U.S. Foundation Officials Gain Firsthand Insight Into Ebola Response

Donations from U.S. private-sector foundations, companies, and individuals have been vital to the response that is helping to bring the Ebola outbreak under control in Liberia. Officials from two key foundations – the Centers for Disease Control and Prevention (CDC) Foundation and the Paul G. Allen Family Foundation – visited Liberia January 17-19 to see how their organizations’ contributions are being used to support the Ebola response. Earlier in the week, they stopped in Guinea and Sierra Leone to assess response efforts in those countries.

The CDC Foundation is an independent, nonprofit organization that works to connect CDC with private-sector organizations and individuals to help make the world healthier and safer through public health programs. Since 1995, the CDC Foundation has provided $450 million to support CDC’s work, launched more than 750 programs around the world and built a network of individuals and organizations committed to supporting CDC and public health.

Since the beginning of the Ebola epidemic last March, the CDC Foundation has worked tirelessly with private-sector donors to provide much-needed project support, supplies, and equipment for use in West Africa. Examples include infection control tools, hiring of locally employed staff, exit screening tools and supplies at airports, such as thermal scanners to detect fever, and tents and living supplies for people who are being monitored for symptoms of Ebola. In Liberia, the CDC-Foundation recently provided the Ministry of Health with 82 trucks and 5 ambulances to assist with transport.

“Our objective during this visit was to see what’s being done with funding provided by private-sector donors,” said Charles Stokes, President and Chief Executive Officer for the CDC Foundation. “There are many needs to be addressed, and donations from our friends in the private sector give us ways to deliver resources quickly and flexibly.” Mr. Stokes was accompanied by CDC-Foundation colleagues Reema Bhakta, senior program officer; Pierce Nelson, vice president for communications; and David Snyder, contract writer and photographer.

The CDC Foundation team was joined during portions of the visit by Gabrielle Fitzgerald, Director of the West Africa Ebola Response Program for the Paul G. Allen Family Foundation, which donated $100 million for Ebola response efforts last October. A portion of these funds has been used to support construction costs for Emergency Operations Centers (EOCs) in Liberia, Guinea, and Sierra Leone. When the project is completed, EOCs will be operational in Liberia at the national level, and in all 15 counties.

The foundation teams kicked off the Liberian portion of their visit on January 17 by meeting with Assistant Minister of Health Tolbert Nyenswah and Deputy Minister of Finance Matthew Flomo at the Ministry of Health. They toured the site where the new national EOC is being built near the Ministry of Health. The CDC Foundation group later joined U.S. Ambassador Deborah Malac and several staff members from CDC Team Liberia and eHealth for a business dinner. The Ambassador commended the two foundations for their exemplary work in supporting the Ebola response.

On January 18, the CDC Foundation team met with CDC Team Liberia to discuss the current outbreak status in Montserrado County, where more than half of all Liberia’s Ebola cases are reported. CDC epidemiologists explained how the county response is using a new decentralized “sector” approach that will allow for more nimble and rapid investigations of Ebola cases.

County visit shows response in action

Following the discussion with CDC staff, the team traveled to Grand Cape Mount County, an area of concern because of an uptick recently in Ebola cases there. In the days before the team’s visit, 4 of 8 cases reported in Liberia were from GCM County. In Sinje, the team met with a group of community, traditional, and religious leaders to learn how they had been trained to recognize the symptoms of Ebola and what to do when a sick person is identified as having Ebola in their communities. The training is supported by funds from the CDC Foundation and managed by The Carter Center’s Access to Justice Project.

“Traditional chiefs and religious leaders are important for gaining trust and behavior change in communities,” said Pewee Flomoku, Chief of Party for The Carter Center project. “We train them on how the virus spreads and the dangers of activities like unsafe burials. These leaders are needed for community engagement and social mobilization to succeed.”

The team also traveled to the county health office, where they met with county health officials and a CDC field team temporarily based in Sinje. Team lead Dr. Agam Rao explained the team’s ongoing work done in collaboration with county and district health officers, community health volunteers, and families in local villages to identify cases and contacts. Through careful case-by-case analysis, the team has identified several lines of Ebola virus transmission that help explain how the infections occurred. CDC field team members in GCM County include Allison Arwady, Susan Hills, Ben Humrighouse, and Namita Joshi.

The hardest part of the day-long trip came when the team took a 30-minute ride over rough, rocky dirt roads to the small village of Camp 3, which has registered the largest number of recent Ebola cases in the county. The traveling party, which included district health officers, was warmly welcomed in the village. They met with the village chief and deputy chief, toured the village, and visited a quarantine tent, which had been provided with CDC Foundation funding, along with other Foundation-supplied items like cooking equipment.

The village’s openness to the CDC Foundation visitors was a reflection of the trust built up over time by the work of the CDC field team. It underscores one of the challenges faced by field teams in GCM and other counties: village resistance to responders and an unwillingness to share information about cases and contacts.

”In Camp 3, as they’ve seen us around and understood that we’re here to help, they’ve become more accepting of us,” said Dr. Rao. “But we’re still dealing with resistance in other communities. It continues to hamper our ability to respond because withholding information means incomplete contact lists, among other things.”

As the visit drew to a close, Mr. Stokes spoke with several Ebola survivors and other villagers and thanked them for meeting with the team. “These are important stories you’ve shared with us,” he told the villagers. “You have shown us how this terrible disease affects communities like yours. We will continue to work with our friends to help bring an end to this epidemic.”