In terms of the number of Ebola cases, the conditions on the ground have rapidly improved over the past three months since our last blog on the outbreak. Though numbers are not always easy to verify, the latest World Health Organization report from the middle of January indicates that Liberia is experiencing its lowest number of cases since early June, with no new cases reported in the final two days of the last week for which figures are available. This, after over 3,500 people have died in Liberia. Cases have also declined markedly in Sierra Leone and Guinea, the other Ebola hotspots, in recent weeks. The number of cases have come down due to increased public awareness, the effective use of ‘contact tracing’ and huge amounts of technical support to improve care and the isolation of patients.
Now that resources are in place to address the immediate health crisis, there are opportunities to address the secondary effects of the Ebola crisis. These secondary effects cover a wide range of challenges from strengthening health systems, to food security to education. For donors focused on impact, addressing these challenges means a chance to ‘build back better’ in a way that can lead to more sustainable impact.
Criteria for identifying organizations to support
Even with the changing realities on the ground, there remain two types of organizations needed to make a meaningful difference in Liberia:
1) The first are the larger international aid organizations that bring specialized skills and critical experience gained from work on emergency management of disasters and reconstruction in their wake. Unlike smaller local groups, these organizations can more readily access global supply chains and the trained personnel necessary to bring a crisis to an end and subsequently provide the logistics, plans and resources to support the recovery. Key characteristics to bear in mind when considering support for international organizations in Liberia include:
- A clear demonstration of impact with funds mobilized to show that support is truly making a difference for people affected by the crisis. For example, Medecins Sans Frontieres can buttress its claim as a major leader in the Ebola response effort by pointing to the operation of eight case management centers providing over 650 beds and treating nearly 5,000 confirmed Ebola patients, roughly a quarter of all confirmed cases.
- Coordination with other organizations to address the crisis in collaborative ways, addressing a specific aspect of the challenge, a particular geographic region, or both; Save the Children has been working with a range of local partners in Liberia, for example, to tackle the crisis through a three-pillar strategy: provide critical care, strengthen health systems, and mitigate the impact of the crisis on essential public services.
- Systems capable of managing the large amounts of resources that have rapidly been channeled into West Africa. Many organizations have seen their budgets grow substantially over the course of the last six months and financial accountability is essential to avoid mismanagement and graft in a difficult context. Liberia’s Minister of Public Works, Gyude Moore, recently called on the government’s international partners to follow its lead in having Ebola relief funds publicly audited.
2) The second are local organizations working on the ground, in coordination with the larger external aid organizations and the government. Before this outbreak of Ebola, these groups evolved organically and had a deep understanding of social, political and economic dynamics in the local communities in which they operate. Key characteristics to bear in mind when considering support for local organizations in Liberia include:
- Local knowledge to both mobilize quickly in response to new outbreaks as needed and also to understand how and where post-Ebola support will be best delivered;
- Ability to inspire confidence in those affected by the disaster. This is especially important with Ebola, where fear and mistrust hampered treatment of many patients and contributed to the death of a health sensitization team in Guinea. Sustained engagement and support of local communities capitalizes on collective support and mutual understanding that emerges over time;
- Ability to reach both urban and rural areas. Monrovia became the epicenter of the Ebola outbreak in Liberia, but more recently there have been persistent isolated pockets of outbreaks in the counties, with the CDC identifying Liberia’s Grand Cape Mount County as a recurring epicenter and exporter of the virus;
- Systems to account for spending as the chaos of disasters of this sort often invites corruption or the misuse of donor funds.
While our focus here is Liberia specifically, these principles broadly apply to organizations working across the Ebola-affected countries.
Taking action: Opportunities to Help
With these criteria in mind and working in close collaboration with the Accountability Lab, a civil society organization in Liberia, we have identified the following opportunities for donors seeking to support efforts to eradicate Ebola in the present and prevent Ebola outbreaks in the future:
Organizations operating on the ground in Liberia to eradicate Ebola:
As we advised previously, Medecins Sans Frontiers has been leading the international response to Ebola. It is an independent, international humanitarian organization that provides emergency medical aid in the hardest-to-serve regions of the world, areas affected by armed conflict, natural disasters, and epidemics. It has coordinated with the International Red Cross, United States Agency for International Development (USAID), and International Medical Corps to establish Ebola Treatment Units (ETU) and isolation beds. While Liberia no longer has a shortage of ETUs, MSF continues to mobilize health care workers, support clinical trials of antiviral drugs and support efforts to promote contact tracing and safe burials, practices which, when institutionalized, reduce the risks associated with any future outbreaks. To support their efforts, click here.
Save the Children is working holistically to build health centers, provide training to health workers and supply protective equipment to those that need it in Liberia. Critically, they are also striving to care for the increasing number of Ebola orphans, and direct 10% of donations towards a fund for the next emergency- ensuring better preparation to handle future crises, a strategy we have highlighted in previous disaster relief guidance. Across the region, Save the Children has trained or supported nearly 2,000 health workers, created almost 300 beds and, in Liberia, manages two community care centers and has installed 150 handwashing stations. To support their efforts, click here.
Last Mile Health is a community health organization that has been working in rural Liberia since 2007. As a result of these sustained efforts, it has the relationships and networks in place to provide care even under the most difficult of circumstances. The team has now partnered with the Liberian government to train frontline health workers and educate communities to prevent further spread of the virus. To support their efforts, click here.
Organizations working to improve community sensitization and awareness efforts to reduce the spread of the virus now and prevent new outbreaks in the future:
Kriterion Monrovia is a Liberian student-run organization that has mobilized to support Ebola awareness messaging across the country. The key to their success is that their voices are accepted as authentic, and are therefore listened to at the grassroots level. Kriterion has dispensed personal protective equipment, distributed rations to isolated communities, and trained everyone from market sellers to village elders on Ebola awareness practices. You can support Kriterion Monrovia through the Niapele Project, a U.S.-based nonprofit, here.
Community Action Against Ebola (CAAEB) is led by nurses Aaron Debah and Roosevelt Dolo. The organization is made up of professional nurses, church members and other community members who spread information to the public through radio programs, drama shows and face-to-face interactions, primarily through house-to-house visits.. You can support CAAEB via Internews/Global Giving, U.S.-based nonprofits, here.
Africare has a long history of working in West Africa, providing emergency relief. It has played a leading role in coordinating international and grassroots efforts to reduce the impact of the virus through weekly Ebola outbreak updates, community awareness efforts, and multi-partner initiatives such as Africa Responds. It also emphasizes local employment generation through its work, building sustainability over time. By November, Africare had trained more than 300 volunteer Ebola emergency responders who in turn provided outreach to more than 150,000 Liberians. You can support Africare here.
Organizations working to address the secondary impacts of the Ebola crisis in Liberia:
The U–Foundation is currently focusing on efforts to ensure that health care workers are able to continue to provide routine care amidst the Ebola crisis. The team also supports efforts to improve sanitation, access to clean water, train teachers, and strengthen literacy rates; investments in human capital that will reap the long term dividends necessary to avert future disasters.
Action Contre La Faim (ACF) has been working in Liberia for over two decades, where its work has overlapped with many of the intense hotspots of Ebola transmission. It has been a leading advocate for a focus on nutrition as a critical component of public health. It has worked closely with the Ministry of Health and Social Welfare and closely collaborates with, and emphasizes capacity-building of its local partners, such as Ground Water Exploration. You can support ACF’s efforts here.
Global Giving is an online platform to fund pre-vetted, grassroots organizations tackling the Ebola crisis . Since 2002, it has provided donors with a transparent and convenient vehicle for finding smaller organizations and projects to support. All recipients undergo a due diligence review, and donor satisfaction is assured through the GlobalGiving Guarantee. To date, Global Giving has raised over $3.2 million in support of 36 locally-driven organizations tackling Ebola in west Africa. To support these organizations, go here.
The situation in Liberia continues to evolve and we will provide further guidance as needed over the coming months.