1. Training structure 20.05.2015 Safety and good quality work Module 1: Knowledge about Ebola Virus Disease Support from the community Support from the hospital administration Support from the population Module 3: Standard pre- cautions Module 2: Community response Module 6: Water, disinfection and cleaning Module 5: Personal protective equipment Module 4: Triage & isolation EFFO Ebola

2. Community response Module 2 20.05.2015

3. Learning objectives module 2 General objectives To know how to respond to Ebola on national, hospital and community level. Specific objectives 1.To know the general strategy against Ebola virus disease 2.To know where Ebola is found 3.To realise the complexity of the preparedness and response to the Ebola virus disease 4.To know the role and tasks of health workers 5.To identify risky behaviours 20.05.2015

4. Risk factors in the event of an outbreak Society Airports Border crossings Bus and train stations Regional and national hospitals Medical centre with surgical unit Health and social promotion centre Paramedics Customs Family Neighborhood Funeral parlour Places of worship Drivers Traditional practitioners Local communities Carers Schools 20.05.2015

5. General strategy - four phases (WHO) 1.Pre-epidemic preparedness 2.Alert (detection, investigation, risk assessment) 3.Outbreak response and containment operations 4.Post-epidemic evaluation -> Focus here: pre-epidemic preparedness in health structure 20.05.2015

6. health system and EFFO project focus Ministry of Health (MoH) / National Disease Control Institutions Regional Health Directorate/ Regional Disease Control Services Local Health Administration/ Rapid Response Team Health promotion centres Medical centres District hospitals University hospitals Administrative sideHealthcare side World Health Organization (WHO) Suspected case: What to do? 20.05.2015 OUR FOCUS

7. Organisational structure of the response (WHO) 20.05.2015

8. What should be done during the pre-epidemic phase? -Establishment of a surveillance system to identify viral haemorrhagic fever -Measures against healthcare-associated infections -Health promotion programme -Collaboration with wildlife health services 20.05.2015

9. What should be done during the alert phase? -Investigate the suspected Ebola case -Obtain laboratory results -Make a decision based on the laboratory results and investigations 20.05.2015

10. Confirmed case: What should be done in the control phase? -Immediately inform local, regional and national authorities about a confirmed case -Declare the Ebola outbreak at WHO -Coordinate and mobilise resources -Epidemiological investigation, surveillance and laboratory 20.05.2015

11. Confirmed case: What should be done in the control phase? -Social and behavioural interventions -Media and communications -Clinical management of patients -Psychological care and social welfare -Research projects and ethical aspects -Logistics and safety -Environmental management 20.05.2015

12. What should be done afterwards? Post-epidemic period -Declare the end of the epidemic -Resume the activities of the pre-epidemic phase -Monitor recovering patients and social problems -Produce the end-of-epidemic report -Keep records on the epidemic -Evaluate the management of the epidemic 20.05.2015

13. Organisational structure (WHO) 20.05.2015

14. Responsibilities at the hospital 20.05.2015 Behavioural intervention: -standard precautions in health structures -precautions in the community/home Media: - It must be clarified in advance who communicates with journalists Psychosocial support: provide psychosocial support to the patient and their relatives - receive psychosocial support from colleagues, family, society

15. Responsibilities at the hospital 20.05.2015 Epidemiology and surveillance: -Documentation of the contacts of suspected cases -Communication to the epidemiology team Care of a suspected case: -Communication of a suspected case -Isolation of the patient -Care -Transfer of the patient to the treatment centre Ethics: -Ensure communication of the patient with family -Provide symptomatic treatment

16. Responsibilities at the hospital 20.05.2015 -Identification of the interim isolation area and safety -Storage of materials for standard precautions -Storage of personal protective equipment -Waste management -Organisation and training of a team to care for suspected cases -List of communication and allocation of responsibility (-> e.g. patient transfer) -Investigation forms: case definition, contact list

17. The tasks in a hospital Detection of an Ebola case Isolate the patient Internal communic ation Epidemiology; official forms Care for the patient Patient transfer Investigative team Family, local population (Media) Responsible team -Triage -Knowledge about the disease -Isolation area -Personal protective equipment -Symptomatic treatment External commu- nication 20.05.2015

18. Epidemiological investigation The epidemiological investigation, monitoring and laboratory is very important for stopping the transmission chains. -> Ask for the current case definition -> Draw up a comprehensive list of contacts for each detected/suspected case -> This is essential for the surveillance of all contacts for 21 days after the last exposure 20.05.2015

19. Practical exercise Which case definition is being used in your health structure? Is there a communication list? Do you have a contingency plan in case of a suspected case? -> Please bring the answers for the exercises tomorrow and the day after tomorrow 20.05.2015

20. Thank you for your attention! 20.05.2015