Community health workers respond to Ebola outbreak in Sierra Leone

11 August 2014
Author: UNFPA
UNFPA Regional Family Planning Coordinator Brima Kamara conducts a training for community contact tracers. Photo credit: Crispin Cole

FREETOWN, Sierra Leone - In May, Sierra Leone detected its first-ever case of Ebola, the deadly and contagious haemorrhagic disease. By the end of July, the country had surpassed neighbouring Guinea, where the break was first reported, in number of positive cases.

The outbreak has spread rapidly through four West African countries - Guinea, Liberia, Nigeria and Sierra Leone - sickening at least 1,779 people and killing 961, according to 6 August estimates from the World Health Organization (WHO).

The fatality rate of Ebola can reach up to 90 per cent , though it has been lower in this outbreak. In Sierra Leone, there have been 631 confirmed cases, with 38 probable cases and 48 additional cases suspected. Some 298 people have died.

"Sierra Leone is like a ship on a stormy wave, said Brima Kamara, UNFPA’s regional family planning coordinator.

UNFPA Regional Family Planning Coordinator Brima Kamara conducts a training for community contact tracers.  Photo credit: Crispin Cole

The outbreak has prompted President Ernest Bai Koroma to declare a state of emergency in the country. Ebola is not the only concern - people are reportedly rejecting medical attention out of fear.

“The people are being threatened by two factors,” Mr. Kamara said, “the disease and the fear factor."

Contact tracing

To contain the disease, the Government, with support from UNFPA and other partners, has been implementing responses at the community level.

UNFPA and the Government have initiated ‘contact tracing’– a method of tracking contacts, or people linked to confirmed or probable Ebola cases – in Kailahun District. Kailahun is the epicentre of the country’s outbreak and the most affect district.
By tracing contacts and monitoring their health, public health officials can track the movement of the outbreak. This also helps ensure early detection of infections and immediate treatment, and will hopefully stem the spread of the virus.
The model has been adopted and is being used in other districts by UNFPA and the Government.

Door to door

UNFPA, along with WHO and the Ministry of Health and Sanitation, have trained 300 health workers to serve as contact tracers.

The tracers go door-to-door to learn about people who might be affected, then follow up with each possible contact. Those exhibiting symptoms of Ebola, which include fever, diarrhoea and vomiting, are closely monitored.

The health workers are also trained to protect themselves from the virus.

The collected data is sent to the District Surveillance Officer and the Government-managed District Ebola Task Force.

The contact tracers are equipped with mobile phones provided through a partnership between UNFPA and the phone companies Africell and Airtel. Each company donated 150 phones that enable health workers to capture and store information in a database. The information is then relayed to the health ministry.

The mobile phone company Skytel also provided 30 mobile phones for contact tracing and surveillance.

Identifying infections

Cases that show signs of Ebola are brought by ambulance teams to a centre where blood samples are collected for laboratory confirmation. Lab-confirmed cases are referred to case management centres in Kailahun and Kenema.

Deaths linked to Ebola are transported for safe burial within 24 hours.

Between 1 and 21 July, 2,458 contacts were listed as possible Ebola cases. Of these, 13 per cent were screened and eliminated as potential infections. The remaining 2,133 contacts were monitored. Of these 3.5 per cent showed symptoms of Ebola.

- Crispin Cole

Sierra Leone
Population : 8 mil
Fertility rate
Maternal Mortality Ratio
Contraceptives prevalence rate
Population aged 10-24
Youth secondary school enrollment
Boys 43%
Girls 41%

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