USACAPOC(A) Civil Information Management (CIM) Cell Ebola

UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
USACAPOC(A) Civil Information Management (CIM) Cell
Ebola Update
21 November 2014
UNCLASSIFIED
Table of Contents
Ebola Update 21 November, 2014
EXSUM
Food Security
Water
Physical Security
Economic and Social Impact
Medical Care
Maps
West Africa ebola outbreak (20 NOV 14)
Food consumption affected by ebola (20 NOV 14)
Health care facility gap analysis
Sample RFI Visualizations
Child vaccinations
Chinese ETU
Plight of the orphaned
Ebola conspiracy
Sierra Leone Community Centers
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
Date:
21 November 2014
Subject:
USACAPOC(A) Civil Information Management (CIM) Cell Ebola Update
CPT Steven F. Hung
(910) 396-9399
Information as of 21 November 2014 as reported by the World Health Organization (WHO)
Guinea: 1,971 Cases (1192 Deaths)
Sierra Leone: 6,073 Cases (1,250 Deaths)
Liberia: 7,069 Cases (2,964 Deaths)
Mali: 6 Cases (5 Deaths)
Executive Summary
Food Security
•
According to the Famine Early Warning System Network (FEWSNET) and Mercy Corps, if no changes occur in
West Africa in the immediate future, households will face critical levels of food insecurity by April/May 2015.
•
Estimates in production are predicting a reduction of upcoming yield of 25 to 50 percent in Liberia due to lack of
laborers.
Water
•
Non-government organizations (NGO) have begun equipping medical facilities with water, sanitation, and hygiene
(WASH).
Physical Security
•
Public perception of corruption and incompetence of the governments within the affected regions, especially within
the quarantine zones, will continue and add to the likelihood of future protests and demonstrations, though outright
armed conflicts in the near future are unlikely.
•
Despite emplacement of border checkpoints, it is expected that the Ebola Virus Disease (EVD) outbreak will spread
due to the migratory patterns of seasonal workers. These migrations are likely to be larger than normal due to the
economic effect of EVD.
Economic and Social Impact
•
Despite gains in the fight against EVD in Liberia, Sierra Leone and Guinea continue to see increases in cases.
Based upon a survey conducted by the Government of Sierra Leone (GoSL) and aid organizations, the message of
safe burials is still not gaining traction in these areas. Many people are staying home to minimize human-to-human
contact to avoid contracting the disease, which further disrupts local commerce and economic activity.
Medical Care
•
The EVD outbreak in West Africa is causing other deadly diseases like malaria, tuberculosis, typhoid, and
dysentery to go untreated, presumably killing more people than Ebola.
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Food Security
Researchers from Mercy Corps (an NGO based in Portland, OR) spoke with 122 households and 122 vendors in three of the
most heavily afflicted parts of Liberia: Lofa County, once the epicenter of the Liberia's Ebola outbreak; Monrovia, the
capital; and Nimba County. Results show that 90 percent of respondents said they were eating less per meal than prior to the
outbreak and 85 percent were eating fewer meals per day. The report suggests that even though the number of people infected
with Ebola has been relatively small—never more than a fraction of all residents in even the hardest-hit regions—the
resulting epidemic of hunger has become far more widespread.
Source: Photograph: Ahmed Jallanzo/EPA
There are two reasons for this problem. One is the increasing scarcity (and rising cost) of food imports. Vendors across the
country are being forced to acquire their goods from Monrovia. Additionally, Liberia, a nation that already imports a large
amount of their staple foods, is becoming increasingly dependent on overseas imports. Due to the outbreak, however, fewer
shipping lines have been willing to travel to Liberia. Those that continue to deliver goods have had to purchase additional
insurance, which is an added cost that is further driving up the price of imports. The food shortage that resulted from the
decline in trade has been made even worse by a simultaneous decline in local agriculture. In northern parts of the country—
like Lofa—where farmers normally rely on imported seeds from neighboring countries, rice production has fallen by as much
as 25 percent in some areas. In the south, which depends heavily on mobile groups of farm laborers, production has fallen by
as much as 50 percent as workers have stayed away in an attempt to avoid the disease. Declining agriculture and trade
combined with a general slowdown in business throughout the country has led to a collapse of the Liberian economy and a
fall in household income. According to Mercy Corps, 66 percent of surveyed households reported that their income has
decreased since the outbreak reached epidemic levels. To make up for their losses, people are often borrowing money to pay
for food or other household expenses. 1 (Mercy Corps)
1
http://www.mercycorps.org/sites/default/files/MercyCorps_Liberia_EconomicImpactEbolaOutbreak_November_2014.pdf
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
According to the World Food Program, there are 1.7 million people experiencing food insecurity (defined by WHO as lack of
“sufficient, safe, nutritious food [required] to maintain a healthy and active life”) in Liberia, Sierra Leone, and Guinea, with
200,000 of those cases directly related to EVD. On 11 November 2014, the United Nations (UN) Human Rights Campaign
released a statement warning that West Africa may be “on the brink of a major food crisis” due to the Ebola crisis. “While the
countries hardest hit by the Ebola crisis struggle to contain the devastating virus, they now face a new challenge,” said Hilal
Elver, UN Special Reporter on the Right to Food. “Experts [predict] that over a million people in the region need food aid to
allay shortages.” The lack of food could result in a domino effect into peace and security; already there have been reports of
stolen food aid. The mayor of the Liberian town of Karnplay has been accused by a local representative of illegally taking a
huge quantity of bulgur wheat meant for distribution. 2 (All Africa)
According to FEWSNET and Mercy Corps if no changes occur in West Africa in the immediate future, households will face
critical levels of food insecurity by April/May 2015. Reports from Mercy Corps show households in West Africa have already
begun to borrow money for purchasing food and household expenses. In addition, Ebola-related restrictions are also
affecting the agricultural sector by preventing cooperative farming consortiums (traditionally called “kuus”) from gathering.
These cooperatives, which usually consist of around 50 people, have been reduced to 5 to 10 people due to restrictions and
fears of EVD. Estimates in production due to lack of laborers are predicting a reduction of upcoming yield of 25 to 50
percent in Liberia. Furthermore, due to uncertainty of how long EVD restrictions will last, reports have indicated that
farmers are hoarding seeds and harvests. If not addressed, the food shortage could lead to an economic collapse of the West
African nations affected by EVD.
2
http://allafrica.com/stories/201411110918.html?utm_source=feedburner&utm_medium=twitter&utm_campaign=Feed%3A+TheLiberianTimesNEWS+%2
8TheLiberianTimes.com++|++The+Liberian+Times++|++Top+Liberian+News+Headlines%29
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Water
To improve infection control and prevention efforts, the United Nations International Children’s Fund (UNICEF) is
equipping up to 600 non-EVD health facilities with disinfectant, hand-washing equipment, soap, sprayers, and water
supplies. UNICEF also plans to provide WASH assistance at Ebola Treatment Units (ETU) as needed and plans to reach
3,000 schools with hand washing and EVD awareness messaging. 3(USAID)
In West Africa, about 25 to 40 percent of people lack access to safe, clean water that is protected from outside contamination,
and in particular feces, according to WHO. Health centers treating Ebola patients may not have access to running water.
Open defecation is practiced in all of the Ebola-hit countries, with the situation being most dire in Liberia, the country worst
affected by Ebola, where only 17 percent of the population has access to toilets and almost one in two people defecates in the
open. Bai-Mass Taal, executive secretary of the African Ministry Council on Water (AMCOW), said the crisis might provide
a key opportunity for a continent struggling to improve its water and sanitation facilities. “Up to 65 percent of hospital beds
in Africa are occupied by patients with water-borne diseases. We spend much of our health bill on curing instead of
prevention,” said Taal. According to WHO, 4 percent of the global disease burden could be prevented by improving access to
safe water and sanitation. Even though one dollar invested in water and sanitation brings a four-fold return in increased
productivity and could prevent costly treatment of water-borne diseases like cholera, there is still insufficient funding for
water and sanitation in Africa. 4 (All Africa)
Africare field recently partnered with Peace Corps volunteers to organize two days of Ebola prevention and WASH training
that reached 400 people across four villages. 5 (Africa Care)
UNICEF has been engaged in raising Ebola awareness in affected countries and working to counter misconceptions about the
disease that put even more people at risk. UNICEF has also distributed protective supplies such as gowns, gloves, bleach, and
1.5 million bars of soap in Sierra Leone as well as millions more in Liberia and Guinea. Apart from Ebola, figures released
3
http://www.usaid.gov/ebola/fy15/fs07
4
http://allafrica.com/stories/201409051608.html
5
http://www.africare.org/africare-peace-corps-reach-hundreds-wash-ebola-prevention-training/
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
recently by UNICEF and WHO say in that 2013 more than 340,000 children under five—almost 1,000 a day—died from
diarrheal diseases due to a lack of safe water, sanitation, and basic hygiene. As the Ebola response takes its toll on the health
services in the affected countries, the practice of hand washing is even more important in warding off these common
diseases. 6 (UNICEF)
One of the most critical ways to prevent infection is through proper hygiene, so CARE will be ramping up the next phase of
its prevention efforts in Sierra Leone and Liberia to distribute soap, water buckets, gloves and chlorine as well as
demonstrating proper hand washing techniques. “Outside every public building there are hand-washing stations, and CARE
staff will be helping with the distribution of hygiene materials so that eventually there will be hand-washing stations outside
every household as well.” said Emmanuel Wilson, Procurement Officer at CARE in Liberia. These important prevention
activities and hygiene promotion are critical to stopping the spread of Ebola. CARE will be conducting these activities in
Sierra Leone and Liberia, including two refugee camps where more than 20,000 refugees are residing in conditions where the
disease could spread quickly if an outbreak occurs. 7 (CARE)
Source: Rein Skullerud/WFP
Bai-Mass Taal, the executive secretary of the African Ministry Council on Water, believes the attention the Ebola outbreak is
currently receiving may be beneficial to affected nations, as it brings to light the large number of infrastructure problems
these countries have. There is some evidence that bears this out, as several NGOs have begun equipping medical facilities
with cleaning, water, and hygiene supplies. Other NGOs have focused on training and educating the local populace on better
hygiene and things that could help avoid the spread of the virus and improve their general way of life. If the NGOs are
successful in this endeavor, we should see a decrease in the spread of the virus and reduction of demand on medical
facilities/personnel.
6
http://www.unicef.org/gambia/media_8648.html
7
http://www.care.org/newsroom/press/press-releases/care-scaling-response-halt-spread-ebola
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Security
New fears have arisen about the spread of EVD into previously uninfected areas, as more than 150 stranded Nigerian teachers
in Sierra Leone, Cote D’Ivoire, and Liberia have reportedly started escaping into Nigeria following the refusal of the federal
government to evacuate them because of the Ebola scourge. 8(NJAID)
Mandatory quarantines have exacerbated already existing obstacles to finding food. The weight of this has been felt most
acutely thus far in the impoverished seaside slum of West Point, Liberia. Fenced off from the rest of the country by the local
military, more than 75,000 inhabitants were left with little food to eat and no way to get it. Deliveries of food supplies by the
government were delayed and often were enough only for a small portion of the population—resulting in a violent uprising
that left two injured and one dead. This lack of food can also domino effect into a threat to peace and security; already there
have been reports about stolen food aid. 9 (The Daily Beast)
The Government of Liberia has announced that a disciplinary board of the Armed Forces of Liberia (AFL) has concluded that
a platoon commander and four enlisted men were guilty of indiscretion and exhibited indiscipline on the 20 August 2014
killing of a boy during demonstrations in the township of West Point. However, no evidence was cited that any of the
personnel of the AFL fired the fatal shot that killed Shaki Kamara. 10 (All Africa)
Distrust among the populace of the government led by President Ellen Johnson Sirleaf is shown in an article written by
Charles B. Russell from The Perspective. 11 (The Perspective)
In much of West Africa, the annual harvest ends around October, and in the following months, workers begin migrating to
find work elsewhere, such as on cocoa and coffee plantations in the Ivory Coast or in fishing ports on the coast. This postharvest migration is a prime example of the high mobility of the region’s population. National borders are porous, and people
cross them freely. This fact worries some observers who are pondering the challenge of stopping the Ebola epidemic
simmering in Guinea, Liberia, and Sierra Leone. With a high level of travel between the three hardest-hit countries and their
neighbors, there is a very good chance that travelers or migrants will bring more Ebola cases into other countries such as
Senegal, Mali, and Cote d'Ivoire (Ivory Coast), thus potentially triggering expansion of the epidemic. 12 (CIDRAP)
According to a report published on 12 November 2014, more than 400 health workers treating patients in Bandajuma, Sierra
Leone had gone on strike. The BBC reports that the health workers, including nurses, porters, and cleaners, were protesting
about the government's failure to give them the agreed weekly “hazard payment” of $100. The Bandajuma clinic is the only
Ebola treatment center in southern Sierra Leone. Medical charity, Medecins Sans Frontieres (MSF), which is responsible for
running the clinic, indicated that it would be forced to close the facility if protests continue. Similar reports have indicated
health care workers striking and protesting throughout the region. 13 (Food World News)
8
http://www.naij.com/325324-ebola-150-nigerian-teachers-flee-liberia-other-countries.html?utm_medium=twitter&utm_source=twitterfeed
9
http://www.thedailybeast.com/articles/2014/11/13/liberia-s-ebola-famine.html
10
http://allafrica.com/stories/201411102745.html?utm_source=twitterfeed&utm_medium=twitter
11
http://www.theperspective.org/2014/0910201404.php
12
http://www.cidrap.umn.edu/news-perspective/2014/11/migrations-west-africa-seen-challenge-stopping-ebola
13
http://www.foodworldnews.com/articles/8607/20141112/sierra-leone-ebola-crisis-health-workers-protests-payment-of-5000-dollars-will-be-given-tofamilies-of-health-workers-who-die-from-the-virus.htm
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Many of the governments in the affected region have implemented the quarantines of areas hardest hit as well as emplaced
checkpoints in the hopes of restricting travel between neighboring countries. These quarantines are often enforced by
military and police forces. AFL forces enforcing one such quarantine were involved in the shooting death of a 15-year-old
boy who was within the quarantine zone of the Township of West Point, Liberia. After a government-sanctioned investigation
into the matter, those AFL soldiers involved were not punished but rather found guilty only of “indiscretion and exhibited
indiscipline.” The perception of insufficient government response to the findings of the investigation sparked protests within
the West Point area. It can be expected that if other such instances of use of government force occur, they will lead to further
demonstrations. Occasionally such protests do escalate into rioting and looting; however, in most cases these tend to
dissipate after a few days and usually do not result in further conflict. This suggests the possibility that government-enforced
quarantines within the region could act as drivers of instability.
Source: (AP Photo/Abbas Dulleh)
The enforcement of these quarantines has also created another crisis: that is one of food shortage to those living within the
zones. Food shortages have subsequently resulted in the theft of food aid as well as further protests and looting. Failure to
adequately address food and water shortages or to protect food aid is likely to increase the difficulty of enforcing these
quarantines as inhabitants break quarantine in search of food and water. As food shortages continue to be a problem,
especially within urban areas, an increase in property crime is likely.
Governments have also emplaced checkpoints at or near the borders and within the affected regions in efforts to restrict both
the flow of people and the potential spread of the disease. The effectiveness of these checkpoints does not appear to be very
great; however, and experts are increasingly concerned that the migration of workers within the region will not be
substantially impacted by such checkpoints. Many of the migrant workers can choose to avoid the checkpoints by simply
utilizing back roads or paths. These harvest migrations have been going on for at least a thousand years and are simply a
way of life within the region. This high mobility threatens to spread EVD beyond its current boundaries, especially since
these workers often tend to travel in groups and to share food and living spaces while traveling.
Compounding the problems of protests and demonstrations within the quarantine zones are protests and strikes by nurses
and health care workers in the region. The lack of hazard payment and lack of proper personal protective equipment (PPE)
are among the chief concerns. These strikes, when they occur, are usually resolved within a matter of days. However,
failure to resolve these strikes will threaten the continued operation of affected medical facilities and, in extreme cases, may
lead to the closure of these facilities.
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Economic and Social Impact
Medical Express reports that in Sierra Leone churches are the only allowable sites for congregations. With EVD rampaging
through Sierra Leone, most ordinary outings are off limits. For fear of contracting the virus that has killed thousands, people
cannot go to school or public events, but churches are open for services. 14 (Medical Express)
The World Bank and other international aid groups confirm these reports. People in Ebola-stricken countries, afraid of
catching the often-fatal virus, are staying home to avoid human-to-human interaction. This has left many households without
income. 15 (NPR)
The World Bank has not yet analyzed recent remittances to Liberia, Guinea, and Sierra Leone. Wiring services Western
Union and Moneygram were not able to share data. However, people from all three communities share similar stories: that
they are constantly transferring money, and that many have shifted away from shipping goods.16 (NPR)
A knowledge, attitudes, and practices survey conducted in early November by the Social Mobilization Pillar—the
coordinating body for EVD social mobilization activities in Sierra Leone—comprising representatives from the GoSL and
relief agencies—identified ongoing misconceptions regarding EVD transmission and response activities. Approximately 34
percent of respondents believed that washing with salt and water kills EVD, and approximately 23 percent of respondents did
not accept alternative burial practices that restrict touching or washing of the body. The Social Mobilization Pillar reported
that EVD awareness activities, including distribution of behavior change materials, radio messaging, and outreach to civil
society and community leaders, aimed at addressing these knowledge gaps are ongoing. 17(USAID)
Source: Sky News Video
Health and humanitarian organizations are establishing village committees—comités de veille (CDV)—throughout Guinea to
create grassroots linkages between social mobilization, contact tracing, and other EVD response activities. According to
WHO, community outreach in Guinea is paramount for successfully responding to the EVD outbreak. The response
community is currently planning 2,250 CDVs comprising 11,250 members. 18(USAID)
14
http://medicalxpress.com/news/2014-11-ebola-hit-sierra-leone-worship.html?utm_source=twitterfeed&utm_medium=twitter&utm_campaign=UFO4U
15
http://www.wbez.org/news/financial-burden-ebola-falls-african-diaspora-111031
16
http://www.wbez.org/news/financial-burden-ebola-falls-african-diaspora-111031
17
http://www.usaid.gov/ebola/fy15/fs07
18
http://www.usaid.gov/ebola/fy15/fs07
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Despite gains in the fight against EVD in Liberia, Sierra Leone, and Guinea, there are continued increases in cases. Based
upon a survey conducted by the GoSL and aid organizations, the importance of safe burial practices is still not gaining
traction in these areas, and many people are eschewing human-to-human contact to avoid infection. This has also resulted in
a severe economic impact in the region; many people are barely able to afford clean, potable water. Evidence from social
media has shown that potable water prices are currently at $5 LD ($0.06 USD) for 500 ml (17 oz.) of drinking water as of 17
November 2014. Based on the UN standard, the minimum need for water per person is 7.5 liters (2 gallons) of potable water.
The average family size in Liberia, Guinea, and Sierra Leone is five persons. Based upon those numbers, each family needs
37.5 liters (20 gallons) of water. Each family would need $4.50 USD in water alone to support the minimum needs for
survival (this calculation does not include WASH). In a country where the average family income is $45.00 USD a shortage
of clean water might occur if support is not increased.
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
Medical Care
Hospitals and health care facilities have been affected in Liberia as some nurses and medical professionals staged a walkout
demanding better pay and safer working conditions in the fight against the deadly Ebola virus. 19( Al Jazeera)
Clinical trials of three potential Ebola treatments will begin in December in Guinea and Liberia at medical centers run by
MSF, the medical charity said on Thursday. The separate trials, involving up to several hundred patients, are designed to test
the drugs Brincidofovir (from the U.S. firm, Chimerix) and Favipiravir (from Japan’s Fujifilm) and to see how well blood
plasma taken from Ebola survivors may work in curing those still infected. Initial results could be available in February 2015,
MSF said in a statement. 20 (Reuters)
Unlike in neighboring Guinea and Sierra Leone, where cases are increasing, MSF teams in Liberia are witnessing a decline
for the first time since the beginning of the epidemic in March. The group’s 250-bed unit in Monrovia is currently treating
about 50 patients. There were no patients in Foya, in the north, by 30 October and no confirmed cases since then. 21 (Wall
Street Journal)
The Ebola field hospital in Bong County, Liberia, which opened in mid-September, has far fewer patients than anticipated. Credit Daniel
Berehulak for The New York Times
Many beds are empty at newly opened Ebola treatment units in Liberia’s urban centers because the outbreak is now flaring in
more rural parts of the country. In Sierra Leone’s capital, there are not enough treatment units as the epidemic spreads there.
Doctors Without Borders (MSF) says the outbreak needs “rapid response teams” that can bring care to remote villages, rather
than trying to get sick people out. Such teams would include medics, disinfection specialists, and psychologists or social
workers and could stamp out a budding outbreak in a village before it can spread. 22(AP)
19
http://www.jollofnews.com/index.php/africa-news/afria/544-strike-over-ebola-pay-hits-liberia-hospitals
20
http://www.reuters.com/article/2014/11/13/us-health-ebola-trials-idUSKCN0IX0MH20141113
21
http://online.wsj.com/articles/who-says-ebola-is-moderating-in-guinea-liberia-1415815085
22
http://bigstory.ap.org/article/4a96f91325b54f49930688a40570e2bb/response-ebola-needs-flexibility-experts-say
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
While these indicators are encouraging, they may at least in part be driven by sick individuals avoiding treatment in medical
facilities, instead attempting to treat the disease at home. Additionally, reluctance to abandon traditional burial practices or
fear of government quarantines may lead some to attempt to hide infected people from medical or government authorities.
British scientists in Sierra Leone say they have cut the delay for Ebola test results from nine days to two, hailing a significant
gain in fighting the outbreak. Britain pledged £20 million ($30 million USD) to build and run the Kerry Town laboratory, as
well as two others being constructed at British treatment centers in Port Loko and Makeni. The money is part of Britain's
£225 million ($352 million USD) commitment to its Ebola response, which includes providing 700 treatment beds across its
former colony. 23 (Medical Press)
Ten new Ebola Community Care Centers are set to open this week in Sierra Leone’s Bombali district as part of a new drive
to bring Ebola treatment closer to communities. Built by UNICEF, the tented centers will boost the number of beds in
Bombali, one of the districts worst hit by the current Ebola outbreak, which has killed more than 1,000 people in Sierra
Leone since May. UNICEF is providing the tents, tarpaulins, and construction materials to build the centers, along with the
day-to-day supplies needed to keep health workers safe from infection and provide patients with supportive treatment.
Funding was provided by the United Kingdom Department for International Development. 24 (UNICEF)
More than 5,000 international healthcare workers and support staff are needed to contain the ongoing Ebola crisis in West
Africa, but doctors, nurses, and emergency responders say the uncertainty about what might happen in the field if they get
sick is slowing down recruitment. International evacuation for patients with active clinical symptoms of Ebola is extremely
limited and may not be achievable if patients have any uncontrolled body fluids, such as vomiting, diarrhea, or bleeding. 25
(IRIN)
China will build a 100-bed treatment center for Liberia and will send 480 medical staff to run and manage this center. 26
(People.cn)
The Ebola epidemic in Guinea is seriously compromising the fight against malaria, its government said. In scores of cases,
doctors are confusing malaria with Ebola, delaying the right life-saving treatment. Guinea’s national coordinator for the fight
against malaria, Dr. Timothy Guilavogui, said malaria each year affects 44 percent of Guineans, or about 5 million people.
The disease kills at least 10 people in Guinea every week, he said. 27 (Relief Web)
The Ebola outbreak in West Africa is causing other deadly diseases like malaria, tuberculosis, typhoid and dysentery to go
untreated, presumably killing more people than Ebola. UNICEF has stated that due to the EVD pandemic, other diseases are
not being treated due to lack of medical staff. Additionally, individuals suffering from other diseases are avoiding medical
facilities for fear of contracting EVD. Death rates due to other diseases are expected to rise significantly due to lack of
treatment and vaccinations.
23
http://medicalxpress.com/news/2014-11-britain-slashes-ebola-results-leone.html
24
http://www.unicefusa.org/press/releases/unicef-open-ten-ebola-community-care-centers-hard-hit-district-sierra-leone/20476
25
http://www.irinnews.org/report/100802/medevac-policy-gaps-slow-volunteer-recruitment
26
http://english.peopledaily.com.cn/n/2014/1114/c90883-8808920.html
27
http://reliefweb.int/report/guinea/ebola-sabotages-guinea-s-anti-malaria-fight
UNCLASSIFIED
United States Army Civil Affairs Psychological Operations Command
Civil Information Management Cell
Fort Bragg, NC
UNCLASSIFIED
CPT Steven F. Hung
(910) 396-9399
There has been a distinct decline in cases in Liberia, offset by an increase in Sierra Leone and Mali. Sierra Leone has seen
the most dramatic rise in new cases. MSF and the UN have both expressed the need for a more rapid response to treat new
EVD cases especially in rural areas. In addition, the 400-person strike in Freetown has made matters worse. In comparison
to Liberia, Sierra Leone has received far less aid then the other EVD-affected countries. The UN Mission for Ebola
Emergency Response (UNMEER) reports that the outbreak in Sierra Leone is particularly virulent in the western areas
around the capital city of Freetown and notes that the number of ETU beds throughout the country needs to scale up
significantly by December to reduce EVD transmission. UNMEER also noted that an estimated 50 percent of EVD cases in
Sierra Leone go unreported.
UNCLASSIFIED
West Africa Ebola Outbreak
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_
^
_
^
Legend
_
^
City
Capital
River
Water
Ebola Outbreak
Cases
Suspected
_
^
1-14
14 - 149
150 - 249
250 - 499
500 - 999
1,000 - 2,999
3,000 +
±
Produced by: USACAPOC(A) CIM CELL
Production date: November 20, 2014
0
20 40
80
120
Miles
Sources: Esri, HERE, DeLorme, TomTom, Intermap, increment P Corp., GEBCO, USGS, FAO, NPS,
NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri Japan, METI, Esri China (Hong Kong),
swisstopo, MapmyIndia, © OpenStreetMap contributors, and the GIS User Community
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_
^
_
^
Legend
_
^
City
Capital
River
_
^
Water
Percentage of poor food consumption
from people impacted by EVD
0 - 5.0%
5.1% - 15.0%
15.1% - 25.0%
> 25.0%
±
Produced by: USACAPOC(A) CIM CELL
Production date: November 20, 2014
0
20 40
80
120
Miles
Sources: Esri, HERE, DeLorme, TomTom, Intermap, increment P Corp., GEBCO, USGS, FAO, NPS,
NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri Japan, METI, Esri China (Hong Kong),
swisstopo, MapmyIndia, © OpenStreetMap contributors, and the GIS User Community
i
n
m
s
a
T
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
West Africa Health Care Coverage
• Colors of districts correspond with number of
Ebola cases, green being the least – red the
most
• Circles represent a 10K buffer area around
every known healthcare facility in the region
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
West Africa
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
Liberia
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
Monrovia
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
Monrovia
Gap in Coverage
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Gap in Regional Coverage
Zoomed In
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Civil Information
Management Cell
UNCLASSIFIED
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Gap in Regional Coverage
Zoomed In
Produced by: USACAPOC (A)
Civil Information
Management Cell
UNCLASSIFIED
CPT Steven F. Hung
910-396-9399
Steven.f.hung.mil@mail.mil
Steven.f.hung.mil@mail.smil.mil
Gap in Regional Coverage
Zoomed In