Sierra Leone's Initial Outbreak Response
In 2014, the nonprofit healthcare organization Partners in Health (PIH), arrived in Sierra Leone to assist the country’s Ministry of Health and Sanitation in developing an organized response to the Ebola virus disease (EVD) outbreak. The result of this partnership was the creation of the Marfoki Ebola Treatment Center in the Port Loko District of Sierra Leone. This center treated and quarantined EVD patients during the outbreak. The following year, the Ministries of Health and Social Welfare developed the Comprehensive Program for Ebola Survivors (CPES) with the goal of using CPES to provide funds from international donors to NGOs that could provide services to Ebola survivors within Sierra Leone. This program was short lived, however, ending in 2017 not long after the Ebola outbreak ended. At this time, many programs for survivors once been funded by NGOs were turned over to the Sierra Leonian government.
Starting in 2014 and continuing throughout the Ebola public health crisis, Partners in Health countered stigmatization within Ebola-affected communities while supporting the economic well-being of Ebola survivors. PIH employed survivors to work with Emergency Response teams to aid in the epidemiological response to Ebola by promoting community-based education in this disease and community surveillance for Ebola cases. Through this program, Ebola-affected communities were able to initiate rapid response measures to suspected Ebola cases.
Funding Over the Years
Pictured: A timeline of funding from a variety of sources (e.g., governmental, non-governmental organizations (NGOs), non-profits, etc.) that was received during the Ebola outbreak and after as Sierra Leone sought to recover. Click the image to download a full-size rendering of the timeline.
During in the Ebola crisis in West Africa, and after the epidemic's end in 2016, private sector funding for Sierra Leone decreased dramatically. In response, ReGrow West Africa—in partnership with the non-governmental organization RESOLVE—was established in 2015 to promote post-Ebola long-term economic recovery and development in Sierra Leone. ReGrow’s program has since offered one-year business development programs to 30 small-to-medium businesses and created a lending system with local banks to meet the investment needs of these businesses.
After ReGrow West Africa's early response, USAID donated $2.4 Billion for "Pillar II" recovery efforts beginning in 2018 and ending Sept 30, 2019. USAID has since stopped funding, arguing that Sierra Leone, Guinea, and Liberia are now more reliant on private sector funding to build resilience.
These community-based programs were essential for not only establishing and supplying care where it was needed, but also de-stigmatizing survivors of Ebola. These programs helped to disseminate information about the disease and how to quickly transition into treatment of the infectious should there be another outbreak. However, since the last outbreak, there has been a decrease in funding for these programs following the removal of government and foreign funding in 2016.
There were multiple public health agencies, including the CDC, who developed the Social Mobilization Action Consortium (SMAC). This was designed to aid the Sierra Leone Ministry of Health during the 2014 EVD outbreak. SMAC trained health workers, community volunteers, and Ebola survivors how to implement the Community-Led Ebola Action (CLEA) approach in the 14 districts of Sierra Leone. This program was intended to set up Sierra Leone for success. It also provided a link for two-way communication between those who needed help and those who were able to supply health services. SMAC volunteers would learn about the community needs through gatherings of the community members. Then, they would implement action plans to address the needs while simultaneously collecting medical statistics from households.
A Mismanaged Government Response
Yusuf Kabba’s Sierra Leone Association of Ebola Survivors (SLAES) joined a lawsuit against the Sierra Leone government for its “mismanagement of the Ebola response and recovery effort.” According to Kabba, the government offered no support to Ebola survivors once they were released from treatment and recovery facilities—survivors were guaranteed free healthcare, but the government never delivered on that promise.
Under Sierra Leone’s government, during the Ebola epidemic, approximately $14 million raised to help survivors and fight the virus went unaccounted for, according to audits that show that many EVD contracts went to persons with close ties to the administration.
See our page on Their Stories for an in-depth view into the effect these unfulfilled promises of funding have had on the livelihoods of Ebola survivors.
Today: COVID-19 and Ebola Survivors
Learning from its experiences in managing the Ebola outbreak of 2014-2016, Sierra Leone, in response to the COVID-19 pandemic, developed an emergency response and preparedness plan weeks before the first cases that allowed the Ministry of Health to respond efficiently and control transmission early.
Sierra Leone also received support from the international community to create treatment centers for COVID-19 patients and train frontline workers to battle this contagion. Part of the country’s success in controlling the spread of disease has been a development of networks to support community outreach, awareness, and mobilization.
Perhaps more impactful for survivors of the Ebola epidemic there, that live in areas hard-hit by COVID-19 too, is direct investment in survivors and local economies from the international arena. Of note is the partnership between the Sierra Leonian government and the African Development Bank which provided $13.5 million in grants to EVD survivors and small entrepreneurs. This partnership was created to support economic and social resilience in Sierra Leone. It was especially important for those communities hard-hit by both the Ebola outbreak of 2014 and the current COVID-19 pandemic.