UNICEF Sierra Leone newsletter, April-June 2015

UPDATE SIERRA LEONE 10 year old Hawa © UNICEF Sierra Leone/2015/Mason

Unite for children

April - June 2015

In Sierra Leone, supporting Ebola survivors on the road to recovery

By Harriet Mason Communication Officer

Contents In Sierra Leone, supporting Ebola survivors on the road to recovery

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Ambulance 'open days' dispel fears in Sierra Leone

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Sierra Leone campaign addresses Ebola’s impact on Birth Registration

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Caring for children orphaned by Ebola in Sierra Leone

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Making schools safer in Sierra Leone during the Ebola outbreak

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In Ebola-hit Sierra Leone solar radios help extend education

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Vox Pop on Back to School

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For children affected by the Ebola virus, either as survivors or after losing family members or caregivers, UNICEF is working with partner organizations to provide psychosocial support and to help them realize a brighter future. hen child survivors like 10-year-old Hawa* emerge from the plastic-walled Ebola treatment centres, there are relief, smiles and often a joyous mix of dancing and singing.

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But people sometimes forget that even after the doctors and nurses have issued a clean bill of health, Ebola survivors still need support, with many having lost parents and caregivers, dealing with residual health issues and managing the trauma that will persist long after the virus has left.

“When I was discharged from an Ebola treatment centre about two months ago, I was feeling very unhappy, because I had lost my mother and five other relatives to Ebola,” says Hawa.

Hawa is not the only one in her community in distress.

Twenty-four other children in the same compound of 80 households are either Ebola survivors or have been

orphaned after losing parents or caregivers to the disease.

psychosocial services provided for the children is helping them to start moving on with their lives.

Just in this compound, the Ebola virus has taken the lives of 34 people. Many residents say the trauma of losing loved ones and the stigma associated with the disease are difficult to bear.

“The diverse support we provide has helped revive the lives of these children,” she says. “Happy faces have replaced the gloomy ones they had few months ago. Now they feel comfortable around their peers, interact more and are gradually replacing the worries of Ebola with hope for a better future.”

Partnerships in support of children Chrisnel John is a social worker for UNICEF partner Defence for Children International (DCI), and she provides weekly support to Hawa and her neighbours. “When I started coming here, the situation of the children was very difficult,” she says.

“There were some survivors who were traumatized, had other health issues, and some orphans who were really depressed, felt solitary and withdrew from their peers and even elder family members.”

“Psychosocial support is critical for children in emergencies, and there's need for them to readily access these social and emotional services,” says Roeland Monasch, former UNICEF Representative to Sierra Leone. “We have therefore scaled up programming to support the psychosocial needs of children who have been affected by the Ebola outbreak and have provided support for over 10,000 children and their families through partners.”

With funding from the UK Department for International Development (DFID), UNICEF is working with 14 partners across Sierra Leone's 14 districts to provide psychological support services to affected children.

Moving on In most cases, children affected by Ebola are timid when it comes to sharing their stories. But Chrisnel uses her years of experience as a social worker to help children feel comfortable.

Achieving dreams The current Ebola outbreak is the worst the world has seen and has had tremendous effects on the lives of children in Sierra Leone, one of the hardest-hit countries in West Africa.

“DCI is doing well for us,” says Hawa, “Aunty Chris has been coming to us every week, she plays with us and encourages us to avoid crying. I thought I was never going to stop crying for my mother and relatives."

She says she feels happier than before she started coming to the support sessions.

“I am thankful to God that I survived this terrible disease,” says Hawa. “I pray every day for Ebola to finish, and I know God will answer my prayers. I want to start moving freely and doing what I used to do before the disease came,” she says.

At her age, Hawa has started thinking of how she could make life better for her family.

“I want to be a bank manager so I can earn money to take care of my family, build them a big house and take care of myself,” she says with a smile. “I am excited to go back to school to learn and finish my schooling, because I need to be educated to achieve my dreams.”

“I made friends with the children, played games, organized arts activities and held group and individual counselling sessions to help them let out their stress,” she says.

In all of this, she didn't forget to remind them of how to stay safe from Ebola.

“I tell them the key Ebola preventive measures including frequent washing of hands with soap and clean water.”

According to Chrisnel, the range of

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Social worker Chrisnel John in a group counselling session with children whose lives have been affected by the Ebola virus © UNICEF Sierra Leone/2015/Mason

April - June 2015

Ambulance 'open days' dispel fears in Sierra Leone

By Issa Davies Communication Officer

he rough and pot-holed mud roads in remote villages like Kabaya, Kambia district, have witnessed a rare sight in the past few months – the presence of modern ambulances. On the day we're there, the section chief of the village, Pa Sane Conteh, joins other elders and women to take a ride in the ambulance: “It is safe! It is safe!” he shouts as he happily disembarks after a seven-minute ride.

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“We are no longer afraid of ambulances and I am encouraging anyone who falls sick not to be afraid of riding in an ambulance to the hospital anymore.”

soon as they heard the sirens of an ambulance blaring in the distance.”

“They thought that an angel of death has come to take another member of their community away and sometimes, when they take people away we never see them again.”

I travelled to Kabaya and other villages in this region, close to the Guinea border, to follow a new initiative designed to respond to these concerns. It is based on the idea that instead of ambulances visiting communities only when cases are reported, it would be good to allow people the opportunity to experience them in a more relaxed context. This would give them the chance to look inside the vehicles, and to learn about the spacesuit-like protective suits, chlorine sprayers, and all other paraphernalia used by those involved in the fight against Ebola.

To people in countries and communities used to such health services, ambulances are viewed as a lifeline for those in immediate need of a rapid medical response.

But as we and our partners have seen, for people in these rural communities in one of Sierra Leone's last The 'open days' have already been held in Port Loko Ebola hotspots, ambulances are frequently viewed with district and Western Area. In Kambia, UNICEF social mobilizers are part of the convoy and they brief suspicion. communities on the work they do at each stop. The One of the residents of Kabaya, Musa Kamara, says initiative in Kambia is led by the CDC Health Promotion Team, with funding from DFID, with the support of ambulances are often seen as “moving coffins.”

CAFOD (for the vehicles and fuel), and social “People used to run away and hide their sick relatives as mobilization partners.In addition to visiting Kabaya, this

April - June 2015

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particular ambulance was set to visit 20 other communities in the district.

turning off sirens to reduce community fear, and increasing dialogue.

Corporal Bangura, an Ebola survivor who is the military driver of the ambulance, said that previously there had been misunderstandings.

Andrew Sesay, an Ebola survivor and social mobilizer with the team explains how positive the ambulances are. He shares that he lost eight members of his family to Ebola because they refused to be taken to treatment centres in ambulances. But he survived because he called the 117 hotline and willingly went inside the ambulance that took him to the treatment centre.

“In the past, during the height of [Ebola] cases, we used to run our siren-blaring ambulances at very high speed in the communities,” he said.

By listening to communities, a number of new measures are being taken by the Government's District Ebola Response Centre, including providing more timely information to families on where sick persons are taken,

Through community engagement, trust is being built up and vital health measures are gaining greater acceptance.

Sierra Leone campaign addresses Ebola's impact on Birth Registration

By Issa Davies Communication Officer bass Mansaray, a 48 year old farmer in Blama town in eastern Sierra Leone beamed proudly while displaying the small yellowish paper that had just been given to his one and half year old daughter, Isata, by local health officials.

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Specially trained surveillance officers ensured that those living in Ebola-affected homes and villages that have been quarantined are registered and immunized.

The teams found that despite the much greater awareness of Ebola, its symptoms and how it is spread, fears persisted in some communities.

“Some parents hid their children away from us because they thought the registration was a strategy to infect their children with the Ebola virus,” said Ahmed Sesay, a Isata was just one of the 200,000 children across Sierra health worker. “Fortunately, each time we encountered Leone supported by a recent birth registration campaign resistance we were able to persuade the families of the organized by the Ministry of Health and Sanitation in health benefits of the vaccine.” collaboration with UNICEF, the World Health Geoff Wiffin, UNICEF's Representative Organization and Plan International. in Sierra Leone, said the push was the first time that a health A 2010 survey showed that 22 per cent of children in campaign had been combined Sierra Leone did not have their births registered, and with a civil registration exercise. initial data suggests that the Ebola epidemic has caused that figure to rise as many families, particularly “A birth certificate gives children in rural communities, avoided health centres because of rights to basic social services like fears of contracting the virus. education and health care. It can also protect them from many The five day exercise also provided forms of child abuse including regular polio vaccinations for underjuvenile detention and sexual five children. violence,” Wiffin added.

Over 10,500 health personnel, Far more parents came social mobilizers and volunteers out with their children to were dispatched across the get registered and be country going from house-toissued with birth certificates house registering under five than was planned and children and at the same expected. time administered the polio vaccine.

Abass Mansaray proudly displays the birth certificate of his to his one and half year old daughter, Isata Blama town, Kenema © UNICEF Sierra Leone/2015/Davies

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April - June 2015

Caring for children orphaned by Ebola in Sierra Leone

By Indrias G. Kassaye Communication Specialist recently saw a grandfather, not old enough to be called elderly, break down and cry. I was accompanying Yusuf Koroma, a social worker attached to the Observation Interim Care Center (OICC) in Portee, a neighborhood in eastern Freetown.

The OICC is where children who may have been exposed to Ebola are brought for observation.

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Following up on children who have gone through the OICC and returned to their homes is a routine part of Yusuf’s duties.

I was joining him for the day as he went out to deliver BP-100 (high energy therapeutic food) to children who have been discharged. Child malnutrition rates in Sierra Leone are among the highest in the world. Malnutrition compromises children’s immunity to infectious diseases, hence the importance of providing therapeutic foods.

Our first stop was at the home of fouryear-old Musu Conteh*, who lost both her parents to Ebola.

At the house Yusuf was met by a chorus of greetings from various members of Musu’s extended family. He and Musu’s grandfather greeted warmly, but there were no handshakes. Yusuf introduced me – I nodded and clasped my hands in greeting. I had not touched anyone since arriving in Freetown two weeks earlier. As long as Ebola is present in the country, the office maintains a ‘no touch’ policy. No handshakes or other forms of bodily contact are allowed. Despite sharp reductions in Ebola rates since last year, the deadly virus is still present in Sierra Leone, and as the spikes in new Ebola cases in June confirm, maintaining all safety precautions remains imperative.

While Yusuf and Mr. Conteh* were talking, catching up on news since the last visit, Musu ran up to Yusuf and gave him a big hug. She was happy to see him although she was shy in front of me. I asked her permission to take her picture, and after looking around at her grandfather and aunt, she turned back, smiled and while nodding said, “OK, you can snap me.”

Yusuf is an Ebola survivor, and as such doesn’t fear contracting the virus again or transmitting it on through casual contact, as it has been more than three months since he recovered.

Musu soon forgot about the strange man with a camera as Yusuf went back to the car to get her supply of BP100 high energy biscuits. He helped her to open one of the packs and she immediately started munching on the

April - June 2015

Yusuf Koroma carrying 4 year old Musu Conteh ©UNICEF Sierra Leone/2015/Kassaye

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emotional exchange in Krio with Yusuf followed, after which we bade them all farewell, Yusuf promising to Then, the mood on the Conteh front porch changed. return in the near future to check up on them.

Musu’s grandfather, who had been watching the whole scene from the recesses of the front porch, got up “I feel good doing this work because I am also a survivor. suddenly, his chest heaving, and rushed inside the dark You can see how happy they are to see me. I feel good interior of his home. The sound of his weeping was working for survivors.” contagious, and soon Musu’s aunt and older cousins were all wiping their tears, sharing his grief for their lost UNICEF supports the operational costs and provides supplies for OICCs throughout Sierra Leone. BP-100 family members. and other nutrition supplies are provided to Ebola “Musu was the first child to be brought to our OICC,” related facilities in all affected areas of Sierra Leone.

Yusuf told me. “We received a call from the District Ebola Close to 4000 cases that have gone through Ebola Command Center and we went for her and brought her centers have been provided with nutrition supplies so to the OICC where we conducted several tests because far. she was having some fever. We first sent her to a holding center and then she came back to us and passed As of 27 June 2015, there have been 8664 confirmed through the 21 days observation safely. Her mother, cases of Ebola in Sierra Leone, of which 1,459 were father and brother, however, died of Ebola. She was then children. The number of confirmed deaths from Ebola discharged from our center and sent to the Interim Care stands at 3,566.

Center, until her grandfather was ready to take her in, UNICEF’s USD 178 million appeal to respond to the and then she moved in with him.”

Ebola crisis in Sierra Leone, remains under-funded, with We waited for Musu’s grandfather to collect himself, and 120.5 million received to date, leaving a funding gap of expressed our condolences to the whole family. An USD 57.3 million. nutritious treat.

Making schools safer in Sierra Leone during the Ebola outbreak

By Wellington Mushayi Monitoring and Evaluation Specialist hen the President of S i e r r a L e o n e announced that schools would reopen this Spring even if Ebola cases weren't down to zero, we knew we were in for a challenge. There were all sorts of complexities given the health emergency, like making schools safe, and decontaminating sites that had been used as Ebola care centres.

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The Ebola outbreak put a lot of our regular work on hold, including our support to the Ministry of Education, Science and Technology (MEST) on setting up an Education Management Information System (EMIS), with backing from DFID. This work had started in April 2014 and was going well until the process stalled in August when Ebola cases started rising exponentially.

As a monitoring and evaluation officer, I knew it was vital to track school preparedness for reopening, particularly to make sure that every school received the hygiene kits, cleaning materials and thermometers that were a

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key part of the reopening safety protocols.

But we didn't have the monitoring systems in place that could provide the information we needed.

Rapid and robust On 6 April, a little more than a week before school reopening, I sat down with our Technology For Development officer, Shane O'Connor, and we knew we needed to come up with a solution that was robust and easy to deploy, one which would allow us to quickly monitor schools, at least before reopening.

In terms of the scope, we knew it was essential for the monitoring to at least cover all schools in areas with ongoing Ebola transmission as identified by the National Ebola Response Centre (NERC) – in four districts. All schools were expected to have the hygiene kits to keep children safe and we had to be proactive in identifying supply distribution gaps, where they might exist.

Three days later, we had a system in place based on UNICEF's RapidPro open-source SMS platform. We

April - June 2015

As part of Ebola protocols, all children and staff wash their hands when entering school. Š UNICEF Sierra Leone/2015/Bindra

quickly identified NGO partners on the ground and agreed who would visit which schools, and took all the partners through a crash orientation to the system the same day – Thursday. By Friday (10 April), system testing messages were coming through from the partners. By Saturday, the full roll-out of monitoring was set to commence. From Sunday, the system was up and running.

That's a less than ideal time to set-up a national surveillance system, but in emergency situations, you just need to work fast and to work beyond the normal working hours. Anyone with an elementary mobile phone can monitor schools after a basic orientation.

Users simply send a text to a shortcode and receive an automatic reply by SMS with sets of questions covering things like whether hygiene equipment has been delivered and whether it is in use.

The system has allowed the District Directors of Education to instantly receive messages about schools that had not yet received supplies and to respond accordingly. All the data received was downloaded in the UNICEF Freetown office, analysed, and shared with all partners and the country's 14 districts twice a day.

Despite the challenges, the RapidPro system really proved its worth. In the three days prior to the opening of schools (14 April), our partners were able to conduct monitoring visits in 1,067 schools in hotspot areas and by 16 April, 2,094 schools had been monitored (1,642 schools were from hotspot communities). When we

April - June 2015

were assured that in Freetown 100 percent of safety supplies had reached schools, we could look at our own data showing exactly which schools were missing key supplies.

Snapshots could be presented each day at the NERC, helping to reassure donors and parents that safety equipment was in place. Where we received information that schools hadn't received supplies, we were able to immediately request deliveries from the buffer stocks stored at the district level. At the end of the first week, from our data, we could see that 92 percent of schools had received hand washing kits; 88 percent had received cleaning materials; and 91 percent had received thermometers.

Importantly, having this data meant that discussions at a national level were evidence-based, rather than focused on anecdotes or impressions.

The whole experience taught me that even in a short period of time, with very limited resources, you can still set-up a really effective monitoring system which can provide a valuable service to the government and other partners, and guide action on the ground. There is now interest in incorporating our work into a ministry monitoring system that can help us track a whole range of data on schools.

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In Ebola-hit Sierra Leone solar radios help extend education

By Issa Davies Communication Officer Young relatives Susan Koroma (15) and Abdul Kargbo (13) both share the same home in the village of Pate Bana Marank village in central Sierra Leone's Bombali District.

As I discovered when I visited their home this month, they also share a sad history – in the past few months Susan has lost both her parents to the Ebola virus, while Abdul lost his mother.

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he virus has claimed the lives of more than 3,400 people in Sierra Leone since May 2014, and Susan and Abdul's community has been hit harder than most – their household alone has lost 21 of its 38 members. As a Sierra Leonean, I could sense the downbeat mood when I was there, it was palpable. Several residents told me about the experience of last seeing their family members being taken away by an ambulance to a distant treatment centre, never to be heard from again.

Gradually though, life is normalizing and Sierra Leoneans are looking to a future without Ebola. With such a young population, education is key part of that future – something that motivated UNICEF to support the government in setting up daily school radio broadcasts during the outbreak so that children could continue learning while schools were closed.

What is in plentiful supply in the village is sunshine. The good news is that distribution has started for 17,000 solarpowered radios to help make the Ebola school radio programmes more accessible to the most vulnerable children in Sierra Leone.

Both children's uncle, Pa Kaprie Fallah, is the current head of their household, and he says he is very happy for the donation. “I used to have a very old radio but that has been out of use for several months and we were starving for information. This radio will help us to know the things that we should do and not do, as we try to recover from this Ebola.”

Schools reopened on 14 April 2015, and school radio programmes will now play a crucial role in enabling the curriculum to be covered before the start of the next school year.

Abdul too wants to play his own role in the Ebola fight: “I will call all my friends and neighbours in my village to sit around the radio in the evenings and listen to messages on Ebola.”

The purchase of the solar radios was made possible by funding from the IKEA Foundation and the government of the United Arab Emirates. “We say a big thank you to the donors of these radios and we will ensure that make the best use of it,” Abdul.

“I want to be a nurse when I grow up as I like to give treatment to my people,” Susan said. She told us that she has been motivated to study harder because of what she has experienced during the Ebola outbreak. “If only I had been a nurse, I would have saved a lot of my people's lives when Ebola struck our village some months back.”

But the village, like many in Sierra Leone, is far from the national electrical grid. Residents are too poor to afford diesel generators, and many struggle to afford a radio, making the school broadcasts on the airwaves – and even the basic Ebola safety broadcasts – inaccessible.

“It is sad to see people dying like that as we did not know what exactly to do since we had no radio to listen for messages and information,” said Susan.

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UNICEF staff member Derick Thullah explains how to use the solar powered radios as he hands them over to children in one of the hardest hit villages in Sierra Leone. ©UNICEF Sierra Leone/2015/Bindra

April - June 2015

Vox pop on school reopening

©UNICEF Sierra Leone/2015/Francia

In 2015 UNICEF Sierra Leone received contributions from:

We also received contributions from UNICEF National Committees in:

Ÿ The Governments of

Canada, Germany, Ireland, Italy, Japan, The Netherlands, Norway, Sweden, Switzerland, United Arab Emirates, United Kingdom, USA Ÿ The European Union,

United Nations, African Development Bank, GAVI Alliance, Global Fund against AIDS/TB/Malaria, Bill & Melinda Gates Foundation Micronutrient Initiative, United Nations Foundation, IKEA Foundation, CERF, OFDA, The World Bank

Ÿ Australia, Austria,

Belgium, Denmark, Germany, Iceland, Italy, Japan, Luxembourg, The Netherlands, Norway, Poland, Sweden, Switzerland, United Kingdom, Global - Thematic Humanitarian Resp and USA

For more information, please contact: John James Head of External Relations and Advocacy UNICEF Sierra Leone Mobile: +232 76 102 401 Facsimile: +232 22 235 059 E-mail: jjames@unicef.org URL: http://www.unicef.org www.youtube.com/user/ UNICEFSL Instagram: unicefsierraleone

Design & Layout by Tolu J. Bade/2015/UNICEF Sierra Leone

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