Sierra LeoneCross Border Strategy on Prevention
and Control of Ebola
Operationalization of the Monrovia Communique
Background to Monrovia Communique
Technical meeting on Cross Border collaboration on the prevention and control of Ebola (09 Dec 2014 in Monrovia)
DELEGATES:• Governments of Sierra Leone, Liberia, Mali• UNMEER, MRU, AU• UN Response teams from Guinea, Mali, Sierra Leone, Liberia
Context:• Cross-border transmission as a prominent feature of the EVD outbreak;• More than a thousand informal and poorly regulated border crossing
points across MRU;• Border communities share livelihoods and population movement
patterns do not regard formal borders
(Select) Recommendations from the Monrovia Communique to inform Sierra Leone strategy
• Laboratory samples should be transported to the nearest testing lab, regardless of borders, and results shared in real time.
• “Open Border Policy” that allows patients to be treated at the nearest Ebola treatment facility without stigmatization because of nationality.
• Authorities on either side of the border share contact lists and information for monitoring and action on a daily basis; and UNMEER support the establishment of a cross border contacts database to facilitate information flow.
• Entry and exit points have reinforced capacities for screening, isolation. Rapid response teams with ambulance capacity should be positioned at formal border crossings and be supported with mechanisms to facilitate deployment across borders, if necessary.
• Ebola supplies be prepositioned near border posts with high cross border traffic allowing for cross border deployment.
• Full involvement and leadership by elders and traditional leaders, and the building of a network of local, national and international anthropologists amongst them for effective EVD control.
Sierra Leone Strategy Border Surveillance and Response
Mano River Union: shared information, guidelines and resources across borders, in line with the recommendations of the Monrovia Communique
District Specific Operations: strong community watch networks; engagement with community and traditional leaders, community-based surveillance contact tracing and social mobilisation
Medical Response: Hubs to be established with necessary surveillance, labs, case management resources (labs, CCCs / EHCs/ ETCs, vehicles, etc.) – to be accessible regardless of nationality
Security: support of SLP, RSLAF, ONS, Customs, Immigration, to work with communities and authorities to monitor and enforce border security.
Border
BorderCrossingPoint
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
Enablers:
MRU: framework for cooperation and shared resources across borders, regardless of nationality
Security: facilitate implementation of the framework: providing support to border area, liaising with community watch groups, and coordinating logistics
BorderCrossingPoint
ETC& Lab
CCCCCC
CCC
Medical Response Facility (isolation or treatment) &/or Lab
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
Implementers:
Community Response: strong community watch networks; community-based surveillance and contact tracing
Medical Response: hubs to be established with necessary surveillance, labs, case management resources (labs, CCCs / EHCs/ ETCs, vehicles, etc.) – to be accessible regardless of nationality
BorderCrossingPoint
ETC& Lab
CCCCCC
CCC
Community surveillance and watch networks
Medical Response Facility (isolation or treatment) &/or Lab
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
ETC& Lab
CCCCCC
CCC
Community surveillance and watch networks
Medical Response Facility (isolation or treatment) &/or Lab
Joint Forces Command Centre, Logistics Base (located at a formal check point)
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
ETC& Lab
CCCCCC
CCC
Community surveillance and watch networks
Medical Response Facility (isolation or treatment) &/or Lab
Joint Forces Command Centre, Logistics Base (located at a formal check point)
Contact tracingSurveillance
Reports
Monitoring, Reporting,Logistics requests /
coordination
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
Contact tracingSurveillance
Reports
Monitoring, Reporting,Logistics requests /
coordination
ETC& Lab
CCCCCC
CCC
Community surveillance and watch networks
Medical Response Facility (isolation or treatment) &/or Lab
Joint Forces Command Centre, Logistics Base (located at a formal check point)
Patient transfer
Lab transfer
Sierra Leone
Pujehun District
Liberia
Grand Cape Mount
Moving towards an operational plan
• Internal discussion and agreement on concept of cross-border collaboration;
• Political discussions and agreement within the MRU, whilst working on the plans to operationalize the principles and concepts of cross-border collaboration;
• Begin conversations with Liberian counterparts on the next steps and way forward (whilst MRU is discussing with Guinea);
• Prepare for launch of plan once MRU formalizes the agreement.
Community-based surveillance and watch groups in
border communities
Medical ‘Hubs’ with border-free
access
Logistical support and surveillance at border points
Strategic Area Key Stakeholders Key questions / areas to consider for planning
•Surveillance Pillar•DERCs•Traditional leaders•Youth groups & women’s
groups (especially traders)•SLP•UNMEER
•How to strengthen local, community networks, including across borders?•How to best train and resource border communities in
this area?•How to best engage traditional/community leaders,
youth groups and women groups in a sustainable manner?•How do these groups interface with security forces on
either side of the border?
•Case Management Pillar•Surveillance Pillar• Labs•RSLAF / Immigration / SLP•UNMEER / WHO / CDC / UK
JIATF
•Strategic locations for Hubs in Sierra Leone & key areas for access across borders;•Security needs for facilitating access across borders;•Communication needs;•Current availability and gaps in S.L. hub facilities (labs,
CCCs, ETUs, ETCs)
• Logistics Pillar•UNMEER / UK JIATF / US Emb•RSLAF / Customs• Immigration / SLP
• Identifying locations for potential joint forces command centres (consider medical hubs)• Logistical support and management at border locations•Strengthening surveillance and health checks at formal
crossing points
MRU Collaboration
•GoSL•NERC, MoHS, MoD, SLP, etc.•MRU, ECOWAS, AU•UNMEER
•Political engagement for signature of MOU•Planning and logistical arrangements:
•National and Community Ebola Response•Security•Medical Response
Operational Plan Development (Proposed Working Groups)