Appeal target: CHF 1,061,852 in cash, kind and services.
Appeal coverage: 38% (against initial amount of CHF 1,358,780, corresponding to 50% of revised amount of CHF 1,061,852)
Appeal history:
• This Emergency Appeal was initially launched on a Preliminary basis on 16 August 2012 for CHF 1,151,632 for 6 months to assist 1,440,000 beneficiaries. CHF 150,000 was allocated from the International Federation of Red Cross and Red Crescent (IFRC) Disaster Relief Emergency Fund (DREF) as start up funds.
• The Emergency Appeal was launched on 17 September 2012 for CHF 1,358,780 for 6 months to assist 1,539,206 direct beneficiaries and 2,000,000 indirect beneficiaries.
• Operations update no. 1 was published on 17 October and provided a progress update on the deployment of three Emergency Response Units (ERUs), consisting of a Basic Health Care Unit from the Finnish and Japanese Red Cross, Community Health Module from the Norwegian and Canadian Red Cross, and a Mass Sanitation Module from the British Red Cross. These bilateral contributions are not included in the current appeal target.
• This emergency appeal revision reduces the appeal amount from CHF 1,358,780 to CHF 997,045. The number of targeted beneficiaries has increased due to the expansion of the target area. Previously the operation has focused only on Kambia, Port Loko, Bombali and Tonkolili, but this revised appeal will see activities expanded to all 13 districts in the country. A proposed SMS messaging system is estimated to reach 2 million with vital early warning and health information.
Summary: The operation is estimated to have already reached more than 2,000,000 people to date in the whole country. Since the beginning of the operation activities have focused mainly on 4 districts, namely; Bombali, Tonkolili, Port Loko and Kambia. They have benefitted from basic health care including daily surveillance, hygiene promotion, and awareness campaigns as well as provision of oral rehydration solution (ORS) and water and sanitation hardware. A field assessment and coordination team (FACT) was deployed to obtain detailed assessment information. IFRC assisted with deployment of 3 Emergency Response Units (ERUs) consisting of a Finnish Red Cross Basic Health Care module (BHC ERU) supported by Japanese Red Cross, a Norwegian Red Cross community health module (CHM ERU) supported by Canadian Red Cross, and a British Red Cross mass sanitation module (MSM ERU).The ERUs operated in the districts of Bombali, Tonkolili, Port Loko and Kambia.
To decrease the transmission of cholera, the operation has provided clinical case management, referral, surveillance, and support to the Ministry of Health (MoH) emergency response. The activities have contributed to reducing the risk of waterborne diseases through water, sanitation and hygiene promotion, as well as improving disaster management and the capacity of the SLRC to respond to cholera outbreaks and other emergencies in the future. The IFRC supported the ERU teams to carry out epidemiological analysis. Additionally, IFRC carried out a Knowledge Attitudes and Practices (KAP) baseline survey in two districts. A follow up survey will be conducted in the same villages at the end of the operation.
The cholera outbreak in Sierra Leone has declined from a high of more than 2,000 cases per week at the peak of the outbreak (in weeks 32 - 34), down to 61 cases in week 48. Although this is a significant decline, the number of cholera cases is still significant, requiring ongoing prevention and control efforts to ensure the outbreak does not spread further. Epidemiological surveillance will be continued throughout the operation.
As a part of the revised appeal, an additional 1,400 volunteers in all districts of the country will receive epidemic control for volunteers (ECV) training. Out of these, 400 volunteers will receive training in case management to supervise 400 oral rehydration posts (ORPs), and 100 additional volunteers will be trained in community surveillance, monitoring and reporting of cases. This enables the SLRCS to establish in every district new ORPs where volunteers provide cholera and severe diarrhoea patients with oral rehydration solution and clean water. Additional community surveillance volunteers will greatly contribute to the reliability and long term sustainability of the National case monitoring system.
Negotiations with telecommunications companies in Sierra Leone are in the final stages and three out of four companies in the country are expected to install the TERA SMS messaging alert system for distributing disaster preparedness and health and hygiene promotion messages to an estimated 2,000,000 beneficiaries. There are over 2,000,000 mobile phones in Sierra Leone and mobile phone ownership is widespread both in rural and urban areas, Most families have access to at least one mobile phone and generally all family members are in a position to benefit from Red Cross messages. The TERA SMS system is specially designed for the Red Cross movement and has previously been installed by the IFRC in Haiti where it was shown to be a very powerful health messaging and DRR tool, underscoring its effectiveness of the system for risk reduction. In case of cholera outbreaks and other types of epidemics or natural disasters, the SLRCS will be able to instantly send targeted SMS messages to millions of beneficiaries based on their geographical location or other risk factors.
As the number of cases has greatly declined, the remaining activities in this revised appeal focus primarily on WatSan hardware, hygiene promotion and expanding the network of SLRCS volunteers capable of managing ORPs, reporting on cases, and hygiene promotion. Currently operational costs are 16.7% of the total budget, while personnel costs are 34.9% and general expenditure 24.5%. This is because software-typed intervention, particularly involving disease prevention through hygiene promotion, are often proportioned differently to operations which focus more distribute NFIs and shelter related activities, which have a higher proportion of operational costs. Software interventions require more human resources and less operational costs. In addition, regardless of funds received, adequate staff - including delegates - are required to ensure that operation is implemented as planned. The operation is only partially funded to date. Should additional funding be made available then additional activities will be implemented, which will rebalance how finances are proportioned.
Cash contributions have been gratefully received from British, Canadian, Icelandic, Japanese, Monaco, New Zealand and Swedish Red Cross Societies, as well as the British Government. In kind contributions (goods, transport and personnel) have been received from British, Canadian, French, Japanese and Norwegian Red Cross Societies. Additional bilateral contributions through the provision of Emergency Response Units have been received from the British, Canadian, Finnish and Norwegian Canadian Red Cross Societies. Donors are urged to provide further support to this operation so that new and previously planned activities can be completed.
Given the fact that cholera outbreaks occur every year in Sierra Leone, repeated outbreaks are likely to occur in the coming years. The activities in this revised appeal are crucial with regard to reducing the risk of cholera epidemics, as well as lowering the number of cases and the case fatality rate in future outbreaks.
