Liberia: Surviving Ebola with care and cash
The ongoing Ebola epidemic is the largest in history, affecting multiple countries in West Africa. Since the breakout in March 2014, over 15,000 people have contracted the illness and nearly 5,500 people have died. The most severely affected countries are Guinea, Sierra Leone and Liberia.
Nutrition Programme
With vaccines still in trial stages, front-line health workers and organisations are working towards enhancing survival rates through other means. As many Ebola patients suffer from vomiting and acute diarrhea, the rapid loss of fluids, nutrients and electrolytes weaken them. This is a key determinant for fatalities. In August 2014, the International Committee of the Red Cross (ICRC) and Médecins Sans Frontières (MSF) teams in Liberia began to address the importance of an appropriate diet to help fight the virus and build immunity.
ICRC nutritionist Lourdes Vazquez puts it simply: “Every patient was receiving the same diet, whilst you have many patients who have difficulties to swallow, you have patients who have sore throat, you have patients with very little appetite. So, based on the different conditions of the patients, each one would need a different diet. With all these assessments, you decide if the patient needs a solid diet, can eat a normal diet, or he needs a soft diet or a liquid diet".
With the help of field experience at MSF Treatment Unit in Monrovia and an online forum called Emergency Nutrition Network, ICRC and MSF began to draw guidelines. The online forum includes doctors and nutritionists in Liberia and abroad discussing the adequate nutritional needs for patients. Three specific diets to deal with different types of patients, including children, have been developed. The nutritional guidelines are shared with other organisations involved in the fight against Ebola.
Due to the lack of accurate data gathered before August, it is still a learning process. But from the limited field evidence and accounts, it is clear that the modified dietary plans and guidelines are enhancing survival rates. For those who previously refused any form of solid food due to bodily discomfort, a liquid/semi liquid diet enhances their chance of survival.
Mobile cash assistance
Post surviving Ebola, victims must then overcome the loss of assets, income and stigmatization. To avoid further contamination, many patients have had their belongings such as clothes and mattresses burnt as part of the disinfection process. Some have lost their source of livelihood. Others are expelled from their dwellings.
To address this issue, every patient who recovers at the MSF unit is on a list for cash grants. The ICRC makes a cash transfer via mobile phones in three installments of USD100, USD 60 and USD 40 over a period of three months in order to help survivors or families of the deceased cope with their loss.
Robert Ghosn, ICRC deputy head of delegation in Liberia: “We thought it would make much more sense to empower them, to give them the dignity to decide, make their own choices, decide if they want to allocate this money to food or to something different.”
Ceaineh Beyan,a market vendor, is 28 years old. She says: “I have three children. The father of my kids left me because he said I have Ebola. He just left me. I’m going to start business with this money to support my children, to eat, to wear clothes, slippers. I do not have clothes anymore, they burnt all my things.”
Amie Sulbah, a nurse who lost her job, says: “When I went back to the community, the same people I have been assisting rejected me. Even today, when I go to the market, I say I want this or that but they don’t want to take my money. They say I got Ebola.”
ICRC’s Robert Ghosn says: “We also hope and we trust that this will also help them start small businesses or restart small businesses that were hit very hard by the crisis and that would allow them long term economic security, or at least improve the economic security.”
The Liberia National Red Cross (LNRC) supports the survivors and families of deceased through a help line. Ambullai Perry, LNRC Director of disaster management: “We don’t want people to continue to be dependent on people for assistance. But we think we can help them. We want the beneficiaries to use the money wisely. Let them use the money wisely, it is very important. Because for now, we are doing this programme in Montserrado County. Let’s see what the future will bring.”
Shotlist
Location: Montserrado County, Monrovia (Liberia)
Length: 08:49
Format: HD & SV H264 MOV
Production: Sadia Bundgaard / Didier Revol
Camera: Victor Lacken
ICRC ref: AV249N
Date: 15 Nov 2014
Copyright: ICRC access all
00 00 Establishing shots of Médecins Sans frontières Emergency Treatment Unit for Ebola patients (2 shots)
00 09 Catering company staff offloading from trunk meals prepared for Ebola patients
00 17 ICRC nutritionist Lourdes Vazquez and MSF staff unwrapping bags containing meals
00 21 MSF female staff prepares liquid diet (2 shots)
00 44 MSF staff put on protecting gear before bringing meals to patients (5 shots)
01 13 MSF staff bringing meals and water into the high risk area (4 shots)
01 35 MSF staff distributing meals to patients (3 shots)
01 55 Patients eating
02 04 ICRC Lourdes Vazquez walking in compound and entering tent for medical staff
02 09 ICRC Lourdes Vazquez with MSF staff discussing nutritional guidelines (8 shots)
02 47 Lourdes Vazquez, ICRC nutritionist (English – 19”)
Every patient was receiving the same nutritional treatment, the same diet, whilst you have many patients who have many difficulties to swallow, you have patients who have sore throat, you have patients with very little appetite. So, based on the different conditions of the patients, each one would need a different diet.
03 06 Lourdes Vazquez, ICRC nutritionist (English – 10”)
With all these assessments, then you decide if the patient needs a solid diet, can eat a normal diet, or he needs a soft diet or a liquid diet.
03 16 Lourdes Vazquez, ICRC nutritionist (English – 8”)
If we don’t provide the best nutritional care we can, then it is more difficult for the person, let’s say, to fight against the disease.
03 24 Lourdes Vazquez, ICRC nutritionist (English – 19”)
So, when the patient is discharged, all of them they receive also a nutritional supplement for a one month period and at the same time, they are part of a list and then the ICRC is using this list to entitle these survivors to the cash transfer programme.
03 44 Robert Ghosn, ICRC deputy head of delegation in Liberia with beneficiaries of the cash transfer programme in front of the Lonestar store where they will retrieve the money (4 shots)
03 58 Robert Ghosn, ICRC deputy head of delegation in Liberia (English – 25”)
We thought it would make much more sense to empower them, to give them the dignity to decide, make their own choices, decide if they want to allocate this money to food or to something different. And we also hope and we trust that this will also help them start small businesses or restart small businesses that were hit very hard by the crisis and that would allow them long term economic security, or at least improve the economic security.
04 25 Foday Gallai, ambulance driver and beneficiary of the cash transfer programme enters the store, talks to a Lonestar employee and get his money from the cashier (7 shots)
05 17 Foday Gallai, ambulance driver and beneficiary of the cash transfer programme (Liberian English – 9”)
I am a survivor of Ebola. I contracted this virus when I went in rescue of a little child who has lost seven members of his family.
05 26 Foday Gallai, ambulance driver and beneficiary of the cash transfer programme (Liberian English – 8”)
I am going to buy some clothes because I destroyed some of my clothes. I need a lot of food, I need to build myself. And I want to go back on the ambulance to help my Liberian brothers and sisters.
05 34 Ceaineh Beyan, market vendor and beneficiary of the cash transfer programme in discussion with a Lonestar employee checking message received from ICRC - close shot on screen (3 shots)
05 52 Cashier counting banknotes and handing them to Ceaineh Beyan (2 shots)
06 05 Ceaineh Beyan, market vendor and beneficiary of the cash transfer programme (Liberian English – 9”)
I have three children. And the father of my kids left me because he said I have Ebola. He just left me.
06 14 Ceaineh Beyan, market vendor and beneficiary of the cash transfer programme (Liberian English – 11”)
Right now there is nobody to help me beside my mother. Nobody wants to see the ground I walk on. Even my children do not have friends. My little one that they used to play with, they are not playing with him anymore.
06 26 Ceaineh Beyan, market vendor and beneficiary of the cash transfer programme (Liberian English – 20”)
I’m going to start business with this money to support my children, to eat, to wear clothes, slippers. I do not have clothes anymore, they burned all my things. Since I left the treatment centre, I haven’t been able to buy clothes for my children. They just have torn clothes.
06 46 ICRC Robert Ghosn with beneficiaries counting banknotes (2 shots)
06 55 Amie Sulbah, nurse and beneficiary of the cash transfer programme counting banknotes
07 00 Amie Sulbah with other beneficiaries counting banknotes (4 shots)
07 23 Amie Sulbah, nurse and beneficiary of the cash transfer programme (Liberian English – 18”)
When I went back to the community, the same people I have been assisting rejected me. Even today, when I go to the market, I say I want this or that but they don’t want to take my money. They say I got Ebola.
07 40 Amie Sulbah, nurse and beneficiary of the cash transfer programme (Liberian English – 11”)
So, it is not easy, even when I am walking in the street people are pointing fingers at me that I am an Ebola patient. Even my children, they are pointing fingers at them. The stigma is not easy.
07 51 Amie Sulbah outside Lonestar shop with ICRC Robert Ghosn and Liberia Red Cross Ambullai Perry, Director Disaster Management (6 shots)
08 19 Ambullai Perry, Director Disaster Management, Liberia National Red Cross Society (Liberian English – 13”)
We have a mechanism in place for a regular follow-up and monitoring where they are on a daily and monthly basis, to ensure that the money we are giving them, they use it wisely.
08 32 Ambullai Perry, Director Disaster Management, Liberia National Red Cross Society (Liberian English – 17”)
We don’t want people to continue to be dependent on people for assistance. But we think we can help them. We want the beneficiaries to use the money wisely. Let them use the money wisely, it’s very important. Because for now, we are doing this programme in Montserrado County. Let’s see what the future will bring.
08 49 ENDS
