During the 2014-2016 devastating Ebola virus disease (EVD) outbreak in West Africa, I worked as the Country Director for Plan International in Freetown, Sierra Leone and was humbled to be part of a coalition of state and non-state actors who participated in the response throughout its peak period until it declined. As we wake up to rising cases of Covid-19, I provide 5 key lessons from EVD in Sierra Leone. I hope this will guide the preparedness and response of the government of Ghana as it provides leadership to manage this outbreak which has now assumed a global pandemic.
Leadership & Conceptual Clarity
Covid-19 will require leadership and conceptual clarity to manage the response, underpinned by an integrated approach given the multi-disciplinary and inter-sectoral nature of the implications of the disease on all facets of life. Covid-19 is not a health sector problem only. The outbreak should be seen as an opportunity to improve inter-sectoral engagement at the design and implementation of the response in the areas of education, psycho-social support, livelihoods, water and sanitation, economy, finance, security, etc Leadership will also ensure strict internal controls are in place to minimize the risk of fraud and corruption in the delivery of essential services to ensure accountability in the use of funds allocated for the government’s preparedness and response programme.
Based on lessons learned from EVD, this article has argued that five key enablers are critical namely conceptual clarity, focus on key human resources, social mobilization and community engagement and strengthening surveillance systems and knowledge management to guide the preparedness and response.
Human Resources Management–Focus on Health Personnel
During such health crises, health workers are always at the frontline with heightened exposure to becoming infected. Adequate protective clothing and equipment need to be provided reinforced by infection control and prevention(IPC) training programs for all health personnel. In Sierra Leone, a well-defined hazard pay/incentive scheme was put in place for health personnel who became motivated to deliver timely life-saving services during very dangerous times. The government must engage leaders of health workers union to ensure alignment of intent to facilitate timely quality health care delivery services.
Social Mobilization & Community Engagement
In my published article entitled “the role of secret societies in defeating Ebola”, I shared the powerful role that faith-based leaders played in social mobilization and community engagement to sensitize the communities to change certain culturally and religiously entrenched behaviors and practices. This significantly enhanced the response to defeat the outbreak. As we fight Covid-19, a piece of key advice is to invest in social mobilization and community engagement with faith-based leaders, community leaders, youth groups, etc so they lead the process to educate communities to take preventive measures.
Strengthen Surveillance Systems & Isolation Protocols
Strengthening surveillance systems and contact tracing is an enabler for disrupting the flow of infections. Identifying the index case, primary as well as secondary contacts is very crucial hence the need to invest resources to strengthen surveillance and contact tracing. This must be reinforced with early warning signals. In the unlikely event that force has to be applied by state actors to enforce isolation measures, there is a need to establish a balance between compliance and community acceptance. There is a requirement to consistently explain why isolation actions need to be established through positively reinforcing communication.
Poor attention to knowledge management is always a weakness that prevents institutions from learning from their experience when they implement programmes or interventions. Investing in knowledge management must be prioritized by the government of Ghana in order to document and capture lessons learned during the current Covid-19 response so it guides future preparedness and response interventions. Given that knowledge management is both an art and a science, capturing lessons, anecdotes from key actors and documenting processes and outcomes ie what worked and what did not work, etc, will go a long way to inform/guide future policy and models to manage crises situations.
In sum, Covid-19 is here with us – we need to support the government as it provides leadership to reduce and stop further infections. Based on lessons learned from EVD, this article has argued that five key enablers are critical namely conceptual clarity, focus on key human resources, social mobilization and community engagement and strengthening surveillance systems and knowledge management to guide the preparedness and response.
Casely Ato Coleman is the Former Country Director at Plan International Sierra Leone, a Fellow at IMANI Africa, and a Visiting Professor of HR at the International School of Management, Senegal.
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