Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone.
An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country's most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH's experience in Sierra Leone is one of multiple partnerships with different stakeholders. It is also one of rapid deployment of expatriate clinicians and logistics personnel in health facilities largely deprived of health professionals, medical supplies, and physical infrastructure required to deliver health services effectively and safely. Lessons learned by PIH and its partners in Sierra Leone can contribute to the ongoing discussion within the international community on how to ensure emergency preparedness and build resilient health systems in settings without either.
Partners In Health Division of Global Health Equity Department of Global Health and Social Medicine, Harvard Medical School.
Corrado
C
Cancedda
Partners In Health.
Sheila M
SM
Davis
Partners In Health Division of Global Health Equity.
Kerry L
KL
Dierberg
Partners In Health.
Jonathan
J
Lascher
Division of Global Health Equity Department of Medicine, University of California-San Francisco School of Medicine Wellbody Alliance.
J Daniel
JD
Kelly
Partners In Health Department of Global Health and Social Medicine, Harvard Medical School Wellbody Alliance.
Mohammed Bailor
MB
Barrie
Princess Christian Maternity Hospital.
Alimamy Philip
AP
Koroma
Port Loko Government Hospital, Port Loko, Sierra Leone.
Peter
P
George
Ministry of Health and Sanitation, Freetown.
Adikali Alpha
AA
Kamara
Koidu Government Hospital.
Ronald
R
Marsh
District Health Management Team, Koidu.
Manso S
MS
Sumbuya
Partners In Health Department of Global Health and Social Medicine, Harvard Medical School.
Cameron T
CT
Nutt
Department of Global Health and Social Medicine, Harvard Medical School.
Kirstin W
KW
Scott
Partners In Health.
Edgar
E
Thomas
Partners In Health.
Katherine
K
Bollbach
Partners In Health Wellbody Alliance.
Andrew
A
Sesay
Partners In Health Wellbody Alliance.
Ahmidu
A
Barrie
Partners In Health.
Elizabeth
E
Barrera
Partners In Health.
Kathryn
K
Barron
Partners In Health Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children's Hospital.
John
J
Welch
Partners In Health Division of Infectious Diseases, Boston University School of Medicine, Massachusetts.
Nahid
N
Bhadelia
Partners In Health Wellbody Alliance.
Raphael G
RG
Frankfurter
Partners In Health.
Ophelia M
OM
Dahl
Partners In Health.
Sarthak
S
Das
Partners In Health.
Rebecca E
RE
Rollins
Partners In Health.
Bryan
B
Eustis
Partners In Health.
Amanda
A
Schwartz
Partners In Health.
Piero
P
Pertile
Partners In Health.
Ilias
I
Pavlopoulos
Partners In Health.
Allan
A
Mayfield
Partners In Health Department of Emergency Medicine, Brigham and Women's Hospital Department of Global Health and Social Medicine, Harvard Medical School.
Regan H
RH
Marsh
Partners In Health Wellbody Alliance.
Yusupha
Y
Dibba
Partners In Health.
Danielle
D
Kloepper
Partners In Health.
Andrew
A
Hall
Partners In Health Department of Global Health at the University of Washington, Seattle.
Karin
K
Huster
Partners In Health.
Michael
M
Grady
Partners In Health.
Kimberly
K
Spray
Partners In Health Division of Global Health Equity.
David A
DA
Walton
Partners In Health Wellbody Alliance.
Fodei
F
Daboh
Partners In Health.
Cora
C
Nally
Partners In Health Wellbody Alliance.
Sahr
S
James
Partners In Health.
Gabriel S
GS
Warren
Partners In Health.
Joyce
J
Chang
Partners In Health.
Michael
M
Drasher
Partners In Health Wellbody Alliance.
Gina
G
Lamin
Partners In Health Wellbody Alliance.
Sherry
S
Bangura
Department of Global Health and Social Medicine, Harvard Medical School.
Ann C
AC
Miller
Partners In Health.
Annie P
AP
Michaelis
Partners In Health.
Ryan
R
McBain
Partners In Health.
M Jana
MJ
Broadhurst
Partners In Health Division of Global Health Equity Department of Global Health and Social Medicine, Harvard Medical School.
Megan
M
Murray
Partners In Health Division of Global Health Equity Division of Infectious Diseases, Stanford University School of Medicine Department of Anthropology, Stanford University, Palo Alto, California.
Eugene T
ET
Richardson
Partners In Health.
Ted
T
Philip
Partners In Health.
Gary L
GL
Gottlieb
Partners In Health Division of Global Health Equity Department of Global Health and Social Medicine, Harvard Medical School.
Joia S
JS
Mukherjee
Partners In Health Division of Global Health Equity Department of Global Health and Social Medicine, Harvard Medical School.
Paul E
PE
Farmer
D003695:Delivery of Health Care; D029043:Ebolavirus / Q000502:physiology*; D004632:Emergency Medical Services; D058872:Epidemics; D006268:Health Facilities; D006282:Health Personnel; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D009938:Organizations; D012807:Sierra Leone / Q000453:epidemiology
Ebola; Sierra Leone; emergency response; health system strengthening
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