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Ebola in Sierra Leone as a Public Health Issue

Community and Public Health Issue

Sierra Leone is a West African country that has a population of more than 7 million people (Lahai, 2017). Emerging from a civil war that lasted more than a decade, the country has a poor health infrastructure characterized by poor access to health care facilities and the lack of adequate equipment at existing health centers (Lahai, 2017). Based on its poor health infrastructure, in 2014, the country suffered one of the worst Ebola outbreaks in recent history (CDC, 2014). According to Lahai (2017), Ebola is an infectious disease that could lead to death if not managed within a few hours after infection. Initial infection often occurs from animals to humans, but its spread often occurs through human-to-human contact. Generally, experts say this disease could lead to fatalities, 50% of the time (Lahai, 2017). However, past outbreaks have shown that this percentage could vary from 25% to 90%, depending on how well countries are prepared to manage them (CDC, 2014).

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Why is this Public Health Issue Relevant?

The Ebola epidemic in Sierra Leone is a relevant public health issue because the country has a poor health infrastructure that cannot properly cope with the challenges associated with managing such a disease. Furthermore, its inhabitants are always at constant risk of new infections and epidemics because its people are often involved in high-risk cultural activities, like eating rats, bush meat, and monkeys, which are often the sources of new infections (Lahai, 2017). Furthermore, there are high illiteracy rates, which have undermined capacity development in the country’s health sector and within the general populace (especially concerning the importance of understanding the epidemiology of the disease). Comprehensively, these factors make Sierra Leone an interesting case to study, especially in the context of the Ebola epidemic.

Description of Public Health Program

As highlighted by LaPelle, Zapka, and Ockene (2006), implementing a successful public health program is difficult because it requires adequate structures, proper supervision, and a high level of preparedness. However, assuming I had unlimited resources, I would start a program called the “Ebola Awareness Campaign” to reduce the risk of new infections of Ebola in Sierra Leone. The program would cover all the four administrative regions of the country – Western area, Southern region, Eastern province, and the Northern region. The program would mainly be targeted at creating behavioral change within the population by eliminating the cultural practices that consistently put it at risk of suffering a new outbreak. This program would be hinged on increasing people’s awareness about Ebola and showing them the link between their behavioral practices and cultural dynamics that foster the spread of the disease (Fertman & Allensworth, 2017).

How the Proposed Program would address the Public Health Issue

According to Selig (1975), it is often easy for public health programs to fail to meet their objectives. However, in the proposed public health program, the risk of Ebola would be significantly reduced by making people aware of their role in increasing their predisposition to the disease, through behavioral and cultural factors. This step would increase their ability to prevent the disease from occurring (Smith et al., 2010). To do so, the program would involve seeking community support by educating the public about the disease. Imparting locals with knowledge about Ebola would also possibly eliminate the fear associated with it because it is a significant barrier to managing the epidemic (De Heer, Koehly, Pederson, & Morera, 2011). Comprehensively, these measures show how the program would address the public health issue.

Has a Similar Program been implemented in the Past? If So, Explain how it was implemented.

The Red Cross had developed a similar health program to increase awareness about Ebola in Sierra Leone. To do so, the organization used mobile radios to communicate with the people and increase their awareness about different ways that Ebola is transmitted and prevented. The uniqueness of the public health campaign was its ability to communicate health messages on mobile radios. Community members could ask questions about the disease, and health care service providers answer them. At the same time, other people listened, thereby increasing the outreach of the program (International Federation of Red Cross and Red Crescent Societies, 2015).

Has it been evaluated? If So, What Methods were used to evaluate it?

The Ebola public health initiative by Red Cross was evaluated based on the number of new infections is decreased. This evaluation criterion was in line with the program’s main goal, which was to reduce the number of new infections to zero. This goal was achieved because of the preventive efforts conveyed in the program. People were able to eliminate the risk of being infected until the country was declared “Ebola-free” (International Federation of Red Cross and Red Crescent Societies, 2015).

What was the Outcome? If they were used, by whom and for what?

As mentioned in the above section, the outcome of the Red Cross Ebola public health campaign was the reduction of new infections and the eventual elimination of new infections. For example, 30 days after the program started, no new infections were reported in a town called Kambia, which bordered an Ebola hotspot, at the border between Sierra Leone and Guinea (International Federation of Red Cross and Red Crescent Societies, 2015). Health agencies learned from the outcome of the program by formulating interventions that worked in Sierra Leone because the Red Cross initiative provided a reliable example of how international health agencies could formulate successful campaigns in the West African country.

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CDC. (2014). Ebola outbreaks 2000–2014. Web.

De Heer, H. D., Koehly, L., Pederson, R., & Morera, O. (2011). Effectiveness and spillover of an after-school health promotion program for Hispanic elementary school children. American Journal of Public Health, 101(10), 1907–1913. Web.

Fertman, C. I., & Allensworth, D. D. (Eds.). (2017). Health promotion programs: From theory to practice (2nd ed.). San Francisco, CA: Jossey-Bass. Web.

International Federation of Red Cross and Red Crescent Societies. (2015). To help stop Ebola Sierra Leone Red Cross works with citizen radio. Web.

Lahai, J.I. (2017). The Ebola pandemic in Sierra Leone: Representations, actors, interventions and the path to recovery. New York, NY: Springer. Web.

LaPelle, N. R., Zapka, J., & Ockene, J. K. (2006). Sustainability of public health programs: The example of tobacco treatment services in Massachusetts. American Journal of Public Health, 96(8), 1363–1369. Web.

Selig, A. L. (1975). Program planning, evaluation, and the problem of alcoholism. American Journal of Public Health, 65(1), 72–75. Web.

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Smith Fawzi, M. C., Lambert, W., Boehm, F., Finkelstein, J. L., Singler, J. M., Léandre, F.,… & Mukherjee, J. S. (2010). Economic risk factors for HIV infection among women in rural Haiti: Implications for HIV prevention policies and programs in resource-poor settings. Journal of Women’s Health, 19(5), 885–892. Web.

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