These actions include providing practical support for a broader dissemination of information on OSH, the development of practical training tools and the checklist of action on Ebola to support the strengthening of the prevention culture with regard to safety and health in order to control the Ebola and other infectious diseases in the workplace. Within the framework of the work plan of the GHA/15/01/UND project, a trainers’ training workshop intended to protect the workers and the workplace against the Ebola outbreak and other emerging infectious diseases was successfully organized in Accra on 28 and 29 October 2015. The purpose of this workshop was to assist ILO constituents and SMEs to develop and implement a global response in the workplace for the prevention and control of the Ebola outbreak, use the workplace as a focal point to communicate information and raise awareness, and to strengthen the roles of workers and employers in the countries’ response and preparedness plans.
ILO training tools on the preparedness plan and the Business Continuity Plan in SMEs were seamlessly transferred during the workshop. This Business Continuity Plan refers to a written plan which contains operational processes to support business continuity in the face of any pandemic. Within the framework of the development of the Business Continuity Plan, SMEs must ensure that their regular operations continue in the event of the outbreak of serious infectious diseases which could disrupt the regular operations of the business.
The visit to a factory with the checklist of control actions was organized within the framework of the trainers’ training. It is a list of simple, achievable and low-cost actions which was extensively applied in workplaces rather than problems that need to be solved. Participants who took part in the action control checklist exercise were required to learn good examples that exist in factories visited rather than to make an evaluation. This practical training tool of the
PAOT methodology guided the participants’ knowledge and experiences towards realistic solutions. Moreover, this checklist of control actions can be used as a routine selfevaluation tool to accelerate the process of improving actions. SME, can apply the checklist of actions in relation to the Ebola disease in the daily selfevaluation by identifying the actions proposed in a specific time frame. Based on a series of training which the participants will
develop downstream, achievable prevention measures will be implemented in the workplace to guide the development and implementation of the preparation of the response to the Ebola disease, with the major activities below: - support targeted businesses to develop and provide information to health workers (for example, data, information sites, etc.), in places that are easily accessible to health workers;
- organize training sessions in the targeted workplace on the basic knowledge and skills for the prevention of Ebola transmission; - assist targeted businesses to undertake self - evaluations of risks by using the appropriate Ebola control action checklists; and - undertake monitoring activities to collect and share good local practices in the workplace.
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Figure 1 : Global legal health coverage
The three countries most affected by the recent Ebola outbreak, Guinea, Liberia and Sierra Leone, experienced a health protection crisis of unprecedented magnitude. It affected thousands of people which suffered and died and also largely impacted on the national economies of the countries. The human and economic disaster was worsened by severe gaps and deficits in health protection coverage and access to needed services.
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Source : ILO World Social Protection Report 2014/2015
ILO strategy on achieving universal health protection in times of Ebola by Xenia Scheil-Adlung, Health Policy Coordinator – ILO Department of Social Protection
The issues. The deficits observed in the three Ebola-affected counties were not unknown prior to the crisis and are unfortunately common in many regions of the world, particularly in low-income countries. ILO estimates that globally more than 44 countries only 20 % of the
population enjoys health protection; thus 80 % of the population in these countries is not affiliated to any health system or scheme providing for health protection and therefore excluded from health coverage. (Figure 1) The most substantial gaps exist in low income countries. In fact, we find a
Figure 2 : Numbers of health workers per 10,000 population, selected countries
Global health worker deficit: 10,3 million
Urban deficit: More than 3 million Rural deficit: About 7 million
Source : Global evidence on inequities in rural health protection, ILO 2015
negative correlation between the income-level of countries and health coverage rates: the lower a country’s income, the higher the gaps in health protection coverage of the population: In low income countries globally 90.3 per cent of the population remains without health coverage. Unfortunately, this holds also true for the three Ebola-affected countries which are among the poorest of the world. In these countries the percentage of people without health
protection coverage amounts to almost 100 per cent. As a result, both health coverage and effective access to needed health services is very limited. This can be shown by a number of indicators reflecting the availability and affordability of services.
Limited availability of services: Funding deficits and health workforce shortages. In many low income countries underinvestment in health protection is
common. However, these funds define to a large part the performance of a health scheme or system, for example the availability of health workers and infrastructure. Thus, a lack of funds for health protection regularly results in access deficits of the population. ILO estimates that in low income countries 92.6 % of the population are excluded from needed services due to financial deficits (ILO WSPR 2015). Most critical for access
to health care is ensuring the provision of quality care through skilled health workers. Based on ILO assessments this requires that countries should have at least 41.1 skilled health workers per 10,000 population to provide essential care to all in need. However, we observe a global health workforce shortage of 10.3 million skilled health workers which are needed to achieve universal health coverage. These health workforce shortages provide serious
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High-level mission of the ILO in Guinea, led by Mrs Dayina Mayenga, Deputy Regional Director of the ILO for Africa, with the support of Mrs Séraphine Wakana, resident coordinator of the United Nations system in Guinea.
health access barriers to 80 % of the global population in low-income countries. Another issue concerns the fact that across regions and within countries, the health worker shortages are not evenly distributed: the majority is missing in Asia and Africa and here particularly in rural areas where more than 7 million health workers are missing. (Figure 2) Thus, while half of the world’s
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“In Guinea and Sierra Leone less than 2 health workers have to provide services to 10,000 persons and in Liberia less than 3.”
population lives outside cities, only 23 per cent of the global health workforce is deployed in rural areas. At the same time, rural areas are those where the majority of poor people is living. The situation is aggravated by insufficient working conditions of the few health workers, particularly low wages. Most deplorable is the fact, that in as many as 98 countries, including 75
developing countries, health worker wages were even cut over the last years. The countries most affected by Ebola are among those that have globally lowest numbers of health workers: In Guinea and Sierra Leone less than 2 health workers have to provide services to 10,000 persons and in Liberia less than 3. (Table 1) The large discrepancy with highincome countries can be
Table 1 : Numbers of health workers per 10,000 population, selected countries Country
Number of health workers per 10,000 populations
Guinea
1.43
Niger
1.56
Sierra Leone
1.88
Chad
2.25
Ethiopia
2.78
Liberia
2.88
Central African Republic
3.05
Haiti
3.57
Tanzania
4.67
Bangladesh
5.74
Norway
195
Switzerland
215
Finland
268 Source : WHO Global Health Observatory (latest available year)
seen when comparing these figures with the health worker density in European countries, such as Finland where 267 health workers care for 10,000 population.
Limited affordability of services: Out-of-pocket payments (OOP). High OOP to receive urgently needed health services are a reality in many countries. OOP are often pushing people into poverty and have the potential to create an important
barrier to access services when in need. However, globally, more than 40 % of total health expenditure is financed from such private resources. What is worse is the fact that the share of OOP in total health expenditure increases with the countries’ poverty rates: In countries where more than half of the population is living on less than 2 US$ a day, about 50 % of total health expenditure derives from OOP (Figure 3) while the share in countries with low poverty rates such as in France is only 7.5 per cent (OECD
2014). In the Ebola-stricken countries Guinea and Sierra Leone 67.4 and 74.9 per cent of total health expenditure are paid outof-pocket respectively.
Strategies. Given the deplorable situation in many countries, including those affected by Ebola, ILO suggests a strategy to rapidly extent health protection to all. While there are no one-fits-all solutions, some key principles need to be met by all countries that
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Figure 3 : OOP as a % of total health expenditure by country level of poverty
Source : ILO World Social Protection Report 2014/2015
aim at achieving universal health protection. As outlined in ILO Recommendation 202 concerning National Floors of Social Protection, they include providing entitlements to health care by national law so as to ensure a rights-based approach. Further, it is necessary to guarantee equitable or at least essential health care, including maternity care that meets the criteria of availability, accessibility acceptability and quality.
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When translating these criteria into action it will be necessary to set a realistic time frame for achieving universal coverage based on attaining the following targets :
Target 1: Mobilizing sufficient funds Based on existing resources and expected expenditure health financing systems, for example social health insurances or tax based systems, should be established that ensure sufficient revenues
from one or more sources. This requires actuarial studies that reflect the current situation such as underfunding and deficits in health worker density. Decisions on policy options need to take into account that contributions are based on the ability-to-pay or are subsidized. Furthermore, in case of deciding on using mixed schemes and systems, strong coordination should be ensured as such approaches have the potential to result in
fragmented health coverage.
Target 2: Access to needed health care enshrined in legislation Countries should ensure through inclusive legislation that the whole population – formal and informal, rural and urban, male and female workers – are legally covered and no one is left behind. Guarantees to at least essential health care should be provided with a view to meeting vital medical needs
and demands including maternal and preventive care. More comprehensive benefits are to be developed as soon as the fiscal situation allows for it.
Target 3: Adequate numbers of health workers trained, recruited, provided with decent working conditions and equitably distributed within countries Based on lessons from the Ebola affected countries, high emphasis should be set on developing the health workforce and providing decent working conditions, particularly wages and occupational safety and health. This requires training, recruitment and equitable distribution, for example in rural and urban areas. Collective bargaining is the best way to negotiate workplace arrangements that attract the necessary number and quality of health-care workers.
Target 4: Provision of effective levels of financial protection guaranteed
Financial protection when accessing health care requires minimizing fees, co-payments and other expenditure that might act as a barrier to access needed health care. Besides excessive OOP, protection from transport costs to reach health care facilities and economic loss caused by reductions in productivity and earnings due to ill health should be compensated.
Target 5: Social dialogue and monitoring established Regular monitoring, feedback and support through tripartite national and social dialogue should be established. Thresholds should be set by the government with a view to measuring both affordability and availability of quality health care and financial protection for all in need.
Target 6: Policy coherence achieved Governments are advised to strive for policy coherence across the social, economic and health sectors that emphasize poverty
“Based on lessons from the Ebola affected countries, high emphasis should be set on developing the health workforce and providing decent working conditions.”
alleviation and labour market policies to avoid unintended increases in inequality. Best practice policies include the development of national floors of social protection as outlined in ILO Recommendation 202.
Target 7: Economic returns of investments realized If well designed and implemented, the above policies for universal health protection have the potential to significantly increase national capacities of health systems in times of crises such as Ebola outbreaks. They can further contribute to poverty alleviation. Moreover, employment effects and job growth arising from direct employment in the health sector and increased overall labour productivity of a healthier population contribute to socio-economic development and inclusive economic growth.
References :
ILO, Social Protection Floors Recommendation (No. 202), Geneva, 2012 ILO, Universal Health Protection – Progress to date and the way forward, Geneva, 2014 ILO, Addressing the Global Health Crisis – Universal Health Protection Policies, Geneva, 2014 ILO, Global evidence on inequities in rural health protection – New data on rural deficits in health coverage for 174 countries, Scheil-Adlung, X. (Ed), Geneva. 2015 OECD, Health Statistics 2014, Paris
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ŠUNICEF GuinÊe
Preventing and controlling the spread of the Ebola Virus Disease Focus on response measures by Theopiste BUTARE, Specialist on Social Protection, ILO-Dakar
The impact of the Ebola outbreak would certainly have been greater had it not been for the numerous national and international measures taken as soon as the outbreak was officially declared in Guinea, Sierra Leone and Liberia. Fortunately, these States and their partners worked quickly to contain the spread of the virus. However, caution is still to be exercised given the few new cases being observed. Focus on the latest news about Ebola and best practices observed during and prior to the crisis.
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Situation assessment. On 7 November 2015, the World Health Organization (WHO) declared that Ebola virus transmission had ended in Sierra Leone. Two months earlier, on 3 September 2015, WHO announced the end of Ebola virus transmission in Liberia. Such an announcement is made when forty-two days have passed since the second negative test was conducted on the last confirmed case in that country; representing twice the maximum incubation
period. Prior to this however, Liberia had been declared officially free of the epidemic on 9 May 2015 but new cases re-emerged on 29 June 2015. There was nonetheless room for optimism on 3 September when WHO announced the end of Ebola virus transmission for the second time in Liberia. Many thought that things would work out right this time. But WHO and the Ministry of Health of Liberia have confirmed three new EVD cases in the country since 20 Novem-
“In Nigeria, specific measures were strictly enforced enabling this country to rapidly and effectively control the EVD outbreak.” ber 2015. They asked the population not to panic because measures were being taken to contain the spread of the virus. Caution is thus required because the origins of these new cases in Liberia remain unknown. And the situation in Guinea? The number of new infections has also decreased considerably in this country. It is however difficult to predict when the end of Ebola virus transmission will be announced. The number of deaths due to EVD, from its outbreak in 2013 to 1 November 2015, is as follows in the three countries: 4,808 in Liberia, 3,995 in Sierra Leone, and 2,536 in Guinea (WHO data, 7 November 2015). The number of deaths among healthcare professionals infected by the virus as at 21 October 2015 is as follows: 192 in Liberia, 221 in Sierra Leone, and 100 in Guinea (WHO data).
The case of Nigeria in brief: The virus arrived in Nigeria in July 2014 carried by a passenger travelling from Liberia by air. A total of twenty cases were identified including health workers. There were a total of eight deaths due to the Ebola virus in this country. On 19 October 2014, Nigeria
was officially declared free of Ebola virus transmission. To date, the virus has not re-emerged. Specific measures were strictly enforced enabling this country to rapidly and effectively control the EVD outbreak. These measures could serve as examples to other countries.
Measures to prevent and control the spread of EVD. The Minister of Health of Nigeria at the time of the outbreak shed some light on his country’s success in the fight against Ebola (Source: New African Magazine, February 2015): - Leadership: All levels of government, from central to local governments, were informed and mobilized to deploy every effort for the eradication of EVD. - Coordination: The Minister of Health was in charge of coordinating all initiatives and measures to combat EVD, and parties involved in this nationwide effort had to take this into consideration. - Health infrastructure: Nigeria had health infrastructure and medical personnel in higher quantity and quality than the other three Ebola-affected countries. A centre for disease control with high performance equipment had just been established in Nigeria two years prior to the EVD outbreak and significantly contributed to help contain the outbreak. - National emergency: The EVD outbreak was considered a national emergency and this allowed the Minister of Health to coordinate the efforts of all, including governors, commissioners for health, medical staff and ordinary citizens. - Transparency: In the production and management of information on the epidemic, communicating with populations in the simplest of languages, and encouraging feedback from persons receiving information. - Request the support of private sector stakeholders: They understand quite fast that their businesses would suffer if an epidemic such as EVD is not contained. Based on this testimony on Nigeria’s success in the fight against the Ebola virus outbreak
within such a short time period, it appears that the other affected countries did not have the same resources as Nigeria from the start. They managed and continue to manage the situation relying on their existing resources. It however does not mean they cannot exercise greater care and determination. Nonetheless, the significant decrease in the number of transmissions and deaths in these countries is a sign that considerable effort is being deployed to put a complete stop to the outbreak. Another relevant point also highlighted in this testimony was the need to fully understand that if there is just one case of Ebola any place in the world where there is a form of transportation, no other country is totally safe from the virus reaching its territory.
Rwanda’s prevention model. In the region, countries which are not affected by EVD also invested significant financial resources and considerable time to stop the advance of the pandemic. Below are a few examples of prevention measures adopted by Rwanda which illustrate the importance of investing simultaneously in different yet inter-related systems (Source: Ministry of Health of Rwanda, article published in Finance & Development, December 2014 issue): - One of the greatest challenges to implementing appropriate prevention measures against an outbreak such as EVD consists of improving the health system while strengthening all the sectors that affect social determinants of health and governance, including finance, transportation, security, and communication, to ensure a collaborative and effective response to such threats. - While it seeks to prevent Ebola from occurring in a country, the health care system should not be distracted from its persistent fight against premature deaths due to maternal and childhood ailments, HIV/AIDS, tuberculosis, malaria, and other diseases. It is critical that it adapt and adjust across all sectors to effectively address such a threat.
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FOCUS ON CONTRIBUTIONS - Ability to govern: The EVD threat tests not only the responsiveness of the health care system, but also the country’s ability to govern. This requires mechanisms for multisectoral and collaborative policymaking, as well as a shared mind-set of making the most of every available resource. This multisectoral approach should not be designed to merely address a particular crisis. It should rather be created carefully and collaboratively over time, and officials as well as the various stakeholders encouraged to work together as problem-solvers rather than competitors for government funds, including during other health crises which may occur. While these adjustments and prevention measures can be costly, the cost of inaction or partial or poorly planned action is far greater. The importance of investing in health system strengthening is quite clear. After all, without health professionals, equipment, and infrastructure, we could not manage any health threat. One of the lessons that crises like the EVD outbreak also teaches is that to improve responses to the next challenge that may await a country, its ability to govern collaboratively must also be strengthened.
Contributions of social security institutions in the fight against EVD. As observed earlier, the fight against Ebola requires considerable resources in a context where tax revenues of States were barely sufficient to provide minimum social protection coverage for vulnerable populations, particularly in terms of health care, prior to the spread of the virus. With the worsening of EVD crises in affected countries, many businesses suspended their activities, tax revenues and social security contributions decreased and national economies entered into a phase of decline. The health system and the education sector were weakened, and the living conditions of the populations considerably deteriorated.
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In this context, how could social security institutions contribute to stopping the spread of EVD and mitigating its impact? Despite a decline in revenues from social security contributions due to the Ebola crisis, these institutions generally represent the most structured and strongest links with better trained staff compared to other social protection mechanisms in the country. This allowed them to provide support in various forms to national efforts in combatting the Ebola virus disease. The Caisse Nationale de SĂŠcuritĂŠ Sociale (CNSS) in Guinea, the National Social Security Insurance Trust (NASSIT) in Sierra Leone, and the National Social Security and Welfare Corporation (NASSCORP) in Liberia thus provided assistance. Drawing on their reserves, these institutions provided much-needed support to the financial efforts of States and also helped to extend awareness-raising programmes on Ebola in at-risk areas with the assistance of their workers who disseminated information, including flyers and brochures, on EVD through their own community-based networks. Equipped with the appropriate knowledge from a reliable source, populations are hence able to take the necessary precautions to avoid contamination. This contributes to containing the spread of the virus. The CNSS in Guinea, one of few institutions in Sub-Saharan Africa which manages a social security and health insurance scheme, mobilized its medical board countrywide to combat the Ebola virus disease. It created within the institution a department in charge of prevention and social action. The staff of the Medical Board and the Department of Prevention visited all affiliated businesses, whose employees then worked through their community-based networks to disseminate preventive measures.
If the three countries successfully eliminate the virus, their social security institutions can thus rely on the recovery of businesses to progressively improve their financial situation and enhance service delivery.
Socio-economic recovery policies in affected countries: expected support from the ILO. During the United Nations Pledging Conference in New York on 9 and 10 July 2015, representatives of Guinea, Liberia and Sierra Leone presented the social and economic recovery policies they plan to implement with the support of bilateral and multilateral partners. These policies are based on the stimulation of economic growth and job creation. They also include social protection programmes focusing on investments in the health sector, strengthening of the education sector, nutrition and sanitation, cash transfers for poor households and for orphans and survivors of EVD. The ILO visited the countries affected to discuss with constituents on areas for collaboration in the post-Ebola context. Their expectations in the field of social protection included: - Support to upgrade and develop health systems, establish and expand mechanisms for access to health care in order to address the immediate needs of populations as well as challenges relating to Ebola-type outbreaks; - Strengthening and modernization of existing contributory social protection systems; - Organization of a national dialogue to determine priority services to be implemented in the framework of a national social protection floor and establishment of a fiscal space for the financing of these services. Considering the different experiences of countries in the region in terms of preventing and combating the Ebola virus disease, the organization of South-South exchanges is an important organization well placed to share good practices in this area with countries worst affected by EVD.
National dialogue for implementation of a social protection floor and strengthening of social protection institutions by Victoire Umuhire, SOC/PFACTS
With regard to healthcare protection, the Ebola crisis exposed the inadequacies of social protection systems in the region to address health-related shocks. The lack of adequate social protection in terms of access to basic healthcare and income security for the entire population or vulnerable populations at least, worsened the socio-economic consequences of the Ebola outbreak in Liberia, Guinea and Sierra Leone. © LayeproPhotos
“Making social protection and its financing a priority in post-Ebola recovery plans”
T
he Ebola crisis worsened poverty levels, unemployment, the informal sector and under-employment, thus creating a vicious circle with increased fragility. In spite of the decline in the number of new infections, socio-economic recovery will take time and will require investments in the relevant institutional reforms. As a UN specialized agency, the ILO’s response regarding this crisis focuses on five areas of intervention: (1) creation of decent jobs through a labour intensive employment programme; (2) strengthening of social protection systems for universal coverage; (3) social dialogue for consensus-building on national priorities; (4) enhancing delivery
of and access to basic services; (5) promotion of a culture of prevention through occupational safety and health programmes. In collaboration with other UN agencies and technical and financial partners, the ILO’s contribution will help countries consolidate and/or build strong public institutions and better respond to health-related emergency situations in a quick and effective manner. Regarding social protection, the ILO recommends a national dialogue on the establishment or strengthening of the social protection floor in each affected country under the framework of Recommendation 202. This process will be participatory and realistic. Participatory, because it will involve all social protection
stakeholders (sectoral ministries, workers’ representatives, employers’ representatives and civil society). Realistic, because it relies on high level technical support for the formulation of social protection policies which can strengthen existing social protection schemes and programmes, or support the introduction of new programmes for enhanced coverage of the population. The primary objective of this dialogue process is to facilitate identification of policy gaps and inadequacies of existing institutions based on national priorities in social protection, and facilitate the necessary reforms as well as their financing to ensure basic social protection for the entire population. The secondary objective is to inform and raise
the awareness of the various stakeholders on experiences acquired in other countries regarding the expansion of social protection systems and coordination mechanisms for their effective implementation. Efforts to strengthen social protection systems, supported by national dialogue, will thus contribute to making social protection and its financing a priority in post-Ebola recovery plans, by ensuring integration of policies and programmes relating to income security and access to basic healthcare services for workers and vulnerable groups, for sustainable socio-economic recovery.
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Public sector health workers in the midst of the Ebola crisis by Odile Frank, Public Services International
The Ebola outbreak in 2014 was devastating for health workers due to several reasons. The outbreak first tainted their reputation and this had an impact on the transmission of the virus as well as on workers. It then exposed the appalling working conditions, which had not been improved early or fast enough. Employment conditions of infected health workers did not include death benefits and lastly the outbreak caused the deaths of an unacceptable number of workers, leaving many families bereaved and the three affected nations (Guinea, Liberia and Sierra Leone) bereft of an invaluable public service. ©UNMEER/Martine Perret
W
ho are the health workers? In addition to doctors and nurses, they include all workers providing care and other services in health facilities such as nursing aids, anaesthetists, midwives, lab and x-ray technicians, security staff, porters, orderlies, kitchen and laundry staff, administrators, accountants, social assistants, chaplains and morgue personnel. Service providers at health services are many and can all be exposed to transmissible diseases in the hospital environment, especially in the case of a
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highly contagious disease such as Ebola. In April 2014, WHO prepared a fact sheet on Ebola entitled “Ebola Virus Disease: Fact sheet N° 103” published in August 2015. In this document, it is stated that “Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced”. On 26 June 2014, in a “Note for
the media” entitled “Ebola challenges West African countries as WHO ramps up response”, it is also stated that “the outbreak is causing concern among health authorities because the deadly disease is being transmitted in communities and in healthcare settings…”. Teams were deployed to these three countries including “infection and prevention control experts to help the countries stop community and health-care facility transmission of the virus…”. These documents cast doubt on the responsibilities of workers
suggesting that the behaviours of health workers had been inadequate for the protection of the general public. These statements, quite damaging for the reputation of health workers, were not widely disseminated and certainly did not solely influence public opinion but embodied the essence. The fear of transmission fuelled doubts regarding the safety and reliability of health services. In this atmosphere of distrust, hospital settings were regularly avoided by patients including those infected by the Ebola virus but unaware of their condition. At the other extreme,
health workers were attacked and killed because of the overwhelming fear that they were disease carriers and not potential saviours. Transmission in health facilities was inevitable due to no fault of the workers themselves. Comparing directives regarding prevention of transmission on the one hand and actual working conditions of health workers on the other, the high number of casualties among health workers seems unavoidable. Indeed, let us take a look at the control measures developed by WHO in the guidance document and updated during the outbreak,
entitled: “Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola» (Interim guidance), published in September 2014. In the chapter on “Key messages for infection prevention and control to be applied in health-care settings”, it is recommended “Prior to entering the patient isolation rooms/areas, ensure that all visitors and health workers rigorously use personal protective equipment (PPE) and perform hand hygiene [to perform hand hygiene, either use an alcohol-based handrub or soap and running water applying the correct technique recommended by WHO, as indicated in this docu-
“Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD.”
ment]. PPE should include: double gloves, gown or coverall and apron, face mask, eye protection (goggles or face shield) head cover, and boots. There is hence a significant list of equipment in these directives: running water; soap; alcohol-based handrub; gloves (correctly sized); consider changing gloves if heavily soiled; change gloves when moving from one patient to the other; wear double gloves one over the other if the quality seems poor; for instance if they tear rapidly when being used); a disposal waterproof apron, waterproof and tear-resistant boots; a surgical mask and quite sophisticated eye protection such as googles or face shield.
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FOCUS ON CONTRIBUTIONS
Alarmed by the number of deaths among members of Public Services International declared by affiliates of our Organization from March/April 2014, we surveyed health workers in the three countries through a questionnaire. It was administered by PSI regional and sub-regional staff between 18 and 25 August 2014, i.e. one month prior to the publication of the abovereferenced guidelines. In this questionnaire, we asked 13 questions to determine the level of information of health workers (as well as the source) and the availability of protective equipment: masks, gloves, eye protection, gowns, boots and alcohol-based handrub that not only met standard protection requirements but also conformed with the level of protection required against the Ebola virus. We asked questions on behaviours relating to protection against disease transmission through blood, including hepatitis and HIV, because we had for several years conducted a campaign promoting such protection. Responses were received and summarized for 42,000 workers in Guinea, 4,000 in Liberia, 3,500 in Sierra Leone and 170,000 in Nigeria where transmission from the three countries was still feared at the time. The responses were striking. On the one hand, hardly any information was lacking and sources were known. But there was a severe lack of equipment for both standard protection and specific protection against Ebola. Basically, the only equipment available was alcohol-based handrub, and in Nigeria alone. No gloves, no gowns, no boots and no masks. However, regarding protective behaviours against disease trans-
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mission through blood, workers were highly compliant with the guidelines because only personal effort was required to keep in mind and adhere to the rules. In conclusion, the findings were grim. The lack of protective materials available to health workers was tragic despite their general knowledge on the subject and their demonstrated ability to use the equipment.
“These families were left with no resources at the death of a health worker.” We now know that the lack of materials and equipment was entirely due to inadequate investments in health systems by governments of the three countries affected as they preferred to invest in extractive industries considered to bring about stronger economic growth and by international financial institutions, such as the World Bank, which encouraged them in this respect. Loan conditions relating to investment pledges in infrastructure should have been met in certain cases, and the unilateral objective of building health infrastructure pursued in other cases. While health workers extensively reported on their poor working conditions – in April
2014 they informed the 15th Ordinary Session of the Ministers of Health of the Economic Community of West African States (ECOWAS) in Monrovia, which acknowledged the outbreak but not its magnitude – they also informed us of the seriousness of the situation for families of health workers. These families were left with no resources at the death of a health worker. The situation was all the more serious as workers often had to take care, not only of their spouse and children, but of the extended family including their parents. Despite their commitment to public service, contracts of health workers rarely included social protection in the event of death, even when loss of life is directly related to their work and is of occupational origin. In order to address this issue, a provident fund was established for health workers’ unions in the three countries affected. Relatively small amounts were paid in one lump sum. Bereaved families did not have alternative remedies and had to adapt to this highly unfavourable situation for them. It is important to note that health workers in a significant number of cases transmitted, without their knowledge, the Ebola virus to members of their family. This darkened their future. Unfortunately, we do not have reliable data on this subject.
Mourning of Ebolaaffected families and countries by Odile Frank, Public Services International
The number of deaths among health workers is rather well known. According to data published by the World Health Organization (WHO) in the “Ebola situation report of 21 October 2015”, there were 100 deaths among health workers in Guinea out of 196 infected, 192 in Liberia out of 378 infected and 221 in Sierra Leone out of 307 infected. This adds up to 513 deaths among health workers out of 881 infected.
I
t c an immediately be observed that casualties were higher in Sierra Leone even though more cases were reported in Liberia. However, less than half of infected health workers survived the disease. It is worth noting that the vast majority of these deaths were among national health workers. It is irrefutable that international staff often working in the humanitarian field saved thousands of lives upon their arrival in the three countries. And their working conditions were certainly quite arduous. They however had all the materials and equipment necessary for protection against Ebola. And in the rare cases where they were infected, they were generally transported to Europe or the United States for treatment. Consequently, their numbers are lower and survival rates higher. Sadly, as much as in its resolution adopted on 18 September 2014 (Resolution 2177 - 2014) at its 7268th meeting the UN
Security Council acknowledged the debt of gratitude to national health workers in the preamble: “Expressing deep appreciation to the first-line responders to the Ebola outbreak in West Africa, including national and international health and humanitarian relief workers…”, it mostly excluded national workers in the operational paragraphs. Whereas it “encourages the governments of Liberia, Sierra Leone and Guinea to accelerate the establishment of national mechanisms to provide for the rapid diagnosis and isolation of suspected cases of infection, treatment measures, effective medical services for responders…”, the Security Council commends international workers through its appreciation and requested action. It thus “commends the continued contribution and commitment of international health and
humanitarian relief workers to respond urgently to the Ebola outbreak and calls on all relevant actors to put in place the necessary repatriation and financial arrangements, including medical evacuation capacities and treatment and transport provisions, to facilitate their immediate and unhindered deployment to the affected countries; …”. And yet, national sacrifice was much greater…
“Less than half of infected health workers survived the disease.”
Earlier, we talked about the bereavement of families, often affected more than once by the outbreak. Huge loss has also been incurred by the three countries. Already affected by the obvious shortcomings of their health services and the insufficient presence of health workers, these countries must now get off to a new start with a diminished and demoralized
workforce in the health sector. Reconstruction efforts are hence necessary given this situation of additional disadvantage. The Sustainable Development Goals adopted on 25 September 2015 by the UN General Assembly have paved the way for a specific road map and actions to be undertaken in this respect. Goal 3 urges all countries to “substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries…”. Health workers in Guinea, Liberia and Sierra Leone must be re-motivated and re-committed. They must overcome their lack of enthusiasm. The first step is therefore to improve the working conditions as well as the employment conditions of health workers who survived the 2014 Ebola outbreak.
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FOCUS ON Reports
Dr El Hadj Ibrahima BAH,
infectious diseases department, CHU Donka, Guinea Testimony by a volunteer turned social misfit due to the epidemic by Hadja Nantenin Dioumessy
“Even we the doctors were wary”
Life was difficult under Ebola - not only for the people infected by the virus, but also for those supposed to care of the sick. Dr. El Hadj Ibrahim Bah, who was in the eye of the storm, shares his unforgettable experience as a doctor. In his view, it was not just about fighting a disease; there was a need to clear all the persistent biases that caused it to spread.
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Why did you embark on this battle, when everyone else dreaded the Ebola virus? Just like any other disease that is not well known it came as a great surprise, with fear at the same time, as we were facing a disease, which was fast becoming an uncontrolled epidemic. The decision to remain in the forefront to combat Ebola was not an easy one. However, I told myself that someone had to dare, agree and just go. Seeing the large number of patients waiting to be cared for, I just told myself that it was time to act with whatever means we had. Before it appeared in Guinea, I learnt that the virus had ravaged the Democratic Republic of Congo. But apart from that, I had also read about it.
You were talking just now about lack of knowledge about the virus. What conditions did you work in? How did your loved ones take this? At the beginning it was not easy. No department was ready for it. We lacked appropriate protection and the number of sick people just kept on rising. The infectious diseases department was one of the few that were taking in suspected cases, and that was why there was a high rate of infection there. It was only when Médecins Sans Frontières (MSF) arrived on the scene that things got better. Staff were recruited, teams were put together and the Ebola treatment centre was set up. In Conakry, where I worked, the centre was opened on 22 March 2014 and the first patients were admitted two days later. On
“I couldn’t bear to see children and babies, who had done nothing to get infected, face the same painful fate.”
“It was not always easy, because I got insulted.” the ground, things were completely different as the people were hostile to any information about the disease. The first mobile messages on the disease did not go down well. Teams deployed to the scene constantly came under threat. Vehicles were burnt and the staff chased out, with death threats at times. Even among doctors, we couldn’t trust each other. Even in the eyes of colleagues we appeared to be traitors and swindlers. They branded us as the mascots of the “whites”, and the powers that be, quite simply because rumours had gone around that Ebola had been brought into the country by the President, for political gain. Apart from the Ebola itself, stigmatization was another problem we had to face. I have many friends who were sacked from their homes. They found themselves in the streets, just because they had decided to engage in the fight against the disease. Personally, I
was sidelined by many members of my family, who no longer wanted to see me at any family gathering. My donor also threatened to throw me out if he had proof that I was involved in the fight against what he termed the “fake virus”. All I had were my friends, who for fear, stayed far away from me. I didn’t hold it against any of them, and I never stopped believing in my commitment and willingness to help stop the spread of this epidemic, which was the most serious of its kind, since its discovery in 1976 in the Congo.
Do you feel safe in this work? With Ebola, there is nothing such as zero risk. Nowhere within the town did anyone feel safe. People did not believe that the disease existed, and therefore followed no rules of hygiene. It may seem bizarre in the eyes of many, but personally, at a given time, it was only at the Ebola treatment centre that I felt safe, because of the high level of security. Over there, we were not allowed to touch each other. Chlorine tanks were available at all corners and posters on behaviour were visible and clearly stated. Outside the centre, we were met with much criticism. In a society where the first reflex action is to shake hands or hug, we were called all kinds of names if we ever dared to tell someone, “No! no shaking of hands or direct physical contact!”. In our close environment, it was almost impossible to give advice to people, who were really aggressive, when it came to Ebola.
What were the most difficult moments for you? Things were very difficult, I must say, when I was at the Ebola treatment
centre. Sometimes we had to care for over 30 Ebola-positive patients or suspected cases at a time. When the epidemic was at its peak, we had about 60 to 75 patients at centre, with a staff working as hard as they could to save lives. Even when tired and stressed out, the staff continued to work. So long as there was a sick person with problems, the team was available. It was hard to see people suffer, with no one wanting to lift a finger. Many succumbed to the disease, and all that was difficult to see every day. “I couldn’t bear to see children and babies, who had done nothing to get infected, face the same painful fate”.
Was there any glimmer of hope in this doleful situation? In this fight, I will always remember the two-month old baby we managed to save. He had been infected, but thanks to God, he managed to pull through. On that day, we all leapt with joy, and it was clear on everyone’s face. Although we had all the other sick people to deal with, the cure of this baby was a sign of hope.
Did it ever occur to you to lose all hope? I realized that I had made a choice and I had no right to make mistakes. It was not always easy, but I didn’t lose hope. Rather, every time I saw a cured patient leave the centre, I was filled with much joy. As the days went by, hopes of seeing the affected countries cope with the disease heightened. Many times, I managed to convince patients who refused to eat or take their medication, to do so. It was not always easy, because I got insulted, but I understood how
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they felt. To think that you have a disease which had no cure was really hard to bear. I told myself that I could have been in their shoes, and they in mine. Deep inside me, I said, “Don’t give up, you have to believe in this, they need you”. Those lucky enough to survive needed help to face their community. We had all been stigmatized, and for many, such rejection from people, was impossible to bear. We therefore gave advice to those who were leaving the centre, reassuring them that we were ready to help them at any time.
What motivates you to continue doing this? My key strength lay in taking the initiative to throw myself into helping alleviate the suffering of people. I had to reassure my colleagues that the war we were waging was crucial to the survival of the people. Since I first committed to helping the Ebola victims, together with MSF, I have
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« More efforts are needed to combat the disease. »
always been listening to people. I subjected myself to threats and insults. One of the weaknesses, to my mind, is not being able to convince all the patients who came in. In the face of all that suffering, I just had to go over and beyond myself to try and save as many lives as I could.
After a year and half of combating the disease, what are your views on the situation? All throughout this battle, I remembered that people had suffered and died, exposing the flaws in our health system. With the disease, it dawned on me that our health workers were not well trained and our structures poorly equipped. What is sad is that after a year, we still meet people today, who do not believe that Ebola is real. Indeed, it is important to think that a thing exists before tackling it. In the initial stages, the authorities probably inadvertently underestimated the severity of the disease. We realize that
despite all the awareness campaigns throughout the country, more efforts are needed to combat the disease. Ebola has bereaved families, and even the country at large, and is still raging on. Mentalities must change, we must learn to help and trust one another, if we are to see the end of this epidemic. We managed to set up a system for more frequent use of chlorine in washing hands. The unwilling ones underwent training and awareness and the people became more flexible toward the health workers. Today, Ebola is still not over, and for us, so long as there is one single case, we will not give up.
FOCUS ON Reports
Agriculture tested by Ebola Agriculture is the mainstay of Guinea’s economy. The outbreak paralyzed the production of several crops, especially in the rural areas, where families faced hunger and malnutrition. by Hadja Nantenin Dioumessy
“We have recorded losses of 240 tons of pineapple.” Arafan Abou Sylla, planteur
B
efore Ebola, the agriculture sector was booming. Today, rice production has fallen by 20% and wheat harvests by 25%. Cocoa, coffee and banana have not been spared. Indeed, farm hands were fleeing from the farms, as rumours were rife in the villages about how the disease was transmitted. Thousands of hectares of farmland were abandoned by owners who were scared of being infected. A recent study carried out by the Government of Guinea showed that 74% of households in the affected areas reduced their daily meal rations, as there was no crop. In Kindia, which is situated 135 km from Guinea’s capital, and still called the “fruit city” because of the quality of its fruits and vegetables, losses account for about half a billion Guinean francs. Farmers paid a heavy toll, according to Arafan Abou Sylla, President of the Union of Kindia farmers “In August 2014, we cut over 25 tons of pineapple for marketing in Senegal. As the border was closed, all our produce rotted. Since then we have recorded losses of 240 tons of pineapple. We are worried since we have no means now. It is even a problem to feed our families. The closure of the border has only
worsened the situation”, complained Mr. Sylla. Apart from pineapple, mango, orange and vegetable farmers also suffered the same fate, helplessly witnessing their produce rot before their very eyes. “When we produce, it is for consumption. If that doesn’t happen, it becomes a loss for us. Ebola did not only bring about victims, it also brought unemployment. “We only live on farming. Without that we are nothing and we rely on no one. With the onset of Ebola, we are lost. In the beginning we didn’t know the disease. Many of us didn’t believe it was here, and as you know, work in the farms requires harmony and mutual help. On the farms, we do everything as a group. When the wives are cooking, the husbands share out the meals. When someone in the group is not well, all the community comes together to take care of the one. With Ebola, farmers were forbidden many things. “When a friend died, it was difficult for the rest of the group to carry out the usual funeral rites. The most difficult, however, was that as a close relative you are considered as one of the contact persons, and as a contact, you cannot go out, and before long,
© LayeproPhotos
“Ebola has slowed down agricultural production.”
Famoyi Beavogui, agronomist the news goes around the village and everyone starts looking at you and your family”. Despite an average annual rainfall of 3,500 mm in 2014, Guinea’s growth rate fell to 0.5%, compared to 4.5% prior to the outbreak, as there was no work. “For over a year, we learnt to visit the sick, keeping ourselves at a distance and weep for our dead without touching them. For us, it was not a natural thing to do, as it was simply important to have dear ones by your side in your most difficult moments”, said the president of the Kindia farmers’ union. About three-quarters of the population are engaged in agriculture, which accounts for nearly 15% of the country’s gross domestic product (GDP). According to the agronomist, Famoyi Beavogui, the impact of Ebola on the agricultural sector is clear: “Ebola has slowed down agricultural production. The rice fields have been abandoned by the
farmers, and yields have been affected, production has reduced and social mutual assistance has ceased. This has impacted the national economy”. Today, the national coordination against Ebola has seen encouraging results. There are fewer and fewer Ebola patients at the treatment centres. Farmers are now going back to their farms. As part of its emergency response to the Ebola crisis and to support the economic recovery measures, the World Bank allocated emergency financing of $15 million to alleviate hunger and revive agriculture in the three countries affected by the outbreak (Guinea, Liberia and Sierra Leone). According to the World Bank, this financing will be used to supply 9,000 tons of certified seeds and 1,500 tons of basic seeds to 200,000 farmers to enable them to plant maize and rice, in an effort to revive the agricultural economy and meet food requirements at the local level. In the meantime, over 230,000 Guineans are suffering from food insecurity.
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In memory Due to the Ebola outbreak in 2014, health workers died in Guinea, Liberia and Sierra Leone. The names of all deceased health workers are unknown to us, but we were able to find the names of the following 324 individuals:
Liberia
1. James Tamba Daah 2. Ramuson Tamba Lenden 3. Dr. Samuel Mutoro 4. RamsonTamba Daah 5. James Tamba Lendan 6. Esther Kezelee 7. Cynthia White 8. Mamadee Kamara 9. Elibetha Smith 10. Tenneh Joe Margibi County 11. Caroline Gaileh 12. Kita Hamon 13. Fatu Brown 14. Nathaniel Kolie 15. Morlue Kinefelee 16. Moses Sarmie 17. Varney Kollie 18. Augustine Siafa 19. Cyrus Gweh 20. Enid D. Dalieh 21. Enoch G. Vah 22. Enoch W. Saywon 23. Ernest N. Gbargleh 24. Jonathan Mullbah 25. Joseph Ballah 26. Mulbah Flomo 27. Philip Moilbah 28. Sonnie Worlobah 29. Stephen Blamah 30. Wellington Quarbo 31. John Quai 32. Nuwoe Kollie 33. Alphonso Gardenett 34. Junior Brown 35. Alex Blo Nyumah 36. Essi Dazzie 37. Anita Sackie 38. Boimah Kromah 39. Beatrice Koheneh 40. Moses Freeman 41. Massa M. Massaquoi 42. Kelvin Sackie 43. Emit Gweh 44. Varney Kpolee
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45. Mark Brownell 46. Isaac J. Washington 47. J. Clarence Kuteh 48. Jemama Harlebah 49. J. Siafa Tamba 50. Joseph Ballah 51. Alice Passewe 52. Nancy Sackie 53. Frincella N. Kolie 54. Joenpu T. Loweal 55. Koon T Gbealin 56. Otino Garpue 57. Stephen T. PAYE 58. Amos Kollie 59. Dorbor W. Akoi 60. Kebbeh Akoi 61. Uriah Folokulah 62. William Vah 63. Fayai Seipoh Nimba County 64. Oliver Kuor Lofa County 65. Robinson Lenden 66. James Daah 67. Mamadee Kamara 68. Elizabeth Smith 69. Stephen A. Tamba Montserrado County Redemption Hospital 70. Esther Kezelee 71. Tenneh Joe 72. Cynthia White 73. Joshua Peters 74. James Moore 75. Dominic Wesseh 76. Sharron Joe 77. Solomon Saydee 78. Sofia Doe 79. Alfred Jonson 80. Dr. Samuel Mutoro 81. Dr. Scotland 82. Dr. John Dada Catholic Hospital, Monrovia
83. Ms. Laurene Togba 84. Layson Wilson 85. Tetee Dogba 86. Richard Kollie 87. Rev. Bro. Patrick Nshamdze 88. Rev. Bro. George Combey 89. Rev. Father Miguel Pajares 90. Rev. Sister Chantal Mutwamame Cynthia Nelson Health Center 91. Edwin J. Dour 92. Augustine Sekou 93. Jessie Williams 94. Elizabeth Korfeh 95. Momo Dolley 96. Victor Tokpah 97. Stephen Borbor 98. William Tandanpolie 99. Roland Gotolo 100. Paul McGill 101. Suoboi Dweh JFK Medical Center 102. Stephen Vincent 103. Dr. Borbor 104. Dr. Brisbane Bomi County 105. Sando B. Sirleaf, Jr. 106. She D. Sirleaf 107. Sando Y. Sirleaf, Jr. 108. Randall Domah 109. Christian Harris 110. Mercy Dahn 111. Younger Gbassie 112. Gormah Kamara 113. Stephen Bundoo 114. Daniel Kouery Grand Cape Mount County 115. Foday Watson 116. James Kollie 117. Bendu Bah
Sierra Leone Kenema 118. Balu J. Fonnie 119. Alex G. Moigboi 120. Hawa Rogers 121. Fatu Sheriff 122. Nancy Kembeh 123. Rebecca Lansana 124. Feima Alpha 125. Memunatu V. Gaba 126. Iye Princess Gborie 127. Serah Mansaray 128. Sarian Kamara 129. Elizabeth Lengie Koroma 130. Baindu Kallon 131. Jeneh Sam 132. Alice B. Koroma 133. Lansana Alpha 134. Baindu Kamara 135. Betty Lahai 136. Jengo Alpha 137. Nancy Yoko 138. Musu Ensah 139. Wuyata Kabba 140. Lansana M. Bangur 141. Hawa Samba 142. Mohamed Fallah 143. Mustapha Gbetu 144. Brima Fambuleh 145. Sahr E. Kokoi Fayia 146. Sidikie Saffa 147. Vandy S. Bockarie 148. Ibrahim Rogers 149. Mohamed Blango 150. Dauda Conteh 151. Bashiratu Kemokai 152. Sahr Nyakoi 153. Vandi Bockarie 154. Sidikie Saffa 155. Dauda Conteh
Kailahun 156. Alpha Rexon Feika 157. Messie Konne
158. Serah Nyokor 159. Josephine Kpundeh 160. Sallay Johnny Musa 161. Cecilla Baion 162. Isha L. Momoh 163. Saio Sesay 164. Massay Eima 165. Saiwo Seay 166. Mamie Gbabai 167. Josephine Brima 168. Dominic Momoh 169. Mark T. Fayia 170. Ibrahim Nalloh 171. Morray Belewa 172. Aminata Kanneh 173. Patrick Vandi 174. Matida Koroma 175. Sellu Aruna 176. Moris B. Ellie 177. Bridget M. Alpha 178. Beatrice Y. Bockarie 179. Aruna Kallon 180. Mohamed Jegula 181. Festus N. Jalloh 182. Samuel K. Kargbo 183. Alenbu B. Sandi 184. Mansaray F. Vandi 185. Bockarie Lansana 186. Moses S. Momoh 187. Alusine Kamara 188. Yawa Kofeh 189. Christiana Nyuma 190. Hawa Bockarie 191. Mamie Swara 192. Satta Abu 193. Mohamed Mansaray 194. Momoh Banya 195. David M. Lissa 196. Margaret Bockarie Military Hospital 197. Gibao Mattia 198. Morie Banya 199. David Gaimba 200. Morrie Banya 201. Jabrick Williams
of health workers who died as a result of Ebola virus disease
202. Foday T Bangura 203. Andrew Mansaray 204. Ibrahim Mansaray 205. Barba Bah 206. James Kallon 207. Marian Sesay Connaught Hospital 208. Hajaratu Serry 209. Lucy Sowa 210. Prince Koroma 211. Mohamed Kamara Rokupa Hospital 212. Alfred Koroma 213. Ruth Lamin 214. Lamin Gobeh 215. Abdul Karim Koroma 216. Hawa Fonti Kargbo 217. Alfred Charles 218. Kadiatu Tholley 219. Ibrahim Tarawallie 220. Sullay Fofanah George Brook Hospital 221. Esther George 222. Mariama Koi 223. Albert Lissa 224. Pamela Deen BO Government Hospital 225. Mahawa Kallon 226. John Williams 227. Prince Siaka Bombali Hospital 228. Hafsatu Thoronka 229. Alfred Sesay Western Area D H M T 230. Rodney S. Bell Well Body 231. Patricia Bockarie
Kissy Mental Hospital 232. Ramatu Conteh Mutual Clinic 233. Yeaby Turay Mabesseneh Hospital 234. Unisa Sesay Kingharman Road Hospital 235. Jenet Morlu 236. Isata Sandi 237. Bankoloh Dumbuya PMO Cline Town 238. Timothy Saradugu Kambia Government Hospital 239. Abdul S. Kamara Kabala District 240. Fatmata K. Sesay 241. Fatmata K. Sesay 242. Gabrel Tarawallie 243. Ballay Saffa 244. Salamatu R. Kamara 245. Philip M. Kamara 246. Augustine Conteh 247. Abu Bakarr Bangura 248. Abdul Kamara 249. Mohamed Thullah 250. Alfred Sesay 251. Alimamy Bangura 252. Sheka Alie Turay 253. Rosaline Mamie Kamara Loko Government Hospital 254. Alice B. Sesay 255. Isatu Z. Bangura 256. Alice B. Sesay 257. George Pratt 258. A B Sesay 259. Fatmata A. Bangura 260. Ibrahim Bah
Moyamba 261. James Tucker 262. Joseph H. Gegbei 263. Abu Bakarr Mansaray Tonkolili 264. Mohamed Kamara 265. Zainab Koroma 266. Mamusu Kanu Doctors 267. Dr. Umar Sheik Kha 268. Dr. Sahr Aiah Rogers 269. Dr. Modupeh Cole 270. Dr. Olivette Buck Headquarter – Youyi Building 271. Lamin Kamara 272. Ibrahim Turay 273. Mohamed Jalloh Pujehun 274. Mohamed Rogers Blue Shield 275. Georgian Brown 276. Patrick Vandy
Guinea Conakry 277. Issiaga Savané 278. Salimata Soumah 279. Gassimou Bangoura 280. Nana Camara 281. Bakary Camara 282. Abdrahaman Diallo 283. Facinet Bangoura 284. Jeanette Haba 285. Siaka Camara 286. Sidiki Kaba 287. Mariam Djoulde Sow 288. Rabiatou Sylla 289. Ibrahima Sylla 290. Camara Ousmane 291. Diallo Youssouf 292. Camara Noumoussa 293. Camara Mamadou Saliou
294. Sylla Souleymane 295. Ernest Haba Dubreka 296. Camara Mohamed Gueckedou 297. Jonas Koundouno 298. Joseph Fara Simbiano 299. Boundeye Franguadouno Fenio 300. Toho Mamadouno 301. Tamba Lamine Wendeno 302. Jean Pierre Kourouma 303. Sia Massandouno 304. Pessa Matronne Leno 305. Philippe Tolno 306. Momory Tolno Macenta 307. Samba Keita 308. Fassa Etienne Kourouma 309. Pepe Loua 310. Toupou Yagbaoro 311. Brigide Sovogui 312. Kojo Guilavagiu 313. Bafode Sylla N’Zerekore 314. Kante Seydou 315. Mamadou Sakho 316. Ibrahima Fernandez 317. Mamadou Aliou Barry 318. Moulou Cherif 319. Facely Camara 320. Moriba Toure 321. Pasteur Moise Mamy 322. Sidiki Sidibe Telimélé 323.Mariama Baillo Barry Yomou 324. Kpamou Odette Yomou
List communicated to Decent Work by Mrs. Odile Frank, Public Services International
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FOCUS ON Reports
Ebola,
a common evil Accounts and accounting errors in Guinean companies by Hadja Nantenin Dioumessy
Doctors dying, farms deserted, schools closed and increase in the number of unemployed, Ebola did not only create victims. It also slowed down Guinea’s growth as it spread throughout the country.
S
ince the Ebola outbreak in Guinea, many jobcreating projects have halted. Information made public by the World Health Organization (WHO) shows that the outbreak has already killed 11,000 people in the three affected countries (Guinea, Liberia and Sierra Leone). According to a company head, the reason is simple: “Ebola was not wellknown by people. We had to deal with an outbreak without a cure, and which forbade any contact with the sick person, without appropriate protective clothing. It brought about a feeling of panic, fear and mistrust”. Taking an example from a newspaper published by one of his friends, he said: “We, as journalists, at once felt the heavy toll Ebola had taken on the country.
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Calls for bids reduced, while companies retrenched their staff. For investors, the message was clear: no traveling to Guinea until Ebola ends. It was hard. Even if the epidemic has reduced, the fear and hesitation remain among many donors”. Today, the companies are at their lowest level. Many of them have had to do away with in-service training for students, while several expatriate positions have been annulled and some employees redeployed elsewhere. For the mining sector, which had been booming, financing has been halted and recruitment suspended. Once again, the dreams of young people who have been jobless for long have been shattered. In Guinea, for instance, the mining company Arcelor
Mittal has evacuated its entire site and suspended expansion works on the iron mine. With Ebola, all the sectors were affected by the outbreak. Transportation was also dealt a heavy blow. At the height of the epidemic, we only had three companies serving the entire country”, says a worker at the control tower at the Conakry international airport. “Prior to Ebola, we were very busy. We expected three or four flights a day. But since Ebola, everything has changed. We can spend days waiting for just one flight, another person said. Another person said that Ebola had truly slowed down things. “As a trader, I had to choose among the airlines, depending on my destination. But since the situation worsened, and Ebola was
characterized as a global health issue, everything has changed. As I was compelled to travel to bring in my goods, I often had to pay double the normal price” according to Alpha Diallo. For the travel agencies, apart from staff reduction and even the total halt of activities in some cases, the level of demand has considerably dropped. “At first, we had the possibility to make reservations for our clients, even the less frequent ones. Sometimes reservations could last several weeks. When the airlines decided not to stop operations in Guinea, it was almost impossible to reserve without paying. Our customers did not understand anything, and it wasn’t easy convincing them that the agency had nothing to do with it. What was happening was beyond the control of everyone”,
said Aminata Baldé, an employee at a local travel agency. Despite the construction of new hotels and renovation of some of existing ones, Guinea was no longer a choice destination. “Many parents, whose children were abroad, preferred for them to stay there, for fear of that they will catch the disease, and also to prevent them from being stigmatized when they returned from vacation, added Baldé. For the first time in Guinea, people were prevented from moving freely within the Economic Community of West African States (ECOWAS) area, and even beyond. At the markets, the atmosphere was quite different from the time when the borders were open. The same goes for the lorry stations. A driver we met at the Senegal lorry station at the Madina market told us about his ordeal: “Every week, I made
two trips, as I had partnered with my brother. When the disease started, the frequency of the trips changed, as the borders were closed. Passengers or drivers could not enter Senegal from Guinea. Many of our passengers were blocked here and there seemed to be no solution”. This regular on the Conakry-Dakar road with some driver friends took in clients from Conakry and went all the way to neighbouring villages at the border, with the hope of bringing in passengers from Dakar. “I was successful once, but that was the only and last time”, he scoffed. At the height of the epidemic, people could not move freely. Passengers in vehicles that entered Conakry were subjected to strict checks. Many Guineans felt they were being stigmatized, directly or indirectly, because of their nationality. “We had the impression that being Guinean was synonymous with carrying the Ebola virus”, accor-
“Prior to Ebola, we were very busy. We expected three or four flights a day.”
ding to Mahmoud, a young trader plying the Conakry-Bamako route. While the border with Mali had not been closed, the checks were many and quite stressful. Invisible enemy, global threat, accursed virus, dreaded disease; Ebola has been called by all kinds of names in West Africa, particularly Guinea, where it started before spreading to Liberia and Sierra Leone. Even though the virus has not been completely eradicated, it is now time to take stock and rebuild the country, especially in the health sector, where it has exposed the shortcomings of the system.
A worker at the control tower
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Being a working woman and coping with Ebola When the choice becomes difficult by Hadja Nantenin Dioumessy
“Before Ebola, my life was pretty calm, without much stress”, said Angeline Tinguiano, every time she had to start a conversation on the subject. First, in Gueckedou (a town situated at the borders with Sierra Leone and Liberia), then Conakry, Angeline started work as a psychologist before moving into health promotion. “At the beginning of the outbreak, there were not many people who believed
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At the start of the week, Angéline Tinguiano starts her day by meeting with her staff. For a year now, this health promoter has been working relentlessly to help the people in the fight against Ebola. After a year of the epidemic, her fight continues and her commitment remains the same.
that the virus was real, and many young people were scared to engage in that type of work. Me, I was not afraid when Médecins sans frontières called me to work in the team of psychologists. I heeded their call, as we were in Guéckédou, and that was where the epidemic broke out. Our work was to reassure the sick persons and their families. For us, it was very important to start by believing that the disease actually existed, and
then, together, we can conquer it.”
“I no longer had any friends, no one to rely on.” Angéline Tinguiano, health promoter
Quite often, confronted with difficult negligent patients, Angeline’s day was taken with making home calls for counseling and isolation. “We believed that once the patient was sent to the treatment centre, he had to be screened to check if he has Ebola or not. Should that be the case, we ensure that he agrees to receive treatment. We also ensured that he
took his medication correctly. Every day, we could go into isolation three to four times. It depends on the psychological state of the patients. The aim was to reassure them that they could rely on us and if they agreed to the treatment, they would be able to survive. In June 2014, when the disease crossed the forest barriers toward Conakry and the neighbouring towns, concern rose among the MSF staff, and a team was deployed right away to the capital. This seemingly incurable disease in a country where population movement was rife was about to wreak havoc. For MSF, the message was clear: “all suspected cases must be isolated and all contacts monitored.” At that time, according to Angeline, “I ceased to be a psychologist, and started accompanying the health promotion teams. My work entailed going to the communities and explaining to
people that Ebola was real, and that it could be avoided and even cured, and if a family member was sick, he or she should be taken to the treatment centre at once. We also had to explain to the people that because of Ebola, healthcare was now comprehensive and free. For many people, Ebola spelled death. But for us, it was clear that one could survive the virus. It was difficult to convince someone who had just lost a loved one that there’s a cure, but we were bent on not losing hope”. For several months, teams were sent to the communities, sector by sector, to raise awareness. When a cured patient had to be released, teams were sent to the family to prepare them and the neighbours. These were emotional moments. “For us, it was our main wish to see all patients cured and returned to their loved ones, and also halt the spread of the virus”, said Angeline.
“It was difficult to convince someone who had just lost a loved one that there’s a cure.”
In this work, one never felt completely safe, according to Angeline, but faith helps you to go on, and you share everything with the colleagues. “Before Ebola, I had always spent my time helping people in distress, but work in an environment where I cannot touch people in order not to spread the virus, was very difficult. I no longer had any friends, no one to rely on. I felt rejected. Apart from my colleagues at work and close family, which had accepted and respected the choice I had made, I had no one else. This is not an easy thing to overcome, but deep inside me, I just told myself that it was only for a specific time”. For Angeline and many others engaged in the fight against Ebola, habits had changed and a lot has happened since the onset of the disease and it was just their belief and perseverance that had kept them going.
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Damantang Albert CAMARA,
Minister of Employment, Labour, Technical Education and Vocational Training, Government spokesman “80 companies have drawn up economic retrenchment plans”
With the crisis situation created by the Ebola outbreak in Guinea, the right to work had to be revisited and dealt with from all angles by the actors concerned, as they were confronted with the need by companies facing difficulties to lay off their staff. This and many other factors were spelled out by Mr. Damantang Albert Camara. Interview.
Your Excellency, your country went through a difficult period recently, because of the Ebola epidemic. Can you tell us what impact this has had on the socioeconomic situation of Guinea? First it came as a shock, as we thought we would be spared such an epidemic. Then we had to react quickly. As you rightly said, there were some direct consequences on the socioeconomic situation of Guinea. The economy was greatly affected, and companies negatively impacted. This led to layoffs and technical unemployment for many of
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the workers that we had to deal with at the labour inspectorate. It also led to a slowdown in activity and above all, we had put together a new way of living, to ensure that the fight against Ebola was established at the work place as well. That was where the real challenge lay, as new procedures had to be adopted for us to operate in a sector we knew nothing about, assess the consequences that we had not planned on labour rights in terms of the possibility of companies to postpone some of their commitments, know whether or not it was a case of force majeure, know about the legal status of layoffs. These are all issues that had to be dealt
with and for which we do not really have the answers even today.
Were other sectors affected? All sectors were hard hit, especially in the affected areas. In the forest areas, for instance, agriculture was highly affected, with low outputs in the rice, cocoa and cereal sectors. In the construction sector as well, most foreigners working with site foremen, some of whom were expatriates, have suspended their work. Also in the mining sector, their responsibility toward the expatriates and their work as a whole was such that they did not want to take risks. Many
even left the country until the epidemic was over. A number of projects and cooperation efforts involving foreign expertise or signing of contracts in Guinea were all postponed until the end of the epidemic. Trips that had to be undertaken by the country did not take place because some countries had put an embargo on travellers from Guinea. You can therefore imagine how heavily this combination of factors weighs on national economic activity.
Has the impact on jobs and workers already been assessed, especially at the workplace?
Two months ago, (Ed.: meeting carried out in May 2015), about 80 companies had deposited their plans for layoffs owing to the Ebola epidemic and drop in activities. The situation has stabilized now that Ebola has more or less been controlled. Some companies have even reopened. The exercise involves several hundreds of workers, if not thousands, since we do not yet have all the statistics, and procedures are still ongoing at the labour inspectorate general. When we consider those under technical unemployment, those that have quite simply been fired and the lack of recruitment owing to drop in activity, we see that thousands of Guinean workers have been affected.
It seems that at the health centres, health workers had been tested for the epidemic. Can you tell us about that? Yes, at the start of the epidemic, owing to lack of knowledge about it, negligence and lack of
communication, many doctors were affected. Indeed, it was after a doctor and his entire family was wiped out by the virus that the first alert was made in March 2014. Health workers bore the brunt of the situation, which led to many deaths and several infected people. Although some of them were cured, people are still living with the effects of the disease in the bodies and in their daily lives. This caused a challenge with continuing to motivate the teams and asking them to remain mobilized behind the epidemic. We did not have too many problems, because generally, the medical staff were mobilized and committed to the fight against Ebola, and always stood their ground when certain behaviours jeopardized the lives of hospital staff and patients alike.
Do you plan to introduce a health security policy at work, which, in future, will protect workers against occupational hazards? One of the lessons drawn from Ebola is first of all the fact that in the beginning it simply had to do with issues of elementary hygiene: washing the hands, avoiding physical contact with a sick person, for medical staff, using gloves. This even should be done systematically. These are thus
“Ebola has become a major parameter in triggering the adoption of laws on health-security at the workplace.” elementary, fundamental and basic principles that must be observed, whether there is Ebola or not. What happened was when the President launched a national emergency health plan; we took up its various elements. There were a number of restrictive measures, obviously, such as forbidding the movement of bodies and avoiding contact. We asked companies to post this emergency plan visibly in their premises. We also asked them to provide a kit for washing hands, for all workers when they get to work. We also asked them to put up posters showing and explaining in a simple but explicit manner what Ebola was, to enable workers to have a good knowledge of the disease. We plan to continue along these lines. We have just adopted legislation on health, safety at work, and we are going to add others on
hygiene. These laws also take into account all measures taken today as part of the fight against Ebola. You’re right, Ebola has become a major parameter in triggering the adoption of laws on health-security at the workplace, and follow up on these measures.
In our countries, West Africa, to be precise, we realized that social protection structures are not yet solid. In the face of such danger, how did Guinea’s social protection structures behave? We have mainly the Caisse nationale de sécurité sociale (National social security fund) (CNSS). Some companies have their social security system, but at the national level, we only have CNSS. We were at the study stage for two other institutions, the National social welfare fund for public workers, which is only for
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civil servants, and the National institute for compulsory health insurance. It is clear that following this epidemic, adopting laws to set up these two structures was accelerated. The President adopted decrees to set up these two structures, which will be provided the human resources and premises needed to start operations. Unfortunately, the social protection system was not ready to cope with this size of epidemic. I must say again, that everything was blurry, technically, logistically and legally with regard to the Ebola. Today, things seem to be somewhat clearer. The aim is to provide more resources to the various bodies on the ground, three in number, to date, to enable them to meet the challenges caused by such epidemics, by covering the reimbursement of medical fees and compensating days not worked and taking care of widows and orphans. Today, all we can rely on are some initiatives by UNICEF and the United Nations to help the families of victims. A social security system should be able to meet those needs. It would be wrong, however, to reduce it to just the Ebola epidemic. The social protection system is, in general, a challenge for all workers in many African countries. We have a social security fund, which has only just started operating in a standardized manner, just like other
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“The President adopted decrees to set up the National social welfare fund for public workers and the National institute for compulsory health insurance.”
funds in other countries. It is not sufficient to meet all the challenges with the social protection of workers in Guinea.
You mentioned the impact on agriculture, but certainly, there is also an impact on farm workers themselves. In our countries, these workers don’t have much access to social protection. Do you have any specific measures to help these people? Yes, there are specific measures. For instance, the Government has been embarking on an agricultural campaign since 2011, a campaign to support agricultural activities, by supplying farm inputs on the ground. Additional efforts were made in the areas affected by the epidemic, to ensure that it cost the farmers in those areas nothing. We are currently examining the possibility of putting mutual schemes in place by sector of activity, so that these activities generate their own social protection and insurance system. We can say simply that it is only at the study stage and we lack the data needed to implement it in the short term. The goal is that in the long run, there should be an insurance and protection system for the workers of these sectors.
You were saying that most foreign firms had to leave the
country. What lessons, can we, as African countries, draw from that, because these are our own companies which remain when situations are difficult? The first lesson is to know how to rely on our own strengths. I think that is so clear. The President has always hammered on that. His goal is to establish a core of local entrepreneurs, and he once again brought the problem to the fore. There is also a “local content” policy for all mining projects which should make for the emergence of this crop of Guinean entrepreneurs, which, as you know, will be those who will remain in Guinea and who will continue help run our economy, whatever the circumstances. This problem was brought starkly to the fore with the departure of entrepreneurs and postponement of some activities because the foreign firms did not wish to work as Ebola raged on. We were, at least, satisfied to see that some friends of Guinea were, I wouldn’t say compelling, but rather encouraging their nationals and enterprises to remain in the country. I’m referring to airlines such as Air France and Royal Air Maroc, which continued to come to Guinea. I’m also referring to all the cooperation projects with Morocco, which have continued with a few minor changes. This, at least, helped our economy not to collapse totally, and some major
projects to be started. We must, ultimately be able to rely on our own enterprises to meet the challenge facing the Guinean economy and the development of Guinea.
Can you tell us about the postEbola revival programme? It’s a recovery programme, which was started on the basis of the impact of Ebola. It was defended in Brussels and Washington by a group of Guinean senior officers and ministers of State in charge of Economy, Finance and Budget, and the private investment promotion agency and other ministries deeply involved in the Ebola issue and Guinea’s resilience. Of course, we received support from several of our international partners. This plan should help provide budget support to make up for the lack of the substantial earnings that Ebola has cost us and revive the health sector to enable us to react very quickly and efficiently when faced with such epidemics. After this, there is the issue of economic recovery, projects for which we need assistance – not only financial but also technical, to make up for lost time.
What do you expect from the International Labour Organization? The International Labour Organization (ILO) is the most important body helping us to
“The International Labour Organization is the most important body helping us to identify all the labour aspects.”
identify all the labour aspects that would enable us to have the laws to deal with situations and others that would provide us with a motivating legal framework for recruitment, absorbing the large mass of unemployed persons, including young people and women. In our discussions with ILO, we learnt that beyond what they could provide us in the form of laws on social protection, health-safety at work, they could also provide structural solutions to deal with youth unemployment.
Do the social partners concur with this plan? Yes indeed. We were lucky in Guinea to have had a sort of social truce; given the difficult times we had been through. Our social partners agreed to go along with the Government and they fully got involved to deal with the consequences of the epidemic and continued to assist Government, albeit, while making certain claims. Together, we are working at the labour and social laws consultative committee. We have already
produced some laws. Some are being adopted, and after consulting with ILO, they will indeed be adopted. Others are also being drafted. So we do receive the support of social partners, and that in itself is a huge step forward.
Your Excellency, ILO wishes to thank you for all you are doing in the area of work. My ministry, and through it, the entire Government and social partners of Guinea also wish to commend the Organization for the constant support given the country in terms of technical assistance, help on the ground or through our discussions.
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SANABA KABA,
Minister for Social Action, Women’s and Child Promotion “52% of victims are women” As it often happens in periods of crisis, the most vulnerable classes in Guinea, namely women and children, bore the brunt of the outbreak. To assess the impact, we met with Madam Sanaba Kaba, Minister for Social Action, Women’s and Child Promotion.
Your country has just gone through a difficult period, with the Ebola. Can you tell us the impact of this epidemic on the underprivileged in Guinea? In the beginning, Ebola seemed like a mere health problem. But we realized that it was not just about health. It was also a social and economic problem. We noticed that 52% of the victims were women and 15% children. What was really unfortunate was the stigmatization of the sick. Even those who were cured were stigmatized, as were children and young girls who suddenly had to become mothers as their parents had died. The closing down of schools also
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led to violence against girls, as family control had broken down in some households. Studies we carried out on the ground showed that gender-based violence had reduced from 2014, especially in the areas affected by Ebola. Economically, the epidemic affected income-generating activities, as a large part of the economy is held by women. It is women who are the first to wake up in the morning and the last to go to bed at night. With the closing of the borders, petty cross border trading was stopped for some time. Exports of market farm produce also had to stop, causing economic loss for women. The consequences of the disease were
therefore huge for the vulnerable groups. Even our social habits were affected. People who could spend a whole week with a bereaved family were now being asked not to come when a family member died, or touch the body, attend the funeral, go to the cemetery or even pray over the body of a loved one. Initially, those taboos caused anger among bereaved fa-
milies, who even became violent. Our department was responsible for mobilizing the people to explain the reasons for those dos and don’ts. Social assistance faced many issues.
How did your department deal with all that? Right at the outset, we knew the epidemic existed. As soon as we heard about the consequences of
“Social assistance faced many issues.”
Ebola, we met with the epidemiology specialists, who explained things to us, and we understood at once that we had to target the most vulnerable groups, namely women and children. We organized ourselves with all civil society organizations, women’s groups, and associations and faced the problem head on, with the women journalist group. We went from public place to public place, and even from door to door to sensitize the people in all the affected areas to describe exactly what the disease was about and provide advice on prevention. I think that helped us a lot, as many people started listening.
Were specific measures taken for your targets, who for the most part, had no social protection system? In terms of managing the disease, I believe that the coverage was countrywide. All infected persons were taken to the treatment centres for free treatment. With respect to dealing with the consequences of the disease, I must admit that the department carried out studies on psychosocial management, the number of activities affected and the level of impact on the living conditions of the people. We conducted a social anthropological study to understand why the response was slow. Based on those studies, we outlined a programme, which we sent to the donors. Orphan children, for instance, were provided for. We devised a cash transfer programme. We also outlined a support and protection programme for children. We also have a six-month cash transfer programme for women, and we took a sampling to enable us to assess the impact.
“Ebola has brought out the flaws in our social protection mechanism.”
You have a social protection project financed by the World Bank. How does this project tie in with the social protection policy of the country and the recovery strategy that is in process? It is a programme to develop a national social protection policy. Ebola has brought out the flaws in our social protection mechanism, in terms of emergency management. This is what urged us on to speed up the development of the programme, which would be used for social assistance on the ground. We have already conducted a first study with national consultants and are currently recruiting an international consultant to validate the document we had prepared. In terms of epidemiology, I believe that it’s a lesson for us all. The epidemiological situation should be a fundamental element of the policy and should not only be limited to emergency cases.
What are you expecting from international cooperation? First, there is UNICEF, which got involved in the issue, and I think last year, the World Bank voted an amount for developing a national social protection policy. Unfortunately, with Ebola, the fundamental goals of the Government had to be shifted to focus on the response to the disease. I hope these funds are brought back. With regard to ILO, we are requesting their technical expertise to support the national committee drafting the national social protection policy. It is a crosscutting committee, with other departments that are concerned with the policy. I strongly hope that the development of this policy will be one of the priorities
of ILO to support Guinea. I also hope the other partners will come on board because it will help us. We even plan to put together a database of vulnerable groups to facilitate assistance given to them, especially as their vulnerability exacerbates during crisis periods. This is a specific case to be dealt with at once. If we had had this database, I think it would have helped us avoid the spread of the disease, because the vulnerable were more exposed to the disease than those with a higher standard of living. The national social policy drafting committee therefore eagerly awaited ILO for its technical and financial assistance to cover costs, where needed. What I would like to add is that I thank ILO for coming in. It is during such difficult periods that we see our true friends. And today, when we speak of Ebola, the impression is that all we’re doing is gather the dead in our streets. Despite this reputation, you agreed to come on the ground to see things for yourselves. I think that will give you a clearer picture of what you can do for us and will facilitate the assistance for us. I’d also like to thank all the technical and financial partners, who, since the disease started, have not relented in their efforts. They supported us, showing us that we are together, even in difficult times.
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Sophie Danielle Kourouma,
workers confederation of Guinea (CNTG) “We hope that support does not take long in coming”. Ms. Sophie Danielle Kourouma is the first Executive Secretary responsible for gender, social affairs and children, of the National workers confederation of Guinea (CNTG). She is also the President of the Guinea national commission for women workers (CONFETRAG). She outlines the impact of Ebola on workers in Guinea – a situation she termed a “nightmare”. She also expresses all the support expected from the partners in Guinea to help alleviate the plight of workers.
Guinea has just suffered from a very difficult Ebola epidemic. What was the impact of this epidemic on workers? Personally, I belong to the health sector. Every time I have to talk about the impact of this disease on workers, I shudder, because I just recall when it all started. Today, the impact is serious, even dramatic. There was already a problem, as Guinean workers have always been needy, if not poor altogether. This poverty worsened with the onset of the disease. All economic activity slowed down. Contracts for workers were all frozen. In addition to that, many enterprises closed down. Investors left. For us, health sector workers, it was a nightmare. The output for health workers dropped
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considerably. This was because, first of all, people were in fear of the disease and the fact that health staff were dying in their numbers; also they hardly visited the health centres. The disease had a social, economic and even financial impact on Guinean workers.
For health workers in particular, this may pose a health-safety problem at work. What are you doing about this generally, and specifically in the area of health? The issue of health-safety at work is a huge one in Guinea. As the saying goes “Every cloud has a silver lining”. That is why we are trying to correct all these flaws, because while Guinea has ratified several conventions on
“For us, health sector workers, it was a nightmare.” the issue, implementation is a problem. For Ebola, we have set up hygiene and health committees in the public, private and semi-public enterprises. These committees are not operating very well because they do not have the requisite training. They do not know exactly what to do in terms of health-safety at the work place. However, they remain there. Even with its meagre resources, the union is also overseeing their training. Finances are needed for certain
types of training. We are still trying to train them gradually. Health centres clearly need upgrading. There is a lot to be done, especially in terms of conditions of work. Imagine the fact that there is no water at some health centres. How can we talk of hygiene in this particular case? In fact, even health workers are compelled to fend for themselves when they are sick, as they have no social security.
“We would like to thank ILO for coming to see us.”
Why is social security an issue? It is part of our claims. Two decrees were enacted to set up two institutions the National social welfare fund for civil servants and the National institute for compulsory health insurance. It is true that implementation has just started. No impact can be seen just yet. We hope that they will soon start functioning to serve workers.
Do you have any specific measures in mind to help farmers and informal sector workers who fall sick? In our union, there are those who work in the informal sector. We have women involved in market gardening. That sector was really hard hit. Productivity fell, labour declined on the farms, following the death of workers. People had
to flee their farmlands. When one heard that Ebola was near, it was as if the shadow of death was passing. Within the groups and cooperatives that we support, we saw clearly that revenue had dropped. Not only did production drop, but they could not market what they had produced, because people were fleeing. All that happened because they felt the full impact of Ebola. With regard to the support measures from Government, I learnt from the media that there had been support from time to time. They brought something symbolic to the families of the deceased. However, I couldn’t tell if there was any true and organized support. There is a post-Ebola recovery plan. That is the reason why ILO sent a mission to Guinea.
Did you contribute to devising the plan? First of all, we would like to thank ILO for coming to see us, because we really needed help. We hope that support will come soon. With regard to developing the plan, we did participate in it. We identified the training component as a priority, and we hope Government will support us on that. We need to ensure improvement in the health system. We must ensure that there are enough means of protection. We also asked for training sessions to build the capacities of the hygiene and health committees, as well as that of the gender unit.
Were your inputs taken into account?
really saying the same thing. Everything is designed to promote the development of the country and to eradicate the disease. I therefore think they will take what we have proposed into account.
We have come to the end of our meeting. Do you have anything else to add? What I’d like to add is that we the members of Guinea’s unions were filled with hope when we saw the ILO team come in, not only to pay us a visit, but also to tell us that they wanted to see how they could support us in in our post-Ebola strategies. That is a big thing for us. We do hope that the support will not be long in coming because we really need it.
I believe that they will take them into account, because we’re
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Ansoumane Camara,
Guinea national employers’ council
“Several sectors have seen their turnover drop by as much as 75%”
The Guinea national employers’ council is the first employers’ organization in the history of Guinea. It was established in May 1992 and comprises a score of sectoral employers’ organizations. Mr. Ansoumane Camara, economic affairs officer of CNPG, will talk about the impact of Ebola on Guinea’s private sector.
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Your country has just suffered an epidemic of the Ebola virus. Can you give us the major impacts of the epidemic on the various sectors? We organized the sectors in three categories. There were sectors where the impact was more because their turnover dropped by as much as 75% in some cases. They were mainly the transport, tourism, hotel and restaurant sectors. We believe that those sectors had been really hard hit, having seen their turnover drop completely. This led to unemployment, as many of those companies had to lay off workers because they could not pay the salaries. The second category of sectors was called the “difficult sectors”. Those were general commerce, building and construction, and security. Those sectors had their turnover drop by 60%. They also faced cash flow problems. Some of them also laid off workers.
The third category, which we called “other sectors affected by Ebola” were those whose turnover dropped by 40% to 50%. Generally therefore, there was a cash flow problem in all sectors, with the direct consequence of laying off of workers. During this crisis, the health
“We gave the National Ebola control coordination 3 billion Guinean francs.” centres were the first to manage the disease. Is there a private health sector component of the employers’ association? If so, how was it impacted by the disease? While it does exist, I must
admit that in our daily activities, you cannot really call it a dynamic sector. This made the issue somewhat a marginal one in all the assessments we made. That is why it is difficult to give precise information about the sector.
Did the impact of the disease on health facilities and health workers have an effect on your businesses? It is clear that it did, because, in the first place, some workers that played key roles in companies had the disease. That is naturally a handicap for the operations of those companies.
There are institutions, which are responsible for social protection and the social security of workers. Do you think these
institutions met expectations? Did they play their role well? We were rather disappointed in the services. These institutions were absent. When the epidemic was at its peak, we did not see them. These include the National social security fund, whose presence was hardly felt at the height of the Ebola.
Were appropriate services rendered to workers and companies in good standing? Despite the fact that companies were making the effort to pay up their contributions, we gave the National Ebola control coordination 3 billion Guinean francs, although we had problems. We however deemed it useful to add our momentum to this solidarity effort, because we were all fighting a common enemy.
Apart from this grant, can you tell us how the private sector has been involved in the national management of the crisis? We embarked on awareness campaigns. It was done sectorally. Some sectors organized themselves as well as they could, and targeted some localities.
We understood that the agricultural sector was
severely hit. Were private sector agricultural concerns impacted? Indeed. That was what urged us on to propose the series of measures and ask for more interventions. These include building storage centres, as some of their produce was rotting. As the borders were closed, the produce could not be exported. Some of those companies had lost as much as 90% of their turnover.
“We have drawn some useful lessons with the departure of these enterprises.”
This shows the severe damage to the sector and the job losses that followed.
We also learnt that most of the foreign enterprises in Guinea left the country. Others wishing to get established hesitated. As the Guinea employers’ association, what do you think about that attitude, with respect to the national enterprises? You know, Guinea is basically a
mining and agricultural country. The mining companies contribute greatly to our national wealth and the GDP. These companies accounted for 25% to 30% of the GDP. It is therefore extremely important. Rio Tinto, a mining giant involved in iron, had just signed a contract with the Government, to the tune of US$ 20 billion. It was just at that time that Ebola reared its head. It was compelled to halt its activities at once, although a lot had been expected from it. Before that, we had drafted a paper with the World Bank, which we called “local content”. In the paper, we outlined the mechanisms that could help the private sector to be part of the mining chain, from extraction to final production. We were entering the operational phase of the local content, just at the time when companies like Rio Tinto closed down. We were unpleasantly surprised by that attitude. While we do understand them, it still left a bitter taste in our mouths.
Guinea is developing a recovery and resilience plan. Is the employers’ association contributing to the formulation? Are you building your capacities to deal with the defection of foreign companies?
First, we asked the public authorities to enhance the participation of the private sector, in the defining of strategies for the recovery of the Guinea economy. It was accepted. We also asked to benefit from official development assistance. That was also agreed to. Besides this financial support, we also requested that our companies should be exposed to some international expertise, to help them gain experience from them and enable them to ensure continuity when these foreign firms leave. We have drawn some useful lessons with the departure of these enterprises. We told ourselves that it was up to our local enterprises to play the role of engines of our national economy. This means that we have to make substantial resources available to those enterprises to build their capacities.
What are you expecting from ILO? Capacity building! This is because we know that ILO can help us to mobilize expertise and also lobby some financial partners to intervene quickly for Guinean enterprises.
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Abdou Amy DIENG Ebola Crisis Manager for Guinea under the United Nations Mission for Ebola Emergency Response (UNMEER) “I call on the people to comply with the rules laid down by Government to eradicate Ebola”. Mr. Abdou Amy Dieng is a Senegalese official. He has been heading the UN Mission for Ebola Emergency Response (UNMEER) in Guinea since January 2015. He previously worked for some 20 years with the World Food Programme (WFP), where he filled several positions, including as WFP Country Representative for Guinea-Bissau, Cote d’Ivoire and the Democratic Republic of the Congo. He also worked in logistics in Angola, Italy, Haiti, Nicaragua and Cameroon. He occupied the position of WFP Country Director for Guinea. He was coordinator of humanitarian action in the Central African Republic, from December 2013 to May 2014. Before taking office in January 2015 in Guinea, he was WFP representative in Ethiopia. Decent Work
Why did the UN General Assembly decide to set up an Ebola emergency action mission on 19 September 2014? The epidemic, which was already ongoing in September 2014, was so intense that the international community was scared that it would spread exponentially. The world had set its eyes on Guinea, Sierra Leone and Liberia. Without international intervention, the experts had predicted that in January 2015, there would be over 1.8 million people affected. Thankfully, we did not get there following the immediate intervention of all national and international actors. The idea of setting up UNMEER was to stop the epidemic and arrive at zero Ebola cases in the three countries affected. This single mission was the first United Nations mission to address public health-related issues.
“Without international intervention, the experts had predicted that in January 2015, there would be over 1.8 million people affected.” The assignment of the mission was to stop the epidemic, treat infected persons, provide basic services, maintain stability and prevent any new epidemics. In your capacity as manager of the Ebola crisis in Guinea, can you tell us about the successes and constraints in pursuing these objectives? The mandate of UNMEER is to coordinate actions among
all national and international partners and the Government of Guinea, specifically with the national coordination set up to combat Ebola. Immense efforts have been made. Today, we have everything that Guinea needs in the fight against Ebola: laboratories, ambulances, Ebola treatment centres, doctors, planes and helicopters. The number of infections has reduced, as have deaths. We see more cases of survivors and fewer cases of Ebola. In the forest area, we have not learnt of any new cases for three months. Currently, we have 20 Ebola cases weekly on average, compared to 180 weekly, last September. This is very encouraging. However, so long as we have not arrived at zero cases, the response is not yet over.
Can you tell us about actual cases to illustrate the scope of the disease
in Guinea? Or at least, can you give an assessment of the situation? Today, we have four active prefectures out of the country’s 33. These are Boké, Dubréka, Conakry and Forécariah). In the week of 7 June 2015, there were 16 confirmed cases. From 8 to 14 June 2015, there were 10 confirmed cases, and in the past week, there were 4 confirmed cases. We thus see a very positive trend.
The health facilities, which led in managing the Ebola patients, demonstrated weaknesses in their ability to deal with the epidemic. In your intervention, were you interested in upgrading health facilities and services? Yes, absolutely! The health facilities and services are very important. Before the intervention by UNMEER and the international community, there were no appropriate structures dedicated to the disease. Now, it is a priority for us to set up facilities capable of detecting and treating Ebola cases in the entire country.
Many health workers were also affected by the disease, and several have died from it. Have measures been recommended to secure and prepare health workers to deal with similar health hazards in the future? Yes, unfortunately, several members of staff have lost their lives in the fight against Ebola. But thankfully, for three months now, there have been no cases of infections among health staff. I’d like to stress that
“Our goal is to ensure that no more Ebola cases are reported in Guinea in the next few months.”
we are currently training staff and recruiting new national ones.
Today, Guinea is launching an ambitious post-Ebola recovery programme. Is UNMEER involved in the process? If yes, at what level? UNMEER will not be involved in
How do you assess the mission generally and what recommendations would you make for future missions of this nature? A detailed assessment will be made once we arrive at zero Ebola cases in Guinea. For now, we have not reached there. Our goal is to
the post-Ebola recovery programme. However, the United Nations agencies, funds and programmes and other partners will support Guinea’s post-Ebola response efforts.
ensure that no more Ebola cases are reported in Guinea in the next few months.
Now that we have passed the emergency phase, will the mission continue its activities? If yes, how will it do it? UNMEER is scheduled to leave on 31 July 2015. However, discussions have already taken place with United Nations system agencies to ensure that activities continue and that resources such as logistics and human capital remain. We are currently working on a transitional plan.
Currently, we must underline the importance of carrying out preventive and surveillance action to avoid new infections in the country. I call upon the people to adhere to the rules laid down by Government to eradicate Ebola. It is extremely important to respect secured burial grounds and never to hide the sick or move dead bodies from one locality to another. Also, no longer should we threaten, attack or hinder the work of the response teams, who are only here to help Guineans fight against Ebola.
What else would you like to add?
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PORTRAIT
Hadja Rabiatou Sérah Diallo An African woman and worldrenowned social justice activist
Hadja Rabiatou Sérah Diallo was born in 1950 in Mamou, in the Fouta Djallon region and trained as an executive secretary at the Ecole des Cadres Techniques de Conakry. Her interest in trade union activities began in her childhood days when she used to participate in neighbourhood meetings. In 1969, at the tender age of 19, she ran for the office of General Secretary of the National Confederation of Workers of Guinea (CNTG) at its second congress. It was not yet her time, but it was the brushstroke of an iron lady with a hand in velvet glove.
H
er moment of glory came in 2000 when her comrades showed their faith in her and entrusted her with the position. She thus became the first woman General Secretary of the CNTG, the oldest and the largest trade union organization in the country with no fewer than 60,000 members. She served two 5-year terms. The Iron Lady, as she is often called in Guinea, placed women and the informal sector at the centre of her struggle. This increased her popularity with the poor, especially under the leadership of the late Lansana Conté, who, like her, was also a man of steel. However, in defiance of the latter’s rule, she led the first general strike the country had ever seen to protest against the decline in the living conditions of the Guinean people. With the backing of her traditional allies represented by women and
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the informal sector, her initiative attracted a massive turnout. Nine years later, Rabiatou embraced the Decent Work concept in order to highlight one of the things she would like History to remember her by as a trade unionist. “What I set out to do was to focus on the involvement of women in development. I wanted to halt their exploitation and rather help empower them so that they would not be relegated to the background. My message was meant not only for the authorities but also for some of our women who underrate themselves by always thinking that men make better leaders. Also, I wanted to break religious and customary taboos that weigh heavily on women so that they can have confidence in themselves, cease to be passive and become active participants. This was one of my early challenges. Furthermore, I held women’s involvement dear to my heart, especially at a time we were undergoing structural adjustment
“I wanted women cease to be passive and become active participants.” programmes (SAPs). The advent of SAP affected women the most in terms of loss of employment, in addition to the youth who do not have jobs today. And yet, the youth are the future leaders. Therefore we had to fight for decent work so that young people cannot be exploited. Also, knowing that the government cannot employ all the young people, I focused a lot of my energy on entrepreneurship for the youth and women so that the complementarity of these population groups may become a reality”. Asked whether she thought she had succeeded in lifting up women to the desired level she said: “I wouldn’t say this has
been a 100% success; however we are satisfied with the role women now play. For example, although the composition of the government or parliament indicates that the minimum of 30% quota for women recommended by the ILO has not been met, today women control the economy. They have invested in the informal sector where they have been organized according to trade in order to encourage them. When you go to villages you find women leaders, women fighters. There still are not enough women in positions of authority or equal pay for equal work and so on. However, we cannot say that what has been achieved is insignificant. But we have to build on these achievements in order to deepen them so that they become visible and beneficial to all”. Recalling an example of African wisdom, Rabiatou said: “I always drew inspiration from what village chiefs would do when confronted with a difficult problem. The chief would tell the gathering: ‘Right, lets sleep over this and come back tomorrow’. But of course he did not sleep but rather consulted his wife at night. And the next day he proudly turned up with a solution. This shows that women are very intelligent. Also, you realize the problem of migratory drifts involves fewer women. Hence, for all these reasons, we are quite satisfied with what is going on. In the first republic, the first president of Guinea, Ahmed Sekou Toure, may he rest
“Without women’s participation one is doomed to fail.”
in peace, became acutely aware of this and entrusted responsibilities to women. He did not want women to be exploited. He empowered them, especially in the area of management. But I have to admit that there has been some regression since. We no longer see the initial momentum of the first Republic. But without women’s participation one is doomed to fail.
Return to Rabiatou’s past.
We are in 2007. The country is facing a popular uprising with the protesters calling for better living conditions and the ousting of officials suspected of corruption. Rabiatou, an indefatigable activist does not need coaxing to lead the protesters. This causes her arrest together with that of other leaders, but she is quickly released under pressure from the international community. Indeed, Rabiatou is not an ordinary woman. Today, one would say that she is networked. Her solid reputation goes beyond the Guinean borders. A profile of her on the guineeactu.info website, mentions that she was the chairperson of Women of
the Organization of African Trade Union Unity (OATUU) in 1999, the Pan-African chairperson of the Democratic Organization of African Workers’ Trade Union (DOAWTU) in 2002, chairperson of the World Confederation of Labour (WCL) at its general meeting held in Brussels in 2007. In 1985, the Governor of Texas made her an honorary citizen of the State of Texas. She was also a member of the International Labour Office (ILO) Governing Body in 2001, member of the International Labour Organization (ILO) Governing Body in 2005, was designated Woman of the World in the Netherlands in 2006 and elected as vice-chair of the 96th session of the ILO’s International Labour Conference in Geneva in 2007. With such a rich track record, at the age of 60 and as a woman crowned with glory and honours, she was appointed chairperson of the National Transition Council (CNT) of the Republic of Guinea. With the dissolution of the National Assembly in December 2008 resulting from the military takeover after the death of President Lansana Conte on 22 December of the same year, the CNT was established to serve as a legislative body from 2010 to 2013. Her social dialogue skills acquired at the ILO were taken into consideration in choosing her to
head the CNT. She confirms this and states: « As the name indicates, ILO is a tripartite organization. It is the only agency of the United Nations where tripartism comprising government, employers and workers can exist. When we speak of justice, decent work and sustainable development, these are initiatives that emanated from the ILO because all the three groups are negotiating, each one according to its paternity and within its working group. But afterwards, they meet at the plenary to hold discussions. In other words, they engage in a battle of ideas. What matters is what is more beneficial to the world of work or the country. It is this specificity of the organization that I appreciate a lot. Also, this is where complaints can be made against a government to call it to order. When a government fails to implement conventions it has ratified and rather chooses to keep them on the shelf, it can be called to order. And there again, the social partners and governments can issue a country report so that the progress made in a particular area or support given to each country can be assessed. Beyond each tripartism, at each conference, heads of state present their programmes in order to garner the views of ILO. Not many institutions do this. This is the role ILO plays and this is why this role has to be preserved in order to strengthen the organization’s capacity to ensure the well-being of United Nations and that of the entire world”.
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“The ILO and international and African trade union organizations invested in me.” Unanimity is not a common feature of humanity and the decision by General Sékouba Konaté, interim President of the Republic of Guinea to appoint Rabiatou is no exception to the rule. This is what she had to say about this milestone in her life: “As you may know, one learns a lot in the trade union movement. I did not attend university and during the transition period many said: “she is not educated, she has no qualifications”. But they forget that I attended the trade union school where one learns a lot and gets educated. I underwent much training in Turin under the auspices of the ILO. I served three terms as a member of the ILO Governing Body. My contacts enabled me to learn on the job. I acquired much experience because I was trained in Africa and at the ILO. The ILO and international and African trade union organizations invested in me to provide all the training and experiences that I have acquired in our country”. She recalled with delight her successful term at the head of CNT. She said as a woman she was proud to have led the transition, successfully accomplished her task and left with her head high.
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She stated further that it was the first time the ILO had given support to a parliament thanks to her interpersonal skills and good relationship with Juan Somavia, who was then the ILO Director-General and the entire multidisciplinary team of ILO in Dakar that travelled to Guinea to assist the CNT. These technicians trained the entire CNT membership in social dialogue so that they would accept, tolerate and speak to each other. “There were ten military members of the CNT, she recalled. When we entered the barracks, the soldiers said: ‘But we also need this kind of training. This is because in the army you have to obey your superior officers rightly or wrongly.’ However, we clearly demonstrated that, at all levels, if you want to achieve success then social dialogue must prevail, and we were able to do this through the ILO. And for the first time we were able to travel upcountry to train local councillors and administrators as well as prepare a document with the ILO and OIF this time supported by the United Nations through UNDP. This has led to the convergence and stability pact that is currently being used by many countries.”
The work of the CNT enabled Guinea to organize a democratic presidential election in 2010, with an improved electoral law, constitution and labour code. Today at the age of 65 and armed with wisdom, “Mother Courage” as her compatriots affectionately call her is not ready to retire. « As long as I can breathe, stand on my two feet and think clearly, I will make myself available to those who have helped me become what I am because they would not want to see the fruit of their efforts thrown into the sea or out through the window. I should be able to share my experience at all levels, in any country, with any individual and even in my neighbourhood. This is why, after the transition, I do not need any bodyguard. I don’t need to be watched over. The people are my protectors. I get close to the people because I want to be in step with them in order to share their needs and know how best I can serve my country, the African continent and the entire world”.
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Report of the Director General : The ILO’s role in post-Ebola recovery effort (Third Supplementary Report) Governing Body, 325th Session, Geneva, 29 October-12 November 2015. – 11p. Link to report : http://bit.ly/1K0kaV2
Guy Ryder, ILO Director General
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n the report presented at the 325th session of the ILO Governing Board held in Geneva from 29 October to 12 November 2015, the ILO Director General outlined the areas of intervention and activities the Organization plans to undertake by 2020 to promote decent work in the post-Ebola recovery efforts in Guinea, Liberia and Sierra Leone. The document states that the role of the Organization is mainly to build national institutional capacities and governance structures aimed at averting similar crisis in the future. The role and intervention areas proposed are as follows:
a) Building national consensus on national priorities for decent work through inclusive social dialogue and strengthening the role of public sector workers by taking lessons from the Ebola crisis; b) Creating jobs and enhancing skills through employment-intensive infrastructure programmes for productive and sustainable assets which reinforce availability and delivery of quality basic public services with special attention to working women ; c) Strengthening social protection systems towards progressive universal coverage; addressing child protection in the context
of objectives towards the elimination of child labour; d) Supporting the recovery of the private and public sectors by promoting the culture of prevention through occupational safety and health (OSH) programmes along the supply chains in collaboration with governments, and employers’ and workers’ representatives; e) Promoting a regional integrated Ebola recovery process within the Mano River Union (MRU) and at the level of the Economic Community of West African States (ECOWAS).
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Guinea Post-Ebola recovery and socioeconomic resilience strategy 2015 – 2017. april 2015. – 80p.
Link to the document http://bit.ly/21AiJ7B
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he post-Ebola socioeconomic recovery and resilience strategy 2015-2017 was formulated to enable Guinea to recover from the effects of the crisis, kick start its socioeconomic development and boost its resilience. The strategy aims at:
of ice-making plants in rural areas to off-set the vulnerability and mitigate the impacts suffered by the fisheries sector; • developing local products through processing at the local level, construction of modern markets, construction of marketing facilities at cross-border zones, revision of trade regulations to take into account the context of globalization and possible crisis situations such as Ebola;
• resumption of infrastructural investments (roads, ICTs, airports, ports etc.) delayed by Ebola;
• supply of livestock nuclei (small ruminants, pigs, poultry) to stock breeders), support to the recovery of existing organizations (groupings, cooperatives, unions), support to the re-opening of markets (information/sensitization, collection and dissemination of statistics) and provision of abattoirs based on food safety standards;
• building the capacity of SMIs, the financial support to facilitate the refund of loans and stabilize the cash-flow of SMEs affected by the crisis, putting in place a policy for promoting local products that were heavily affected by the bad press caused by the Ebola viral disease (EVD), assistance to and use of local SMEs in the supply of goods and services chain and creation of an emergency fund to support the private sector;
• building resilience capacities of the educational system in view of possible epidemiological crises and acceleration of the implementation of the Education Sector Programme (ESP) 2015-2017;
• provision of social and health infrastructure at landing points, installation of cold storage rooms for the preservation of sea products in urban areas and construction
• remobilizing mining projects delayed, suspended or postponed, with emphasis on the strengthening of communication actions;
• strengthening the achievements of macroeconomic stabilization and the support of private sector-led strong and inclusive growth;
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• funding the response capacities against EVD and improvement of the national health system; • strengthening of access to health, sanitation and drinking water;
• strengthening of the empowerment of vulnerable persons, with special focus on the youth and women in order to enhance their resilience to future shocks.
Recovering from the Ebola crisis : Submitted by United Nations, The World Bank, European Union and African Development Bank as a contribution to the formulation of national Ebola recovery strategies in Liberia, Sierra Leone and Guinea Full report: http://bit.ly/1FXnmuk Summary report: http://bit.ly/1IMcmB4
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his comprehensive report is an input to the national post-Ebola recovery planning process. It reflects opinions expressed by the partners during the Ebola Recovery Assessment mission including officials from various ministries, UN agencies, nongovernmental organizations (NGOs), development partners and civil society. It provides an assessment of the significant progress made by affected countries to contain the epidemic. It describes the stabilization and recovery planning efforts and explores points of fragility that led to the epidemic that occurred at local level to degenerate into a regional humanitarian social, economic and security crisis with major international ramifications. It identifies supplementary measures the countries must take to achieve zero Ebola cases and establish conditions for reducing the risk of
resurgence. It also examines the loopholes and challenges to national development recovery. The report will serve as the basis for enhanced advocacy by the UN SecretaryGeneral to support post-Ebola recovery. The advocacy was conducted with the Peace Consolidation Commission, World Bank, European Union, African Development Bank and other development stakeholders. The first section of the report analyses policies, makes recommendations and suggests actions following the mission and additional consultations with the stakeholders. Section II describes the context of the report by highlighting the challenges of the post-Ebola recovery, international response, scope of the recovery process and messages from the consultations. Section III covers
health-related issues in light of the burden borne by the health systems in the three countries. Issues of conflicts or political instability were embedded in the development narratives of the countries over the last decade. It is for this reason that Section IV examines the consequences of the Ebola virus in the area of governance, peacebuilding and social cohesion. Section V deals with the effects of the crisis on public services and infrastructure. Section VI focuses on the socioeconomic impact of the epidemic and socioeconomic revitalization needs. Section VII dwells on the impact of the Ebola virus on women, children and the youth. It also assesses the role of the private sector and some sub regional and regional issues. Section VIII draws general conclusions and highlights key messages. The last section (IX) identifies the future outlook and next steps.
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CURRENT EVENTS
Transition from informal to formal economy Francophone Africa lays the bridge
A sub regional workshop for sharing experiences in the transition towards informal economy in Francophone Africa was held from 27 to 30 October 2015 in Somone (77 km from Dakar, capital of Senegal). A workshop organized by the ILO’s International Training Centre and the Department of Employment Policies in Geneva and the Decent Work Technical Support Team (ETD/BP-OIT) based in Dakar.
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tatistics provided by Moussa Oumarou, Director of ILO’s Governance and Tripartism Department representing the ILO Director-General at the opening of the meeting illustrated the role of informality in African economies. In subSaharan Africa, for example, informal employment represents 65% of non-agricultural employment. This, combined with informal agricultural employment, suggests that the informal sector is growing. “These figures are a cause for
concern to us, he said, because research shows that the incomes of the majority of workers and economic units of the informal economy are less than the average incomes of all the workers. They are deprived of stable and secure work. They lack social protection, are exposed to poor working conditions – with higher occupational safety and health hazards and they are often incapable of exercising their fundamental rights, are deprived of freedom of expression and of representation at work”. Faced with this situation, it became necessary to reformulate
“Clear political will is necessary for any effort aimed at a transition to formal economy.”
the policy interventions in order to facilitate the transition to formality. Hence the participants to this workshop appreciated the opportunity to share experiences of transition to the formal sector. For four days, they shared the good practices drawn from the presentations and discussions and identified challenges specific to their contexts. The workshop report indicates that “clear political will is necessary for any effort aimed at a transition to formal economy. Moreover, it is important to define and implement an integrated policy framework. Coordinating actors around a national strategy makes for a more effective and beneficial implementation. The formulation and implementation of formalization policies and initiatives must be based on an analysis of the national context by which the objectives of the formalization must be clearly defined. The impact of interventions must be assessed and measured and any stakeholder must be involved in the formulation of project.” With regard to the implementation mechanisms, the synthesis document of the meeting indicates that the participants upheld good governance and the fight against corruption as the key to success. To this end, it is essential to promote a culture of respect for regulation. Thus, it is necessary to put in place an appropriate legislative
“Make you want to go formal.”
and regulatory framework and adherence to this framework should be promoted through inspection of “mixed work”, backed by a combination of coercive and punitive measures. According to the experts other success factors include sensitization and communication. They see these two elements as necessary “in conveying the message of formalization because it has to make you want to go formal”, in other words make formalization attractive and the informal undesirable. Furthermore, the participants agreed on the need to combine the formalization of enterprises with that of employment. They are convinced that “the formalization of enterprises requires an increase in productivity and the competitiveness of informal units. Hence, there is a need to formalize without impacting the viability of economic activities […]”. This summary of key messages of the workshop ends with this appeal: “Organizing actors of the informal economy is an important step in the formalization process, and employers’ and workers’ organizations have a role to play at all levels of their implementation. Recommendation 204 can serve as a guide […]”. Recommendation 204 concerns the transition from the informal economy to the formal economy. It was adopted in June 2015 by the ILO constituents. It provides a new dimension to the advocacy for formalization. This recommendation provides that each country
undertakes a diagnosis of its informal economy and that the framework of interventions to offset inequalities be based on sound knowledge of the causes, consequences and complexities of the phenomenon in each country. The La Somone workshop brought together tripartite delegations (government, employers’ and trade unions organizations) from Senegal, Benin, Cote d’Ivoire, Burkina Faso, Mali, Cameroon, Togo and Chad. Representatives from UN Women and UNIDO also attended. The participation of sister UN agencies in the workshop form part of the mobilization for the transition towards a formal economy. This transition is a contribution to achieving Sustainable Development Goal 8, namely, “Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all” particularly target 8.3. The latter aims to “promote development-oriented policies that support productive activities, decent job creation, entrepreneurship, creativity and innovation, and encourage the formalization and growth of micro-, small- and medium-sized enterprises, including through access to financial services”.
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CURRENT EVENTS
© LayeproPhotos
Promoting green employment Senegal validates its strategy
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he event forms part of the Partnership for green economy action (PAGE) launched in the country in November 2014. The programme, which covers a seven-year period, aims to deploy the joint expertise of the five UN agencies (UNIDO, UNDP, ILO, UNEP and UNITAR). The mission of PAGE is achieved through the support provided by 30 countries, including Senegal, involved in a transition to
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Senegal organized its first edition of Green Economy Days in Dakar from 18 to 19 November 2015 under the theme: The transition towards green economy in Senegal: policy and strategic framework for stimulating action”.
a green economy. This is done through the mobilization of public opinion, formulation and evaluation of policy options, facilitation of the implementation of policies from a sustainable perspective, etc. Diagnostic. The green economy days helped validate the national strategy for promoting green jobs (SNPEV). In his presentation of the strategy, Seynabou Diouf, the consultant who spearheaded the formulation process noted that at the
end of the consultations with the various stakeholders, a consensual definition of green employment in Senegal was adopted: «any decent human activity, individual or collective, that generates income, safeguards the environment and ensures a rational use of natural resources”. The study makes an in-depth diagnosis of policies and the institutional, organizational and regulatory framework for promoting green jobs.
The policies formulated by the government all aim at promoting green jobs. This is the case of the Policy Letter of the Environment and Natural Resources Sector (LPSERN 2009 – 2015), the Emergent Senegal Plan (PSE), Green Jobs Promotion Project (PPEV 2014 – 2015), the New National Employment Policy (NPNE 2015 - 2019) and the programme to support green job opportunity creation (PACEV 2015 – 2019). These policies were accompanied by an institutional framework comprising funding and technical support initiatives such as FONGIP, FONSIS, FNPEF, the ASC/ Emplois/Jeunes, the FIJ, and le FISE; support and employment entities such as the National Youth Employment Agency (ANPEJ), ADEPME, the National Civic Service (SCN), National Integration and Agricultural Development Agency), (ANIDA), the Community Commodities Programme (PRODAC); training and funding entities similar to Technical Education and Vocational Training Development Fund (FONDEF), National Vocational Training Board (ONPF) and National Employment and Skills Centre; in addition to high labour-intensive project implementation agencies such as AGETIP, APIX and AGEROUTE. In terms of legislation, the study shows that the promotion of youth employment is ignored by the labour code, but this is offset by a national state-private employers’ convention (CNEE). Furthermore, the informal economy
that should help promote youth employment is averse to the labour law; and the promotion of training and youth employment is ignored in collective bargaining processes. The study concludes that the effectiveness and impact of employment policies and programmes are for the most part, limited by the absence of an institutional framework for coordinating interventions by stakeholders. This accounts for the poor consolidation of knowledge in the employment sector, particularly green employment. Despite these shortcomings, the study shows that green employment potential in the country is high. The expert, Seynabou Diouf, ensures that the green employment sector can, in the current context, provide interesting opportunities in terms of employability and integration of the unemployed into basic trades. This is the case in the areas of liquid sanitation, household and related wastes, environment and green spaces, renewable energies (sun and wind), biodiversity, ecological and ecotourism services, agroenvironmental management etc. But it stems from a few major constraints, especially access to financing in view of the high level of investments needed; complex tax laws that make it difficult for businesses to comply with current taxes and levies; inadequate skilled labour in green trades. Vision. Based on this assessment, the National Green Jobs Promotion Strategy (SNPEV) has been linked to the long-term vision agreed to
“The budget for the strategy is estimated at CFAF 2 998 500 000.”
by Senegalese society based on the emergence of the intra and intergenerational solidarity. To this end, SNPEV advocates green jobs in a resilient economy for the emergence in intra and inter-generational solidarity in 2035”. It is to this end that the strategy aims to put in place a framework in which policies, institutions and governance contribute to the judicious management of natural resources and reduction of environmental hazards. Thus, it is set within a framework of strong, sustainable and inclusive growth that fosters increased incomes and employment and helps reduce poverty through public and private investment in the natural capital. The implementation of the SNPEV shall follow five strategic thrusts: strengthening of the legislative, institutional and regulatory framework; creating green employment opportunities; strengthening human capacities; developing suitable financing policy; setting up of a communication and monitoring-evaluation system. The budget for the strategy is estimated at CFAF 2 998 500 000. According to Madam Seynabou Diouf: “this strategy provides a global and coherent response to unemployment (particularly that of the youth and women) and environmental degradation in Senegal. However, its success is dependent upon the coordination of the efforts of all the stakeholders and skills development as well as the mobilization of accessible and sustainable financing”.
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PERSPECTIVES
Informal economy Professor Ahmadou Aly Mbaye Professor of Cheikh Anta Diop University of Dakar (Senegal), Director of Applied Economic Research Centre (CREA)
“Gary Fields, professor of economics at Cornell University often said that the only consensus one can have in our profession on informality is the absence of consensus”; virtually any author who speaks about informality has his/or own definition of the term. His colleague at Cornell University, Ravi Kanbur says that any economist who speaks of the informal must begin by defining what he/she means by informal. I believe this is quite significant; another economist James Heintz says the same thing. This shows that there is not a single definition for the concept of informality. The reason is that economists use a multitude of criteria to define informality. Many hold the view that informal activities are small in size and, thus, size becomes an appropriate criterion for definition. Others believe that registration is a criterion and that once a business
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is registered it becomes a formal enterprise. However, some studies have shown that this is not necessarily the case. Other criteria used include the accuracy of accounts, mobility of the workplace, type of tax paid, access to bank credit, etc. It is obvious that, taken individually, each of these criteria captures an aspect of informality, but not all. Most studies on informality use an approach that differentiates formal employees from informal ones; and enterprises into formal and informal ones, which is surprising to the extent that generally economic factors are not characterized this way. When one speaks of development, there is a multiplicity of criteria that must be taken globally to determine the level of development of a country. Similarly, in diagnosing diseases like malaria, doctors do not consider only the body temperature of the
“Informality should be defined as a continuum.”
patient, but rather all the relevant symptoms. In considering the issue of informality, surprisingly, individual criteria are used and the units to be studied are classified accordingly, namely enterprises or employees: but when the classifications obtained are compared with these alternative criteria it is soon realized that the classification does not tally. Arabsheibani and Carneiro undertook this exercise in 2006 on Brazilian employees and realized that there were as many formal-informal employee classifications as there were criteria. Informality should be defined as a continuum since there is not one criterion that can individually account for all the facets of the phenomenon. Informality is the result of a combination of characteristics. Defining informality as a continuum means that all the criteria identified
Formalization of the informal economy remains a major issue in African countries. It was the central theme of a sub-regional workshop organized in Senegal from 27 to 30 October 2015 by the ILO’s International Training Centre in Turin, ILO’s Employment Policies Department in Geneva and the Decent Work Technical Support Team (ETD/BP-Dakar). Selected among many other equally deserving experts, they share with us their viewpoints and experiences on the informal economy.
in the literature must be considered jointly in order to characterize the level of informality of Africa, since, in fact, there is not a single level of informality. There are many levels of informality. Paradoxically, while economists are divided on the definition of informality, they seem to agree on the causes. The first is the fragility of the State. The commonest example is the case of southern Africa. Countries such as South Africa and Namibia that are relatively powerful have a more reduced level of informality than the others. The quality of the business environment is also important. Other factors that need to be considered include the tax ratio, corruption, bureaucracy, existence of a predator government that rewards the elite, perception of honesty and the competency of public actors. Concerning the characteristics of enterprises in West and Central Africa, figures from national accounts show that in the primary sector virtually all the enterprises
are informal, for example: Senegal 92%, Burkina Faso 100%, and Benin 100%. In the other sectors, the level of informality is quite high. Our studies on West and Central Africa have shown other characteristics such as the following: levels of capitalization are very low; productivity decreases as the level of informality increases; informal enterprises use less ITCs than those of the formal sector, they export less and their level of employment is weaker; there are more women in the informal sector than in formal or large informal businesses; the average level of informal monthly wages in the various countries is exceedingly low with the lowest average in Benin with CFAF 62 155 for the informal economy compared to CFAF 324 802 in the formal economy; in Africa, generally, recruitment processes are not transparent and personal relations play a key role especially at the informal level. I would now like to talk of cross-border trade as it would help us introduce the
concept of large-scale informal sector. We shall illustrate this with the example of Benin. In this country, the second-hand car trade is highly lucrative. It is estimated that it represents 10% of GDP. This plays an extremely important economic role and it is dominated by informal economy players. Last year’s (2014) figures show that 150 000 vehicles were imported whereas only 1500 were imported in the formal economy, representing a paltry 1% of the informal car imports. Another area where the large informal is much in evidence is the retail of fuel. In Cotonou, formal petrol stations are virtually non-existent. Most car owners get their supplies from informal retailers. And I can assure you that these dealers are not poor. One such dealer is reported to have said he was willing to pay the government CFAF 5 billion annually to get the latter off his back.
Faced with this situation, what policy shall we pursue? In our view, generalist policies that target the informal sector will be ineffective. The reason is that the informal is heterogeneous and demands for policies vary according to the informal segment. Therefore, sets of measures are required to address the various needs of segments of the informal based on an inclusive approach. Consequently, private sector support programmes should be revised. There are a number of institutions in our countries that do not have financing and clash with one another since they have the same mandate. Regarding trades such as mechanics, carpentry, it is important to organize the actors, as it is done for farmers, because, individually, they cannot have access to expensive equipment. They should be assisted to put in place such equipment and manage them communally.
Hence, in Africa the large informal has a significant share of the economy and this, in my view, is not sufficiently documented.
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Hamidou Sawadogo Director General of the Informal Sector in Burkina Faso
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“In Burkina Faso we have a general directorate for the informal sector which represents one of the four pillars of the Ministry of Youth, Vocational Training and Employment. It was in 1992 that the Ministry of Employment, Labour and Social Security established the Informal Sector Promotion Directorate. The directorate was transferred to the Ministry of Youth and Employment at its inception on 6 January 2006 under the name Informal Sector Support and Monitoring Directorate.
To find employment for the young and fast-growing generation attempts were made to link vocational training and employment to issues of the youth since they are affected by employment problems the most. Concerning the use of the term “informal sector” it needs to be noted that by that we mean “informal economy”. We have been instructed by our minister to change the term and use “informal economy” in all official documents and this is being done.
In July 2013 the directorate for the informal sector was upgraded to informal sector general directorate following a request by trade unions. The trade unions, which were active in the sector, claimed that in view of their numbers (94% of the working population occupy informal employment), they deserved a general directorate.
Since its inception, the DGSI has made a number of achievements. Taking into consideration the need to make the informal sector fully play its role as the driving force of a dynamic emerging and employment-creating private sector, the ministry has, through the directorate in charge of the informal sector, achieved the
following for the informal sector: holding two editions of the National Informal Sector Forum” in 2008 and 2010; organizing three editions of the “Salon des Métiers du Burkina Faso” (Burkina Faso Trades Fair); organizing 11 editions of the “Grand Prix du Secteur Informel”. Five hundred industries selected from 13 regions in the country participated in this contest. They are trained in tax compliance, social security, occupational safety and health, and encouraged to join authorized management centres. In sum, good corporate and employment practices are inculcated in them. And now a local jury has been set up in each region to assess the enterprises and determine whether they have applied what they learnt in their day-to-day business practices. Subsequently, some are selected at the regional level and assessed by a national jury. This is what
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constitutes the national contest and the winners and runner-up in each trade receives an award. On the whole, 16 trades are involved and the overall winner becomes the winner of the informal economy grand prix and receives a cash prize of CFAF 1 million, the runner up CFAF 750 000 and the second runner up CFAF 500 000. While the achievements I have enumerated above are to be attributed to the DGSI, it is also true that it is facing considerable challenges. These are primarily financial difficulties (inadequate and delayed release of funds) that hamper the timely implementation of its activities. An example
is the cancellation of two editions (2012 and 2014) of the National Informal Sector Forum, which is supposed to be held on a two-yearly basis. There are also organizational difficulties. The Salon des Metiers du Burkina Faso, an activity that involves informal economy stakeholders, is organized by a directorate other than the one in charge of informal economy. To this may be added challenges related to working conditions such as lack of office premises for the DGSI staff. Despite these challenges, the DGSI endeavours as much as possible to achieve the objectives set.
Going forward, the DGSI plans to organize on an annual basis the National Economy Forum and the contest “Grand Prix de l’Economie Informelle “(Informal Economy Grand Prix). We also hope to formulate and implement a national informal economy strategy and its operational plan. We also wish to hold training sessions on the formalization of employment and informal economic units for the benefit of informal sector stakeholders and information and sensitization sessions for local stakeholders on the mainstreaming of informal economy in the formulation of regional and communal development plans.
“We also hope to formulate and implement a national informal economy strategy and its operational plan.”
Furthermore, we intend to put in place an umbrella structure for informal economic actors, build the capacity of graduate and out-of-school workers of the informal economy; train the DGSI staff in the formalization of the informal economy and entrepreneurship, as well as informal economy young workers in the formulation of business plans and micro-enterprise management. We also hope to train members of associations and professional associations of the informal economy in organizational life, provide advanced training and retraining for informal economy young workers in their various trades”.
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Edmond Comlan Amoussou Director General of the National Employment Agency of Togo
To transit Togo out of the informal economy, Edmond Comlan Amoussou proposes the human services model.
“The most common form of human services in Togo is domestic work, generally known as maid service. In the Lome district alone, there are about 30 000 salaried workers 70% of whom work in the informal economy; 31% of needs are not met; 54.9% of persons employed in the sector do domestic work; 70.10% of households interviewed in Lome use them; their wages generally range from CFAF 10 000 to CFAF 15 000. Most domestic workers do not have any social protection (occupational hazard, illness, maternity and old age). Only 2.7% of employees are registered with the National Social Security Fund. Legal working hours are not observed: average of 17 hours per day (from 5 a.m. to 10 p.m.); virtual non-existence of paid leave and lack of professio-
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nalism among the workers due to lack of vocational training. However, domestic workers contribute directly to GDP formation and indirectly when many women with family responsibilities freely go about their work. How can the enormous employment potentialities of the sector be harnessed? There is a need to professionalize the sector and give it a suitable legal framework, hence the idea of establishing a pilot human service programme entailing services provided by individuals to individual homes. There are 3 major categories: services to family (school support, child care in or outside homes); daily life services (house cleaning by home agents, home monitoring etc.); services to dependent persons (assistance to sick, the
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aged and disabled persons). To put this idea into practice, we designed a pilot human service programme aimed at developing the human service sector. The specific objectives are as follows: restructure the various trades of the human services sector; promote the capacity for sector actors; promote the use of human services by households; strengthen the capacity and employability of workers of the human service sector; contribute to improving the living and work conditions of sector employees; encourage the setting up of an institutional framework to govern the sector. We want to ensure that 5000 persons are employed within a period of three years. Two poles have been identified to serve as a mechanism for implementation and monitoring: one decision pole in the form of a committee chaired by the Ministry
of Employment (National Monitoring Committee) whose role is to monitor programme activities; an implementation pole spearheaded by the ANPE which is also the executing agency of the programme. There will be three types of monitoring. First, technical monitoring that will focus on the implementation of the programme and the monitoring of indicators. This will consist in tracking the progress of activities and their outcomes in relation to the programme activities. Second, there will be financial monitoring which will ensure cohesion between disbursements, the progress of activities and monitoring of all payments made under the programme.
“We designed a pilot human service programme.”
The implementation period will extend from 2016 to 2018. The trades selected are social assistance, child care and house help service. Currently, Togo has training and certification services for the three trades. The programme details were shared with all the stakeholders at an official ceremony held on 1 April 2015. ANAPE launched from its own resources the implementation of a pre-pilot phase to train 45 applicants for the 3 trades. The programme is estimated to cost CFAF 1.6 billion over a three-year period. Pending government’s funding, we used CFAF 30 million from ANPE’s resources to fund this pre-pilot phase and demonstrate to the government that it is feasible”.
Lastly, administrative monitoring of the management of contracts signed with the programme implementation partners.
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“In the area of the formalization of the informal economy, Latin American countries can be cited as examples since they have managed to reduce their informality in recent years. However, informality rate remains high: 46.8% of informal jobs. In addition, there are significant country disparities because in Costa Rica, for example, informal employment rate for 2013 was 30.5% compared with 73.6% for Guatemala. But overall, all the countries were able to achieve significant results in reducing informal economy and informal employment.
Coumba Diop Programme Officer, Employment Policy, ILO International Training Centre, Turin
The other characteristic of informal employment in Latin America is that informal employment is more frequent in the formal sector. Two-thirds of informal employment is found in formal sector enterprises. Obviously, informal sector enterprises are characterized by low productivity and a majority of self-employed operators. But over there, informal employment occurs in the formal sector. This raises the issue of compliance with regulations. They also have informal employment in household units in the form of domestic work. Analysis by socioeconomic profile indicates that 55% of young employees and 49% of women are
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in the informal sector. Although this is less than in Africa, it is still significant. And what is worrying is that 64% of jobs are held by people with low-level of education. They either never went to school or only had primary education. Also, there is a majority of self-employed namely people who operate their businesses alone and small and medium businesses that are more affected by informal employment. The poverty-informality correlation in Latin America validates the hypothesis that the incidence of informality is high in a context of poverty. The poorest 10% of the population have an informal employment rate of nearly 72.5%. Hence the vulnerability rate is greater among the poor as compared to the 10% of the richest. They have informal employment because they are employed in formal businesses, but this is much less. With regard to intervention, the majority of Latin American countries have developed targeted actions for working groups and economic units. For example in Honduras, they targeted unemployed and informal workers by providing them with the possibility of undergoing two months of internship paid for by the Government with the possibility of
having a third month if the trainee is hired by the enterprise. Hence it is an arrangement they have with the entrepreneurs. In Trinidad and Tobago they have targeted disabled persons. They give them two years of training and later help them find jobs. They conducted an impact assessment that showed that 55% of disabled trainees find jobs in the formal sector the following year. Thus, the programme has been successful. In the Dominican Republic, the target has been on existing and new small and medium enterprises to help them acquire good habits right from the start of businesses. There are also champions of integrated strategies. Interesting examples are found in Argentina, Brazil, Columbia and recently Mexico and Peru. But what is worth noting here is that the integrated strategies have different entry points. This is similar
to the formulation of policies based on the context in which one finds oneself. For example in Argentina, they have a plan that started in 2003. The entry point is to formalize informal employment. In Brazil, they focused on informal enterprises and implemented their programme from 1996 to 2014. In Columbia they did the opposite. Rather than focus on the informal, they tried to give incentives for creating formal jobs and formal enterprises. Here, what needs to be noted is that even the countries I have mentioned do not have the same entry point. They developed their strategy through learning by doing. They improved as they went along and reviewed the situation and I believe this is an interesting learning process.
“In the area of the formalization of the informal economy, Latin American countries can be cited as examples.”
Mexico and Peru, which came on the scene later and benefited from impact assessments in other countries, have put in place formalization action plans. What is interesting in these programmes is that they mobilized already existing interventions and did not seek out new ones. They mapped out what already existed and tried to build on them based on a specific formalization objective. The other interesting aspect, which needs to be considered, is the definition of quantitative targets. They did not say, “in our action plan we shall...” they had quantitative objectives. The case of Peru is a clear example: in 2016 they want to reduce informal employment by 4%, 10% by 2020 and 10% by 2030”.
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Fréderic Lapeyre Head of the Informal Economy Unit, Department of Employment Policies, ILO
“Currently there is heightened international awareness of the need to facilitate the transition from informal economy to a formal economy. The objective of this formalization is to alleviate poverty, reduce vulnerabilities and foster the development of microenterprises that are sustainable and productive. It has been observed that whenever the level of informality is high, the levels of poverty and vulnerability are also high. Hence, as part of this sustainable development agenda, under the Agenda for Decent Employment and Decent Work, it is essential to facilitate the transition from informal economy to formal economy. What one seeks to achieve through formalization is to ensure that workers can have better working conditions, better
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living conditions for themselves and their family and that economic units can have a better environment to operate in within their activity sector. Hence, these formalization policies will contribute to providing better levels of social protection for workers and their families by registering them with social security schemes. This will also foster the registration of micro and small enterprises to enable them gain access to microfinance tools as well as capacity building and vocational training programmes. Formalization should also help enhance their productivity and incomes as well as foster a more inclusive development. Recommendation 204 which was recently adopted (June 2015) by the International Labour Conference aims at three main objectives: first, transition from informal
economy to formal economy, while at the same time safeguarding the living conditions of all those who have been caught in the informal economy web; second, the issue of decent employment creation notably for the youth who need to enter the labour market but do not have any opening in the formal economy; and third, avert informal systems in formal sector enterprises. There are 12 guiding principles of this recommendation. But the objective is to acknowledge the diversity of the situations depending on countries and regions and putting in place integrated policy frameworks for formalization that are suitable for the various contexts. Such integrated frameworks must be defined in the context of social dialogue. It is through tripartite mechanisms in which social partners
(workers’ and employers’ organizations) must be part of the process of formulation and implementation of integrated formalization frameworks. Regarding the scope of application, what the recommendation seeks to do through its guiding principles and policies is to facilitate the formalization of economic units through a mechanism for applying the new procedures; simplifying regulatory frameworks and at the same time formalizing employment. The focus of the recommendation is as follows: there must be formalization of enterprises and employment, in other words, better coverage of workers through social security registration, as well as better occupational safety and health”.
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