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Ebola response

 

Status of request of assistance

In consultation with the UN Special Representative of the Secretary General for the Ebola response as well as the UN Resident and Humanitarian Coordinator in Liberia, OCHA has decided to deploy an UNDAC team to be based in Monrovia, Liberia, in response to the 
Ebola outbreak. 

The UNDAC team will be deployed to support the establishment of the national coordination platform and optimize the critical coordination functions necessary to enable a timely and efficient response by all international actors.

 

Operational Environment

Country baseline data

Country name: Republic of Liberia
Capital: Monrovia (population according to the 2008 census: 970,824)
Population: 4,092,310 (2014 estimate)
Time zone: GMT
International dialing code: +231
Religion: According to the 2008 National Census, 85.5% of the population practices Christianity. Muslims comprise 12.2% of the population, largely coming from the Mandingo and Vai ethnic groups. Traditional indigenous religions are practiced by 0.5% of the population, while 1.5% subscribe to no religion.
Administrative divisions: Liberia is divided into fifteen counties, which, in turn, are subdivided into districts and further subdivided into clans.
Media landscape: State-run LBS operates Radio Liberia. China has helped to renovate its transmission infrastructure. The private broadcasting scene includes some 15 radios and a handful of TV stations in the capital. Around a dozen newspapers publish regularly. In 2010, Liberia enacted West Africa's first freedom of information law. However, large fines imposed in libel cases have encouraged self-censorship, reports US-based Freedom House. BBC World Service broadcasts in Monrovia on 103 FM. Internet use is limited to 0.7% of the population owing to cost, a low literacy rate and poor infrastructure, Freedom House noted in 2011. (BBC)


Maps
MapAction - Liberia Districts Map

 

 

Operational priorities (last update: 3-October-2014 16:45 by Matthew Charles Lyle, OCHA)

KEY CONCERNS: 

- 3.37 million people are in need of assistance (OCHA, 16/09/2014). The Ebola outbreak have completely outstripped the Government’s and international actors’ capacity to respond and control the epidemic (WHO, 08/09/2014).
- Between March and 23 September, 6,553 cases of Ebola and 3,083 deaths have been reported in Guinea, Liberia and Sierra Leone (WHO, 26/09/2014). The numbers of registered cases and deaths in all three majorly affected countries seem to underestimate the real magnitude of the outbreak (WHO, 16/08/2014). 
- Non-Ebola medical needs cannot be met (OCHA, 16/09/2014), leading to an increase in non-Ebola related child morbidity and mortality (UNICEF, 26/08/2014).

SNAPSHOT:

Liberia continues to be the country most affected by Ebola. As of 23 September, 3,458 cases and 1,830 deaths had been reported (WHO, 26/09/2014). As of 15 September, 75% of those infected or who have died from Ebola have been women (Government, 15/09/2014). There continues to be a high number of new cases in Lofa county. Ebola has been reported for the first in Grand Kru county, in the south: six confirmed 17

ACCESS:
Poor road conditions are posing challenges for the transfer of cases in Tapitta, Nimba county, as well as the delivery of food assistance in Grand Kru county (Government, 26/09/2014).

FOOD SECURITY:
WFP has delivered food for about 96,000 people affected by food shortages and quarantined in Bomi, Bong, Grand Cape Mount, Grand Bassa, Lofa, Margibi, Montserrado, Nimba, and Rivercess counties (WFP, 01/09/2014). 449,000 people are targeted for food assistance over the next three months (WFP, 11/09/2014). Quarantine and movement restrictions have meant that traders have been unable to travel to buy food and farmers cannot harvest their crops (international media, 10/08/2014;27/08/2014). A recent market assessment indicates that prices of some food items have increased rapidly. Cassava prices in Monrovia increased by up to 150% in the first two weeks of August. Increasing transportation costs have added further upward price pressure (FAO, 02/09/2014). Between July and August, imported rice prices increased on average by 12% (WFP, 29/08/2014).

HEALTH AND NUTRITION: 
Non-Ebola-related child morbidity and mortality has increased, as the national health system is unable to meet either Ebola or non Ebola medical needs (OCHA, 16/09/2014; UNICEF, 26/08/2014).

CONTAINMENT MEASURES: 
On 19 August President Ellen Johnson quarantined two affected neighbourhoods, including Monrovia's West Point slum. The quarantine on West Point was lifted on 30 August (international media, 30/08/2014). A night curfew imposed from 20

August means all entertainment centres and all video centres are to be closed at 18:00 (AFP, 20/08/2014). On 11 August, Lofa county was put in quarantine, becoming the fourth county in quarantine after Bomi, Grand Cape Mount, and Gbarpolu (international media, 11/08/2014). The President declared a state of emergency for a period of 90 days on 6 August (Government, 06/08/2014). All markets in border areas are closed until further notice (AFP, 30/07/2014). Liberia closed its borders on 29 July, with the exception of major entry points and the airport. One commercial airline has suspended all fights from Sierra Leone and Liberia to Nigeria (OCHA, 29/07/2014). The crossings that are still open, together with the international airport, will intensify screening of travellers (ECHO, 29/07/2014).

PROTECTION:
The 27th of August UN Women reported: “As Ebola cases continue to rise, women remain disproportionately affected. According to data from Liberia’s Ministry of Health and Social Welfare, women account for between 55 to 60 percent of Ebola related deaths in Liberia, with the rate of infection of women being a lot higher than men. This is mainly attributed to the role of women as caregivers, nurses and cross-border traders” (UN Women, 2014). Moreover, past decades of internal conflict in Liberia left a large number of young people without any good prospect for the future; this combined with that Ebola made the government not consider the widespread displacement an urgent priority, can exacerbate protection issues (Shilue & Fagen, 2014).

Healthcare provision: The Ebola outbreak has completely outstripped the Government’s and international actors’ capacity for response and control (WHO, 08/09/2014). In Bong county, the two largest hospitals have been closed, leaving over 330,000 people without health care (international media, 12/09/2014).

There are more new cases than Ebola treatment centres have capacity to manage (WHO, 08/09/2014). WHO assessed that, in Montserrado county, 1,000 beds are needed to treat people with Ebola while only 240 are currently available (WHO, 12/09/2014). Case investigation and contact tracing teams cannot not meet needs (UNICEF,06/09/2014). Laboratory capacity needs strengthening. Logistical capacity, such as transport for health staff, equipment, and medicines, is extremely limited, especially in Nimba county (WHO, 05/08/2014; Ministry of Health, 28/07/2014). Personal protective equipment is almost out of stock (Government, 10/09/2014). In Lofa county, bodies cannot be buried due to the lack of body bags (Government, 19/08/2014). The only crematorium in the country is overwhelmed (international media, 22/08/2014).

On 2 September, nurses at Monrovia’s largest hospital went on strike, demanding better pay and equipment to protect them against Ebola (international media, 02/09/2014). In Lofa county, health workers have threatened to stop working if risk premiums were not distributed (Ministry of Health, 28/07/2014).

EXPECTED EVOLUTION
According to a WHO projection, the aggregate caseload could exceed 20,000 by early November (WHO, 28/08/2014). According to the Center for Disease Control (CDC), if the virus continues to spread at the current rate, Liberia and Sierra Leone will have reported about 550,000 Ebola cases by late January. The CDC estimates that officially reported cases are about 40% of the real burden in Liberia and Sierra Leone, indicating a possible total of 1.4 million cases in Sierra Leone and Liberia by late January (CDC, 23/09/2014).

PROTECTION:
40 children in Margibi county, whose parents have died from Ebola, are considered vulnerable. Affected children, rejected by the community in Dolo Town, are living in a school building (Government, 10/09/2014).
According to local media, armed forces have been shooting to people trying to cross the border illegally from neighbouring Sierra Leone (INGO, 18/09/2014).

SOCIAL TENSIONS
On 20 August, violence erupted in West Point slum. Soldiers opened fire and used tear gas on crowds protesting at the quarantine. Four residents were injured in the clashes (AFP, 21/08/2014). On 17 August, a quarantine centre was attacked and looted, mostly by young men armed with clubs. Seventeen Ebola patients fled. They were found two days later (AFP, 19/08/2014). Health officials expressed concern that the stolen supplies, likely infected with the virus, could result in the further spread of the disease (donor, 20/08/2014). 

Community resistance against health workers and treatment remains high (WHO, 06/08/2014). People are frustrated because of the delays in provision of lab results and removal of sick patients and dead bodies (Government, 08/08/2014). In Monrovia, many have complained that overstretched health workers have been leaving bodies on the streets and in homes for days (AFP, 04/08/2014). In Nimba county, people are moving out of Ganta from fear of Ebola (Government, 21/08/2014).

 

 

Customs and immigration

The team managed to enter the Country, obtaining visas on their arrival in Monrovia, thanks also to the collaboration of the Liberian government.

 

 

Security situation

PLEASE NOTE: On Tuesday 16th of September IFRC and WHO staff were among 10 health workers who were attacked in Wamey (South Guinea). 8 of them were found dead.

Immediate Security Information: Both the ICRC (Gueckedou) and MSF (Macenta) have experienced and reported intimidation and threats from local people in South East Guinea. This behavior appears to stem from fear and lack of knowledge of the Ebola Virus Communities have even suggested that it is international organisations spreading the virus when making threats against staff of responding organisations. 

The UN Medical Services in consultation with WHO have assessed the risk to all UN staff in the Ebola affected countries as LOW . This includes international and national staff and would also UN medical staff working directly with victims who follow the correct protocols with the correct protection.

Controversial reports in a major Liberian newspaper could increase security fears for foreign workers. Please check http://washington.cbslocal.com/2014/09/11/largest-liberian-newspaper-us-government-manufactured-ebola-aids-virus/
Please find attached medical guidance.

A nationwide curfew started on 20 August. No movement is allowed between the hours of 11pm and 6am. The Liberian authorities are setting up road blocks to restrict movement around the country (except for categories of essential workers) and using the security forces to enforce quarantine for certain areas including Lofa County. In Monrovia, authorities have now lifted the quarantine of West Point. (FCO, UK)



CDC Ebola Factsheet
WHO Ebola Infographic Airports and Travelling
CDC Ebola Key Messages
Background information
Liberia Security Situation

 

 

Access

PLEASE NOTE: Flights direct to Monrovia have been identified on both Brussels Airways and Royal Air Morac. Therefore, UNDAC team and supporting staff will likely be transferred straight into Monrovia without travelling via Accra (Ghana). Emergency Ebola awareness training will still take place but in Monrovia on arrival. (OCHA)

Government of Ghana has agreed to setting up an airbridge for UNMIL in Accra. UNMIL has started making bi-weekly flights to Monrovia this week. 
In parallel, WFP is in discussions with DFS about setting up a UN Humanitarian Response Depot, also in Accra. This hub would serve for dispatching both stocks and personnel to the main-affected countries.

UNHAS started operating a helicopter service for humanitarian staff and cargo in Liberia. The helicopter schedule and the flight routes are attached.

The Logistics Cluster has published its Concept of Operations (ConOps):

- Coordination units in Dakar, Monrovia, Freetown and Conakry
Regular coordination meetings held in all the above locations

- Storage services in Guinea, Liberia and Sierra Leone
Transport

- Based on needs, transport services can be provided from main hubs to other strategic logistics locations
Information Management

- Dedicated IM Officers in Monrovia, Liberia, and at regional level in Dakar, Senegal

Please find the ConOps attached.

MOVEMENT RESTRICTIONS:

“With the exception of the Malian/Guinean border, all main border crossing points between Guinea, Sierra Leone, Liberia, Cote d’Ivoire, Senegal and Guinea-Bissau have officially closed” (FEWS, 2014).
As late as 8 September, always according to FEWS the major seaports in the region (Freetown, Conakry, Monrovia) were fully operational, but in the areas that have been most affected by the outbreak formal movement restrictions (blockades and checkpoints with screening for symptoms) have been enforced to the population (FEWS, 2014).



UNHAS Flight Schedule
UNHAS Cargo Movement Request Form
UNHAS Focal Point Assignment Form
UNHAS Passenger Booking Form
UNHAS WAC Effective Schedule 25 August
UNHAS User Guide
UNHAS Access Routes, Oct
UNHRD Cargo Routes
Maps
LOG Cluster Liberia Access Constraints Map 24 Sep

 

 

Communications

CATEGORIES USED TO CLASSIFY EBOLA CASES

Suspected Criteria: Any person, alive or dead, who has (or had) sudden onset of high fever and had contact with a suspected, 
probable or confirmed Ebola case, or a dead or sick animal OR any person with sudden onset of high fever and at least three of the following symptoms: headache, vomiting, anorexia/ loss of appetite, 
diarrhoea, lethargy, stomach pain, aching muscles or joints, difficulty swallowing, breathing difficulties, or hiccup; or any person with unexplained bleeding OR any sudden, unexplained death.

Probable Criteria: Any suspected case evaluated by a clinician OR any person who died from ‘suspected’ Ebola and had an epidemiological link to a confirmed case but was not tested and did not have laboratory confirmation of the disease.

Confirmed Criteria: A probable or suspected case is classified as confirmed when a sample from that person tests positive for Ebola virus in the laboratory.

 

Response coordination

Coordination setup

>>>FOR THE CONTACT LIST OPEN THE LINK ON THE RIGHT<<<

The OCHA Regional Office (ROWCA) has currently staff deployed to Liberia, identifying the set up that the UNDAC team will be requested to support. 

IHP deployed a team to assess the situation on where to best set up a base camp for humanitarian actors; IHP and OCHA in Monrovia will discuss options for the setting up or strengthening of the required coordination structure in support of the Government of Liberia and the Humanitarian Country Team

See attached the coordination structure of the Government of Liberia. 

Furthermore please find an operational overview, a 3W map and a compiled contact list.

UNDAC team

The UNDAC team arrived in Monrovia early this morning and will be staying at the Grand Royal Hotel. The team is planning to be split and embedded with the National Disaster Response Centre (NDRC) and the Ebola Operations Centre (EOC), which is now being set up by the US DART team.

The team composition is the following:
1. Mr. Laurent Dufour (OCHA), Team Leader
2. Mr. Charles Bernimolin (OCHA), Deputy Team Leader
3. Mr. Peter Kaas-Claesson (Denmark) 
4. Dr. Argo Parts (Estonia)
5. Ms. Marla Nykyri (Finland)
6. Ms. Claudia Cephas Page (Liberia)
7. Mr. Sunday Babatunde (OCHA)
8. Ms. Eidimtaite Gintare (OCHA)

International Humanitarian Partnership:
9. Mr. Thorkild Nielsen
10. Mr. Richard Hoffskov Lund
11. Mr. Lars Andersen

MapAction
14. Ms. Elizabeth Hughes
15. Ms. Anne Frankland
16. Ms. Anna Mason
17. Ms. Rebecca Stedham

European Union Civil Protection Mechanism 
18. Mr. Dimitri De Fré

The team can be reached through its Gmail account: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

We will provide more detailed information as it becomes available.



Contact List
3W Map
Operational Overview
Liberia Coordination Structure
3W and list of organisations 22nd September 2014
Sierra Leone 3w and list of HO
Maps
MapAction - Monrovia Situation

 

 

Assessments and reports

Please find attached a risk assessment conducted by Public Health England.

Furthermore please find Meeting Minutes of the Regional Preparation and Response Group, held 5 Sep 2014.



Regional Meeting Minute 5 Sep
Public Health England Risk Assessment 31 July

 

OSOCC Monrovia

Situation

Please find attached the first external UNDAC situation report. The reports will be published daily, except for Sundays. 

As you will see from the report, the situation remains serious with number of cases increasing in the country.


Situation reports
UNDAC Situation Report 26 September
UNDAC Situation Report 27 September
UNDAC Situation Report 29 September
UNDAC Situation Report 30 September
UNDAC Situation Report 1 October

 

 

Announcements

Location and contacts

The UNDAC team is embedded in the Ebola Operations Centre (EOC), together with Government of Liberia representatives and US DART Team. The NECC is located in the LIBTELCO building, on 18th street.

The team leader, Laurent Dufour can be reached on the phone: +231(0)770180350. 

The UNDAC team will be using the following e-mail address for all communications: This e-mail address is being protected from spambots. You need JavaScript enabled to view it . The MapAction team can be reached through This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Security information

UN DSS Advisory #51 2014 - 27 September

VILENT DEMONSTRATION AT ELWA INTERSECTION, RIA HIGHWAY.
All UN personnel are hereby informed that there is an ongoing violent demonstarion at ELWA junction.
All staff are directed to avoid that area until further notice.
Emergency Contact Details:
VSAT 4237 and 4243
Mobile Phone 0770-314444; 0770-319372 (Security operations 24/7)
VHF Radio Channel 4 (4 UNMIL) Channel 2 (UNAFPs) – HF Channel 1 - Call sign “ZULU Base SEL Call ID # 4444

UN DSS is based in the UNMIL compound. Their emergency contacts are the following: +231(0)770314444, +231(0)770319371 and This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Important: the curfew in Monrovia is currently set at 23.00 to 6.00

 

 

Meetings (last update: 30-September-2014 18:02 by Gintare Eidimtaite, OCHA)

Mondays

12:00 Psychosocial Support subcommittee meeting 
14:00 Logistics Cluster coordination meeting 

Tuesdays

09:00 Social Mobilization and Awareness subcommittee meeting
10:00 Child Protection Sector meeting
14:00 Contact tracing subcommittee meeting
15:00 Dead Body Management subcommittee meeting

Wednesdays

12:00 Psychosocial Support subcommittee meeting

Thursdays

12:00 Logistics Cluster meeting
13:00 Protection Cluster meeting

Fridays

12:00 Psychosocial Support subcommittee meeting
14:00 Contact tracing subcommittee meeting

Saturdays

14:00 Health Partners meeting

 

Translation

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