Plan staff blog on our work with children across the world.
27 February 2015: "We have come to break from the past by having a declaration that speaks to the future." With these words, Kenyan Ambassador Macharia Kamau opened the second session of post-2015 intergovernmental negotiations in New York last week.
These monthly negotiations between government representatives at the UN in New York are the final stage of the global conversations to define the next global framework for sustainable development.
For this session, UN country representatives met to discuss the content of the declaration that will introduce the Sustainable Development framework to the world. And while member states may differ for now on the specific topics they'd like to see covered in this historic text, all seem to agree that it should be a bold and ambitious call to action that sets out the collective vision for the road to sustainable development by 2030.
Children scarcely mentioned
In the discussion document produced by those running the session, children and young people were scarcely mentioned, neither as the rising generation that will inherit the sustainable development agenda for better or worse, nor as active and vital participants for achieving the Sustainable Development Goals (SDGs).
Aside from the few hours when civil society and other stakeholders were given the floor, the needs and contributions of younger stakeholders were largely neglected in member state discussions, with just a few exceptions.
A strong statement from the Netherlands was one notable exception. Dutch representative Peter van der Vliet explained that he recently found his 13-year-old daughter working on a homework assignment on the SDGs using a child-friendly version of the goals and targets.
"I was impressed to see how all 17 goals were presented in language that 13 year olds can easily understand, both in words and drawings," he said.
No laughing matter
He went on to suggest in 2 separate statements that young people be involved in drafting the declaration to ensure that the language is understandable and has broad appeal. Each suggestion elicited laughter from some in the audience.
For Plan, active and meaningful participation of young people in designing and implementing the SDGs is not a funny or cute ideal. We see it as the smart and right thing to do.
Taking into account the global demographic reality, recognising the right of children to have a say in the decisions that affect them, and welcoming the innovative ideas and talents young people have to offer, we see their engagement as essential for building an inclusive, rights-based framework - and for holding all actors to account for their commitments.
Young voices essential in SDGs
Based on our experience in child-centered community development, we have argued that young people will be an essential voice within post-2015 accountability processes at all levels.
"Young people's engagement is important now, while they are still 'young', but as the timeframe for the SDGs elapses, today's young people can develop into tomorrow's active and engaged adults who continue to work for the achievement of the goals, and pass on their valuable experience and knowledge to upcoming generations" (Walker et al. 2014, p. 24) .
We applaud the Netherlands' suggestion to include young people in drafting the declaration, as well as all other components of the SDG report.
Furthermore, we call on governments to remember that the success of the sustainable development agenda depends on the active engagement of today's children, adolescents, and young people, whom we will count on to drive it forward.
It's difficult to imagine writing a truly visionary post-2015 declaration without them.
Learn more about Plan's global child and youth participation work
Read Plan's post-2015 policy briefings
24 February 2015: I live in Moyamba district, in the Southern Province of Sierra Leone. A few weeks ago, as a young reporter for Plan Sierra Leone, I attended a Sierra Leone Association of Journalists training on the role of the media in Ebola prevention. I learned that 70% of people who contracted the virus got it through touching dead bodies. It is necessary for us to think about the practice of burials presently in the country and count the cost.
At the start of the outbreak, there were misleading messages in the media which contributed to the spread of Ebola. One of the most common messages was that Ebola is incurable. Also people thought the virus could only be spread through animals and not by body fluids.
The media should provide reliable information to ensure a better understanding of how to curb the disease at the community level. By sending out the correct messages about Ebola the media can promote behavioural change, and counter fear and misleading information.
Six critical messages
In the training, we learned about 6 critical messages, called in our local dialect, Leh Wi Dreb Ebola, or Act Against Ebola:
- Treat any death as if it could be Ebola.
- Call 117* and district call centres to report all deaths.
- The dead body should only be handled by people who are trained in safe medical burial practices and are wearing protective equipment.
- Protect yourself.
- Do not touch, wash, or clean the body.
- Do not touch the body fluids of a dead person or anything a person who has died from Ebola has touched.
Burial rites have to be changed
A few days ago a famous man in my community died. He was a teacher in one of the renowned schools in Moyamba district and even composed the school song in 1962. He was also a member of a big secret society in Sierra Leone.
Most people were thinking he would have been given a befitting burial, but because of Ebola the burial team was called. They did not wash the corpse nor did they allow any of his family members to go close to his body.
The burial team dressed the corpse but unfortunately he was placed in a black body bag and lowered in a coffin. The family was not happy about this because they think black symbolises evil.
Disinfectants were sprayed all over the rooms where the deceased and family lived. Neighbours were afraid to even go and sympathise with the bereaved family.
As part of the ceremony, the burial team called on a pastor to offer prayers to lay to rest the late man. Words of condolence were said at a distance from family members and some old boys solemnly sang the school song which the man composed so many years back.
Secret society laws
According to one member of the family, they are now worried they have broken the laws of the society the late man used to be in. Before the outbreak, when a member of a secret society died, only those that were part of that society could take part in the burial process or wash the body of the deceased. Nobody could say that person was dead until that was declared by the head of a secret society.
The family believed that after Ebola the laws of the secret society mean it would hunt them physically and spiritually. Families that took part in safe burials during Ebola need to be protected by laws so they are not penalised.
I spoke to young people in that same community and they said they were worried about the way the dead are treated. One of them said to me: “I will protect myself so that I would not be buried like this. Before now when we saw the corpse, we stood in adoration and honoured the dead.”
The young people say they follow all necessary procedures to protect themselves from Ebola because they wouldn’t like to be buried this way. They consider it strange.
The message is working
It is important to encourage people to understand that at this moment, traditional ways of conducting burials cannot be helpful and if they continue to promote such practices they are putting their own lives at risk, and the entire community at risk of contracting the virus.
In communities where burial activities are mostly connected to religion, it is essential that we engage people by providing information, dialogue and create a platform for community groups to be trained to perform religious burial rites on the corpse in the presence of the bereaved family.
At the moment here in Sierra Leone we still have some people or communities that are still ignoring the messages of safe burials and not reporting dead bodies, but the majority are now actually reporting the dead.
As a result of the high level of illiteracy in our country, many people can easily misinterpret information, which has been the main source of fear and the spread.
The media is so powerful here and I’m sure the relentless efforts of sending out correct and consistent messages will ensure behavioural change and community awareness amongst the grassroots.
* Sierra Leone Ebola hotline
Sierra Leone's health workers are succeeding in the face of danger from disease and stigmatisation, blogs Fiona Carr after a visit to an Ebola community care centre.
19 February 2015: It’s 13 years since I was last in Sierra Leone. Then, the country was just recovering from the civil war, now they are fighting a different sort of war, this time with an invisible enemy: Ebola.
Over the past week we’ve travelled hundreds of miles visiting community care centres (CCCs) where people with suspected Ebola come to be assessed; a centre for children orphaned or abandoned as a result of Ebola and makeshift classrooms where volunteers are helping children continue their studies while the schools remain closed.
Plan International is at the forefront of much of this work. In the CCCs we are responsible for the logistics including procuring essential equipment, training the health workers how to put on their protective gear properly and providing the various workers with incentives to work there.
For the children we are providing psychosocial counselling as well as practical support like food, blankets and hygiene kits so they can keep clean – an essential weapon in the fight against this deadly disease. In the makeshift classrooms we are providing radios so the children can follow the lessons broadcast by the Ministry of Education.
Many of the children we have spoken to have lost family members to Ebola, some like Precious, 14, speak bravely and fluently about their loss, others like Timothy, 9, are shell shocked and can barely speak at all about the trauma they have suffered.
The first CCC we visit is in Gbaneh, Port Loko, which is about 3 hours drive north of Freetown. Port Loko is still a hot spot for Ebola and there are 5 CCCs here, 2 treatment centres and 1 interim care centre. All of the different centres are surrounded by high walls or fences and only a few people from the outside are allowed in and out.
In order to enter the CCC we must first have a safety briefing and we are instructed not to touch anyone or anything once we enter. Then we wash our hands, first in a chlorine solution, then with soap and water and finally with disinfectant. Next we join a line as one by one we each balance on one leg in turn as we carefully place the sole of first one boot and then the next into a large bowl of chlorine.
The final step is to have our temperatures taken and recorded in a book - mine is 35.8. Once this procedure is complete we are allowed through the gate where we are greeted with much curiosity by the teams working here. Last week they had 67 suspected Ebola cases - in the previous 48 hours they haven’t had any, so things are quiet. Everyone is keeping their fingers crossed that this state of affairs will continue.
Shunned and stigmatised
The first person to introduce themselves is Francis, Plan’s local community co-ordinator. Plan is a household name in Sierra Leone and this has been vital in helping to persuade people to come forward and be tested.
Francis’ job is to go into the local community and talk to people about the centre and how going there will help them. Francis introduces us to Sheba Gbereh III, the Paramount Chief for this area. Like Francis, his support for the CCC has been important in how the centre has been accepted rather than feared by the community.
Next we meet the nurses. They have all been working here since the centre opened late last year. They live, eat and sleep here and haven’t been home at all to see their own families. Most of them are worried about the sort of reception they will receive when they do eventually go home.
The stigma surrounding Ebola survivors or anyone associated them is high. One person I spoke to said: “People hail Ebola survivors as heroes for surviving and then they throw stones at them because they have survived…”
Can you imagine what it must be like for those survivors to have survived a living hell and then be shunned and stigmatised?
In Gbaneh CCC the nurses ‘home’ when they are off duty is a large tent in the corner of the compound. The tent is sparsely furnished with a plastic table, a few plastic chairs and mattresses piled high in a corner ready to be placed on the floor at night.
They are a close knit group and they pass the time instead chatting and talking about when they will be able to return home. I spoke to Nurse Kadiatu about her experience and her hopes for the future: “It’s been tough working here but we won’t go home until there is zero Ebola,” she said.
“I miss my daughter desperately but I need to be here to help. I hope that Ebola will soon be over so I can return home and hold my daughter in my arms, she is 7.”
Also working in the CCCs are the cleaners who make sure the facilities are all regularly cleaned and disinfected, and the sprayers who disinfect the workers.
To remind themselves there is another life outside the high fence, they have customised their little hut with chalked signs and messages showing their allegiance to football. Following the UK premier league is a national obsession here in Sierra Leone and judging by the number of messages citing the Red Devils and the Gunners, Manchester United and Arsenal seem to be the cleaners’ favourites.
It’s been a humbling experience talking to all of the workers in the CCC and seeing their dedication to each other, their communities and their country. As we leave and once again wash and disinfect our hands and boots and have our temperatures recorded (mine is now 35.7), I can’t help but wonder what the future holds for everyone once this invisible enemy is defeated.
Support Plan’s emergency Ebola response
The people in Ebola burial teams are risking their lives to fight the disease and deserve our applause – not to be pushed away, blogs Kamanda, one of Plan’s Global Youth Advisory Panel members.
4 February 2015: The burial team is one of the roles in the Ebola response with the greatest risk - but the teams have made an incredible impact in the fight against the disease.
The first time I saw an Ebola burial team was frightening and quite memorable. It was September when I was passing by our cemetery to pay a visit to a friend.
The cemetery was bushy and I was alone. As I approached the curve, I saw 3 of them all in plain white dress from top to bottom. My initial feeling was I had seen dead people, or even angels of death, so I had to walk away hard.
As I became more frightened I prudently pulled off my slippers and ran. At last I met some people who I told about my experience. They mockingly told me: “Man those were the burial team persons you have been hearing of; that is how they dress.”
I realised I had been running from living human beings who are risking their lives to save the lives of many.
Preventing the spread of Ebola
In my community, Port Loko in Sierra Leone, there are 2 categories of burial teams - either from the Sierra Leone Red Cross Society or the District Health Management Team. Both are responsible for responding to death alerts.
Burial team members are people aged 18 to 40, but few are female. Each team is made up of drivers, beneficiaries communicators, swabbers and safe and dignified burial volunteers. Their roles include taking a swab from the deceased’s mouth for an Ebola test, engaging with the deceased’s family members, and washing and burying all corpses, irrespective of the type of disease that killed the deceased.
Initially this was seen as a very risky job hence few people opted to do the job. The disease continued to spread as there were many corpses of people who died from Ebola and other diseases lying in the streets, and our people were unsafely burying on their own.
This contributed immensely towards the spread of the disease as surveys report that 70% of the spread of the disease is as a result of unsafe traditional burial practices.
Discriminated against and marginalised
Now, due to the current effort and increase in the unemployment rate, many are pledging their lives, volunteering for a risk allowance of Le500,000 (US$100) a week. However, these teams are still perceived as being most at risk of having the virus, hence the community people including their family members discriminate against and marginalise them.
A safe and dignified burial officer who leads a team of volunteers told me, “People no longer offer to sell goods to me in some places I used to buy them.”
I challenge anyone to say that doing this work is wrong. To me, the burial teams are the safest of all of us as they always execute their work prudently and follow due procedures.
These people wear double hand gloves and personal protective equipment on their bodies; they wash their hands with chlorine liquid and spray themselves with it, among other precautions, when carrying out their operations. Honestly, I have never heard of a burial team member who either got in contact with the virus or died of it.
A woman joins the burial team
A woman of 27 has been recruited by the Sierra Leone Red Cross to be a part of their burial team in my area.
The involvement of women has come late in this fight, following some strong concerns raised by women and other people in the communities regarding handling of female corpses. The women were not comfortable and happy about the ways men handle female corpses.
The female burial team member told me: “I take it as a challenge to save the lives of my people.” She also said that “being a part of the burial team means a lot to me particularly because 80% of the deaths are female and there was no one to ease the women’s corpses”.
She is the only woman recruited in the burial team so far. She told me “because I am a part of the burial team, my family members ignore me, my friends shun me and because of this it reached to a point I became discouraged. I later gained strength when some women started telling me they want to be part of the burial team.”
How to help the teams
I describe these people as saviours, heroes and heroines, who deserve applause and kudos for their fantastic work. There is no need for us to push them away from us. They are a part of us and besides they are risking their lives to save the lives of many Sierra Leoneans, Africa and the world at large.
There is a need to provide the burial teams with good, safe accommodation and motivational packages, as they are being shunned by their family members and in their respective communities. Some even fear to go back to their communities and live with their families.
Some sort of compensation for them after the outbreak could also be a great boost, recognising that they are a part of the few who risked their lives in this terrible era to save the lives of many.
Support Plan’s emergency Ebola response
Learn more about Kamanda and his role on Plan’s Global Youth Advisory Panel
3 February 2015: Over the past 10 years, many disasters have occurred in West Africa. For most, responses took place and issues were resolved.
However, a big disaster is still happening and with unimaginable consequences among a vulnerable population: our daughters.
Female Genital Mutilation (FGM) is a common practice in many countries in West Africa, including mine. It can have devastating consequences on victims, including life-long psychological and physical trauma.
Numbers are still high, despite the heartbreaking stories shared by girls and women who have undergone FGM.
A few weeks ago, I read an article about a girl who suffered FGM.
“I cannot explain the feeling of terror that runs through the mind of an excised girl when thinking of the upcoming wedding. On the day of their wedding, brides undergo another painful ‘surgery’ to reverse the infibulation to allow consummation of marriage,” she said.
“In most cases, intervention is done by a traditional practitioner without any anaesthesia or little care for hygiene. Sometimes it is performed on the floor in the bathroom. It is only after completing this procedure that an excised girl is considered ‘free’. She usually has her first sexual experience the same night.”
How far have we gone?
In 2014, the prevalenceof FGM in Mali was 85% for women aged 15 to 49 and 84% of girls from 0 to 14 . When you read other research reports, for instance, in Guinea-Bissau, 94.5% of girls and women have undergone FGM in the region of Gabu and 92.8% in Bafata region. In Sierra Leone the rate is of 88.6%.
As Chair of the Parliamentary Network Against Violence Against Women and Girls, I wonder: “How far have we gone?"
For me, figures should be disaggregated to allow a better reading of the current situation. It would be critical to see which girls and generations are the most affected.
If in a given figure less than a quarter represents girls aged between 5-12, it would probably mean that efforts are ongoing and huge change has been made over the last 15 years. These efforts must continue until we approach zero cases.
Yet, much of this is about overcoming traditional beliefs. It might seem a big challenge, but it is possible.
Projects are often implemented and they run from 3 to 5 years, which does not give much time to see results. Figures are quantitative, so what about the quality, the change of minds?
Reaching across generations
Only the transfer of awareness from one generation to another will allow the practice to be questioned and eventually stopped.
Many issues have been raised such as health, but communities have turned to more hygienic methods.
People try to avoid social stigma, and that is where suggestions must be made.
A mother will prefer to have her daughter undergo FGM in a safe, sterile environment so she will find a husband, to ensure she is successful in business and to stop her from being a laughingstock in the community.
The challenge here is to understand and take into account the way communities who practice FGM works, thinks and interacts. A methodology that ensures the whole community is responsive to our messages is the winning one.
Again, laws are not enough, as it is more to do with communities themselves.
A new approach
The approach used by our partners for development, such as child rights organisation Plan International, seems to be working.
The ‘child to child’ and ‘child to parent’ approach allows girls to raise awareness and promote their rights among themselves and with their parents, using methods that are creative and do not offend people’s sensitivities, such as acting, drawing, poetry, songs.
It has helped many girls express themselves in public and share their experiences without fear and embarrassment.
It is important that communities are involved from the start to avoid creating new stigmatised groups among them, while children, women, traditional practitioners, traditional and religious leaders, health workers, authorities, teachers, local organisations, non-governmental organisations and policy makers should take part in the fight against FGM.
Patience and real commitment is essential if we are to significantly reduce FGM cases. The road is still long, but there must be a willingness to change and it must begin now. Helping our girls to escape FGM must be a priority.
Therefore, I call on all stakeholders and partners to continue to raise awareness throughout communities.
We need to ensure the views of communities are heard too and we can only get them to listen to us and, in turn, change their behaviour if we understand their logic. For that, we need tact, time and patience.
Of course, young people have their part to play in the fight against FGM too and we must empower them to come up with their own suggestions and ideas. Our role is to support them, so we ensure a positive change is made for our girls.
International Day of Zero Tolerance to Female Genital Mutilation** is marked on 6 February each year.
Learn more about Plan’s work to stop female genital mutilation
* Facts from WHO
**Plan is not responsible for the content on external websites
How can aid agencies be more accountable to people? Alex Jacobs, Director of Programme Quality at Plan International, shares lessons from Typhoon Haiyan.
27 January 2014: At a recent event to launch a special edition of Humanitarian Exchange Magazine on the Typhoon Haiyan response in the Philippines, we discussed how aid agencies can be more accountable to the people they serve. The concept of Accountability to Affected People, or AAP, as it is known in the jargon, means, in general, enabling them to influence what we do.
Everyone agrees it is a good idea. Or even a foundation of good practice. In theory, it ensures that the assistance we provide is relevant and respectful to the people we serve.
In the Haiyan response, there’s plenty of evidence that we’re getting better at it. And also that there’s a way further to go. (See also the CDAC Network’s material on Community Feedback Forms, which is practical, powerful and deserves replication.)
Tools for accountability
The organisation I work for, Plan International, along with World Vision and the International Organisation for Migration are collaborating on a project to trial common tools for accountability*, funded by the UK’s Department for International Development. It’s a very encouraging area, that’s already been picked up by the UN in Iraq*. They are developing a single call centre for people to find out about humanitarian services and lodge complaints.
As ever, it’s more complicated in practice than we hoped. Different agencies are already using their own tools. We are supporting local media and government-citizen accountability, rather than setting up separate systems. See this recent field report* for more. Look out for a full report in May/June.
As a sector, we’ve been trying to reform practice for years (e.g. the HAP standard, the Sphere Core Standards, even the 1993 Red Cross Code of Conduct). But progress has often been trumped by other pressures, including overstretched teams struggling to design and run projects fast in chaotic situations.
The new Core Humanitarian Standard, launched last month, provides a chance for a new approach. We need a simple agenda that addresses the core issues that shape field work.
The 5 point plan
How about this initial 5 point plan to improve accountability to affected people?
1. Invest in leadership at all levels
Without consistent leadership, accountability will be washed away by other priorities. The UN Office for the Coordination of Humanitarian Affairs’ AAP Coordinators have a crucial role to play, across the whole of any response. Within agencies, leaders need to be identified in head office and field offices with specific responsibility to ensure that accountability gets the attention it requires. And they need to be backed up by resources.
2. Simplify the requirements (and the jargon)
We need to simplify the requirements for transparency and community engagement, and build them into our core practice. This means cutting through the confusing jargon of: Accountability to Affected People, Communicating with Communities, Preventing Sexual Exploitation and Abuse etc. Can we settle on simple, intuitive terms instead? We need staff to focus on talking to local people in ways that work from their point of view, and include marginalised groups, rather than off-the-shelf tools. And we urgently need the international organisations that lead these different areas to work together on a simple, consistent approach.
3. Use collective approaches where possible
The more that different agencies use the same terms and tools, the cheaper and easier for everyone. And the easier for communities and government to understand us and talk to us. The Core Humanitarian Standard provides a common foundation. It may not be perfect, but it’s pretty good and that’s good enough. We should use it. We should collaborate on collective tools like feedback mechanisms, communication campaigns and assessment tools where possible.
4. Adapt project plans
Agencies need to be able to adapt their work in response to what local people tell them. Can we agree with donors (and internally) that we will review and re-plan the activities of all major projects 3 months after work starts (particularly in the first year of a major response); and then also at least annually? More flexibility would be better, but inevitably hard to organise on the ground.
5. Report beneficiary satisfaction
Donors and senior managers should require field teams to systematically report beneficiaries’ satisfaction with their work. This could be done however it makes sense in the context. It has the potential to generate real insights into the work carried out and reinforce a focus on listening and responding to local people.
This agenda is work in progress. I hope it can develop into a contribution to the World Humanitarian Summit in May 2016.
For more on Alex Jacob’s thoughts, visit his blog: ngoperformance.org
* Plan is not responsbile for the content on external websites.
26 January 2015: I am a member of the National Children and Youth Advisory Board of Liberia, a group sponsored by Plan Liberia and Defence for Children International-Liberia. We are providing psychosocial support to 100 Ebola-affected families in Monrovia.
Psychosocial support is an approach that helps victims of Ebola to cope with stress and fosters resilience in communities and individuals affected. We offer emotional and social support to children and families so they can live with hope and dignity, and recover from the impacts of the disease.
A team of 7 members (3 children and 4 youth) from our group has been selected to carry out the psychosocial support activities. We have been given training on providing psychosocial support to children in crisis and now we give counselling and distribute food and other items to families in need. This is being seen as a vital task for the young people.
Orphaned children in need of help
One day while in a community in Brewerville, we got to the home of 5 children – Amin, Cecelia, Martha, Sarah and Joel – who had lost both parents to the Ebola virus. Their eldest brother contracted the virus while taking care of their parents and also died. They were being looked after by Amin, who is just 16 years old.
The news of the death of the children’s parents was hidden from them, even members of their community were afraid to break the news. All they kept telling the children was that their parents were responding to treatment and would come home soon.
We visited their home to get to know them and had some interesting conversations about their lives. The smallest child was so happy that he didn’t even want us to leave. In fact, they told us that since their 21 day quarantine, we were the first people to visit them and share fun with them.
Breaking bad news
After the first visit, we built a very strong relationship with the children and they began to trust and confide in us. They told us not a single person from their family had called to check on them. They also told us that they fed themselves from the proceeds generated from the cold water they sold, while they hoped for the return of their parents.
It was not an easy thing breaking the news of their parents’ death to them. We gradually did it by drilling the children by asking some rhetorical questions like: what will you do if this happened? And in the end, we told them the truth. They cried a little but also took courage from their own answers to our previous questions. That helped them recover.
Afterwards, we documented their case and brought them supplies. They were highly grateful for our intervention, saying it was timely and needed. We also forwarded their names to the Ministry of Health and Social Welfare for additional support.
Currently, the children are in a government childcare centre. All efforts are being made to trace family members of the children for possible family reunification.
Youth are proud to be part of the fight
Ebola has caused untold suffering for Liberian children, damaging the already weak child welfare systems. Most Ebola victims began to lose hope due to stigmatisation and rejection by family members and communities. We see psychosocial support services to child survivors as one of the best interventions for restoration and recovery.
Each member of our team shows real passion, commitment and enthusiasm for what we are doing and it makes us feel a part of the fight against Ebola.
Sometimes it gets tough, risky and challenging. At times some of us get tempted to shake hands or touch the people we are supporting out of sympathy or empathy but again we get reminded by another team member of the preventive measures. That has been one of our greatest strengths.
Keeping safe from Ebola
We have also been very careful in carrying out our work. We were all given hand sanitisers and disinfectants to help protect us from contracting the virus, and moreover, we have ensured a proper covering of our bodies before going into the community, which is another safety measure we put in place to avoid contracting the virus.
If this killer virus is to be stopped, there is a need for more people to engage in the work we are doing. To defeat Ebola, we must start by accepting its survivors as our heroes and heroines. We must support and protect them.
Our government and her partners should see reasons to support such initiatives. There’s a need for more funding to be directed to psychosocial support and the establishment of a special task force to respond to the psychosocial needs of Ebola victims and survivors.
Please support Plan's life-saving work – donate to the Ebola appeal
21 January 2015: I have just returned from Liberia and Sierra Leone after spending a week there. To my surprise, I found that most aspects of life in the two countries worst-affected by Ebola continue as normal.
This is somewhat contrary to the impression one gets from the outside. People are going about their lives in most respects as usual and the streets are bustling.
Obviously there are some changes, such as the check points for health and hand-washing outside most buildings and on major roads, lots of posters about Ebola on the streets, the Ebola care and treatment units that have sprung-up, and the almost deserted airports.
This is a unique emergency, the likes of which has not been experienced anywhere in the world in recent times - a major outbreak of a highly dangerous and contagious disease such as Ebola in countries with particularly weak infrastructure and health systems. The situation has required a highly complex and sophisticated response. Just the setting-up and daily management of Ebola treatment centres alone is complicated and requires high levels of expertise, not to mention everything else, including border controls, managing the air corridors, front-line tracing of potential infected, dead-body disposal, community outreach, awareness raising, and community relations, logistics/supply chain, recruitment of personnel, dealing with high levels of stigma and fear both within and outside affected countries.
Front-line responders are real heroes, in particular the health workers, contact tracers and burial teams. During our brief visit, the most moving part was to the Plan supported community care centre in Foredugu, Port Loko, in Sierra Leone. There, we met the nurses and staff hired by the government, some of whom had been working non-stop for four months in a highly risky environment, and in regular contact with infected people.
The head nurse told us how she had managed the centre every day for four months and how she had been unable to see her own children and family during this entire time because of her family’s fear about her work with Ebola. We were also introduced to two small boys, and their mother, who were survivors of Ebola and who had lost their father and brotherand the head nurse talked about how the nurses had taken the surviving family members in and loved them.
We also heard stories of contact tracers who had to search for potential infected and then deal with highly emotional and resistant communities and families to get them to go to community care centres for diagnosis and treatment. And, we met a doctor in Liberia who told us of how he had led the initial response in his county with minimal outside help and who had seen many of his colleagues become infected and die.
New cases declining
The commitment and work done by front-line staff, most of whom are local and have minimal support, as well as those coming in from outside, and in the midst of such danger, is simply incredible and hopefully will be recognised by the governments and agencies involved.
The combined response is working. The number of new cases is now declining in all three countries: Guinea, Liberia and Sierra Leone. It would appear that this is due to the combined work of all agencies involved, and all interventions, including the community care and treatment facilities, tracing of cases, body disposal, hygiene measures and community awareness raising.
For example, we visited a Plan supported community hygiene training session in Bomi, Liberia, and it was clear that it was well run, effective and community members highly engaged. Agencies are working very well together overall and an example is the effective collaboration between Plan and Partners in Health at the treatment centre in Port Loko, in Sierra Leone. Here, Partners in Health does all the front line clinical work in the centre, while Plan provides management and logistics support, including providing supplies and meals to staff and patients every day. While the work is not yet done and everyone needs to remain vigilant until there are no more cases, the indications are that we could soon see an end to the outbreak in these countries.
Plan is playing a substantial role in the response. The organisation stayed in the affected countries and quickly established relevant roles and scaled-up and managed a significant response. Our existing presence and capacity in-country was a great advantage. We have raised $40 million, reassigned existing staff, hired many new staff, and we are directly impacting over 2.5 million peopledirectly. The response has been difficult, has stretched our capacities, and we have made mistakes, yet we have continued to address challenges and move forward. Our efforts have been recognised by governments, donors and peers as contributing significantly to the response.
Assuming the trend of declining cases continues, all agencies need to begin planning for early recovery and transition. We also should try to change the narrative of the media, some of whom have criticised emptying facilities as a waste of money.It was prudent of organisations to build centres based on responding to a potential worst case.The fact that collectively the response has prevented a worst case and the situation is now improving quickly should be seen as a success.
Five years after the devastating earthquake hit Haiti the landscape has changed - with more children in primary school than ever before, blogs Plan Haiti Country Director, John Chaloner.
9 January 2014: Five years ago, on 12 January 2010, a massive earthquake hit Haiti. An estimated 3.5 million people were affected, while 220,000 people are thought to have died. Everyone in Haiti on that dark day remembers where they were.
Just to test the nation further, starting in October 2010, Haiti was impacted by a cholera outbreak which has to date killed an estimated 8,562 people and infected about 700,000 others.
Haiti had not had cholera for over 100 years. It was ill-prepared to respond anyway, never mind during a period of earthquake response. Tropical storms Isaac and Sandy also hit the country, in August and October 2012 respectively, hampering the earthquake response, bringing more fatalities and leaving large parts of the country under water.
Five years later in Haiti, however, the landscape has changed. That is not to say that the then poorest country in the western hemisphere, even with a massive investment of donor cash, now looks like Dubai but, after over 3 years of relatively stable government, there is a difference.
Gone is most of the estimated 19 million cubic metres of rubble generated by the earthquake; over 1 million people – some 10% of the entire population of Haiti - made homeless by the earthquake have been rehoused after living in camps since the earthquake.
Roads, especially in the capital city of Port-au-Prince, have been repaired and many paved for the first time. Houses damaged by the earthquake have been rebuilt and small businesses have multiplied. Several international standard hotels have been constructed as have a couple of large supermarkets.
More children in school
The collapse of the education system, with about half the schools in the country being affected by the earthquake, has been reversed and today there are more children in school, at least at the primary school level, than ever before.
Of course the Haitian government, huge amounts of cash, donors, the alphabet soup of UN agencies and international non-governmental organisations, plus a cacophony of other aid groups et al, have contributed to the recovery to date but, as could always be argued in times of crisis, it is ordinary people who prove themselves extraordinary.
Youth emergency response
Haitian youth were the first group of people to respond to the aftermath of the earthquake. Organising themselves quickly they were digging people out of the rubble and searching for medical help almost immediately.
Haitian families, whose homes were intact, invited other families to shelter in their houses and courtyards providing mattresses, food and shelter. As women organised in their neighbourhoods to distribute any relief supplies they had to the needy, so men provided security for them. The roll call of local heroes is long.
Challenges of course remain. Haiti has suffered from appalling - and often brutal - governance for decades and many Haitians have voted with their feet leaving the country to seek better prospects elsewhere.
During the past 4 years some 80% of the staff in my office having babies have chosen to deliver them in the USA or Canada – not a comment per se on the Haitian health services but a move to guarantee their children an alternative nationality and better prospects in the future – just in case!
The country remains poor with a still fragile education system, poor and expensive health services and high unemployment. The government mantra is that ‘Haiti is open for business’ and indeed it is, but services are poor - especially electricity supplies - with some main and many feeder roads in poor condition which impacts negatively on a largely agricultural economy.
One gain from the earthquake, however, has been the end of the state run fixed telephone system and the introduction of mobile technology which is popular and widespread. The chattering classes are here in Haiti not just in the parlours of the western world!
The biggest challenge remains governance, however, and the need to build trust in the workings of government. In a world where faith in politicians is at an all-time low Haiti faces another uphill struggle. But Haiti survives and its people move on. When I go back home to the small village in the United Kingdom where my family live, I’m often approached by local people who, with pained looks on their faces, ask how things are in Haiti these days.
My stock reply now is that they should realise that Haiti is a Caribbean island and that many North American and European holidaymakers pay good money to spend a week or 2 viewing and learning about Haiti’s history, admiring the spectacular scenery and soaking up the sunshine on the beaches. All these attributes and a people who are used to dealing with adversity – there’s hope!
Read about Plan's response to the Haiti earthquake
Learn about Plan’s global emergencies work
2014 got off to an exciting start for Sierra Leone. There was a boom in the mining industry and even tourism seemed promising. The atmosphere was hopeful, and people were going about their daily business as normal.
Fast forward a few months, and absolutely everything had changed. Daily life in many communities was unrecognisable, with schools closed, whole districts under quarantine, and people afraid to leave their homes. Some airlines started to desert us, companies started closing down, and any hope we had of tourism vanished.
May 2014 - Some truths are impossible to face
In May, the World Health Organization reported the first cases and deaths of Ebola in Sierra Leone – 7 confirmed cases were reported in Kailahun district.
I called my Uncle from the eastern border town of Koindu. ‘“There is no such thing as Ebola,” he said convincingly. “What is it then?” I asked. “A plane carrying witches at night crashed and those on board perished. That’s why they are bleeding as they take their last breaths.”
To him, a witchcraft explanation was the most logical one.
When rebellion started from this same border town of Koindu in 1991, people in Freetown, the capital city, denied that a war existed. Once again, no-one wanted to face a terrible reality – Ebola. Maybe some truths are just impossible to face.
June 2014 - My relative must be treated as a suspect
I called my close relatives in Bo, located in the southern region, to inform them that no-one, not even relatives, should be allowed into the house. My aunt called me the following day and told me that her son had arrived. “He said nothing, he just came back with his luggage and occupied his room,” she told me.
“He should not be allowed into your home in case he has Ebola,” I told her sternly.
My aunt was silent, before saying loudly, “But he is my son”.
I told my aunt she must treat him as a suspect. “Don’t let anyone enter his room and watch him carefully. If he starts to show symptoms of the disease, call 117 immediately. Do you understand?”
She agreed. After hanging up, I was annoyed with myself for my lack of empathy. But you don’t kick out Ebola with weak feet.
Twenty one days later, the incubation period was over. I called my aunt for a final check.
“He is doing fine,” she said. “The only problem here is that the neighbour next door died yesterday of Ebola, and their home is now under quarantine.”
I felt as if the ground was collapsing beneath me. The neighbour’s house is just a stone’s throw away from her own. All the neighbour’s kids come at night to my aunt’s house to watch television.
October 2014 - Tackling Ebola
Even with the reality we were facing and the ambulance sirens blaring in our villages, we still had hope that no family member would contract the disease. More cases were still being confirmed, but me and my family were doing all we could – monitoring our temperatures and keeping our spirits high.
As part of the emergency response, Plan opened its first Community Care Unit in Sierra Leone. How brave the staff are to support communities in this way in the worst of times. I have visited some of the centres and saw first-hand the efforts of health care workers to keep patients alive.
December 2014 - Signs of hope
By the end of December, confirmed Ebola cases had skyrocketed to more than 7,000 in Sierra Leone. But our hopes of beating the diseases had grown even further with increases in safe burial teams, additional Ebola Community Care Units opened and more Plan staff on the ground.
Although cases are still increasing in Sierra Leone, we take hope from areas like Kailahun, where the outbreak first started in the country, which has reported no new cases for several weeks. But the battle is far from over.
2015 - Preparing for post-Ebola?
With schools closed for months, the impact of Ebola has taken its toll on my children. They are kept inside our gated compound and my 11-year-old son keeps complaining that he can’t go out and play with his friends. I understand, but I can’t give him that space while the dreaded disease is still a risk.
Responses to the many problems brought by Ebola vary a lot. But the opinion of one man I met during a community visit stood out for me. “The real way to address Ebola, which is now endemic here and is bound to be recurring sporadically even after the current outbreak, is to prioritise education,” he said. “That way, we can deal with Ebola from its roots and not from its branches”.