Oxfam was already operating in the region, and urgently scaled up its emergency programmes in response to the outbreak. Building relationships with medical partners, assessing where we could add the most value and have the greatest impact, and taking advantage of our existing areas of expertise, we were able to help over 1.3 million people, in Liberia, Sierra Leone and Mali.
We carried out work in a number of key areas, playing a vital role in providing essential services to medical partners:
- Ensuring safe water supplies and sanitation systems to Ebola treatment centres, enabling the centres to provide the best possible facilities for Ebola sufferers. These centres were run and managed by Oxfam's medical partners.
- Supplying protective equipment and hygiene items to teams carrying out vital public health work and burying the dead, including gloves, masks, overalls, goggles, soap and chlorine.
- Training community health workers, community leaders and government workers to spread key messages around the prevention, identification and treatment of Ebola.
- Carrying out public health promotion over radio, billboards and text messages to help people protect themselves.
Oxfam found that women were the most marginalised and vulnerable, but were also responsible for health care for their families. As a result, we decided to focus on reaching out to women specifically to ensure they were empowered with the right information to take care of both themselves and their families, using media and communications that were tested with women before being rolled out on a wider scale. We also utilised existing social networks in communities and started training community health volunteers. These groups promoted awareness of the Ebola virus using picture books as a
starting point to explain Ebola transmission routes, and how people could take positive action to break the cycle of transmission. This led to more individuals spreading key messages within their own communities, taking the opportunity to become part of the solution.
Supporting government efforts was also vital, and Oxfam was able to build on long standing relationships to meet specific needs. For example, working alongside the Montserrado County Health Team in Liberia, we were able to quickly identify a shortage of chlorine supplies, and supply the department with sufficient amounts to chlorinate more than enough water to last the outbreak.
Beyond work in communities and health centres, Oxfam has also been providing water and sanitation facilities to schools, enabling classes to resume while protecting the health of students and staff. The facilities were supported by child-to-child training, which allowed children to take good health messages to their peers and parents. This was a special initiative that made children into agents for change - research showed that these facilities also had a positive impact on reducing water-borne diseases in the wider communities.
The immediate Ebola crisis is now over. But the effects across the region have been huge - not only have communities been torn apart, but economies, at a local and a national level, have been badly affected. (The World Bank estimates that Guinea, Liberia and Sierra Leone will lose at least US$2.2 billion (£1.6 billion) in economic growth in 2015 as a result of the epidemic.) Oxfam is looking toward how it can support economic recovery and the revitalisation of livelihoods. A study conducted in partnership with a number of organisations in Liberia revealed that the
majority of women in Liberia depend on self-employment, and that they suffered major economic losses. So we are looking to support rural communities in restarting traditional income generating activities (mostly through agriculture) while also exploring how communities can diversify their income streams.
We also plan to remain engaged in improving water, sanitation and hygiene (WASH) provision as a prevention and control measure against the spread of future epidemics. Having largely focused during the crisis on supporting water and sanitation in health facilities and schools, there is a significant need for addressing requirements in the wider community. Throughout the response and the early recovery period, Oxfam noted that almost all community members were using infrastructure installed at health facilities and schools - putting them under greater strain than they were
designed for. This will very quickly shorten the lifespan of hand pumps, latrines, and hand washing structures, leaving health facilities and schools in a weakened state. Oxfam is planning to build on its successes from the Ebola response by continuing to improve and install WASH facilities in schools and couple this work with WASH installations in communities. Conducting these together will not only meet immediate needs but also serve as a way of further supporting the sustainability of facilities in schools and health facilities, which were already very weak prior to the Ebola
To ensure the right environment for these plans to be worked out, Oxfam is developing an advocacy strategy that will bridge the work done during the crisis to ongoing advocacy at a national and regional level. The leaders of Sierra Leone, Liberia and Guinea have stressed the importance of having a 'home-grown' recovery plan, focused on health, education, water and sanitation, which Oxfam will be fully supporting. We are also looking at the specific gender dynamics that exist post-Ebola, to ensure that women are empowered through locally acceptable means, their specific
protection needs are integrated into all Oxfam programmes, and that they are able to participate on an equal footing.