Emergency Plan of Action (EPoA) Ethiopia: Ebola Virus Disease Preparedness
Date of issue: 30 October,2014
Operation start date: 29 October, 2014
Expected timeframe: Three months (End 29 January, 2015)
Date of disaster: NA
DREF Operation Operation n° MDRET014; Glide n° EP-2014-000039-ETH
Operation manager: Jill Clements, IFRC Ethiopia Country Representative
Point of contact: Gashaw Dagne, Emergency Health Coordinator, Ethiopia Red Cross Society
Overall operation budget: CHF 46,641
Number of people affected [by the plan]: 3,431,260 persons
Number of people to be assisted: 80,600
Host National Society presence (n° of volunteers, staff, branches): 160 volunteers and 36 branch office staff.
Red Cross Red Crescent Movement partners actively involved in the operation: IFRC [International Federation of Red Cross And Red Crescent Societies]
Other partner organizations actively involved in the operation: Federal Ministry of Health, Médecins Sans Frontières, United Nations Children Fund, World Health Organisation and other partners
A. Situation analysis
Description of the disaster
A fast-spreading outbreak of the Ebola virus disease (EVD) is affecting several countries in West Africa. In February 2014, there was an outbreak of the virus in Guinea, which has since spread to Liberia, Nigeria, Senegal and Sierra Leone and causing untold suffering and hundreds of deaths in these countries. In the Democratic Republic of Congo (DRC), an outbreak of the EVD has also been reported. As of 8 October 2014, a total of 6,737 cases, and 3,061 deaths had been recorded, which were attributed to the EVD. In Guinea, 1,103 cases and 668 deaths have been registered, with the regions of Macenta, Gueckedou,N’Zerekore and Kissidougou most affected. In Senegal, 1 confirmed case has been reported, along with 73 confirmed contacts. It is the first time an outbreak of this size is being experienced in West Africa; and the number of cases is expected to increase exponentially.
The virus has continued to spread across borders in West Africa. To date, no treatment or vaccine is available for EVD, which kills between 25 and 90 per cent of victims, depending on the strain of the virus. The disease is transmitted by direct contact with blood, faeces or sweat, or by sexual contact or unprotected handling of contaminated corpses. Efforts to stop the ongoing spread and bring the epidemic to an end are gaining in commitment and capacity; however the risk for further spread, both within the affected countries and more widely is also a real possibility and needs to be planned for appropriately.
Ethiopia is categorized by WHO as “level 2” risk of transmission of the EVD through the importation of the virus by travel via Ethiopian Airlines, which has several flights to and from countries in high risk areas. In addition, there are a number of inter connected flights, which can possibly bring travelers from affected countries into the country. Incountry international airports such as Bahir Dar, Dire Dawa and Mekele and could be the routes of entry of the affected individuals. Land crossings and sea ports could also be possible routes of entry for the affected individuals as most of the borders are porous, specifically through Kenya, a country which is already designated as “a high risk”, and other routes through Dewele, Gambella, Metema, and Somali region borders.
Since the confirmation of the EVD in Guinea, the IFRC with National Societies have developed response strategy.
The strategy includes supporting the National Societies of the affected countries and countries with a physical border to the affected countries.
The main activities implemented by IFRC to support affected National Societies include:
* Strengthening National Society volunteer and coordination networks through logistics and training support;
* Clinical case management, support with isolation and life-support;
* Contribution to epidemiological investigation and epidemic control measures;
* Case finding, contact tracing, disinfection and dead body management;
* Information, education and communication to the population and reduction of stigma;
* Psychosocial support; coping with crisis, grief and loss.
Main activities the IFRC is supporting the National Societies with a physical border to the affected countries include:
* Preparedness for response through volunteer training in communication around epidemics and behavioral change;
* Supporting Ministries of Health in prevention activities and social mobilization;
* Pre-positioning personal protective equipment and related training (but not through this DREF operation budget).
* Adaption and dissemination of information, education and communication material linked with community social mobilization activities.
Summary of the current response
The Ethiopia Red Cross (ERCS) has many years of experience in providing humanitarian and disaster relief to the most vulnerable people affected by conflict and disasters. In the last decade ERCS has assisted more than 100,000 disaster-affected people each year through the provision of food and non-food emergency assistance mostly in drought, flood and conflict affected areas of the country. Most recently ERCS has supported national emergency rounds of polio vaccination, provided assistance to Ethiopian returnees from Saudi Arabia and implementing hygiene promotion and disease surveillance activities for South Sudan refugees.
ERCS has participated in the high level and sub-group technical task force led by the Federal Ministry of Ethiopia. ERCS is a member of the Task Forces for EVD preparedness, which have been established by the Public Health Emergency Management Institute (PHEMI), part of the Federal Ministry of Health (FMoH), at National, Federal and Regional levels; as well as a Social Mobilization Taskforce.
ERCS has contributed to the National EVD preparedness Plan of Action (PoA), which has been developed by the PHEMI/FMoH, specifically focusing on social mobilization activities with the “Local Edir and Women association” in the Addis Ababa Administration and border regions. ERCS has knowledge and experience of social mobilization through its existing volunteers, which are involved in on-going interventions across the country. ERCS is also participating on the preparation and production of EVD related Information, Education and Communication (IEC) materials.
Overview of Red Cross Red Crescent Movement in country
The IFRC country representation office is working closely with ERCS to support their response to emergences happening in country including the EVD preparedness. The IFRC country representation is playing a lead role in coordination efforts including collaboration and information sharing with international agencies and organizations in-country, as well as part of the UN Humanitarian Coordination Group. In September 2014, the IFRC East Africa regional office provided training for three members of staff from Ethiopia (One from PHEM/FMoH) as part of an EVD preparedness workshop with other participants from the horn of Africa National Societies.
Overview of non-RCRC actors in country
Following the EVD outbreak in West Africa, the Ethiopian authorities has taken precautions to prevent the virus from entering the country. The PHEM / FMOH have carried out activities including the training more than 200 health workers on EPD preparedness (the risk factors, symptoms, and key steps to preventing transmission of the virus); as put in place disease surveillance systems, established an isolation unit and pre-positioned Personal Protective Equipment (PPE) for use by its frontline staff in high risk situations. Further EVD preparedness training is planned to the Journalists at the federal level and various regions in addition to staff from various development sector offices.
As noted, the FMoH has a developed National EVD preparedness PoA, in collaboration with stakeholders including with stakeholders such as ERCS, Médecins Sans Frontières (MSF), the United Nations Children’s Fund (UNICEF) and World Health Organization (WHO), which have all been allocated into sub-groups based on their area of expertise, for example, ERCS are working closely with the social mobilization sub-group. The PHEMI/FMoH has established Taskforces for EVD preparedness. Under each Task force there are different Sub-committees (social mobilization, logistics).
Needs analysis, beneficiary selection, risk assessment and scenario planning
Needs assessment
Ethiopia has not experienced EVD in the past, and the population has limited knowledge of the virus, and social mobilization / awareness raising activities are required to address the population’s fears and misconceptions surrounding it, specifically related to transmission and behaviors required to avoid risk. The Taskforce has identified priority areas for the implementation of the EVD preparedness PoA as those that border neighboring countries including, Kenya, Somalia and Sudan.
Risk assessment
The ERCS in accordance with the country PoA has proposed a DREF operation, which will involve social mobilization activities in 10 of the most at risk sub-cities of Addis Ababa, as well as the border towns of Humera (Tigray Region) and Moyelle (Oromia Region). The DREF operation will use existing ERCS volunteers that are based in the target areas, and activities will be carried out in collaboration with “Local Ider” and Women association group following the previous experience of working with these organizations.
* Addis Ababa is the capital city of Ethiopia. It is the largest city in Ethiopia, with a population of 3,384,569 (Central Statistical Agency of Ethiopia 2007). As a chartered city (ras gez astedader), Addis Ababa has the status of both a city and a state. It is where the African Union and its predecessor the OAU are based. It also hosts the headquarters of the United Nations Economic Commission for Africa (UNECA) and numerous other continental and international organizations.
* Moyale is a market town on the border of Ethiopia and Kenya, which is split between the two countries. It has an estimated total population of 25,038 (Central Statistical Agency in 2005).
* Humera is a town and separate woreda in northern Ethiopia, near the borders of Sudan and Eritrea. Located in Mi’irabawi Zone of the Tigray Region. It has an estimated total population of 21,653 (Central Statistical Agency of Ethiopia 2007).
The DREF operation will target those members of the population that have been identified as being most vulnerable to EVD, specifically local health workers, traders, taxi drivers and the youth.
B. Operational strategy and plan
Overall objective
The overall objective of this DREF operation is to contribute the National EVD PoA where ERCS is contributing in the implementation of social mobilization activities and awareness raising activities.
Proposed strategy
Through the DREF operation, the ERCS is looking to support the activities that have been prioritised within the National PoA, as well as strengthen coordination with stakeholders. The activities will focus on:
Priority activities:
* Train up to 160 volunteers will be (over a 2 day period) on Epidemic Control for Volunteers (ECV) and Social Mobilization, specifically related to EVD (Addis Ababa (100), Humera (30) and Moyale (30). In Addis Ababa, four parallel trainings (25 volunteers per training) will be carried out; while in Humera and Moyale, two trainings (30 volunteers per training) will be carried out. The ERCS will use the staff members that received training on EVD preparedness (from the IFRC East Africa regional office – see above) to facilitate the training; in collaboration with respective regional level MoH staff who have received training on EVD from the FMoH. Following the training the 160 volunteers will cascade what they have learned through social mobilization and awareness raising activities, which will include 12 community sensitization sessions targeting leaders (of the Local Edir and Women Association), school teachers and religious leaders in the 10 sub cities of Addis Ababa, and the two border towns of Humera and Moyale. The 160 volunteers will disseminate EVD preparedness messages through social mobilization activities carried out in the most at risk communities in their respective areas, which it is estimated will reach 80,600 people. The trained leaders from the Local Edir & Women Association, school teachers and religious are also expected to disseminate EVD preparedness messages in their communities, for example, through community discussions. It is expected that about 84,000 people will be addressed indirectly by these community structures.
* IEC materials will jointly prepared in collaboration with Social Mobilization Taskforce members (ERCS, Médecins Sans Frontières, UNICEF and WHO). The IEC materials will be prepared centrally; translated into the language by each region, and then printed as required. The ERCS will distribute the IEC materials in the target areas (Addis Ababa, Humera and Moyale), which are expected to reach 80,600 people (16,000 households).
* The ERCS will participate in the established Task force and sub-committee meetings; as well as follow up and information sharing on EVD with branch offices and volunteers in order to ensure disease surveillance. Please note that this does not require any cost as there are existing volunteers in each respective area to carry out these activities; and the system has already been established.
Operational support services
Human resources
ERCS has planned to work with the existing staff and 160 volunteers in the implementation of DREF operation in the Addis Ababa, Humera and Moyale; in collaboration with MOH at each level. Each volunteer will be deployed to carry out social mobilization and awareness raising activities for a period of 15 days. A Regional Disaster Response Team (RDRT) member is not required to support the operation since the ERCS has existing expertise to carry out the training and social mobilization / awareness activities.
Logistics and supply chain
All items will be procured locally for the implementation of the DREF operation, this will include stationery for training, and the preparation/printing of IEC material, which will be carried out in collaboration with other members of the Social Mobilization Taskforce (please refer above). Please note that CHF 450 has been budgeted to cover vehicle costs, maintenance and mileage in each of the three locations (Addis Ababa, Humera and Moyale).
Information technologies (IT)
No information technology (computers etc.) costs will be incurred in the implementation of the DREF operation, with the exception of phone and mobile phone charges, which has been budgeted for under “Communications”
Communications
ERCS will ensure the that the activities carried out are promoted through local media and visibility material, which will be shared with the IFRC at regional and zone level to support communications with donors that have contributed to this DREF operation.. ERCS will provide regular updates on the operation.
Security
Ethiopia is at present a peaceful country and no security issues are expected to have implications for the implementation of the DREF operation.
Planning, monitoring, evaluation and reporting (PMER)
The ERCS branch offices (in Addis Ababa, Humera and Moyale) will report directly into the emergency preparedness and response department located at ERCS national headquarters (NHW). ERCS branch secretaries will be accountable for the successful implementation of the DREF operation. The ERCS volunteers will collect reports from those trained community leaders on the process and pass the report through the ERCS branch offices to the NHQ.
The ERCS emergency preparedness and response coordinator will compile the reports and send every two weeks to the IFRC country representation office, which will then be shared with IFRC East Africa regional office. The ERCS will ensure that all narrative reporting related to the DREF operation is submitted no later than 45 days after the end of activities. The ERCS will submit reports to the FMoH at the weekly Taskforce meetings; and a joint national monitoring plan of the National PoA developed by the members.
During the course of the operation, the ERCS has also budgeted for two missions to monitor the activities that are being carried out in Addis Ababa, Humera and Moyale. Each monitoring mission will be for seven days, and comprise two staff members from NHQ and a driver. An IFRC monitoring mission has also been budgeted. ERCS will carry out a lessons learned workshop will be carried out at the end of the operation, which will comprise 35 participants that were involved in the operation, with the results shared with the IFRC East Africa regional office.
Administration and Finance
The ERCS Administration and Finance Department support will facilitate the financial management, which is required for the implementation of the activities contained within the DREF operation. The ERCS will submit all financial reports to the IFRC country representation office within two months of the end of the operation.
[For detailed operational plan and budget, read this].
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