3 pitfalls Ebola recovery must avoid

Health worker Alivin Davis poses next to the a board featuring handprints of Ebola survivors in Liberia. Photo by: Neil Brandvold / USAID / CC BY-NC 

Although Sierra Leone has seen a recent — and troubling — surge in Ebola cases, Liberia’s schools reopened this week, and all three outbreak-affected countries have committed to bringing the number of new cases to zero in the next 60 days.

While the Ebola crisis is far from over, officials in government and the international development community have begun to think more the medium and long term. What can they learn from past post-crisis recovery initiatives?

Devex asked aid officials and government officials from the region how to avoid some of the most common pitfalls that can plague — haunt, even — recovery and reconstruction efforts. Here are three of them.

1. Quality over quantity.

In 2010, a flood in Pakistan washed away close to 1 million homes and 6.5 million acres of crops, according to the International Monetary Fund. The humanitarian response was quick; the United Nations raised $500 million to cover the first 90 days of disaster relief. As reconstruction got underway, foreign aid groups tried rebuilding with local bamboo and inadvertently inflated prices, leaving businesses with excess stock that locals couldn’t afford.

By not paying closer attention to the economic effects of foreign aid on the local market, humanitarian groups hurt livelihoods and slowed reconstruction in the country.

It’s a spectre that should still loom large as international donors and their partners navigate economies in post-Ebola West Africa.

Getting familiar with community capacity as well as needs in Sierra Leone, Liberia and Guinea even before an intervention is on the ground, said Wendy Taylor, director of the U.S. Agency for International Development’s Center for Accelerating Innovation, is one way to localize and stay relevant in the midst of recovering markets.

One of USAID’s efforts in West Africa has been using a new model for crisis response — the Ebola Grand Challenge for Development — in order to stay in step with evolving need.

USAID announced last week a second round of finalists in the Grand Challenge — and hinted at the possibility of a third round — the scope of which will deviate slightly from the original. In its first round, the open-source competition drew more than 900 ideas from around the world on how to make Ebola health workers’ jobs safer. But this round, Taylor said, “is shifting slightly to keep up with the dynamic situation.”

Adjusting a project’s scope “in real-time,” Taylor said, means that aid efforts can be more adaptable.

“It’s very easy for innovators to focus on how to get their prototype right, how to get their innovation to work and they forget how to scale it for the end user and for certain market segments,” she told Devex. “Having multiple calls is a key advantage.”

Doing just one call for ideas won’t capture changing needs and thinking, Taylor suggested: “You have to stay on top of it.”

2. Prioritize local ownership.

Some of the most resounding “lessons learned” in recent humanitarian history were prompted by the earthquake that devastated Haiti in early 2010.

An influx of foreign aid — though well-intentioned — created chaos on the island and crowded its private sector out of the market. The combination of poor on-the-ground analysis and coordination of international relief led to what many experts have called a sluggish recovery.

Just as it did in Haiti, Mercy Corps is stressing the value of local manpower and coordination in Ebola-struck Liberia to facilitate a wider-reaching and more inclusive recovery. Mercy Corps is currently leading a USAID-funded consortium, the Ebola Community Action Platform, comprising mostly local organizations and networks to reach communities and dispel misinformation.

Through its outreach, ECAP has found that one huge obstacle in post-Ebola efforts is already becoming clear: The traumatizing disease has left in its wake rampant stigma, and not just against survivors: Communities are hesitant to seek out medical care or aid from fear of the disease. One of the greatest difficulties faced by outreach workers, Anderson said, is the alienation and misinformation within traumatized communities.

“We know that such discrimination can have tragic psychological and economic consequences for families and individuals,” Anderson told Devex. “Past experience has also shown that Ebola can spread quickly when people fear seeking help. Addressing stigma is therefore critical to winning the fight against Ebola.”

To tackle discrimination — both against aid workers and among community members — Anderson said that the sooner a community can take ownership of the recovery, the better.

“Addressing stigma is therefore critical to winning the fight against Ebola,” Anderson said, pointing to the use of trusted community members and leaders to reach out and address local trauma.

And in an environment where fear and stigma can sidetrack progress, she said promoting “positive participation and reintegration of survivors, their families and Ebola workers” puts the emphasis on the medium and long-term for lasting results.

3. Plan to stay.

Many factors can stunt or push out aid programs. When humanitarian aid was blocked from Gaza last year, for instance, many aid groups were forced to relocate and change the scope of their mission. Financial and media capital can also dry up, or the emergence of other crises can take center stage.

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In war-torn South Sudan, where the aid response has been slow since previous conflicts faded from the headlines after the country’s independence in 2011, the United Nations has struggled to generate humanitarian support and last year the country narrowly avoided a nationwide famine.

Making matters worse, the Syrian refugee crisis struck just as widespread violence took hold of South Sudan, leaving both conflicts with insufficient resources. A $1.27 billion appeal by the United Nations for food aid to South Sudan last year has still not been met, despite last week’s pledges.

The concern that aid efforts will taper off once a crisis fades from the headlines is a perennial one, and it bears remembering as Ebola cases decline in West Africa.

“We must use this momentum not just to get back to where we were, but to build up health systems to last beyond this crisis and into the next,” Tolbert Nyenswah, Liberia’s assistant minister of health, told Devex. “We need the aid community to stay and build, not pick up and go once Ebola is under control.”

The solution, according to Martien van Nieuwkoop, manager of the World Bank’s agriculture global practice, is to move beyond temporary solutions quickly by integrating the needs of Ebola-hit communities into existing programs.

Temporary initiatives can often yield only temporary results, van Nieuwkoop suggested, so absorbing Ebola efforts into existing medium- and long-term programs can give them staying power.

“When Ebola hit,” van Nieuwkoop recounted, “it was only natural to mobilize West Africa Agricultural Productivity Program, adapt it and make it fit for purpose given its strong network of extension agents and their links to farmers and farming communities.”

WAAPP, founded in 2007, was created with the goal of bringing cutting-edge agricultural practices to West African farmers, but will now make its largest contribution to date — $15 million in seeds and supplies — to the three Ebola-hit countries.

What should be the focus of Ebola recovery in West Africa? Let us know by leaving a comment below.

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About the author

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    Molly Anders

    Molly Anders is a former U.K. correspondent for Devex. Based in London, she reports on development finance trends with a focus on British and European institutions. She is especially interested in evidence-based development and women’s economic empowerment, as well as innovative financing for the protection of migrants and refugees. Molly is a former Fulbright Scholar and studied Arabic in Syria, Jordan, Egypt and Morocco.