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BACKGROUND: The current outbreak of Ebola virus disease (Ebola) has produced unprecedented numbers of survivors thought to be clinically resistant to reinfection. Despite thousands of survivors, little is known about their needs, long-term clinical sequelae, and potential for participation in the public health response. Our objectives were twofold: identify how a District Emergency Operations Center (EOC) in Bombali District could integrate survivor needs and care management into EOC protocols and assess feasibility of survivors contributing to the local Ebola response.
METHODS: We conducted a rapid assessment in Bombali from October 2-6. The team interviewed five EOC Psychosocial Support Pillar members, observed psychosocial counseling, reviewed all survivor records, and co-facilitated a group discussion with 24 survivors recruited by the district regarding potential roles in the response and barriers to recovery and reintegration. Content analysis was performed to generate themes on qualitative data; quantitative data was analyzed descriptively.
RESULTS: As of October 6, 71 survivors returned to Bombali from treatment facilities; median age was 28.5 years, 37 (52%) were female and earliest date of discharge was August 10. Gaps in management activities were identified (e.g. transportation, family reunification for children, and follow-up). Respondents identified four potential roles dependent upon individual survivor skills: community educators, media spokespersons, medical and supportive care providers, and spiritual guides. The majority of survivors were interested in participating in Ebola response activities; however, they noted three types of unmet needs: immediate (e.g. food, clothing, and housing), short-term (e.g. stigmatization and discrimination), and long-term (e.g. education).
CONCLUSIONS: Survivors are interested in contributing to the local response. Current strategies require additional coordination, comprehension, and tangible supports. Integration of survivor issues into emergency planning is warranted.