In line with the International Health Regulations (IHR 2005) and the Global Health Security Agenda (GHSA), IOM aims to contribute to the prevention, early detection and response to Ebola Virus Disease (EVD) in Southern Africa, East and Horn of Africa, and West and Central Africa from a human mobility-centred perspective.
Aligned with priorities outlined in the EVD Strategic Response Plan 4 (SRP4), IOM’s Health Border and Mobility Management framework, the GHSA and IHR, IOM seeks to contribute to the continued containment, recovery and future health system preparedness for EVD by prioritising enhanced active disease surveillance through supporting technical and operational capacity in health screening and contact tracing, community event-based surveillance, and risk communication and community engagement at Points of Entry (PoE) and among border communities in order to save lives and prepare for future outbreaks. In strengthening the capacities of relevant stakeholders, IOM aligns its priorities with the Sustainable Development Goal (SDG) for early warning, risk reduction and management of national and global health risks. IOM invests in training frontline workers on early detection, prepositioning of medical supplies to support any immediate response and prevention of disease spread including infection prevention and control in the case of an outbreak.
IOM plans to continue its crucial programming supporting EVD survivors, their families, and health workers with mental health services and psychosocial support, ensuring that the rights, dignity, interests and needs of vulnerable populations (including EVD survivors and their families, women and girls, the elderly, young people and people living with disabilities) are reflected in the ongoing EVD response, and addressing protection needs exacerbated in the context of such outbreaks. In addition, IOM will implement activities aiming to contribute to the containment of the recently declared 13th EVD outbreak in DRC, targeting travellers and mobile communities as well as communities living along mobility routes and PoEs.
Mental Health and Psychosocial Support (MHPSS) services are key to supporting EVD survivors, the families of those affected, health workers and other persons having experienced traumatic events in the context of EVD outbreaks. MHPSS services provided by IOM will include:
- Raising awareness in border communities to prevent, anticipate and address risks of violence, discrimination, and marginalization of EVD survivors and their families;
- Providing psychological first aid (PFA);
- Implementing psychoeducation (including self-care and stress management) for EVD survivors and their families to learn how to cope with traumatic experiences;
- Establishing interdisciplinary psychosocial mobile teams (PMT) to provide assessments, individual and group counselling (in line with COVID-19 prevention measures) and guided support groups for EVD survivors, their families and other vulnerable groups, as well as socio-relational activities that help to overcome stigmatisation of EVD survivors and their families by fostering social cohesion (e.g., sport and play activities, creative and art-based activities or cultural events and rituals);
- Enabling safe and dignified burials for people who died if possible, or alternative rituals that allow for dignified alternative ways of mourning;
- Training and supervising community health workers to provide psychosocial support services; and
- Integrating MHPSS issues into the training of disease screeners, health workers, immigration officials, educational staff and community leaders, including traditional healers.
EVD outbreaks have exacerbated pre-existing vulnerabilities, such as risks of violence, exploitation and abuse, as well as discrimination and socioeconomic instability. IOM will ensure that the rights, dignity, interests and needs of vulnerable populations, including EVD survivors and their families, women and girls, victims of trafficking, the elderly, young people and persons living with disabilities, are reflected in the EVD response. Following lessons learned from previous EVD outbreaks, all activities will be planned in close collaboration with communities, local authorities and leaders, as well as health service providers to address protection and assistance needs of communities through:
- Supporting assessments of the effects of the outbreak on vulnerability to violence, abuse and exploitation in order to define the problem and build quality responses;
- Strengthening existing protection mechanisms and psychosocial support services to identify and support persons in need of care or protection, and providing referral to appropriate services including specialized mental health services (following a quality/rights assessment);
- Supporting awareness raising among targeted populations, with a focus on women and girls as well as young people, through social mobilization agents, religious leaders and women’s associations, on how to access services and seek support, the risks of gender-based violence (GBV) and human trafficking; and
- Training relevant staff and implementing partner staff on GBV and the prevention of sexual exploitation and abuse (PSEA), including how to safely and ethically respond to a disclosure of a GBV incident, and contribute to inter-agency efforts regarding PSEA complaint mechanisms.
In response to the 13th EVD outbreak in DRC, IOM will help ensure that travellers and host communities have access to water, sanitation and hygiene (WASH) facilities along key mobility corridors by:
- Constructing permanent water supply and hand washing stations at congregation points along the mobility continuum, targeting both travellers and host communities;
- Constructing permanent latrines at key sites along mobility corridors; and
- Supporting community-based mechanisms to promote ownership and to maintain WASH infrastructure.
Following the cessation of the recent EVD epidemics in DRC and Guinea and in the context of the recently declared 13th outbreak in DRC, IOM aims to continue preparedness and mitigation efforts, increase the resilience of the health system to better respond to future health threats and to include mobility related public health risks in existing health surveillance models. Travellers, the local population, migrants, internally displaced persons (IDPs) and refugees will be at reduced risk of contracting and being exposed to a variety of health threats due to enhanced prevention and response efforts by IOM and partners. People directly targeted will include Ministry of Health staff, border officials and frontline health workers at PoEs that will be trained and supported by IOM, as well as migrants along the mobility continuum and the communities living in the surroundings of the targeted PoEs.
IOM's priority for 2022 and beyond in DRC, neighbouring countries and West Africa is to continue to support governments to meet IHR commitments and strengthen IHR core capacities at the national and regional level in order to better prepare and respond to future health threats and public health hazards. This will occur through focusing on prioritising health components of preparedness and risk reduction through population mobility mapping, strengthening capacity at PoEs and points of control (PoCs), health systems strengthening and strengthening coordination mechanisms and partnerships with appropriate actors to ensure appropriate, timely, targeted and sustainable interventions whilst striving to build national capacity in line with the targets outlined within the humanitarian-development peace nexus.
In 2022, IOM in DRC, neighbouring countries including Burundi, Rwanda, Tanzania, Uganda, and South Sudan as well as countries in the West Africa region will (depending on local context, capacity and priorities):
- Develop standard operating procedures (SOPs) and train staff to enhance frontline detection capabilities of various health threats;
- Establish and build upon pre-existing national and cross-border coordination mechanisms, in order to enhance regional information management and related mechanisms, whilst fostering enhanced regional collaboration and communication with governments, UN agencies, civil society, NGOs and community representatives;
- Develop and pilot a community- based surveillance and risk communication and community engagement (RCCE) strategy for mobile populations crossing international and sub-national borders such as informal traders;
- Continue to develop a decentralized approach to preparedness and management of epidemics, integrating disease surveillance within the existing peripheral health system;
- Support the rehabilitation and activation of public health emergency operations centres;
- Conduct monitoring and support supervision missions with the Ministry of Health to monitor screening operations at borders in terms of procedures and compliance to standard operating procedures;
- Maintain surge capacity and first response teams to promptly react in the event of resurgence of EVD cases;
- Enhance the collection, transmission, analysis and reporting of epidemiological surveillance data through the use of technology, including online data collection tools; and
- Support the testing of dead bodies for EVD in areas of active EVD transmission in the context of the 13th outbreak to strengthen surveillance mechanisms.
IOM will support Ministries of Health (MoH), border authorities and other partners to enhance the capacity of priority PoEs to detect, isolate and refer suspected EVD cases and contacts and enhance surveillance along mobility routes. This will include:
- Conducting simulation exercises at PoEs/points of control (PoCs) to build the capacity of border and health personnel to detect, and appropriately respond to public health hazards;
- Bolstering staff capacity to detect, manage and refer EVD cases through the development, validation and monitoring of EVD-related standard operating procedures, tools, guidelines and training (such as disease screening, surveillance, infection prevention and control (IPC), case management, contract tracing and risk communication) at PoEs/PoCs;
- Improving PoE and health screening point infrastructure and supplies, including the improvement of WASH infrastructure (separating infrastructure for men and women and ensuring accessibility for children and people with disabilities) and the provision of necessary WASH and health equipment and supplies for disease screening and infection prevention and control;
- Building capacity at designated PoEs for public health event preparedness and response by developing public health emergency response plans and conducting simulation exercises;
- Implementing training for frontline workers to enable them to effectively engage with travellers and address resistance to disease screening at PoEs/PoCs. Such training will include training on PSEA;
- Implementing community event-based surveillance in communities surrounding PoEs/PoCs, and training a network of community health workers and community leaders to reinforce this system; and
- Supporting the MoH to better integrate PoE surveillance actors into the national surveillance system and information flow - such as the District Health Information Software 2 - for epidemic-prone diseases.
IOM has, over time, adapted its response during outbreaks through active engagement with mobile communities, the establishment of community feedback mechanisms and platforms for dialogue, and after action reviews to analyse its response and improve the efficiency of future response strategies. IOM will continue to strengthen the evidence base for effective crisis response through the collection, sharing and analysis of displacement and population mobility data so that its programming continues to be informed by the needs and realities within the communities it serves. Entities targeted include government counterparts such as Ministries of Health, border management officials, intergovernmental agency partners and non-governmental organizations with whom analyses and reports will be shared to support evidence-based EVD preparedness and response.
Combined with epidemiological data, mobility data is key to predicting the dynamics of current epidemics and informing preparedness and response strategies into the future. IOM will enhance existing national-level disease surveillance systems by strengthening the collection of mobility-related data using Population Mobility Mapping (PMM) methodologies developed during the West Africa EVD outbreak, to increase the capacity to prevent, detect, report and respond to public health threats including EVD by:
- Conducting participatory mapping exercises to identify high-risk transmission mobility corridors and key gathering areas to inform local and sub-national preparedness and response plans and disseminate findings to communities and partners to inform response operations;
- Installing flow monitoring points in relevant PoEs to measure the volume of flows and trends and monitor cross-border movements;
- Analysing mobility data and EVD epidemiological reports to produce situation reports and maps, including regional-level analysis leading to the identification of key intervention areas, alongside informed and targeted public health interventions at local, national and regional levels that can help halt the spread of EVD; and
- Sharing critical epidemiological and mobility information widely to support inter-agency coordination, including the mapping, updating and sharing of information at local, national and regional levels, leading to a more informed response to limit the spread of EVD.
Burundi, Democratic Republic of the Congo, Guinea, Rwanda, Sierra Leone, South Sudan, Uganda, United Republic of Tanzania
Figures are as of 31 December 2020. For more details of IOM's operational capacity in country, please see the IOM Capacity section.