A Closer Look: The Ebola Outbreak
THE IMPACT ON WOMEN’S HEALTH AND FAMILY PLANNING
During 2014 and 2015, West Africa fought the largest, deadliest outbreak of Ebola in history. Over 11,000 people died, including more than 500 health workers.
In the three hardest-hit countries—Guinea, Liberia, and Sierra Leone—the impact on health systems was devastating. Reproductive health care ground to a halt as funds and resources were diverted to cope with the epidemic. Family planning services were suspended, clinics turned away patients, and hospitals shut their doors. The outbreak took a particularly severe toll on women. Because women are traditionally caregivers, they suffer higher rates of infection. For pregnant women, Ebola is virtually a death sentence: their mortality rate from the virus is 90%. The risk of sexual violence against women and girls is also heightened in such a crisis. Many FP2020 partners were at the front lines of the international Ebola response, and many are now deeply involved in the recovery. While the epidemic may be over, the damage to health care systems and family planning programs will take years, if not decades, to repair.
In Guinea, Liberia, and Sierra Leone, UNFPA provided emergency reproductive health kits to help local staff cope with the crisis: clean delivery kits for pregnant women, contraceptive supplies, basic medical kits, blood transfusion sets. Shipments of disinfectants, medical gloves, heavy-duty aprons, and handwashing equipment were dispatched to facilities throughout the region. UNFPA also distributed thousands of individual dignity kits, which contain personal items—soap, toothpaste, sanitary napkins, underwear—to help women and girls maintain basic hygiene. To compensate for the lack of skilled birth attendants, UNFPA mobilized retired midwives to deliver babies at community centers.
Marie Stopes is a key provider of family planning and maternal care in Sierra Leone, and the nurses and midwives have long been trusted figures throughout the country. But the Ebola outbreak created widespread fear of health workers and the contagion they were thought to carry. The Marie Stopes outreach teams worked hard to regain people’s confidence, even traveling to villages in unmarked vehicles so as not to create panic. Marie Stopes also supported the national response to Ebola by training health workers, setting up call centers, staffing command posts, managing Ebola care centers, and providing regular radio talks about the importance of family planning and the threat of Ebola.
“The communities that once welcomed us before the Ebola outbreak started to reject all health workers for fear that they would spread the virus. They drove us away from their villages. This happened in almost every village we visited.”
Marie Stopes Sierra Leone
“We knew that the disease disproportionately affected women. We could see that nurses, predominantly women, were among the greatest number of victims. Many of them were dying and leaving children unattended, or were becoming victims of stigma and discrimination.”
WRESL AND IPAS
Women’s Response to Ebola Sierra Leone (WRESL) is a civil society consortium of women’s groups who came together to tackle the Ebola epidemic. Keenly aware of the disease’s disproportionate impact on women, WRESL pitched in with community mobilization efforts, advised the Ministry of Health and Sanitation on gender issues, and launched a national handwashing campaign with the help of market women. To document the impact of Ebola on the ability of women and girls to access family planning and other reproductive health services, WRESL partnered with Ipas to conduct an assessment survey in the eight worst affected districts in Sierra Leone.
The International Planned Parenthood Federation (IPPF) and its member associations responded to the epidemic by integrating Ebola prevention into existing reproductive health services. The Planned Parenthood Association of Liberia launched awareness campaigns, provided personal hygiene kits, and leveraged its youth program to serve as a key platform for Ebola education. The Planned Parenthood Association of Sierra Leone established handwashing sites in all its offices and clinics, and distributed protective gear and sanitary commodities. In Guinea, the Association Guinéenne pour le Bien-être Familial organized an Ebola awareness and prevention campaign that included a workshop, outreach materials,and thousands of home visits.
EngenderHealth has worked in Guinea for decades to improve reproductive health, with a special focus on preventing maternal death and injury. In the face of Ebola’s deadly toll on pregnant women, EngenderHealth launched an urgent effort through village motherhood networks to raise awareness of the virus and teach prevention.
Learn more about women and children in humanitarian settings on familyplanning2020.org
“We learned from the Ebola crisis that health systems in Africa remain extremely fragile and highly vulnerable to health emergencies. The Ebola crisis not only wiped out individuals and families, it affected entire health systems, taking human, technical, and financial resources away from family planning and other health matters.”
Dr. Yetnayet Asfaw
In Sierra Leone, UK support funded over half of all Ebola beds, and provided funds for burial teams, training of frontline staff, labs and testing, PPE suits and vehicles. The UK is continuing to support reproductive health services in Sierra Leone alongside regional preparedness, so that countries are ready to quickly respond to cases of Ebola and other infectious diseases. The UK is also committed to supporting Sierra Leone’s 9-month Early Recovery and Transition Plan and 2-year Recovery Strategy for long-term sustainable recovery, which focuses on health, education, social protection, and economic recovery.
As the Ebola outbreak recedes, countries are working to reboot their family planning programs. With support from CHAI, the Liberian Ministry of Health and Social Welfare has begun holding Contraceptive Days at local health centers. Because of the long hiatus in routine family planning service delivery during the outbreak, community mobilization activities inform women when the Contraceptive Days will be held so they can schedule a trip to their local clinic at the right time.
USAID deployed a massive response to help West Africa battle Ebola, and is now equally committed to helping the region recover. Work is centered on restoring vital health services—including family planning, prenatal and maternal health care and nutrition, and programs to prevent and treat infectious diseases—and getting life back on track: children back in school, parents back at work, markets and businesses back up and running. Most importantly, USAID is helping Guinea, Liberia, and Sierra Leone rebuild their health systems and infrastructure to be stronger and more resilient—so that a tragedy like the Ebola disaster will never happen again.
Yasmin Jusu-Sheriff was originally quoted on www.eboladeeply.org. Mary Kaifineh was originally quoted on www.mariestopes.org.