In May 2014, the Ebola virus made its way across the border from Guinea to the East of Sierra Leone – the first ever recorded cases of the killer disease in Sierra Leone – and by July it had reached the capital city, Freetown. By early-November, cases had been recorded in all 14 Districts of the country and over 500 new cases were being recorded every week. The virus spread quickly, taking advantage of the weak healthcare system, lack of preparedness by government and international partners and lack of precedent for an outbreak of this scale. As the numbers rose, the need for national-level coordination and district-level control became more urgent.
Although the Ebola outbreak has since been widely reported, at the time, no one grasped the scale of the challenge. AGI had never worked in a humanitarian emergency before, but by the time Ebola reached Freetown we knew the situation had dire consequences not just for the people affected by the disease, but for the whole economy and stability of the nation.
The only way to achieve greater control was to have information on the outbreak, exactly where it was being transmitted, who needed to be isolated and where facilities and assets were. AGI got to work helping the Government of Sierra Leone and international partners to build systems to collect and analyse information and build decision-making and operational structures to respond to the information. We worked with the Government to establish a national hotline for the Ebola response to log and send out all Ebola alerts about potential cases and deaths to the relevant District authorities; the first command and control centre for Ebola in Freetown to run the daily operations of the response in the District; and the National Situation Room to collect, analyse, interpret and present data to the leadership for more informed decision making. We kept the President informed about the realities on the ground so he could keep his Government focused on the most pressing issues of the day.
These interventions resulted in all deaths in Freetown and surrounds being managed safely within 24 hrs of being reported, an important statistic when every minute a body waits for collection it increases the risk of infecting other people. We helped produce some 190 briefings which have been presented to the national Ebola response leadership to support and target national interventions. We helped train 198 operators at the 117 Ebola hotline call centre and set up a team which has made tens of thousands of call-backs to callers to ensure they had received the response required for the sick or deceased in their home or community.
Importantly, AGI was there, every day, working alongside counterparts in Government to lead the emergency response in their country. Our embedded advisors and relationships with the senior leadership in government allowed us to roll up our sleeves and get involved early on, set up the systems and structures required, but crucially, support Sierra Leoneans to stand up and lead their own response.