It Starts at the Community Level
The rural areas are hit hard by Ebola yet there is little if any large field hospitals in these areas to help. Community health workers and traditional birth attendants play an important role in all of the societies in getting health care to the more rural areas. Training of the community health workers to start IVs, monitor households, refer cases to field hospitals placed in the more rural areas where access for all is available. This is not an urban disease, bush meat contaminated with Ebola is more common in rural areas and can be part of the education (along with supplemental food) that community health workers can distribute to avoid continued use of bush meat, dispel myths and distribute education.
During research in March and April 2014 is was clear that most of the justice and access to health care for SGBV survivors was urban based. Rural areas are dealing with Ebola but we do not have a good idea how that is happening and how healthcare workers are helping or giving eduction to the communities hardest hit by Ebola in Sierra Leone, Liberia, or Guinea. Sierra Leone is easier to travel in as roads are well maintained for the mining industry whereas the roads in Liberia are mud paths that take hours to navigate. Starting in Voinjama Liberia where the roads go to Guinea and Sierra Leone in rural areas might be a good way to sample (cluster sample) homes and get qualitative information from community health workers on what is happening in the rural communities and how best to get help to these areas. There is a Swiss run hospital in Voinjama and but this cross road and tri-border might be the place to helo in a field hospital where rural community members can be assessed without contaminating the hospital used by many including large numbers of maternity patients.
Woman in Port Loko, Sierra Leone who gave Andrew Beard permission to photograph her. She sells to the local community and curious researchers like us.