Sierra Leone reported the highest incidences of Ebola, with 14,122 cases and 3,956 fatalities (a 28 percent fatality rate), as of March 2016.1 Of the cumulative fatalities, 446 were children.
The following text has been excerpted from The Government of Sierra Leone- National Ebola Recovery Strategy for Sierra Leone (2015-2017)
The socio-economic impact of the disease has been devastating. To date more than 8,000 infection cases and more than 3,000 deaths have been recorded. Medical personnel are among the victims, with at least 295 health care workers infected and 221 dead, including 11 specialized physicians. This is especially worrying, as these personnel were already in short supply. The ratio of skilled health personnel to population size has been reduced from an already low level of 17.2 personnel per 10,000 people before the outbreak to the current record low of 3.4 per 10,000. The required minimum ratio is 25 per 10,000. Of the cumulative deaths, 446 are children: 222 girls and 220 boys. Orphans are estimated at 8,345: 4,182 girls and 4,163 boys. Widows are estimated at 954 and widowers at 465.7
Economic growth rates have slumped since the onset of Ebola, which followed very strong growth rates in 2012 and 2013, of 15.2 and 20.1 percent respectively. The gross domestic product (GDP) growth rate for 2014 is estimated at 7 percent, and 1 percent excluding iron ore, compared to the 11.3 percent projection at the beginning of the year. For 2015, the economy is projected to contract by 23.5 percent, and by 1 percent excluding iron ore.8
As outlined in the National Ebola Recovery Strategy for Sierra Leone (2015-2017), the country has six immediate priorities:
Eradication of the disease: Enhance disease surveillance and contact tracing; improve infection prevention and control; maintain safe and dignified burials; deepen community engagement by increasing awareness of disease prevention and recognizing the signs of Ebola; increase cross-border surveillance; sustain support for mental and psychological services; and improve operational public services.
Restoring health services: Objectives include a review of the national health system, strengthening of health care facilities, and ensuring compliance with infection protection and control standards; leveraging existing foreign medical teams to address immediate health staff shortages; recruiting and training health personnel; restoring the trust of communities; improving surveillance and health management information; ensuring the thorough disinfection of all facilities used as holding and treatment centers; and providing medical and economic support to Ebola survivors.
Increasing access to water and sanitation: Measures include the provision of emergency water, sanitation and hygiene (WASH) services to Ebola care centers; disinfection of affected communities and monitoring of WASH services; restoration of WASH service delivery in health units and schools; and promoting positive health and hygiene behavior through community engagement and ownership.
Getting children to school: Efforts are being made to decontaminate educational institutions used as holding and treatment centers; repair schools to basic operational level; promote better health habits and access to water and sanitation; train teachers in key areas related to Ebola prevention and response, including the identification of signs and symptoms, psychosocial support for survivors, and the use of infrared thermometers; provide early Ebola detection devices and isolation facilities; expand school feeding programs; provide incentives for pupils to return to school; and support the most vulnerable children, including girls and children with disabilities, as well as Ebola survivors.
Protection of the most vulnerable: Recovery assistance will be targeted at the most vulnerable and affected individuals—Ebola survivors, orphans, widows and widowers. Interim care centers and homes will be established. The reintegration of Ebola survivors and related health workers, including burial teams, into their communities will be facilitated, and livelihood support provided.
Implementing prudent macroeconomic policies: The government will provide support to the agricultural sector; rebrand the country and improve its image through destigmatization campaigns to restore tourism and attract private investment, as well as ensure the resumption of air and sea transport operations; provide support to the energy sector; resume public infrastructure programs, including road works; improve the implementation of revenue collection strategies; strengthen the implementation of financial service policies and maintain appropriate monetary and debt policies to stabilize the financial sector.9
Financial Requirements of the Government of Sierra Leone’s National Ebola Recovery Strategy (2015-2017)10
|Program Area||Recovery Cost (USD Millions)|
|Getting to and maintaining zero infections||$146.8||$49.4||$12.1||$208.3|
|Restoring basic access to healthcare||$140.1||$146.9||$87.0||$374.0|
|Getting children back to school||$95.7||$44.7||$17.8||$158.2|
|Social protection for women, children and other vulnerable groups||$68.7||$28.0||$18.6||$115.3|
|Water and sanitation||$67.6||$52.0||$32.0||$151.6|
|Boosting the private sector, including agricultural activities||$73.0||$42.1||$22.0||$137.1|
|Provision of energy services to support recovery efforts||$42.6||$41.7||$35.0||$119.3|
|Coordinating implementation, monitoring and evaluation||$10.4||$6.0||$3.0||$19.4|
The narrative above includes excerpts from the Government of Sierra Leone- National Ebola Recovery Strategy for Sierra Leone (2015-2017) . The data regarding donor pledges, commitments and disbursements was collected by the Office of the Security-General’s Special Adviser on Community-Based Medicine and Lessons from Haiti.