EVD Training Guide- AAC3

WEST AFRICAN TRAINING FOR EBOLA PREPAREDNESS AND OUTBREAK RESPONSE

Training Guide

Second Edition November 2015

WEST AFRICAN TRAINING FOR EBOLA PREPAREDNESS AND OUTBREAK RESPONSE - TRAINING GUIDE

Training guide on Ebola and other disease outbreak management

1

TABLE OF CONTENTS ACKNOWLEDGEMENTS ....................................................................................................... 3 FOREWORD .............................................................................................................................. 4 BACKGROUND ......................................................................................................................... 6 JUSTIFICATION FOR THE GUIDE ...................................................................................... 6 Objectives of the Training ....................................................................................................... 7 TRAINING IMPLEMENTATION GUIDE ............................................................................ 7 Course title ............................................................................................................................... 7 Target Audience ....................................................................................................................... 7 Duration and Methodology for Delivery ................................................................................. 7 Certification (award and awarding body) ................................................................................ 8 Assessment ............................................................................................................................... 8 Resources ................................................................................................................................. 8 Monitoring and Evaluation ...................................................................................................... 9 COURSE CONTENT ............................................................................................................... 10

Session 1.0 Workshop Opening and Pre-Test ............................................................... 11 Session 1.1 History, Biology and Amplifiers of Ebola ................................................. 12 Session 1.2 Impact of the Ebola Epidemic on West Africa........................................... 13 Session 1.3 Overview of Especially Dangerous Pathogens .......................................... 14 Session 1.4 National Leadership, Policies, Guidelines ................................................. 15 Session 1.5 Community Responses ............................................................................... 16 Session 1.6 Communications and Public Relations...................................................... 18 Session 2.1 Surveillance, Contact Tracing, and Containment ....................................... 19 Session 2.2 Preparing the Health Centre for Ebola Surveillance and Patient Management .................................................................................................................. 20 Session 2.3 Psychosocial Services for Individuals and Communities........................... 21 Session 2.4 Health Services for Ebola and Non-Ebola Conditions ............................... 22 Session 2.5 Human Resource for Ebola Response: Task Sharing, Task Shifting, and Task Specialization ................................................................................................. 23 Session 2.6 Water, Sanitation, Utilities, and Facilities for Responding to Ebola ......... 24 Session 2.7 Overall organization of the Ebola Treatment Unit ..................................... 25 Session 3.1 Universal Precautions to Prevent EDP Infection and Nosocomial Infections. ...................................................................................................................... 26 Session 3.2 Infection Prevention and Control for Ebola Response Team. .................... 27 Session 3.3 PPE for Ebola Management ....................................................................... 28 Session 3.4 Collecting Blood Samples and Safe Transportation................................... 29 Session 3.5 Clinical Care in the Ebola Treatment Unit ................................................. 30 Session 3.6 Health Worker Preparation for Work in an Ebola Treatment Unit ............ 31 Session 3.7 Cleaning and Disinfecting Protocols for Ebola .......................................... 32 Session 3.8 Environmental Cleaning, Linen Cleaning & Waste Management ............. 32 Session 4.1 Dead Body Management in the ETU and the Community ........................ 33 Session 4.2 Screening and Triage for EDPs .................................................................. 34 Session 4.3 Practical: Hand Washing ............................................................................ 35 Session 4.4 Practical: Chlorine Solutions’ Preparation ................................................. 36 Session 4.5 Practical: PPE Donning and Doffing.......................................................... 37



2

Session 4.6 Practical: Handling Dead Bodies in the ETU and Community .................. 38 Session 5.1 Discharge Protocols for Ebola Patients ...................................................... 38 Session 5.2 Emerging Treatment and Prevention Options EVD and EPDs .................. 39 Session 5.3 Collection and Storage of Data in ETUs .................................................... 41 Session 5.4 Logistics and Operations ............................................................................ 41 Session 5.5 Ebola Research During an Outbreak .......................................................... 42 Session 5.6 Post- Test, End of Course Evaluation, Course Closure .............................. 43

APPENDICES .......................................................................................................................... 45

IST OF ACRONYMS

Glossary of Abbreviations Accordia Accordia Global Health Foundation, USA CDC US Centers for Disease Control and Prevention DRC Democratic Republic of Congo EDP Exceptionally dangerous pathogen ETU Ebola treatment units EVD Ebola viral disease IDI Infectious Diseases Institute, Makerere University, Uganda MSF Medicines Sans Frontiers / Doctors Without Borders NCDC Nigerian Centre for Disease Control NMOD Nigerian Ministry of Defence PPE Personal protective equipment SOP Standard operating procedure USAMRIID United States Army Medical Research Institute on Infectious Diseases VHF Viral haemorrhagic fevers WAIDI West African Infectious Diseases Institute, Nigeria WHO World Health Organization



3

ACKNOWLEDGEMENTS The West African Infectious Diseases Institute (WAIDI) would like to extend its heartfelt appreciation to the following organisations: The Nigerian Ministry of Health The Nigerian Centre for Disease Control Accordia Global Health Foundation Members of the West African Academic Alliance (WA AA) Members of the West African Infectious Diseases Institute (WAIDI) United States Army Medical Research Institute on Infectious Diseases (USAMRIID) The Nigerian Ministry of Defence (NMOD) The World Health Organisation (WHO) The Ugandan Ministry of Health The Infectious Diseases Institute, Makerere University, Kampala, Uganda (IDI) ExxonMobil Médecins Sans Frontières (MSF)/Doctors without Borders The US Centers for Disease Control and Prevention (CDC) Special thanks to the WHO for allowing adaptation to the guidelines they have published. We would also like to acknowledge with gratitude the following individuals and their organizations for giving us their invaluable time, and for contributing their technical knowledge and expertise, enabling the completion of this guide. Name: Organization:

Prof. Abdulsalami Nasidi Prof. Idris Mohammed Dr. Alex Coutinho Dr. Major Mathew Chambers Dr. Umaru Sekabira Iorwakwagh Apera Walter Joseph Arinaitwe Sejal Vashi Robert L. Mallett

NCDC and WA AA WA AA Accordia Consultant USAMRIID IDI WAIDI IDI IDI Accordia

We acknowledge the financial support provided by ExxonMobil and Accordia towards this training guide. We also wish to acknowledge MSF, CDC and WHO, whose materials were referenced in developing this manual.



4

FOREWORD Since it began in March 2014 the Ebola virus outbreak across West Africa quickly became the deadliest outbreak of the disease since its discovery in 1976. In addition to killing over ten thousand people in eighteen months, the Ebola outbreak was complicated by a particularly high mortality rate among health care workers treating patients with the disease, largely due to a lack of preparedness and capacity to mount a rapid response. Once the epidemic was widely recognized many health care workers deserted their healthcare facilities, fearing that they themselves may contract the disease. As health facilities were crippled or shut down people living in the worst affected areas of West Africa faced an even greater lack of access to adequate healthcare as the remaining facilities quickly became overburdened. In July 2014 the first case of Ebola was documented in Nigeria. Arrival of the disease triggered a highly effective response, including isolation of those affected and tracing of all those who had made contact with those infected by the disease. Within Nigeria there were eight deaths, twenty confirmed or probable infections, and over nine hundred individuals placed under observation, illustrating how easily the virus can be introduced from neighbouring countries. Thankfully, despite Nigeria’s large population and proximity to the worst-affected countries, these numbers pale in comparison to the outbreak’s death toll of 11,304 across the highly infected countries of Sierra Leone, Liberia, and Guinea reported by the WHO as of October 4th, 2015. Ebola response teams in both the highly-infected countries and Nigeria faced a myriad of different challenges, however it has been noted that both response efforts lacked integrated training guidelines for addressing gaps in clinical management, surveillance, contact tracing, community mobilization, infection prevention, and management of the infected deceased. Effective preparation for outbreaks of Ebola and other diseases across Nigeria and greater West Africa requires a massive collaborative effort to build and strengthen systems for preventing and managing these outbreaks across countries, as well as effective leadership from the respective government agencies, and broad support from international organisations. The West African Infectious Diseases Institute (WAIDI), with generous funding from ExxonMobil, has led and coordinated the development of this state-of-the-art comprehensive training guide that is based on key lessons learnt during the current and previous Ebola outbreaks. Vitally, it addresses the knowledge and skills’ gaps among all relevant actors in outbreak mitigation activities. The content of this training guide contains materials derived from expert experience in the field, WHO & MSF material on Ebola management, the USAMRIID course on especially dangerous pathogens, and site-specific videos shared online.The development of this guide involved a wide stakeholder consultative approach, including a development workshop attended by representatives from twelve Nigerian Universities, two Federal Ministry of Health Institutions, and the Nigerian Military. This guide does more than simply illustrate the appropriate medical practices to undertake with Ebola patients; new sections have been added to highlight the importance of community preparedness and response mechanisms. Crucially, there is additional emphasis on logistics and administrative support systems to respond rapidly to epidemics of this nature. This



5

training curriculum explores how traditional cultural practices might increase susceptibility to Ebola, but critically also identifies how such cultures can forge a strong community response to such an epidemic. In addition to informing practical disease management within the Ebola Training Units (ETUs), this guide considers community-wide and culturally appropriate approaches to mitigate the social factors that facilitate the spread of such highly infectious diseases. It takes into consideration the social impact such outbreaks have on community structures, the traditions and customs that may worsen an epidemic, and management of the reintegration of survivors. Although intended for an audience of medical practitioners and academics, it is expected that the lessons from this guide will in turn cascade from on-the-ground healthcare professionals to the local communities they are serving. Thus, this guide can serve as a highly effective asset in complementing the typical clinical response to infectious disease outbreaks in West Africa once they reoccur.

Professor Abdulsalami Nasidi, OON

Director, Nigerian Center for Disease Control

For The Honourable Minister of Health



6

1. BACKGROUND TO THE TRAINING GUIDE Amid the unprecedented outbreak of Ebola across West Africa that began in March 2014, Nigeria confronted the threat of an Ebola epidemic and was successful in containing the disease. The WHO declared Nigeria free of the Ebola virus at the end of October 2014, within three months of the first incident reported. Within Nigeria there were eight deaths, twenty confirmed or probable infections, and over nine-hundred individuals placed under observation, illustrating how easily the Ebola virus can be introduced from neighbouring countries where the outbreak took hold at unprecedented scale. Maintaining readiness to prevent and address future outbreaks in Nigeria will require a massive collaborative effort, effective leadership from the Nigerian Government and its agencies, as well as broad support from international organizations. The West African Infectious Diseases Institute (WAIDI) aims to play a critical role in navigating the overall response to future outbreaks, in support of the Nigerian Centre for Disease Prevention & Control (NCDC) and other West African government entities. Having mobilised Nigeria’s academia, WAIDI is well positioned to contribute specialized expertise from its global network of internationally renowned experts in epidemiology and disease. WAIDI plans to run targeted rapid-response training sessions for the academic sector, developing the capacity to cascade training from teaching communities, to clinical practitioners to public health professionals, teaching each party what roles they can most effectively play in minimising outbreaks. WAIDI is uniquely positioned to facilitate the academic sector’s contribution to the National Ebola Response Plan over the past three years; already it has linked twelve Nigerian universities to support the national scale-up of efforts to combat HIV, TB and malaria. This experience, together with the resources of the WAIDI global network, can now be rapidly adapted and deployed in the fight against emerging infections such as Ebola. Once this training guide is used successfully in Nigeria it will be easy to adapt to other countries in West Africa as well, in addition to other resource-limited areas across Africa and the world. WAIDI led and coordinated the development of a state-of-the-art, five-day training program with the aim to cascade training to communities, health practitioners and public health professionals. A wide stakeholder consultative approach led to the development of this guide, integrating lessons learnt from this and previous epidemics. This guide will complement ongoing efforts to build sustainable preparedness systems for outbreaks of Ebola and other contagions, in addition to providing a basic rollout training platform for local Ebola containment and response units.

2. JUSTIFICATION FOR THE TRAINING GUIDE The 2014-15 outbreak of Ebola in West Africa exposed many shortcomings in the region’s readiness to mount an effective response to outbreaks. Delayed detection of the outbreak resulted in the deaths of countless health care workers and community leaders. At the height of the outbreak many health facilities shut down, deserted by health care workers, and the mortality rate of this epidemic topped that of all earlier Ebola outbreaks. Efforts to put together Ebola response teams lacked integrated training guidelines that comprehensively



7

addressed gaps in clinical management, surveillance, contact tracing, community mobilisation infection prevention and management of the deceased. The lessons learnt during this most recent, as well as previous Ebola outbreaks, led to the development of this comprehensive training guide. It is designed to address the knowledge and skills gaps identified amongst the multidisciplinary and multi-sectoral players involved in Ebola outbreak response activities. Whereas existing training guidelines address a limited audience, this guide outlines a multifaceted approach, central to outbreak preparedness and the ability to respond effectively to Ebola, addressing all health care workers involved in an outbreak response.

1.1. Goal of the Training: The aim of this training is to build capacity for the prevention and containment of outbreaks of Ebola and other emerging infections amongst health care workers in Nigeria.

1.2. Objectives of the Training: 1. To build capacity for surveillance for Ebola and other emerging infections that can

cause epidemics in Nigeria and the West African sub-region 2. To build capacity for the early detection of Ebola and other emerging infections that

can cause epidemics in Nigeria 3. To build capacity in Nigeria for appropriate health facility-based management of

Ebola, and other emerging infections that can cause epidemics in Nigeria 4. To improve community-based disease prevention activities and fully engage the

community in the management of outbreaks

3. TRAINING IMPLEMENTATION GUIDELINES

1.3. Course Title: This training guide is intended for facilitators of the “West African Training on Preparedness and Response to Ebola and Outbreak Response.”

1.4. Target Audience This course targets a wide range of professionals involved in healthcare service provision, including management, administrative and frontline service providers. The specific categories of professionals include: Ministry of Health staff, health facility-based care workers (clinical professionals, public health officers, janitors, records staff, mortuary attendants, ambulance drivers and medical social workers), community-based health workers, and burial team members. Clinical professionals include specialist physicians, medical officers, clinical officers, nurses, midwives, laboratory personnel, dental officers, pharmacists, and other paramedical staff. Others parties include environmental scientists, veterinarians, and other professionals relevant to an EVD response. The course is intended to address twenty-five participants per session.

1.5. Duration of the Course and Methodology of Course Delivery A complete training regimen is five days long and requires a minimum of four experienced facilitators with an assistant facilitator/rapporteur. Content is delivered via didactic lectures, PowerPoint slideshow presentations, short video clips narrated by the trainers followed by



8

discussion, practical sessions involving demonstrations, and exercises to practice key skills. Where possible, some sessions would occur within mock / real Ebola Treatment Unit (ETUs).

1.6. Certification (award and awarding body) At the end of the training, participants are awarded a certificate of successful completion if they attain 80 percent or above in the post-training test and demonstrate the ability to perform key tasks related to infection prevention and control. This high pass mark has been set because it is absolutely necessary for responders to Ebola to have the right knowledge to protect their lives, the lives of their colleagues and the lives of the patients entrusted to them. Certificates shall be awarded by the Nigerian Centre for Disease Control (NCDC) and WAIDI.

1.7. Assessment: Competencies acquired (knowledge, attitudes and skills) will be assessed through:

- Written pre- and post-tests - Practical assessment based on critical skill areas such as preparation of bleach

solution, donning and doffing personal protective equipment (PPE), and hand-washing

- Attendance at a minimum of 90 percent of all training days

1.8. Resources: Materials and resources required for each of the modules are listed in each session section in this training guide. The following resources will be required for successful execution of this training:

(i) Facilitators: This training is executed by two (and up to five) facilitating individuals, who:

a) have attended a training-of-trainers course in management of Ebola patients, and, b) have acquired experience in Ebola management through working in ETUs

(ii) Health Learning Materials:

The following reference materials will be utilised: A participant manual with supplemental documents compiled using this guide, the WHO manual on the treatment of Ebola, relevant videos and PPEs; the Doctors Without Borders / Medicines Sans Frontiers (MSF) Ebola management manual, and guidelines from the US Centers for Disease Control and Prevention (CDC USA).

(iii) Venue for the Training The trainings will be conducted preferably within or near hospitals with ETUs, enabling participants to appreciate the importance of facility design, and the movement of patients and health workers through the ETU. The training room for theoretical sessions shall have adequate space for practical sessions.



9

(iv) Other Materials Item Quantity Name tags 30 Electrical plug capacity with sufficient sockets or extension cables plug points for electrical equipment listed below

5 minimum

Large chart paper / Flip charts 2 Speakers 2 PowerPoint computer projector 1 Laptop computer 1 Markers 2 packets

(different colors preferred)

Masking tape 2 Printed materials: • Pre-test • Post-test • Participant guide • End-of-course evaluation forms • Clinical management of patients in the Ebola Treatment Centres and

other care centres in Sierra Leone (WHO) • WHO Participant Manual with handouts as outlined in each session

30 each

1.9. Monitoring and evaluation There will be continuous monitoring to ascertain knowledge and skills acquisition. Pre- and post-test results will be collated and analysed. During the training participants will be observed performing tasks to ensure competency. It is acknowledged that in the event of an Ebola epidemic all front line health workers will need at least one day’s refresher training at the ETU where they will be working, followed by another two days of shadowing experienced health workers. This ensures that critical knowledge will be refreshed at the time the skills are needed.



10

4. COURSE CONTENT The training agenda shall be as follows over five days: Day One Session # Session Title Time

Allocation 1.0 Workshop Opening and Pre-Test 30 min 1.1 History, Biology and Amplifiers of Ebola 120 min 1.2 Impact of the Ebola epidemic on West Africa 30 min 1.3 Overview of Especially Dangerous Pathogens (EPDs) 60 min 1.4 National Leadership, Policies, Guidelines 60 min 1.5 Community Responses 60 min 1.6 Communications and Public Relations 60 min Day Two Session # Session Title Time Allocation 2.1 Surveillance, Contact Tracing, and Containment 60 min 2.2 Preparing the Health Centre for Ebola Surveillance Management 60 min 2.3 Psychosocial Services for Individuals and Communities 60 min 2.4 Health Services for Ebola and Non-Ebola Conditions 60 min 2.5 Human Resource for Ebola Response: Task Sharing, Task Shifting and

Specialization 60 min

2.6 Water, Sanitation, Utilities, and Facilities During an Ebola Epidemic 60 min 2.7 Overall Organization of the Ebola Treatment Unit (ETU) 60 min Day Three Session # Session Title Time

Allocation 3.1 Universal Precautions to Prevent Infection and Nosocomial Infections 45 min 3.2 Infection Prevention and Control for Ebola Response Team 60 min 3.3 PPE for Ebola Management 60 min 3.4 Collecting Blood Samples and Safe Transportation 30 min 3.5 Clinical Care in the Ebola Treatment Unit 120 min 3.6 Health Worker Preparation for Work in an Ebola Treatment Unit 30 min 3.7 Cleaning and Disinfecting Protocols for Ebola 60 min 3.8 Environmental Cleaning, Linen Cleaning, and Waste Management 60 min Day Four Session # Session Title Time

Allocation 4.1 Dead Body Management in the ETU and the Community 45 min 4.2 Screening and Triage for EDPs 45 min 4.3 Practical: Hand Washing 60 min 4.4 Practical: Chlorine Solutions’ Preparation 120 min 4.5 Practical: PPE Donning and Doffing 120 min 4.6 Practical: Handling Dead Bodies in ETU and Community 30 min Day Five Session # Session Title Time

Allocation 5.1 Discharge Protocols for Ebola Patients 45 min 5.2 Emerging Treatment and Prevention Options for EVD and EDPs 45 min 5.3 Collection and Storage of Data in ETUs 120 min 5.4 Logistics Supplies and Operations 45 min



11

5.5 Research during an Outbreak; Regulation and institutional approval 45 min 5.6 Post-Test, End-of-Course Evaluation, Course Closure 45 min

Session 1.0 Workshop Opening and Pre-Test Purpose of the session: To create a socially conducive environment for learning that gives the trainees freedom of

expression To determine participants level of knowledge prior to the beginning of the training

Objectives By the end of the session, the trainees should be able to: 1. Acquaint themselves with each other and refer to each other by name 2. Acquaint themselves with their facilitators and refer to them by their names and vice versa 3. Follow the norms and leadership of the class 4. Express their own course expectations 5. Familiarize themselves with the course aims and objectives 6. Familiarize themselves with the

− Course schedule − Relevant training materials − Administration and logistical information

Procedure 1. Welcome the trainees to the course and ensure that they have all registered and received

all the required training materials or resources. 2. Introduce the trainees to the registration forms and reassure them that this activity is to be

done each morning of the training period. 3. Explain the background to the training course. 4. Introduce the team of facilitators 5. Ask the trainees to introduce themselves by peer or self, following the guidelines agreed

upon (see bullets below). 6. Ask the trainees to mention one course expectation and fear about the training. One of the

facilitators should be noting these down on a flip chart: − Name and preferred name − Place of work − Cadre in service − Expectations − Likes and dislikes − Fears about the training

7. Ensure that each trainee has got his or her preferred name printed on the name tag. 8. Show a slide on the course aims and objectives. Discuss these in relation to the trainees

own expectations. Note any areas of overlap or discrepancies and further discuss these with the trainees to gain consensus.

9. Identifying group leadership, setting ground rules and expectations of the training:



12

(i) Brainstorm with the trainees on what type of leadership they wish to have and who of them should take the responsibility.

(ii) Write their nominations on the flip chart. Their ideas might include the following: − President/group chairperson − Welfare officer − Spiritual/religious leader − Time keeper

(iii)Post the confirmed names on the class wall for reference by the class. Lead the class to congratulate the successful candidates.

10. Brainstorm with the trainees on how they wish to conduct themselves while in the training-work shop norm setting:

− Respect for one another − Punctuality − Talking one at a time − Active participation − Mobile phones on silent mode or switched off − Equal opportunity for asking and answering questions − Appreciation for work done by facilitators and the trainees

Write the confirmed ground rules and post them on the class wall for reference.

• Introduce the trainees on how to make an evaluation of the day’s proceedings using the forms available. Reassure the trainees on the significance of evaluating the day.

• Communicate administrative and logistical information. • If there is any official opening for the training explain procedure for inviting guests. • Give a pre-test.

Resources needed:

• Flip chart stand, flip charts, masking tape and markers • PowerPoint presentations on ‘Course aims and Objectives’, ‘Course schedule’, and

‘Introduction to the Course’ • Pointer, name tags

Session 1.1 History, Biology and Amplifiers of Ebola Learning Objectives By the end of this session, the trainee should be able to: 1. Explain the origin of Ebola viral disease (EVD) 2. Discuss how Ebola is transmitted to humans 3. List the symptoms and signs of EVD 4. Explain the progression of EVD 5. List activities/locations where cases are more likely to multiply 6. Explain why cases rapidly multiply in these locations Session Content Outline: 1. Definition of EVD



13

2. Signs and Symptoms of EVD 3. Clinical progression of EVD 4. Factors that amplify an Ebola outbreak 5. Activities/locations where cases are more likely to multiply 6. Reasons why cases rapidly multiply in these locations 7. Describe strategies for controlling amplification of the epidemic in these

locations/activities Learning Experiences: • PowerPoint presentation: PowerPoint 1.1 Ebola Overview and Biology WHO/PED

presentation • Video on how the epidemic began and spread: Video 36 Resources: • Projector, laptop computer, flip chart, markers • Video 36, Appendix 1: How world’s worst Ebola outbreak begun with one boy’s death;

BBC; https://ww.youtube.com/watch?v=_vEpvXHzJLo Assessment: • Pre- and post-test questions

Time Requirements: Didactic 120 minutes Procedure

Facilitator welcomes the trainees to the session. Emphasize to the trainees the importance of this session. Project the slides containing the objectives of the session and explain them in

relation to the importance of the session to the entire course. Ask participants what they understand about EVD; factors that amplify outbreaks. Present slides 1, 2, and 3 and respond to participants questions along the way. Show Video 36, allow for a brief five-minute discussion about the video and

proceed with the PowerPoint presentation up to the second to last slide. Ask the energizer focal person to lead a five minutes exercise to energize the group at the end of one hour.

Resume the presentation, check understanding of key concepts by asking questions related to the objectives.

Present the last slide, which summarises the session.

Session 1.2 Impact of the Ebola Epidemic on West Africa Learning Objectives By the end of the session, the trainee should be able to: 1. Appreciate the social and economic impact of Ebola on countries 2. Describe the potential and actual social and economic impact of Ebola

Session Content Outline 1. Social impact of Ebola 2. Economic impact of Ebola

https://ww.youtube.com/watch?v=_vEpvXHzJLo



14

3. Impact on other aspects of life Learning Experiences • PowerPoint presentation to be adapted from Ugandan Ministry of Health SOP manual • Videos on impact of EVD

Resources • Projector • Flip charts x 2 • Markers x 5 • Video 1: Liberian handshake lost to Ebola outbreak; AFP

https://www.youtube.com/watch?v=L-NVlSJQAx0 • Video 2: Spike in pregnancies and abuse in Ebola-hit Sierra Leone; AFP;

https://www.youtube.com/watch?v=-Psv5FdZSFo • Video 3: Ebola outbreak hits African economies hard; Al Jazeera;

https://www.youtube.com/watch?v=cTRcMrbaE5w • Video 4: Ebola - life without school in Guinea; AFP;

https://www.youtube.com/watch?v=VfLBhfymA9A • Video 5: Low turnout for Liberia vote amid Ebola fears; Al Jazeera;

https://www.youtube.com/watch?v=gEie13slq28 • Video 6. Nigeria schools reopen after Ebola break; Reuters;

https://www.youtube.com/watch?v=4fUIUZA83Vg Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. Brain storm on the likely social and economic impact of Ebola. Show Videos 1, 2, 3, 4, 5, and 6; allow for a brief five-minute discussion about the

video and present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 1.3 Overview of Especially Dangerous Pathogens Learning Objectives By the end of the session, the trainee should be able to: 1. Explain what especially dangerous pathogens (EDPs) are 2. Outline mode of spread of EDPs 3. List reasons why EDPs are on the increase

https://www.youtube.com/watch?v=L-NVlSJQAx0

https://www.youtube.com/watch?v=-Psv5FdZSFo

https://www.youtube.com/watch?v=cTRcMrbaE5w

https://www.youtube.com/watch?v=VfLBhfymA9A

https://www.youtube.com/watch?v=gEie13slq28

https://www.youtube.com/watch?v=4fUIUZA83Vg



15

4. Appreciate the importance of knowing EDPs, and why capacity for their detection and management should be built amongst health workers

Session Content Outline 1. What is an EDP? 2. Why are EDPs important? 3. Modes of spread of EDPs 4. Factors why EDPs are on the increase 5. Why capacity for management of EDPs amongst health care workers is important

Learning Experiences The USAMRIID/IDI PowerPoint presentation on EDPs Testimony Resources LCD projector Flip charts x 2 Markers x 5 Assessment Pre- and post-test questions Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course. Ask participants to define EDPs, list factors why they are on the increase, list the

EDPs they have heard of. Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts- by asking questions related to the

objectives. Present the last slide which summarises the session.

Session 1.4 National Leadership, Policies, Guidelines Learning Objectives By the end of the session, the trainee should be able to: 1. Appreciate the importance of involving national leadership in ensuring adequate

preparedness and response to outbreaks 2. Value the role of quarantining and restricting movements of people and communities

infected by Ebola 3. Describe the role of national leadership in restricting the spread of Ebola and other

diseases 4. Discuss the benefits/dangers of quarantining, locking down, and restricting movements of

people and communities infected by Ebola



16

5. Discuss the challenges of quarantining, locking down, and restricting movements of people and communities infected by Ebola

Session Content Outline 1. The role of national leadership in restricting the spread of Ebola and other diseases 2. Benefits of quarantining, locking down, and restricting movements of people and

communities infected by Ebola 3. Challenges of quarantining, locking down, and restricting movements of people and

communities infected by Ebola 4. Importance of involving the national leadership in ensuring adequate preparedness and

response to outbreaks

Learning Experiences • PowerPoint presentation to be adapted from Ugandan Ministry of Health manual • Videos Resources • LCD projector • Flip charts x 2 • Markers x 5 • Video 7: Liberia police quarantine area over Ebola fears; Al Jazeera;

https://www.youtube.com/watch?v=xM1iTKmmcD8 • Video 8: Sierra Leone Ebola curfew causes food shortages; Al Jazeera;

https://www.youtube.com/watch?v=Y6RY2H-hh4g. Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions) Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Brainstorm about role of national leadership in Ebola and other outbreak

containment, quarantine as a method of restricting Ebola spread (ten minutes). Show Videos 7 and 8, then allow for a brief five-minute discussion about the

video, and present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 1.5 Community Responses Learning Objectives By the end of the session, the trainee should be able to:

https://www.youtube.com/watch?v=xM1iTKmmcD8

https://www.youtube.com/watch?v=Y6RY2H-hh4g



17

1. Understand community characteristics (social, economic, cultural, beliefs, practices and infrastructure) that affect responses to health care and disease

2. Effectively communicate to patients and community members 3. Effectively engage community leadership 4. Tailor communication packages to community-specific needs

Session Content Outline 1. Beliefs (religious, cultural, peer) 2. Behaviour change communication and strategies 3. Community characteristics (social, economic, political) 4. Health-seeking behaviour 5. Leadership involvement → who are the leaders? 6. Factors influencing access to health services Learning Experiences • PowerPoint presentation to be adapted from Ugandan Ministry of Health SOP manual • Videos (five minutes each) Resources • PowerPoint projector, audio speakers • Flip charts x 2 • Markers x 5 • Videos 9 and 10 (Appendix 1) • Video 9: Healers hinder Senegal's Ebola fight; Al Jazeera;

https://www.youtube.com/watch?v=-P8Xw1mMO20 • Video 10: Churches join fight against Ebola in Sierra Leone; AFP;

https://www.youtube.com/watch?v=v1JRXP3tSVg Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions) Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Brain storm about role of cultural and religious practices in fuelling Ebola & other

outbreaks (ten minutes). Show Videos 9 and 10, then allow for a brief five minute discussion about the

video and present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

https://www.youtube.com/watch?v=-P8Xw1mMO20

https://www.youtube.com/watch?v=v1JRXP3tSVg



18

Session 1.6 Communications and Public Relations Learning Objectives By the end of this session, the trainee should be able to: 1. List communication channels and modes of delivery for Ebola related messaging 2. Recognize the importance of mass communication as an effective response tool 3. Describe the key characteristics of an effective message 4. Explain the benefits of involving communities in developing appropriate messaging

Session Content Outline 1. Communication channels and modes of delivery for Ebola related messaging 2. The importance of mass communication as an effective response tool 3. Key characteristics of an effective message

Learning Experiences • Brainstorming - see procedure below • PowerPoint presentations to be adapted from Ugandan Ministry of Health SOP manual • Videos

Resources • Flip charts x 2 • Markers x 5 • LCD projector • Videos 11, 12, 13, and 14 (Appendix 1) • Video 11: Radio DJs in Sierra Leone join the fight against Ebola; AFP;

https://www.youtube.com/watch?v=Ew4-NLy4Fys • Video 12: Ebola - 'Don't eat no monkey...Don't eat no bat', MSF,

https://www.youtube.com/watch?v=QLcKdsub3h8 • Video 13 WHO-EMRO - animated video on Ebola, WHO;

https://www.youtube.com/watch?v=qnvlQHJkBBY • Video 14: Wash ya hand o (Pidgin); Lens on Ebola;

https://www.youtube.com/watch?v=6hIUY8xyL48

Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions) Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Brainstorm about role of communication, type of messages to disseminate in an

outbreak, briefly explain why communities should be involved in designing messages (ten minutes).

https://www.youtube.com/watch?v=Ew4-NLy4Fys

https://www.youtube.com/watch?v=QLcKdsub3h8

https://www.youtube.com/watch?v=qnvlQHJkBBY




19

Show Videos 11, 12, 13, and 14, then allow for a brief, ten-minute discussion about the video and present the PowerPoint presentation up to the second last slide.

Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 2.1 Surveillance, Contact Tracing, and Containment Learning Objectives By the end of the session, the trainee should be able to: 1. Define Ebola and the different case definitions 2. Explain the role of health workers in surveillance 3. Describe the reporting mechanisms used by Ministries of Health 4. Use the various reporting tools 5. Define the modes of transmission and amplification 6. Describe the dynamics of an Ebola epidemic (spreading) 7. Explain the importance of contact tracing (outbreak investigation)

Session Content Outline 1. Ebola case definition 2. Use of data points for reporting 3. Outbreak investigation 4. Contact tracing: why, how, and who 5. Dynamics of epidemics and control strategies 6. Surveillance mechanisms: active and passive Learning Experiences • Brainstorming exercises -see procedure below • PowerPoint presentation 2.1: USAMRID-IDI Clinical Care and Public Health Notification

and reporting and the MSF strategies summary PPT • Video

Resources • Flip charts x 2 • Markers x 5 • LCD projector • Video 16 (Appendix 1) Contact tracers hunt down Ebola in Sierra Leone; AFP;

https://www.youtube.com/watch?v=W6Ru7LuU_gc


Facilitator welcomes the trainees to the session. Emphasize to the trainees the importance of this session.



20

Project the slides containing the objectives of the session and explain them in relation to the importance of the session to the entire course (five minutes)

Brainstorm on the importance of contact tracing, reporting and surveillance (five minutes)

Show Video 16, allow for a brief ten-minute discussion about the video and present the PowerPoint presentation up to the second last slide.


Session 2.2 Preparing the Health Centre for Ebola Surveillance and Patient Management Learning Objectives By the end of this session, the trainee should be able to: 1. Outline considerations in preparing health facilities for Ebola surveillance and patient

management 2. State challenges encountered in preparing heath facilities 3. Describe solutions to those challenges 4. Identify enabling factors to successful implementation of surveillance and treatment of

Ebola patients at a site Session Content Outline 1. Considerations in preparing health facilities for Ebola surveillance and patient

management 2. Challenges encountered in preparing heath facilities 3. Solutions to challenges encountered in conducting surveillance and management of

patients at health facilities 4. Factors contributing to successful implementation of surveillance and treatment of Ebola

patients at a health facility Learning Experiences • Brainstorming exercises -see procedure below • Case studies • PowerPoint presentation 2.2 MSF strategies summary: “Preparing health centre, health

post or hospital outpatient for Ebola surveillance,” and “Preparing Health facilities in at-risk countries for screening for Ebola”

Resources • LCD projector • Flip charts x 2 • Markers x 5 Assessment • Drills, repetition exercises, and practical application of learnt information • Group and individual exercises • Case studies



21



relation to the importance of the session to the entire course. Brainstorm on how health facilities should be prepared to take on surveillance and

case management activities during an outbreak of Ebola (ten minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key considerations in preparation of facilities. Present the last slide, which summarises the session.

Session 2.3 Psychosocial Services for Individuals and Communities Learning Objectives By the end of the session, the trainee should be able to: 1. Appreciate the value of psychosocial services during an Ebola outbreak 2. State reasons why some patients are abandoned at ETUs 3. List ways of minimizing the number of patients abandoned in ETUs 4. Appreciate the need to provide care for orphans of patients who die of EVD and

individuals who will be abandoned as a result of EVD 5. Appreciate the psychosocial problems faced by orphans and abandoned individuals 6. Explain how to care for orphans and abandoned individuals in an Ebola outbreak 7. Understand the psychosocial needs of healthcare workers and other individuals involved

in and responding to the Ebola epidemic Session Content Outline 1. The role of psychosocial services during an Ebola outbreak 2. Reasons why some patients get abandoned at ETUs 3. Ways of minimizing the numbers of patients abandoned in ETUs 4. Caring for orphans of patients who die of EVD, and individuals who will be abandoned as

a result of Ebola 5. Psychosocial problems faced by orphans and abandoned individuals 6. Psychosocial needs of Ebola responders

Learning Experiences • Brainstorming exercises-see procedure below • PowerPoint presentations to be adapted from the Uganda Ministry of Health

manual/standard operating procedure manual • Videos 15, 17, 18, 19, 20, and 21 (Appendix 1). • Video 15: Ebola facts - Using celebrities to communicate key messages; Lens on Ebola;

https://www.youtube.com/watch?v=xTeIhXiFCSg • Video 17 Ebola - Frontline Report- Ane Bjøru Fjeldsæter, MSF Psychologist; MSF;

https://www.youtube.com/watch?v=64URkG-8z8w • Video 18 Ebola outbreak - 'I lost 5 members of my family'; BBC;

https://www.youtube.com/watch?v=kgiYP9hJF5Y

https://www.youtube.com/watch?v=xTeIhXiFCSg

https://www.youtube.com/watch?v=64URkG-8z8w




22

• Video 19: Health workers in Sierra Leone dance to cheer up Ebola patients; AFP; https://www.youtube.com/watch?v=xA_c2wy9OzA

• Video 20: Lives of Ebola survivors deeply affected after recovery; Al Jazeera; https://www.youtube.com/watch?v=gsMjulAl4uc

• Video 21: Reine Lebel, a psychologist, talks about her work with Ebola patients; MSF; https://www.youtube.com/watch?v=IJDYLeWKZHg

Resources • LCD projector • Flip charts x 2 • Markers x 5 • Patient cards x 30 • Handouts Assessment • Pre- and post-test questions Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Brainstorm on the role of psychosocial services during an Ebola outbreak (five

minutes) Show Videos 15, 17, 18, 19, 20, and 21, then allow for a brief ten-minute

discussion about the videos, and present the PowerPoint presentation up to the second last slide.


Session 2.4 Health Services for Ebola and Non-Ebola Conditions Learning Objectives By the end of the session, the trainee should be able to: 1. Describe strategies for ensuring uninterrupted health care service delivery to Ebola and

non-Ebola patients 2. List challenges that may be encountered in providing health care services during an Ebola

outbreak 3. Outline solutions to challenges in providing health care services during an Ebola outbreak

Session Content Outline 1. Strategies for ensuring uninterrupted health care service delivery to Ebola and Non Ebola

patients during an outbreak 2. Challenges that may be encountered in providing health care services during an Ebola

outbreak 3. Solutions to challenges in providing health care services during an Ebola outbreak

https://www.youtube.com/watch?v=xA_c2wy9OzA

https://www.youtube.com/watch?v=gsMjulAl4uc

https://www.youtube.com/watch?v=IJDYLeWKZHg



23

Learning Experiences • Brainstorming -see procedure below • PowerPoint presentation to be adapted from Ugandan Ministry of Health SOP manual • Case discussions • Video

Resources • LCD projector • Flip charts x 2 • Markers x 5 • Video 24 (Appendix 1) Preventing malaria while fighting Ebola in Liberia; MSF;

https://www.youtube.com/watch?v=VnfamJhQz_A



relation to the importance of the session to the entire course (five minutes). Brainstorm on challenges of continuing health care services in an Ebola outbreak

(five minutes). Show Video 24 and allow for a five-minute discussion about the video and present

the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking the following, “What should be

done to ensure health services are not interrupted during an outbreak?” Present the last slide, which summarises the session.

Session 2.5 Human Resources for Ebola Response: Task Sharing, Task Shifting and Task Specialization Learning Objectives By the end of this session, the trainee should be able to: 1. List the cadres of individuals needed to adequately respond during an Ebola epidemic 2. Outline the resources that must be provided to responders 3. Explain the leadership structure required during a response 4. Identify the complexities of organizing a response while understaffed 5. Explain the “do’s and don’ts” of multi-tasking in an ETU

Session Content Outline 1. Cadres of individuals needed for adequate response to an Ebola epidemic 2. Supplies required by health care workers in an outbreak 3. Leadership structure used during a response




24

4. Caring for carers 5. Complexities of organizing a response while understaffed 6. Multi-tasking in ETU- when is it acceptable

Learning Experiences • PowerPoint presentation 2.5: Health Worker preparation for work in Ebola outbreaks and

coping with the heat • Discussions • Videos 25-28 Resources • LCD projector • Flip charts x 2 • Markers x 5 • Video 25, Doctor in Sierra Leone clinic fights Ebola solo; Reuters

https://www.youtube.com/watch?v=g_1r5qgOTqg • Video 26, Ebola outbreak- 'We're having to make impossible choices' says British doctor:

BBC; https://www.youtube.com/watch?v=lS4DGSbMxx0 • Video 27 Liberia medical workers may strike; CNN.

https://www.youtube.com/watch?v=IimW315UOyU • Video 28 (Appendix 1) Nurses in Ebola-hit Sierra Leone back to work; Al Jazeera:

https://www.youtube.com/watch?v=KC2l6ISKMwE

Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course (five minutes). Brainstorm on the various cadres needed in an outbreak situation; define task-

sharing, task-shifting in the context of Ebola case management (five minutes). Show Videos 25, 26, 27 and 28, then allow for a brief discussion about the videos

(ten minutes) and present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 2.6 Water, Sanitation, Utilities, and Facilities for Responding to Ebola Learning Objectives By the end of this session, the trainee should be able to: 1. Discuss key water and sanitation considerations required to handle Ebola viral disease

cases 2. Explain how to channel water supply, medical waste, body fluids and refuse in an ETU

https://www.youtube.com/watch?v=lS4DGSbMxx0

https://www.youtube.com/watch?v=IimW315UOyU




25

3. Describe the importance of providing adequate light in an ETU 4. Outline ways of ensuring proper sanitation in an ETU 5. Discuss ways of managing waste at an ETU Session Content Outline 1. Water and sanitation consideration required to handle Ebola viral disease cases 2. How to channel water supply medical waste, body fluids and refuse in an ETU 3. Provision of adequate light in an ETU 4. Ensuring proper sanitation in an ETU 5. Explain how to manage waste at an ETU

Learning Experiences • PowerPoint presentations: EVD Module 4 support services • Brainstorming- see procedure below • Demonstrations • Resources • LCD projector • Flip charts x 2 • Markers x 5 • Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions) Time Requirements: Didactic 60 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Brainstorm on key water and sanitation considerations required to handle EVD

outbreaks (five minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide which summarises the session.

Session 2.7 Overall organization of the Ebola Treatment Unit Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the different sections/zones of the Ebola Treatment Unit 2. Explain the rational for the design of the ETU 3. Outline activities conducted in each section of the ETU 4. Explain the flow/movement of staff in the ETU 5. Explain the flow/movement of patients in the ETU



26

Session Content Outline 1. Structural design of the ETU 2. Rationale for the design of ETUs 3. Activities conducted in each section of the ETU 4. Flow/movement of health workers in the ETU 5. Flow/movement of patients in the ETU

Learning Experiences • PowerPoint presentations • Video Resources • PowerPoint presentation: 2.7 Overall organisation of the Ebola Treatment Centre and

screening • Video 29 (Appendix 1) Incredible aerial view of MSF's Ebola centre in Monrovia, Liberia

- the largest ever built: https://www.youtube.com/watch?v=SZusF0x6LnU • Flip charts x 2 • Markers x 5 • LCD projector



relation to the importance of the session to the entire course (five minutes). Ask participants to mention briefly the key considerations in designing ETUs, key

activities conducted within the ETU (ten minutes). Present the PowerPoint presentation up to the second last slide Check understanding of key concepts by asking questions related to the objectives. Show Video 29 and ask participants to comment on the design seen. Present the last slide, which summarises the session.

Session 3.1 Universal Precautions to Prevent EDP Infection and Nosocomial Infections Learning Objectives By the end of this session, the trainee should be able to describe the universal precautions to prevent EDP, nosocomial and other infections.

Session Content Outline • Universal precautions to prevent EDP, nosocomial and other infections

https://www.youtube.com/watch?v=SZusF0x6LnU



27

Learning Experiences • Brainstorming - see procedure below • PowerPoint presentation: 3.1 Overview of Trainings for Ebola infection control

Resources • LCD projector • Flip charts x 2 • Markers x 5 Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course (five minutes). Brainstorm on universal precautions to prevent EDP, nosocomial, and other

infections (ten minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 3.2 Infection Prevention and Control for Ebola Response Team Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the standard precautions for Infection Prevention and control for Ebola response

teams 2. Outline additional precautions (contact and droplet precautions) for Ebola 3. Explain what to do in case of accidental contact with infectious body fluids, or a needle-

stick accident Session Content Outline 1. The standard precautions for infection prevention and control for Ebola response teams 2. The additional precautions (contact and droplet precautions) for Ebola 3. What to do in case of accidental contact with infectious body fluids

Learning Experiences • PowerPoint presentation • Case study discussion

Resources • PowerPoint 3.2: Infection Prevention and Control for Ebola Response Team • Flip charts x 2



28

• Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions) Time Requirements: Didactic 30 minutes Procedure


relation to the importance of the session to the entire course (five minutes). Ask participants to mention briefly the standard precautions for Infection

Prevention and control for Ebola response teams (ten minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 3.3 PPE for Ebola Management Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the various PPE items 2. Explain the role of each PPE item 3. Identify which PPE items are reusable and those that are for single use 4. Decontaminate and disinfect PPE Session Content Outline 1. The various PPE items 2. The role of each PPE item 3. Reusable and disposable PPE items 4. Process of decontamination and disinfecting PPE

Learning Experiences • PowerPoint presentations • Video Resources • PowerPoint presentation 3.3: PPE for Ebola (supplemented by WHO pictorial guidelines) • Flip charts x 2 • Markers x 5 • LCD projector

Assessment • Pre- and post-test questions



29

• Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course (five minutes). Ask participants to mention the various PPE items, explain the role of each, and

identify the reusable and those that are for single use (ten minutes) Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 3.4 Collecting Blood Samples and Safe Transportation Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the safe procedure for collecting blood samples from EVD suspects and patients 2. Explain how to prepare blood samples for safe transportation 3. Explain how to safely transport blood samples of EVD suspects and patients

Session Content Outline 1. Safe procedure for collecting blood samples from Ebola suspects and patients 2. Preparation of blood samples for safe transportation 3. Transportation of blood samples of Ebola suspects and patients

Learning Experiences • PowerPoint presentation 3.4: WHO Blood sample collection from Ebola suspect

guidelines to be supplemented by SOPs for blood sample collection in the Uganda manual.

Resources • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course (five minutes).



30

Brain storm on the safe procedure for collecting and transporting blood samples from Ebola suspects and patients (ten minutes).

Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts by asking questions related to the objectives. Present the last slide, which summarises the session.

Session 3.5 Clinical Care in the Ebola Treatment Unit Learning Objectives By the end of this session, the trainee should be able to: 1. Identify signs and symptoms of EVD 2. Describe how complications of EVD are managed 3. Review and understand treatment guidelines for EVD and its’ complications 4. Monitor patients admitted in the ETU

Session Content Outline 1. Signs and symptoms of EVD 2. Treatment of EVD and complications of EVD (dehydration, high temperature, bleeding,

etc.) 3. Monitoring of patients admitted in the ETU

Learning Experiences • PowerPoint presentations • Video

Resources • PowerPoint presentation 3.5: Clinical management of patients in the Ebola Treatment

Centres and other care centres in Sierra Leone (WHO) pocket guide, Working in the ETU • Flip charts x 2 • Markers x 5 • LCD projector • Video 33 (Appendix 1): Ebola battle through nurse's eyes:

https://www.youtube.com/watch?v=La4YvsudGjQ




relation to the importance of the session to the entire course. Brain storm on key principles for managing EVD complications (ten minutes). Present the PowerPoint presentation up to the second last slide. Show Video 33.




31

Check understanding of key points. Present the last slide, which summarises the session.

Session 3.6 Health Worker Preparation for Work in an Ebola Treatment Unit Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the key sections of an ETU 2. Explain how health workers conduct themselves while inside ETUs (the dos and don’ts

while in an ETU) 3. Describe the key elements of managing patients/suspected cases admitted to ETUs 4. List key infection prevention while in an ETU for staff and suspected cases

Session Content Outline 1. Layout and design principles of an ETU 2. How health workers conduct themselves while inside the ETUs (the dos and don’ts while

in an ETU) 3. Key elements of managing patients/suspected cases admitted in ETUs 4. Infection prevention while in an ETU

Learning experiences • PowerPoint presentations • Video

Resources • PowerPoint presentation 3.6: Health Worker preparation for work in Ebola outbreaks and

coping with the Heat • Flip charts x 2 • Markers x 5 • LCD projector • Video 32 (Appendix 1) Goggle camera' records Ebola crisis -

https://www.youtube.com/watch?v=K5UpQxPil6Y



relation to the importance of the session to the entire course. Brain storm on key principles for keeping Health care workers safe while working

in ETUs (ten minutes). Present the PowerPoint presentation up to the second last slide.




32

Show Video 32: Health Worker Preparation for Work in an Ebola Treatment Unit.

Check understanding of key points. Present the last slide, which summarises the session.

Session 3.7 Cleaning and Disinfecting Protocols for Ebola Learning Objectives By the end of this session, the trainee should be able to: 1. Describe key elements of the cleaning and disinfecting protocols for Ebola 2. Understand the use of different concentrations of solutions used in Ebola disinfection

Session Content Outline 1. Describe key elements of the cleaning and disinfecting protocols for Ebola 2. Describe the concentration of solutions used in Ebola disinfection and their preparation Learning Experience • Brainstorming- see procedure below • PowerPoint presentation 3.7: Environmental Cleaning and Waste management (WHO)

Resources • Flip charts x 2 • Markers x 5 • LCD projector



relation to the importance of the session to the entire course. Brainstorm on key elements of the cleaning and disinfecting protocols for Ebola,

ask participants to mention concentrations of the different disinfectants (five minutes)

Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 3.8 Environmental Cleaning, Linen Cleaning & Waste Management Learning Objectives By the end of this session, the trainee should be able to: 1. Describe how the ETU is cleaned 2. Explain how linen/boots/goggles in the ETU are cleaned



33

3. Discuss management of waste material in the ETU

Session Content Outline 1. Describe how the ETU is cleaned 2. Explain how linen/boots/goggles in the ETU is cleaned 3. Discuss management of waste material in the ETU

Learning Experiences • PowerPoint presentations Resources • Standard Operating procedures for case management and Infection Control during Ebola

case management in Uganda • PowerPoint presentation on Cleaning an Ebola Treatment Unit to be adapted from

Uganda SOP manual • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. Brainstorm on key considerations during the cleaning of linen and waste

management (five minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 4.1 Dead Body Management in the ETU and the Community Learning Objectives By the end of this session, the trainee should be able to: 1. Appreciate that in an outbreak of Ebola there will be deaths due to Ebola in homes, the

community, in health facilities, and on the way to hospital 2. Appreciate the requirements of handling Ebola dead bodies appropriately 3. Outline the do’s and don’ts of taking care of a person who has died of Ebola 4. Describe the procedure for conducting a safe and dignified burial of a person who has died

of Ebola



34

5. Discuss the challenges of getting communities to adapt to safe methods of handling and burying dead people in their communities (Ebola and non-Ebola deaths)

Session Content Outline 1. Where does death of Ebola patients occur during an Ebola outbreak? 2. Requirements of handling Ebola dead bodies appropriately 3. Do’s and don’ts of taking care of a dead body of a person who has died of Ebola 4. Procedure for conducting a safe and dignified burial of a person who has died of Ebola 5. Challenges of getting communities to adapt to safe methods of handling and burying dead

people in their communities (Ebola and non-Ebola deaths)

Learning Experiences • PowerPoint presentations • Videos

Resources • PowerPoint presentation Session 4.1 a & b: Ebola Dead body management part 1 and 2.

O-Monrovia part 1 & part 2. • Video 1 (Appendix 1)- Liberian handshake lost to Ebola outbreak-Impact of Ebola:

https://www.youtube.com/watch?v=L-NVlSJQAx0 • LCD projector, flip charts and markers



Facilitator welcomes the trainees to the session. Emphasize to the trainees the importance of this session. Project the slides containing the objectives of the session, and explain them in

relation to the importance of the session to the entire course. Brainstorm on the supplies needed for handling Ebola dead bodies; ask participants

to repeat the do’s and don’ts of Ebola dead body management (ten minutes). Present the PowerPoint presentation up to the second last slide. Show Video 1 and ask participants what was done correctly about dead body

management. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 4.2 Screening and Triage for EDPs Learning Objectives By the end of this session, the trainee should be able to: 1. Appreciate that on a daily basis amongst the patients who visit health facilities there could

be some with Ebola and other EDPs




35

2. Explain why health care workers often do not consider EVD to be one of the conditions patients present with until outbreaks are confirmed

3. Describe how health care workers should assess patients during a confirmed Ebola outbreak

4. Describe how health facilities should implement an effective triage system

Session Content Outline 1. Reasons why health care workers do not consider Ebola to be one of the conditions

patients present with until outbreaks are confirmed 2. How to assess patients during a confirmed Ebola outbreak 3. How health facilities should implement an effective triage system

Learning Experiences • PowerPoint presentations Resources • PowerPoint presentation Session 4.2: Screening and Triage for EDPs • Reference book- Sierra Leone Ebola Treatment Centre Pocket Guide: Dec 2014, pages 17

to 19 • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)


Facilitator welcomes the trainees to the session. Emphasize to the trainees the importance of this session. Project the slides containing the objectives of the session and explain to

participants in relation to the importance of the session to the entire course. Brainstorm on the difference between screening and triage (five minutes). Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 4.3 Practical: Hand Washing Learning Objectives By the end of this session, the trainee should be able to: • Correctly wash hands before and after a procedure

Session Content Outline • Practical session on correct procedure for hand washing



36

Learning Experiences • PowerPoint presentations • Videos Resources • PowerPoint presentation Session 4.3: Infection prevention and control for the clinical team

Sierra Leone, slides 2-9 • Videos 34 and 35 (Appendix 1) • Video 34: Hand Washing Technique-WHO Approved- USAMRID-IDI EDP Course

material • Video 35: Why, When & How of Hand Hygiene for Healthcare- USAMRID-IDI EDP

Course material • Hand washing facility and soap • Flip charts x 2 • Markers x 5 • LCD projector



Follow the step by step process as outlined in the WHO guide. Pair up participants to go through this exercise with facilitators providing

guidance. Show Videos 34 and 35.

Session 4.4 Practical: Chlorine Solutions’ Preparation Learning Objectives By the end of this session, the trainee should be able to: 1. Correctly prepare 0.5% chlorine solution 2. Correctly prepare 0.05% chlorine solution 3. Know the expiation period for chlorine solution after preparation

Session Content Outline 1. Practical exercise on how to prepare 0.5% chlorine solution 2. Practical exercise on how to prepare 0.05% chlorine solution

Learning Experiences • Practical experience preparing the two concentrations of Chlorine solution • PowerPoint presentations

Resources



37

• PowerPoint presentations by Session 4.3: Infection prevention and control for the clinical team Sierra Leone slides 28-33, “Chlorine solution, Chlorine granules, water, measuring utensil, buckets, gloves”

• Flip charts x 2 • Markers x 5 • LCD projector

Assessment • Pre- and post-test questions • Ability to mix correct solutions of Chlorine concentrations


Follow the step by step process as outlined in the WHO guide. It is advisable to pair up participants to go through this exercise with facilitators

providing guidance.

Session 4.5 Practical: PPE Donning and Doffing Learning Objectives By the end of this session, the trainee should be able to: 1. Correctly put on full PPE for protection against Ebola and EDPs 2. Correctly put off PPE

Session Content Outline 1. Practical session on putting on (donning) PPE 2. Practical session on putting off (doffing) PPE

Learning experiences • PowerPoint presentation of the steps to don PPE Resources • WHO Pictorial chart on donning and doffing PPE • Full PPE sets (gloves, gum boots, scrub suit, coverall, face mask, hood if not part of the

coverall, goggles, apron) • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)


Follow the step by step process as outlined in the WHO guide.



38

A pair of facilitators should go through the step by step process with participants observing (this should take forty-five minutes, for both donning and doffing).

Participants should be paired up to go through this practical exercise with facilitators providing guidance and feedback.

The participants should switch roles along the way, for each one to get a chance to practice.

Session 4.6 Practical: Handling Dead Bodies in the ETU and Community Learning Objectives By the end of this session, the trainee should be able to: 1. Appropriately handle a dummy Ebola dead body 2. Correctly disinfect a site where the dummy dead body is found

Session Content Outline 1. Practical exercise on handling of a dummy dead body

Learning Experiences • Practical demonstration led by facilitator Resources • Dummy dead body or a locally available object e.g banana plant stem, dead body bags,

full PPE • Projector, flip charts and markers • +/-Videos Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)


Follow the step by step process as outlined in the WHO guide. Pair up participants to go through this exercise with facilitators providing

guidance. A facilitator must emphasize that Ebola dead bodies must always be handled in full

PPE.

Session 5.1 Discharge Protocols for Ebola Patients Learning Objectives By the end of this session, the trainee should be able to: 1. Describe the criteria for deciding readiness for discharge 2. State key messages given to Ebola survivors at discharge 3. Discuss the process of discharging Ebola survivors 4. List items given to Ebola survivors at discharge (discharge package) 5. Explain the ways in which Ebola survivors can be involved in the fight against Ebola 6. Discuss ways of survivor reintegration into the community



39

Session Content Outline 1. The criteria for deciding readiness for discharge 2. Key messages given to Ebola survivors at discharge 3. The process of discharging Ebola survivors 4. Ebola survivor discharge package (items given to Ebola survivors at discharge) 5. Ways in which survivors can be involved in the fight against Ebola 6. Ways of Ebola survivor reintegration into the community

Learning Experiences • Brainstorming-refer to procedure below • PowerPoint presentations • Videos 22 and 23 Resources • PowerPoint presentations to be adapted from the Ugandan SOP manual. • Hand out: Sierra Leone Ebola Treatment centre pocket guide Dec 2014 page 88,89,90 • Video 22 and 23 (Appendix 1) • Video 22: The boy who tricked Ebola; Discharge Protocols for Ebola Patients.

https://www.youtube.com/watch?v=9OQXZWz15_A • Video 23: Three testimonies of Ebola survivors; Discharge Protocols for Ebola Patients;

https://www.youtube.com/watch?v=5P9xj9j9Hgs • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. Brainstorm on the procedure for discharging Ebola patients, key messages to give

Ebola patients at discharge (five minutes). Present the PowerPoint presentation up to the second last slide. During the next ten minutes, show Videos 22 and 23 followed by a discussion of

key points noted- this should not exceed ten minutes. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 5.2 Emerging Treatment and Prevention Options for EVD and Other EPDs Learning Objectives

https://www.youtube.com/watch?v=9OQXZWz15_A

https://www.youtube.com/watch?v=5P9xj9j9Hgs



40

By the end of this session, the trainee should be able to: 1. List treatment and prevention options that are being studied for future use in Ebola

epidemics 2. Describe the key principles guiding the development of these options 3. Discuss the challenges related to developing new treatments and vaccines in the context of

an epidemic

Session Content Outline 1. Ebola treatment and prevention options under development 2. Key principles guiding selection of these options 3. Challenges related to developing new treatments and vaccines in the context of an

epidemic

Learning experiences • PowerPoint presentations • Videos

Resources • PowerPoint presentations to be adapted from the Ugandan MOH SOP manual (MSF,

WHO) • Video 30: Ebola virus outbreak 2014 - three hopes for a treatment; Emerging Treatment

and Prevention Options for EVD and EDPs. The New York Times. https://www.youtube.com/watch?v=KV-2F67cSqI

• Video 31: How could serum help in fight against Ebola; Al Jazeera https://www.youtube.com/watch?v=GaR6Y9W9KHw

• Flip charts x 2 • Markers x 5 • LCD projector




relation to the importance of the session to the entire course. For about five minutes, ask participants to share information on Ebola treatment

options under development, in case they have any. Present the PowerPoint presentation up to the second last slide. During the next ten minutes show Videos 30 and 31, followed by a discussion of

key points noted- this should not exceed ten minutes. Check understanding of key concepts. Present the last slide, which summarises the session.

https://www.youtube.com/watch?v=KV-2F67cSqI

https://www.youtube.com/watch?v=GaR6Y9W9KHw



41

Session 5.3 Collection and Storage of Data in ETUs Learning Objectives By the end of this session, the trainee should be able to: 1. Understand the importance of patient records management 2. Explain how record keeping can be improved at an ETU 3. Discuss ways of capturing data of a patient at the ETU and transmitting it outside of ETU

safely 4. Establish ways of integrating and sharing Ebola data

Session Content outline 1. The importance of patient records management 2. Ways of improving record keeping at an ETU 3. Ways of capturing data of a patient at the ETU and transmitting it outside of ETU safely 4. Ways of integrating and sharing Ebola data

Learning experiences • Brainstorming –refer to procedure below • PowerPoint presentations • Discussions Resources • PowerPoint presentations to be adapted from the Uganda MOH manual • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. In about ten minutes, ask participants to brain storm on how data from patients can

be captured and transmitted out of ETUs safely. Present the PowerPoint presentation up to the second last slide. Check understanding of key concepts. Present the last slide, which summarises the session.

Session 5.4 Logistics and Operations By the end of this session, the trainee should be able to: 1. List the drugs and supplies required for Ebola outbreak management



42

2. Appropriately quantify requirements for Ebola outbreak management 3. Describe the operational requirements for a well-managed ETU 4. Discuss the logistical and operational challenges of controlling an Ebola outbreak 5. Outline solutions to challenges of controlling Ebola outbreaks

Session Content outline 1. Drugs and other supplies required for Ebola outbreak management 2. Quantify requirements for Ebola outbreak management 3. Operational requirements for a well-managed ETU 4. Logistical and operational challenges involved in controlling an Ebola outbreak 5. Solutions to challenges involved in controlling an Ebola outbreak

Learning experiences • Brainstorming- refer to procedure below • PowerPoint presentations • Discussions Resources • PowerPoint presentations to be adapted from the Uganda MOH SOP manual • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. For about ten minutes, ask participants to brainstorm on drugs and other supplies

required for Ebola outbreak management, and challenges associated with providing adequate logistics in an outbreak.


Session 5.5 Ebola Research During an Outbreak Learning Objectives By the end of this session, the trainee should be able to: 1. Understand the value of research in Ebola outbreak management



43

2. Discuss the ethical considerations to be made in the conduct of research during an Ebola outbreak

3. State the procedures to be followed for the conduct of research during an Ebola outbreak 4. Identify research priorities for Ebola management 5. Explain research opportunities available during an outbreak 6. Enumerate challenges faced in research in an Ebola outbreak

Session Content Outline 1. The value and role of research in Ebola outbreak management 2. Ethical considerations in the conduct of research during an Ebola outbreak 3. Procedures to be followed for the conduct of research during an Ebola outbreak 4. Research priorities for Ebola management 5. Research opportunities available during an outbreak 6. Challenges faced in research in an Ebola outbreak

Learning Experiences • Brainstorming, refer to procedure below • PowerPoint presentations to be adapted from the Uganda MOH SOP manual • Discussions Resources • PowerPoint presentation • Flip charts x 2 • Markers x 5 • LCD projector Assessment • Pre- and post-test questions • Participation (i.e. asking and answering questions)



relation to the importance of the session to the entire course. For about ten minutes ask participants to brainstorm on potential areas of interest

for research during an Ebola outbreak and the challenges of conducting research during an Ebola outbreak.


Session 5.6 Post-Test, End of Course Evaluation, Course Closure Purpose of the session:



44

To close out the session and provide participants with: - Summary information shared during the training that they will need for

reference - Certificates - Contact details for follow on questions - Evaluation forms for their feedback on the training and facilitation - A post-test for their completion during the session

Objectives By the end of the session, the trainees should have: Provided feedback on how they perceived the course for purposes of improving

subsequent courses Received key note comments aimed at encouraging them to implement what has been

learned Answered the post-test for trainers to determine participants change in level of knowledge

at the end of the training Procedure Distribute post-test scripts and ask every participant to answer independently. Mark the post-test answer sheets and display marks. Distribute end of course evaluation forms for each participant to fill. If there is an official close, then invite the official to make a brief closing statement

and hand out certificates.



45

APPENDICES

Appendix 1: List of Videos for Course Sessions Title Session Source Retrieved from 1. Liberian handshake lost to

Ebola outbreak-Impact of Ebola

Impact of the Ebola Epidemic on West Africa

AFP https://www.youtube.com/watch?v=L-NVlSJQAx0

2. Spike in pregnancies and abuse in Ebola-hit Sierra Leone


AFP https://www.youtube.com/watch?v=-Psv5FdZSFo

3. Ebola outbreak hits African economies hard


Al Jazeera https://www.youtube.com/watch?v=cTRcMrbaE5w

4. Ebola - life without school in Guinea


AFP https://www.youtube.com/watch?v=VfLBhfymA9A

5. Low turnout for Liberia vote amid Ebola fears


Al Jazeera https://www.youtube.com/watch?v=gEie13slq28

6. Nigeria schools reopen after Ebola break


Reuters https://www.youtube.com/watch?v=4fUIUZA83Vg

7. Liberia police quarantine area over Ebola fears

National Leadership, Policies, and Guidelines

Al Jazeera https://www.youtube.com/watch?v=xM1iTKmmcD8

8. Sierra Leone Ebola curfew causes food shortages

National Leadership, Policies, and Guidelines

Al Jazeera https://www.youtube.com/watch?v=Y6RY2H-hh4g

9. Healers hinder Senegal's Ebola fight

Community Responses

Al Jazeera https://www.youtube.com/watch?v=-P8Xw1mMO20

10. Churches join fight against Ebola in Sierra Leone

Community Responses

AFP https://www.youtube.com/watch?v=v1JRXP3tSVg

11. Radio DJs in Sierra Leone join the fight against Ebola

Communications and Public Relations

AFP https://www.youtube.com/watch?v=Ew4-NLy4Fys

12. Ebola - 'Don't eat no monkey...Don't eat no bat'

Communications and Public Relations

MSF


13. WHO-EMRO - animated video on Ebola

Communication and Public Relations

WHO https://www.youtube.com/watch?v=qnvlQHJkBBY





























46

Title Session Source Retrieved from 14. Wash ya hand o (Pidgin) Communication

and Public Relations

Lens on Ebola


15. Ebola facts - Using celebrities to communicate key messages

Communication and Public Relations

Lens on Ebola


16. Contact tracers hunt down Ebola in Sierra Leone

Surveillance, Contact Tracing, and Containment

AFP https://www.youtube.com/watch?v=W6Ru7LuU_gc

17. Ebola - Frontline Report- Ane Bjøru Fjeldsæter, MSF Psychologist

Psychosocial Services for Individuals and Communities

MSF https://www.youtube.com/watch?v=64URkG-8z8w

18. Ebola outbreak - 'I lost 5 members of my family'


BBC https://www.youtube.com/watch?v=kgiYP9hJF5Y

19. Health workers in Sierra Leone dance to cheer up Ebola patients


AFP https://www.youtube.com/watch?v=xA_c2wy9OzA

20. Lives of Ebola survivors deeply affected after recovery


Al Jazeera https://www.youtube.com/watch?v=gsMjulAl4uc

21. Reine Lebel, a psychologist, talks about her work with Ebola patients


MSF https://www.youtube.com/watch?v=IJDYLeWKZHg

22. The boy who tricked Ebola Discharge Protocols for Ebola Patients

MSF https://www.youtube.com/watch?v=9OQXZWz15_A

23. Three testimonies of Ebola survivors

Discharge Protocols for Ebola Patients

WHO https://www.youtube.com/watch?v=5P9xj9j9Hgs

24. Preventing malaria while fighting Ebola in Liberia

Health Services for Ebola and Non-Ebola Conditions

MSF https://www.youtube.com/watch?v=VnfamJhQz_A

25. Doctor in Sierra Leone clinic fights Ebola solo

Human Resource for Ebola Response: Task Sharing, Task Shifting, and Specialisation

Reuters https://www.youtube.com/watch?v=g_1r5qgOTqg























https://www.youtube.com/watch?v=g_1r5qgOTqg

https://www.youtube.com/watch?v=g_1r5qgOTqg



47

Title Session Source Retrieved from 26. Ebola outbreak- 'We're

having to make impossible choices' says British doctor


BBC https://www.youtube.com/watch?v=lS4DGSbMxx0

27. Liberia medical workers may strike


CNN https://www.youtube.com/watch?v=IimW315UOyU

28. Nurses in Ebola-hit Sierra Leone back to work


Al Jazeera https://www.youtube.com/watch?v=KC2l6ISKMwE

29. Incredible aerial view of MSF's Ebola centre in Monrovia, Liberia - the largest ever built

Overall Organisation of an Ebola Treatment Unit

MSF https://www.youtube.com/watch?v=SZusF0x6LnU

30. Ebola virus outbreak 2014 - three hopes for a treatment

Emerging Treatment and Prevention Options for EVD and EDPs

The New York Times


31. How could serum help in fight against Ebola?

Emerging Treatment and Prevention Options for EVD and EDPs

Al Jazeera https://www.youtube.com/watch?v=GaR6Y9W9KHw

32. 'Goggle camera' records Ebola crisis

Health Worker Preparation for Work in an Ebola Treatment Unit

BBC https://www.youtube.com/watch?v=K5UpQxPil6Y

33. Ebola battle through nurse's eyes

Clinical Care in an Ebola Treatment Unit

CNN https://www.youtube.com/watch?v=La4YvsudGjQ

34. Hand Washing Technique-WHO Approved

USAMRID-IDI EDP Course

35. Why, When & How of Hand Hygiene for Healthcare

USAMRID-IDI EDP Course



















48

Title Session Source Retrieved from 36 How world’s worst Ebola

outbreak begun with one boy’s death

History, Biology and Amplifiers of Ebola

BBC https://ww.youtube.com/watch?v=_vEpvXHzJLo

Appendix 2: List of PowerPoint Presentations and Hand-Outs for Course Sessions Day One Session number #

Hand out title Source

1.1 Ebola Overview and Biology WHO 1.2 Impact of the Ebola epidemic on West

Africa Presentation to be adapted from Ugandan Ministry of Health manual

1.3 Overview of Especially Dangerous Pathogens (EPDs)

USAMRIID-IDI EDP Course

1.4 National Leadership, Policies, Guidelines

Presentation to be adapted from Ugandan Ministry of Health manual

1.5 Community Responses Presentation to be adapted from Ugandan Ministry of Health manual

1.6 Communications and Public Relations Presentation to be adapted from Ugandan Ministry of Health manual

Day Two Session number #


2.1 Clinical Care and Public Health Notification and reporting

USAMRIID-IDI EDP Course

2.2 Strategies to stop Ebola transmission Preparing health centre, health post or hospital outpatient for Ebola surveillance Preparing Health facilities in at-risk countries for screening for Ebola

MSF strategies summary PPT WHO WHO

2.3 Psychosocial Services for Individuals and Communities


2.4 Health Services for Ebola and Non-Ebola Conditions


2.5 Health Worker preparation for work in Ebola outbreaks and coping with the Heat

WHO





49

2.6 EVD Module 4 support services ICAN 2.7 Overall organization of the Ebola

Treatment Centre and screening WHO

Day Three

Session number #


3.1 Overview of Trainings for Ebola infection control

Republic of Liberia ministry of Health

3.2 Infection Prevention and Control for Ebola Response Team

WHO

3.3 PPE for Ebola 3.4 WHO Blood sample collection from

Ebola suspect guidelines WHO

3.5 Clinical management of patients in the Ebola Treatment Centers and other care centers in Sierra Leone pocket guide Working in the ETU

WHO WHO/IMAI

3.6 Health Worker preparation for work in Ebola outbreaks and coping with the Heat

WHO

3.7 Environmental Cleaning and Waste management

WHO

3.8 Cleaning an Ebola Treatment Unit WHO Day Four Session number #


4.1 Dead Body Management in the ETU and the Community

Session 4.1a & b Ebola Dead Body Management part 1 and 2

4.2 Screening and Triage for EDPs Session 4.2 Screening and Triage for EDPs

4.3 Practical: Hand Washing WHO Pictorial guide 4.4 Practical: Chlorine Solutions’

Preparation Session 4.3 Infection prevention and control for the clinical team Sierra Leone slides 28-33

4.5 Practical: PPE Donning and Doffing WHO pictorial guide 4.6 Practical: Handling Dead Bodies in

ETU and Community No need for a PowerPoint

Day Five Session number #


5.1 Discharge Protocols for Ebola Patients To be adapted from the Uganda MOH manual under development



50

5.2 Emerging Treatment and Prevention Options for EVD and EDPs

To be adapted from the Uganda MOH manual under development

5.3 Collection and storage of data in ETUs To be adapted from the Uganda MOH manual under development

5.4 Logistics supplies and operations 5.5 Research during in Outbreak;

Regulation and institutional approval To be adapted from the Uganda MOH manual under development

Appendix 3. Course Schedule for the Training on Preparedness for Ebola and other Disease Outbreaks in Nigeria Time Monday Tuesday Wednesday Thursday Friday

8:00-9:30

Opening and pre-test 2.1 Surveillance, Contact Tracing, and Containment

3.1 Universal Precautions to Prevention Infection and Nosocomial Infections

4.1 Dead Body Management in the ETU and the Community

5.1 Discharge Protocols for Ebola Patients

1.1 History, Biology, and Amplifiers of Ebola

3.2 Infection Prevention and Control for Ebola Response Team

4.2 Screening and Triage for EDPs

5.2: Emerging Treatment and Prevention Options 2.2 Preparing the Health

Centre 9:30-10:00 Break

10:00-11:30

1.1 History, Biology, and Amplifiers of Ebola cont.

2.2 Preparing the Health Centre cont. 3.3 PPE for Ebola

Management 4.3 Practical: Hand Washing 5.3 Collection and Storage of Data in the ETU

1.2 Impact of the Ebola Epidemic on West Africa 2.3 Psychosocial Services for

Individuals and Communities 1.3 Overview of Especially Dangerous Pathogens 3.4 Collecting Blood Samples 4.4 Practical: Chlorine

Solutions Preparation

11:30-1:00

1.3 Overview of Especially Dangerous Pathogens cont. 2.4 Health Services for Ebola

and Non-Ebola Conditions 3.5 Clinical Care in the ETU 4.4 Practical: Chlorine Solutions Preparation cont.

5.3 Collection and Storage of Data in the ETU cont.

1.4 National Leadership, Policies, Guidelines

5.4 Logistics, Supplies, and Operations 2.5 Human Resource for

Ebola Response 1:00-2:00 Lunch

2:00-3:00 1.5 Community Responses

2.5 Human Resource for Ebola Response cont.

3.5 Clinical Care in the ETU cont. 4.5 Practical: PPE Donning

and Doffing 5.5 Research During an Outbreak 2.6 Water, Sanitation,

Utilities, and Facilities 3.6 Health Worker Preparation

3:00-3:15 Break

3:15-4:45

1.6 Communications and Public Relations

2.6 Water, Sanitation, Utilities, and Facilities cont.

3.7 Cleaning and Disinfecting Protocols for Ebola

1.5 Practical: PPE Donning and Doffing cont.

5.6 Post-Test, End of Course Evaluation, Course Closure

2.7 Screening and Overall Organization of the ETU

3.8 Environmental Cleaning, Linen Cleaning, and Waste Management

4.6Practical: Handling Dead Bodies in the ETU and Community

Appendix 4: Register of Participants in the Inaugural Ebola Readiness Curriculum Adaptation Workshops, January 2015

WAIDI/NCDC Ebola Readiness Curriculum Adaptation Workshop Register of Participants

January 19-24, 2015

S/No Name Institutional Affiliation Designation

1 Prof. Kabiru Sabitu Ahmadu Bello University, Zaria Professor 2 Dr. Garba Iliyasu Bayero University, Kano Lecturer 3 Dr. Joshua Abubakar

Difa Gombe State University, Gombe Fellow

4 Dr. Bamidele Oke Nigerian Institute of Medical Research, Lagos Research Fellow 5 Dr. Uzochukwu

Ikemefuna Chijioke Nnamdi Azikiwe University, Awka Reader

6 Dr. Aaron Oladipo Aboderin

Obefemi Awolowo University, Ile – Ife Reader

7 Dr. (Mrs) Eno Ebong University of Calabar Director, Health Services 8 Dr. Oyinkan Sofola University of Lagos, Lagos Associate Professor 9 Dr. Mohammed Arab

Alhaji University of Maiduguri, Maiduguri Senior Lecturer

10 Dr. Ohanu Ekechukwu Martin

University of Nigeria, Nsukka Senior Lecturer

11 Dr. Ibanga Inyang University of Uyo, Uyo Senior Lecturer 12 Flying Officer Olabode

Muzemilu Akorede Ministry of Defense Health Implementation Program, Abuja

Medical Officer

WAIDI/NCDC Ebola Readiness Curriculum Adaptation Workshop Register of Participants

January 19-23, 2015

S/No Name Institutional Affiliation Designation

13 Prof. Idris Mohammed Gombe State University Pro - Chancellor / Chair Governing Council 14 Keshinro Babajide Directorate of Defense, Walter Reed Program - Nigeria Director, Science 15 Wing Commander

Alfred A Ogbonda Nigerian Air Force, Abuja Medical Officer

16 Major General AE Life Ajemba

Ministry of Defense Health Implementation Program, Abuja.

Director General

17 Col. Taiwo Adebayo HQ Nigerian Army Medical Corps, Lagos Director Dental Services 18 Robert Nelson United States Embassy, Abuja Country Director 19 Dr. Ifeanyi Okudo World Health Organization, Nigeria Country Office, Abuja National Program Officer, IDSR 20 Dr. Mary Stephen World Health Organization, Nigeria Country Office, Abuja National Program Officer, NCDS 21 Mathew Scott

Chambers U.S. Army Medical Research Institute of Infectious Diseases, U.S.A.

Course Director, Clinical Research Trial Investigator

22 Dr. Alex Coutinho Accordia Global Health Foundation, U.S.A. Consultant 23 Arinaitwe Walter

Joseph Infectious Diseases Institute, Uganda. Technical Trainer

24 Dr. Umaru Ssekabira Infectious Diseases Institute, Uganda. Head of Training and Capacity Development 25 Anosike Ifeoma West African Infectious Diseases Institute, Abuja Workshop Rapporteur 26 Apera Iorwakwagh West African Infectious Diseases Institute, Abuja Director 27 Lanem Law Kuma West African Infectious Diseases Institute, Abuja Program Support Consultant

Documents

EVD Training Guide- AAC3