23 March 2015 – One year since the first cases of Ebola were detected. The virus has infected 24,000 people and killed 10,000 (source :WHO), among them a lot of children. It has affected mainly three countries : Guinea, Liberia and Sierra Leone. Despite a significant decrease in the number of cases, the epidemic is not over and a lot remains to be done. Children are the most vulnerable as they can find themselves in very unstable situations when they lose their parents or are left behind with insufficient health care.
What is done for children in this crisis ?
While the global community reviews the response to the largest outbreak of Ebola in history, Terre des Hommes highlights what is being done specifically for children affected by the crisis.
Children are profoundly affected by the current crisis but are largely missing from the public health dialogue. These children are not only grieving, they are also likely to have urgent needs for alternative care. Kinship care is widespread in the region, but the stigma attached to Ebola has reportedly affected the willingness of some extended families to house contact children from families exposed to the virus. Stigma is also reported in relation to ‘survivor children’ who have been infected but overcame the disease.
When those survivors return to kin and community they may be shunned. This is affecting migratory or mobility patterns of children and youth as there is often no other option than to leave and move on.
Under these circumstances the Visa suspensions for the Ebola-hit West African nations that several high income countries have passed recently do more harm than good. They place additional pressure on the countries facing Ebola and complicate the travel to and from the affected countries by aid workers. According to the WHO, exit screenings and vigilance in the rest of the world would be sufficient to control the virus.
Reinforcing the response for children : the action of Terre des Hommes
Children in communities are harder to find and to provide with essential care and protection services. However, children are at the centre of this crisis and need to be at the centre of the response. We need to adapt as we work: inaction in the absence of perfect data is not an option.
Terre des Hommes is active on the field and works with affected families and children. This means reaching them where they are, not only in centres but in their homes and communities. It means working with community leaders and decision-makers to understand and address the causes of non-compliant and risky behaviours responsible for transmission. It means recognising traditional healers and integrating them in the formal health system.
A concerted effort among four TDH organisations active in the region has been put in place. Terre des Hommes Foundation Lausanne together with Terre des Hommes Italy and with the support of Terre des Hommes Netherlands and Terre des Hommes Germany, implement a large-scale response to the epidemic.
Terre des Hommes extends its action from emergency phase to longer term focusing on community health. Acting on the key components of the Primary Health Care as well as health information, health financing and staff training with a focus on mother and child care and protection. TDH brings its contribution within country national policies and within the efforts of the international community to contain the current public health crisis of Ebola outbreak.
Concentration should be put on the most affected countries but also on neighbouring countries. Investments are urgently needed to make the health systems more robust and resilient. It’s necessary to bring services closer to people and foster community engagement and participation. The communities themselves know best what they need.That is why Terre des Hommes is also intervening in neighbouring countries to strengthen health systems and build resiliences.
The Care Centers and family-care arrangements
Interim or Observation Care Centers have been established by governments in Monrovia (LBR), Port Loko (SLE), Lunsar (SLE) and Makeni (SLE) . They provide a place of care and protection for children who have been exposed to Ebola but are not exhibiting symptoms of the disease.
The overwhelming majority of children who have come into contact with the Ebola virus, without being infected, are not admitted to these Centers but rather are being cared for by family or extended family within their communities.While there is great benefit in the preservation of family care, this situation poses a risk to both the children, family and community members, and calls for concerted mobilization and coordination in quarantine communities to bring appropriate services such as quality diagnostic and medical services, nutrition, mental health and psychosocial support, training for family,etc.
Report of the High Level Meeting on Ebola Affected Countries (10-11 December 2014) in which Terre des Hommes made an intervention.
The Report Pushed to the Limit and Beyond : A year into the largest ever Ebola outbreak by Médecins Sans Frontières
To know more on Terre des Hommes actions on Ebola and Primary Health Care :
Guinea : Terre des Hommes Lausanne
Ivory Coast : Terre des Hommes Italy