Dana Carr recently returned from Sierra Leone where she served as a Canadian Red Cross delegate to assist in the fight against the Ebola outbreak. Dana is a field epidemiologist with a nursing background, specializing in communicable disease surveillance and outbreak investigation. The British Columbia native also has specialized training to provide humanitarian assistance in public health emergencies. Red Cross Talks spoke to Dana about her recent experiences in Sierra Leone and addressing gaps to combat the current Ebola outbreak:
Have you deployed as a Red Cross delegate before?
Yes I was deployed to Haiti during the cholera outbreak in 2010/11. The Canadian Red Cross had set up a cholera treatment centre. We supported the Haitian Red Cross in case management and prevention and control, community awareness and sensitization.
On your latest mission to Sierra Leone, can you tell us about your responsibilities?
My primary role was to gather and analyze available data/information, to help identify potential gaps (e.g. resources) and constraints (community resistance) which were contributing to the spread of Ebola in Sierra Leone and to support the prevention and control activities taken on by the Sierra Leone Red Cross to address some of these gaps.
By monitoring the outbreak, you were able to help identify gaps that could help stop the spread of the disease. Can you talk more about that?
The body of a person who has died of Ebola is still infectious and has to be prepared and buried according to specific guidelines set out by WHO. It was recognized early on that bodies were being left in communities or not being buried properly... and there were not enough trained personnel to deal with all the burials. The Red Cross identified this as a gap they could address and began training a number of Sierra Leone Red Cross volunteers.
A second identified gap was around Contact Monitors. It is critical that people in the community who have been in close contact with a confirmed case of Ebola be monitored for symptoms for a full incubation period (21 days). Early identification of a contact who becomes symptomatic, and likely infectious with Ebola needs to be removed from the community and moved into isolation to prevent spread. This is a very labor intensive activity as there can be many close contacts for a single case and these villages are often remote and difficult to access.
Another gap was the shortage of vehicles and investigation teams. Investigation teams are public health professionals that investigate rumors or are alerted to cases of Ebola in a community. They are the first responders and also a critical component to prevent the spread. There were plans to increase the number of teams however transportation is still a major constraint.
In terms of psychosocial support, fear and stigma around Ebola are major contributors to the spread of the disease in Sierra Leone and neighboring countries. The need for trained personnel with psychosocial skills was identified as a gap. The Red Cross conducted workshops and developed a psychosocial program to train Sierra Leone Red Cross volunteers.
Can you tell us more about what the local Red Cross volunteers are doing?
The Sierra Leone Red Cross volunteers are involved in many activities. There have been volunteers who have lost friends and family members but they continue to work in the communities and are involved in a variety of activities including contact monitoring, dead body management, sensitization and awareness (drama, theatre, songs, radio shows) and psychosocial support.
Are you planning to go back?
That's a good question. I have no immediate plans but would certainly consider returning if the Red Cross needed someone with my skills.
You can read more about Dana's recent experience in Sierra Leone in this article by the Times Colonist.
