UPDATE SIERRA LEONEUnite for children

“Well, we thank God for the Community

Care Centres, but it's not easy working here,” says nurse Josephine Conteh as she waits for the first pa�ents to arrive at the new eight‐bed care unit, known as a CCC, in the

village of Pate Bana Mara in Bombali District,

northern Sierra Leone.

When construc�on started, the village

was ini�ally under

quaran�ne and workers

had to cross over a

ribbon placed

across the entra‐nce and

exit to the village, which saw around 100 Ebola cases.

“We are expec�ng pa�ents to come in, and we are ready to receive them and care for them, give them the best treatment that we can provide as nurses,” says Ms. Conteh. “We don't want to see anyone die in this community, espe‐cially Pate Bana, because they have suffered a lot, so we are figh�ng hard so that it does not occur again.”

The first ten CCCs in Bombali were opened in mid‐Nove‐mber with more than 200 clinical health workers and hygienists trained to work in the pioneering centres estab‐l ished in record �me by UNICEF. Many workers come from the same communi�es they work in, part of an effort to bring isola�on treatment and basic care closer to the village level. As of earlyJanuary 2015, 46 CCCs havebeen built by UNICEF and itspartners, and they have beenvisited by more than a thousand sick people.

bringing isolation closer to homeBy John James, Head of External Relations and Advocacy, UNICEF Sierra Leone

October - December 2014

Nurse Josephine Conteh at the new Community Care Centre in Pate Bana Mara, Bombali District, northern Sierra Leone. ©UNICEF/2014/James

New Ebola cases con�nue to be reported in Bombali District, one of the most heavily affected parts of the country, with 953 confirmed cases, out of Sierra Leone's 7,160 cases, according to government figures (as of 25 December).

Community owned

At a nearby CCC in Mapaki, site manager Kamel Sesay says the new centre will reduce delays and make care more transparent. He said villagers didn't really understand what was happening when sick people were sent hundreds of miles away for treatment.

“But now, we are here, you can see, you can pay a visit, the pa�ent can talk to you and there are community health workers who are our brothers, so these are the differences,” he says.

The centres are run by the Government's District Health Management Team, with supplies and support from UNICEF and local partner World Hope Interna�onal, and funding from the UK Department for Interna�onal Development (DFID).

“This is really community owned – you just have to look at the architecture of it,” says Shanelle Hall, head of UNICEF's global supply division, who visited the sites. “You can see that the facili�es are such that people can come visit their loved ones that are in isola�on and are being care for. It's staffed by people from the community, so it really is supposed to build trust, provide a service and help change behaviour.”

Huge difference

The ini�al CCC pilots were set up by the World Health Organiza�on (WHO) in Port Loko District and other agencies, and partners are now looking to expand units across the country.

Working with communi�es is a key part of the process. Ahead of construc�on, there were extensive consulta�ons with local authori�es and tradi�onal chiefs to determine the most appropriate sites.

That process was then replicated in Phase II of the project, with 13 sites in Tonkolili District, followed by 12 in Kambia District. Two 24‐bed CCCs were set up at the end of 2014 in the Western Area which surrounds and includes the capital Freetown, and an upsurge of cases in Kono District saw us build four CCCs there.

“I think it makes a huge difference,” says Patrick Umarau Koroma, represen�ng Mapaki's Paramount chief during a visit to the site. “Our people up to this point did not believe that Ebola is real, but seeing a place like this convinces them that this is a dangerous disease that has entered our communi�es. The centre alone tells them 'Yes, indeed – Ebola is real.'”

October - December 2014 2

©UNICEF Sierra Leone/2014/James

Isata Kabia, Community Health Nurse, "I am not afraid of the Ebola. I stand by my work to save people, then I will con�nue to save people. That's all I need."

Saffiatu Kanu, Community Health Nurse“I love my people because I'm Sierra Leonean. I am not afraid of trea�ng my people because I know if I am afraid this sickness will spread because I know Ebola is the fastest to kill people, so I'm just help my people, work for my people, treat them as human being, that's why I am here."

Memunata Kallon, Nursing Aide"I came here to assist Sierra Leone as a whole and the community because Ebola is now killing our rela�ves, neighbours, around the community of my life, so I think it is necessary that we join hands together and fight Ebola for our country, because people are dying."

Michael S. Bangura, Cleaner & Sprayer"Since this Ebola epidemic started, I have my two brothers who died in this epidemic so I decided to volunteer so that I can help them with figh�ng this epidemic to go away from our country, so that why I volunteer to be here."

Alfred Thompson, Site Manager"I am a clergy, but I was a�ached to this job because I saw the way people died, especially as I lost my best friend and my wife also lost her best friend through this epidemic. So it moved me to come out and play my own way as much I can, to help the people. "

Beatrice Kargbo, Maternal Child Health Aide"Let me go somewhere that I will be protected, and to take care of people. So that's why I decided to leave the PHC for now and come over here. Just to console them, to give them hope, everything is not lost, there is life a�er Ebola so it's more encouragement for them."

John Bangura, Security "I went to school un�l this Ebola virus came to Sierra Leone, many of my friends have passed away through this Ebola, so I give my life to work at this CCC community center, to prevent people being infected and help stop this Ebola virus. Maybe a�er the Ebola you go to school, maybe not, so I gave my life to serve the people as a Sierra Leonean."

Heroes of the Ebola fight

©UNICEF Sierra Leone/2014/Nesbitt

UNICEF's Community Care Centres first opened in Bombali in November. Since then, more than 1,300 people have been triaged at the CCCs.

Here's a tribute to the heroic men and women serving in the CCCs to fight Ebola.

www.facebook.com/unicefsierraleone twitter:@UNICEFSL

bout 450 survivors of the deadly Ebola disease

Ahave so far converged in Kenema, Bo and Kailahun in south‐eastern Sierra Leone between October and December. These mee�ngs help them to discuss their experiences, learn how to

deal with its psychological a�ermath and find ways to help those infected.

Organized by the Ministry of Social Welfare, Gender and Children's Affairs, with support from UNICEF, OFDA and other partners, the gatherings are the first in a series of similar events to empower those who are immune to the disease.

“A key challenge that parents, care workers and many of us working on the Ebola response are facing is how to care for children who have been affected or infected with Ebola without pu�ng their care givers at risk,” said Roeland Monasch, UNICEF Representa�ve in Sierra Leone. “One crea�ve way to address this gap is to work with Ebola survivors who can provide these children with the love, care and a�en�on they so badly need.”

In a climate ruled by fear, those who survived Ebola are o�en shunned by their communi�es. Children are par�cularly vulnerable, especially when they or their parents have to be isolated for treatment.

The survivors at the mee�ng heard from experts on how to deal

with the trauma and accompanying s�gma�za�on. Health professionals also told them about how they can support health and community workers in caring for quaran�ned persons in communi�es and treatment centres.

“I felt as if I had been reborn a�er I was discharged from the treatment centre,” said Mohamed, a middle aged health worker in Kenema. “We were faced with high levels of s�gma�za�on and discrimina�on in our own communi�es but we resisted and became stronger and stronger every day.”

“Sierra Leone is facing one of the biggest crises in its history, and to defeat Ebola we need the help of every ci�zen,” said Hon Alhaji Moijue Kaikai, Minister of Social Welfare, Gender and Children's Affairs. “People who have survived Ebola give hope to others who are s�ll figh�ng the disease. We need to accept survivors and welcome them back to our families and our communi�es. We appeal to all partners to join in the fight against Ebola with ac�ons not words.”

The second Knowledge, A�tudes and Prac�ce (KAP2) survey that was facilitated by the NGO Focus 1,000 in November reveals that there has been a significant reduc�on in s�gma�za�on of Ebola survivors. Only 14 per cent of people s�ll clung to the view of not welcoming back a neighbour who had survived and recovered from Ebola as compared to 75 per cent in KAP1 in August.

Surviving

Ebola UNICEF supports experience sharing meetings for Ebola survivors

By Issa Davies, Communication Officer, UNICEF Sierra Leone

October - December 2014 4

©UNICEF Sierra Leone/2014/James

After Ebola – a boy's return to life, and his community, in Sierra Leone

BO, Sierra Leone, 30 December 2014 – Musu Koroma will never forget the day she was told that her 14‐year‐old son Sanfa had died of Ebola.

Sanfa had been studying at a Koranic school in the village of Gbonjiema, which is a two‐hour walk from his small village of Pelewahun. He and another boy were infected with Ebola virus. He was taken to the Moyamba district capital, Bo.

“I heard from the government officials that the two boys infected in the village Gbonjiema had died,” says Ms. Koroma.

It would have come as no surprise to Pelewahun. Ebola was deadly. A tradi�onal funeral ceremony was organized. Mourners cooked and shared a meal, with some food set aside to feed Sanfa’s spirit on its journey to the next life.

Back to life, back to the community

As the family tried to cope with their grief, informa�on began to surface that the boy might be alive. Reports of his passing were the result of poor lines of communica�on – a problem that would con�nue, as the family had their hopes li�ed and dashed various �mes in the days following Sanfa’s ‘death’.

As it turns out, Sanfa had survived.

When he was released from care, the en�re village turned out to welcome him home, a spectre who had defeated the deadly illness. UNICEF provided support to help reunite the family and reintegrate Sanfa into his community, assuring a social service officer from the Ministry of Social Welfare, Gender and Children’s Affairs would be present, delivering a Reunifica�on and Family Tracing kit and helping to arrange distribu�on of food ra�ons by the World Food Programme (WFP).

Sanfa returned home with a store of rice, beans and palm oil and some other essen�als to start life again from scratch. UNICEF also delivered therapeu�c food to help Sanfa

rebuild his strength.

A new role for Sanfa

Survivors of Ebola can face s�gma and discrimina�on when they are well enough to return to their homes. Sanfa's community, however, welcomed his return. Not only had the boy survived Ebola – but his re‐entry into the village helped reinforce messaging about Ebola that UNICEF and partners h a d been delivering to help avoid s�gma. “We had heard

through the radio that survivors could not infect other people,” says Sanfa’s uncle Joseph, a teacher.

Now that Sanfa is well on the way to rebuilding his strength, he is pu�ng his ‘second life’ to use

in the fight against Ebola. UNICEF is carrying out social mobiliza�on ac�vi�es in Gbonjiema to spread awareness about

Ebola and how to avoid it. At a recent event, team members from UNICEF partner Ac�on against Hunger (ACF) greet the chief. The villagers enjoy tradi�onal songs and dances. Women

clap along while Agnes Ngele, the government ’s soc ia l mobi l i za�on

coordinator in Moyamba district, dances in the centre of the circle.

The U N I C E F coordinator in Moyamba introduces Sanfa, who has come to help raise

awareness in the village. He speaks in Mende, a local language. The audience listens cap�vely.

Sanfa’s voice is secure and clear. He is proof that Ebola isn’t necessarily a death sentence. “People in the Ebola treatment centre gave me food and drinks, and they encouraged me,” he says. “I knew that I was going to get be�er.

“When you feel the first symptoms, go to the hospital.”

When Sanfa has finished talking, there is silence. But it doesn’t last very long. The two social mobilizers from ACF carry on with the sensi�za�on session on how to avoid more Ebola infec�ons.

Sanfa looks a bit �red a�er the effort – he’s s�ll recovering – but he sees the role he can play in the fight against Ebola. It’s been a confusing and difficult �me for his family. But, with Sanfa on the mend, and on the road helping spread the word about preven�ng and trea�ng Ebola, these villages in Moyamba district can steel themselves against this killer virus and take steps toward staying well.

The new psychosocial training manual for Ebola affected communi�es and survivors for use by mental health and psychosocial experts was also launched at the first conference for 35 Ebola survivors in October.

Over the next few months, UNICEF is planning to train Ebola survivors during similar mee�ngs across the na�on. Almost 1,500 people have survived Ebola since the beginning of the outbreak in Sierra Leone out of over 7,100 infected (as of 25 December).

October - December 2014 5

By John James and Yolanda Romero, UNICEF Sierra Leone

© UNICEF Sierra Leone/2014/Nesbitt

Youth voices in the time of EbolaBy Yolanda Romero, Communication Consultant, UNICEF Sierra Leone

Ask young people in Sierra Leone if they are playing a

role towards the fight against Ebola, and they would answer with a resounding yes. A new ini�a�ve supported by UNICEF to engage

young people, U‐report, gives them a pla�orm for

their voices.

Through a free mobile pla�orm and social monitoring tool, U‐reporters can organize polls, send concerns on what is happening in their communi�es and alert key stakeholders about these concerns.

“It's amazing to have a new medium for young people to get involved in what's happening in our country,” says 21 year old Agnes Ruth Bull, one of the first U‐reporters in Sierra Leone. To become a U‐reporter, 13 to 35 year‐olds just need to text “join” to 8020 with an Airtel or Africel SIM card.

The very first poll conducted on 28 November asked, “Are young people really playing any role towards the fight against Ebola?” From 133 registered U‐reporters, 77 per cent of them answered yes. The results are published in real �me on a Facebook . Around 85 per cent of the respondents pageacknowledge ge�ng informa�on on Ebola from social media.“The U‐report is an excellent ini�a�ve”, says 30 year old Mohamed Kabba. “I'm very grateful to be part of the first group of reporters, par�cularly for a blind person like me. It shows how inclusive the concept of youth is for UNICEF.”

Strengthening the social mobiliza�on pillar

As the lead agency for the social mobiliza�on pillar of the Ebola response, UNICEF engages various sectors of society—from youth to religious leaders to women's groups ‐ to influence people's behaviour on Ebola preven�on.

“We need more targeted and intensive ac�on among women and young people in the country,” says Roeland Monasch, UNICEF Representa�ve in Sierra Leone.

It has been eight months since social mobiliza�on ac�vi�es began, and there has already been a marked improvement as evidenced by two Knowledge, A�tudes and Percep�on (KAP) studies that reveal these beliefs and a�tudes are changing.

According to the results of the second KAP report conducted by Focus 1,000 with support from UNICEF and CDC, the comprehensive knowledge about Ebola has increased up to 11 per cent. On Ebola preven�on, those who accept that Ebola can be prevented by avoiding contact with body fluids rose from 87 to 93 per cent while over 90 per cent of respondents said they would go to the hospital if they had a fever or suspected that they had Ebola. The propor�on of respondents who hold a discriminatory a�tude towards Ebola survivors decreased from 94 to 46 per cent.

Misconcep�ons remain a challenge though with only slight improvements: six per cent of respondents s�ll believe that Ebola can be prevented by bathing with salt and hot water while 12 per cent believe the virus can be treated successfully by spiritual healers.

One third of respondents revealed that they would not accept alterna�ves to tradi�onal burials. Around 70 per cent of the new Ebola cases in the country are related to burials. This is why UNICEF considers religious and tradi�onal leaders in chiefdoms as key influencers, to convince Sierra Leoneans that washing the bodies of their loved ones a�er they pass will do more harm than good.

Women play a big part in spreading the word out on Ebola prevention. ©UNICEF Sierra Leone/2014/Bade

During the workshop on the U-report, Agnes Ruth Bull, shares her concerns about Ebola. ©UNICEF Sierra Leone/2014/Romero

October - December 2014 6

Ebola: helping people with impaired vision to stay safe By Yolanda Romero, Communication Consultant, UNICEF Sierra Leone

In Sierra Leone, social mobiliza�on teams have been spreading the message out about how best to protect yourself from the Ebola virus. One large billboard sponsored by UNICEF and the Sierra Leone Football Associa�on is typical: promo�ng

hand washing and the 117 Ebola hotline. Elsewhere, what are o�en quite graphic posters, explain the symptoms and what to do.

The messages are clear for all to see. But they're not accessible to everyone, especially the country's more than 40,000 visually‐impaired people.

UNICEF and the Government of Sierra Leone co‐lead the social mobiliza�on pillar, which includes a subgroup for people special needs, so that they are not forgo�en in the overall messaging. The UN Development Programme (UNDP) have even helped produce Ebola messaging in braille.

Basiru Bah, 17‐years‐old, is visually impaired and explains some of the struggles as he seeks to share the right messages with his friends. “When I go to any Ministry to make my advocacy work, if there is no person standing near the point where the bucket with chlorinated water is, I can't use this preven�ve measure.”

The commonly heard mantra 'Don't touch', is also problema�c: “I need to touch the shoulder of the people who guide me. Giving our family members the correct messages on preven�on could be a solu�on. In blind associa�ons they suggest we use long sleeves [to reduce human contact],” he says.

Like all of his fellow Sierra Leoneans, Basiru's life has been deeply affected by the Ebola outbreak. “I'm an advocate for the

children's rights, both for impaired and non‐impaired children. Because of Ebola, I decided to move from my family house to the School for the Blind in Freetown,” he says. Now he is closer to the Ministry of Social Welfare, Gender and Children's Affairs and the Ministry of Educa�on, Science and Technology where he sees that he

has a role to play.

“My advocacy plans have been disturbed by the outbreak,” he says. Now when he goes to any ins�tu�on to advocate for the rights of the children the answer is always the same: Ebola is the priority.

Moreover his studies are in limbo: “I was preparing my West African examina�on when the outbreak started and it was put on hold for all the country because of Ebola.” According to UNICEF, more than 100,000 children in Sierra Leone have been affected by the postponed dates of the examina�on.

“I used to have a very ac�ve social life,” says Basiru. “Now I don't even ask my friends to go and visit them.” Even the religious prayer has changed: “I'm Muslim,” says Basiru, “and in the Islamic preaching we shake our hands when we finish, and we are not doing it anymore.”

Ose‐to‐Ose Ebola Tok

One of the flagship ac�vi�es of UNICEF's social mobiliza�on

team was suppor�ng the government's three‐day house‐to‐house campaign from 19 to 21 September. More than 28,500 social mobilizers went door‐to‐door to reach 94 per cent of the 1.5 million households targeted to share informa�on on ways families could protect themselves. Around 75% of households in Sierra Leone prefer receiving informa�on in this manner. UNICEF has also been training women vendors or okada drivers to be effec�ve communicators on Ebola.

“We trust the government that the Ebola virus will stop,” Idrissa Samura, 17, who benefited from the campaign, stands outside his home in Freetown.

“We must have faith because, right now, we are not happy, and the economy is not good, and our movement is restricted. In two months I believe the virus will leave,” he says.

Community members take the Ebola fight to the streets. about Ebola. ©UNICEF Sierra Leone/2014/Bindra

©UNICEF Sierra Leone/2014/Romero

October - December 2014 7www.facebook.com/unicefsierraleone twitter:@UNICEFSL

hese days in Sierra Leone, most people do all they

Tcan to stay clear of hospitals and health centres, where those infected with Ebola virus are being s h e l t e r e d a n d t r e a t e d . I t m a y b e a n understandable response to a deadly epidemic,

but the wider health impact of such fears is already being felt, most notably in the steep decline in vaccina�ons. Na�onal immuniza�on rates for the pentavalent vaccine for diphtheria, whooping cough, tetanus, haemophilus influenza and hepa��s B were above the target of 90 per cent un�l August, when they started dropping significantly.

“The drop in vaccina�on levels is really worrying and really undermines the work we've been doing over the past few years,” says Yaron Wolman, Chief of Child Survival and Development with UNICEF Sierra Leone. “Children are now exposed not just to the Ebola virus, but also to other devasta�ng illnesses like measles, Rota virus and yellow fever, while polio may be lurking in the corner.”

Big drop

The first Ebola deaths in Sierra Leone were confirmed 26 May. A recent assessment carried out by the Sierra Leone Ministry of Health and Sanita�on, in collabora�on with UNICEF has revealed that the number of children a�ending health facili�es for the third dose of Pentavalent vaccine (DPT/Hep B and Hib) went down by 21% na�onally.

For measles, vaccina�on rates dropped from 99 per cent in January to 72 per cent in November.

Parents hoping to get their children vaccinated also seem to be changing their approach. At the �ny vaccina�on post next to the Government's Central Medical Stores in Freetown, a group of five mothers line up under the blazing sun to vaccinate their newborns, whose cries blend with the dogs barking and the local music shack blaring messages on Ebola.

Queues at this post were once a rare sight, but the nearby Kingharman Road Government Hospital and George Brook Community Health Centre have closed their doors because of

In Sierra Leone, vaccinations another casualty of Ebola By John James and Yolanda Romero, UNICEF Sierra Leone

A group of mothers line up to vaccinate their newborns after the closure of two nearby health facilities. A drop in vaccination levels is undermining years of progress in the health sector. ©UNICEF Sierra Leone/2014/Romero

October - December 2014 8

an Ebola infec�on of health workers there.

“Since the outbreak started in May, mothers have been procras�na�ng about visi�ng hospitals due to the fear of being infected by the disease,” said one of the nurses at the vaccina�on post, who didn't want to give her name. She says she's afraid of Ebola, but confesses she's forgo�en to use the protec�ve face mask. She uses a plas�c apron as well as gloves.

“I try to change my gloves with every child a�ended,” she says. “But with the workload it's easy to lose track.”

Campaigns suspended

The World Health Organiza�on (WHO) guidelines for immuniza�on programmes during the Ebola outbreak advise against vaccina�on campaigns, because of the threat of Ebola transmission. For clinics and health centres, they recommend protec�ve gloves are worn and changed for each pa�ent receiving vaccina�ons, and they call for strict hand hygiene.

In Sierra Leone, mass vaccina�on campaigns have already been suspended. Inside the Central Medical Store centre, regular vaccina�on for babies con�nues. The babies are weighed and then receive the polio vaccine and BCG vaccine for tuberculosis. Since the outbreak of Ebola, however, their temperature is no longer taken: “We do not have an infra‐red

thermometers, and we do not want to use the usual one anymore,” says the nurse.

More supplies are being brought in by UNICEF, with support from the World Bank, the UK Department for Interna�onal Development (DFID) and the European Union's Humanitarian Aid and Civil Protec�on department (ECHO). UNICEF is providing vaccines and basic protec�on kits to vaccinators, benefi�ng around 200,000 children.

On 10 October, the first shipment of Infec�on Preven�on Control supplies and consumables for Primary Health Units arrived, including gloves, aprons, coveralls, goggles and face shields. These supplies are crucial for small clinics like the one at the Central Medical Stores to provide malaria treatment, antenatal care, postnatal care, HIV support, nutri�on services and immuniza�on.

The supplies are being distributed star�ng with Primary Health Units in the districts most affected by Ebola: Western Area, Port Loko, Bombali, Tonkolili, Moyamba and Bo.

A massive social mobiliza�on effort is being conducted na�onwide for communi�es who have stopped going for vaccina�ons for fear of being infected with Ebola.

A baby receives BCG and polio doses in the vaccination unit near the Central Medical Stores in Freetown, Sierra Leone. Regular vaccinations in Sierra Leone continue, while vaccination campaigns have been put on hold. ©UNICEF Sierra Leone/2014/Romero

October - December 2014 9

Fighting two killers at once:

hen you're living in Sierra Leone and you

Wstart coming down with a fever, headache and aching joints, one word is on everyone's mind: Ebola! But the symptoms are also common to other

diseases including malaria, the country's deadliest disease. Anecdotally, the Ebola outbreak also makes people with more long‐standing diseases more reluctant to seek medical a�en�on because of fear of catching Ebola in health centres.

These is why a new UNICEF‐supported an�‐malaria campaign was conducted targe�ng 2.4 million people, close to half Sierra Leone's popula�on.

“Our aim is make sure malaria cases don't get mixed up with Ebola, and also to do what we can to reduce the number of malaria deaths,” said Nathalie Daries from UNICEF Sierra Leone's health sec�on. Misdiagnosing people suffering from malaria puts extra strain on Ebola services, par�cularly isola�on beds and tes�ng services.

In Co�age, close to the Ola During Hospital for children in Freetown, 18 year old Aisha receives four boxes of malaria drugs. In the household there are three children living with their mother. “I'm very happy to receive the an�‐malaria drugs,” says Aisha, “we have suffered from malaria uncountable �mes in the family.” The interven�on targets all ages above six

months.

Ebola hotspots; the priority

The campaign started on 5 December, with the most‐Ebola affected areas receiving priority coverage: Port Loko District (1,164 confirmed cases), Bombali District (960) and Western Area around the capital Freetown (Urban = 1,772/ Rural= 994). Tonkolili, Kambia, Koinadugu and Moyamba were also part of the campaign. A second round of the an�‐malaria drug distribu�on will take place in January to cover the same districts as recommended by WHO.

Volunteer campaign

With funding from the German Government, over 9,300 community health workers have been trained to go door‐to‐door to help administer the drugs, consis�ng of the effec�ve an�‐ malarial Artesunate and Amodiaquine (AS + AQ) combined tablets.

Abdul Sesay, 26, is one of the outreach workers. “I'm proud of being a volunteer doing this work for Sierra Leone,” he says. He hands out the medicine and answers ques�ons from beneficiaries, while volunteer Jusufu Rachid, 22, takes notes of how many boxes have been distributed. They exchange roles when they feel like a change. “We received a training of three

Malaria & Ebola By Yolanda Romero, Communication Consultant, UNICEF Sierra Leone

October - December 2014 10

18 years old Aisha asks questions to health workers about how to administer the malaria drugs to her four year old sister and her one year old brother. UNICEF Sierra Leone/ 2014/ Romero

days and we follow a strict protocol not going into the houses together with respec�ng the no touch policy,” Abdul adds, reflec�ng concerns about keeping safe during the Ebola emergency.

38 year old Kadyatu Konte has four children of 15, 10, 5 and 2 years old. She receives the an�‐malaria drugs while listening carefully to the explana�ons of the health workers. “I'm very happy to receive the drugs because I'm very scared of Ebola,” she says.

The outreach workers distribute the malaria drugs to family members by order of age. The mass distribution campaign targets every Sierra Leonean over the age of six months. UNICEF Sierra Leone/2014/Romero

Kadyatu Konte, a 38 years old mother in East Freetown, receives the boxes with Artesunate+ Amodiaquine to prevent the

number one killer in Sierra Leone: malaria. She listens attentively to the instructions on how to take the drugs.

UNICEF Sierra Leone/2014/Romero

October - December 2014 11www.facebook.com/unicefsierraleone twitter:@UNICEFSL

HIV/AIDS in the context of Ebola UNICEF supports experience sharing meetings for Ebola survivors

ack of schooling, changes in medicine delivery,

Leconomic downturns – the impact of Ebola on ordinary Sierra Leoneans in general and HIV carriers in par�cular has been severe. Despite the challenges, UNICEF is suppor�ng partners like NGO HAPPY to

provide support in this difficult �me.

Mohamed, a talka�ve and sharp 13‐year‐old boy living in Freetown, is HIV posi�ve. When the Ebola emergency was declared many things changed for him. From a rou�ne monthly visit to the treatment centre to receive an�‐retrovirals, now the doctor who gives him the medicines is dressed in protec�ve gear. “I'm scared because I think that someone who covers himself is a bad person,” Mohamed says.

Since Ebola started medicines are delivered every two months to reduce human contact. “If the person is not very well educated, it can lead to an overdose,” Mohamed fears. The doctors handing them out no longer even give out the medicines by hand: they just put them on the table. “It makes me feel bad,” adds the young boy.

Ebola has also had a nega�ve economic impact that significantly affects people with chronic diseases. Mohamed's parents lost their jobs when their NGO was closed down. The increasing price of commodi�es is also making their struggle more difficult.

Kadyatu's story

“I should be at university since September,” says Kadyatu, another HIV posi�ve child, with a mixture of resigna�on and

impa�ence. “I should have taken my West Africa examina�on and now I'm at home doing nothing.” More than 100,000 teenagers in Sierra Leone like Kadyatu are affected by the suspended examina�ons, with almost 3 million children out of school a�er the government halted schooling to prevent Ebola to spread.

“One of my HIV posi�ve friends who was o�en ill died recently because she couldn't be looked a�er in the hospital due to the Ebola outbreak,” says Kadyatu. “She was so nice. She loved dancing, singing,” she says of her friend. She says that in the early days of the Ebola outbreak all the a�en�on in the health centres was focused on Ebola.

Since then, infec�on control at health centres has improved. UNICEF and other agencies brought in a huge number of supplies to support the Ministry of Health and Sanita�on with more than 3,000mt of gloves, protec�ve suits, body bags for the dead, and other essen�al consumables.

“Us HIV posi�ve pa�ents are afraid of being sent to Ebola holding centres because the symptoms of our illness can be similar to those of Ebola,” said Kadyatu. She says that some�mes they suffer from fever or vomi�ng and they fear ge�ng confused with Ebola pa�ents. “I feel we are neglected,” she says.

And like all Sierra Leoneans, people with HIV are bearing the same difficul�es, even with taking public transport. “If you don't take a transport and you walk, you sweat, and people can think that you have fever and you are ill,” adds Kadyatu.

October - December 2014 12

©UNICEF Sierra Leone/2014/Romero

Before the outbreak, only 20% of young people had comprehensive knowledge on the preven�on and transmission on HIV. Having mul�ple sexual partners and the rare use of condoms make the risk of infec�on worse.

UNICEF is suppor�ng the Government of Sierra Leone in providing training and medical supplies to prevent transmission of HIV from the mother to the unborn child. In 2013, 92% of HIV infected pregnant women receive medica�on to prevent the transmission of the disease to their unborn child.

Kadyatu (not her real name) says she feels “neglected” since the Ebola outbreak started in May 2014 in Sierra Leone. Some HIV patients are afraid of going to hospital because they fear being mixed up with Ebola patients. For those quarantined at home because of Ebola UNICEF, through localpartner HAPPY, deliver to patients' front door. UNICEF Sierra Leone/2014/Romero

October - December 2014 13

In 2014 UNICEF Sierra Leone received contributions from:

The Governments of Canada, Ireland, Japan, The Netherlands, Norway, Sweden, United Kingdom, United Arab Emirates and USA

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, OCHA

UNICEF National Committees from: Australia, Austria, Belgium, Germany, Iceland, Italy, Japan, Luxembourg, The Netherlands, Norway, Poland, Sweden, Switzerland, United Kingdom and USA

For more information, please contact:John JamesHead of Communication, External Relations,Advocacy and Leveraging Resources, UNICEF Sierra Leone

Mobile: +232 76 102 401Facsimile: +232 22 235 059E-mail: jjames@unicef.org

URL: http://www.unicef.orgwww.youtube.com/user/UNICEFSL

Partnerships in action UNICEF engages people from all walks of life to fight Ebola. From market women to international donors, to the President and motorcycle riders,

each one has a role to play in stamping out the epidemic. Together, we can surmount the odds. Together, we can provide children of Sierra Leone a

better future.

Design & Layout by Tolu J. Bade

A symbolic cheque for 25 thousand pounds was

handed over to Freetown market women for

Ebola sensitization and sanitation

improvements, courtesy of the English Premier

League and the English Football Association

(FA). In the handover was the UK Ebola

Emergency coordinator, Donal Brown,

UNICEF's Global Ebola Emergency

coordinator Dr Peter Salama and Isha

Johansen, President of the Sierra Leone FA.

UNICEF Sierra Leone/2014/James

President Dr. Ernest Bai Koroma launching the

Community Care Centre in Newton with

UNICEF Sierra Leone Representative, Roeland

Monasch. UNICEF Sierra Leone/2014/James

Jusif just started his first ever paid job in an

interim care centre for Ebola orphans after he

recovered from Ebola. UNICEF is engaging

people like him who are now immune to the

virus to help in the response. UNICEF Sierra

Leone/2014/Dunlop

150 brand new 10,000-litre water tanks

were handed over by UNICEF's WASH

Specialist Gaelle Fohr (center) to Sierra

Leone's Minister of Water Resources

Momodu Maligi, (left) and Guma Valley

Water Company General Manager

Bankole Mansaray (right). The tanks will

be installed in the capital Freetown and the

surrounding area to provide water services

to the most vulnerable. UNICEF Sierra

Leone/2014/Francia

Through the joint effort of UNICEF and

UNDP, motorbike riders such as

Mohammad are now our partners in

fighting Ebola. Okada drivers participated

in workshops to help spread the message

about Ebola prevention. UNICEF Sierra

Leone/2014/Bade

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