Responding to Epidemics With Courage and Hope

Between 2015 and 2019, CARE has run 57 projects that aimed to stop the spread of infectious disease epidemics—like Ebola, cholera, and Zika—in 20 countries around the world. These projects collectively worked with 9 million people directly and 16.7 million indirectly. A variety of donors contributed to these responses, for a total of $146.3 million.

These responses prove that things can get better. We already have many of the tools it will take to help the world respond to and overcome COVID-19.

What did we accomplish?

• People knew how to protect themselves: In Sierra Leone’s Emergency Ebola Response Project, people were 80% less likely to be wrong about the causes of Ebola, and 12% more likely to know how they could avoid contracting Ebola. In Ecuador and Peru’s Zika Response, up to 98% of people were using data from community-based health systems to protect themselves, and 89% of women in Ecuador were applying best practices to stay safe.
• More people wash their hands: In Yemen’s Emergency Assistance for Vulnerable and Conflict-Affected Communities, families were 2.6 times more likely to wash their hands. In Sierra Leone’s Emergency Ebola Response Project, people were 30% more likely to wash their hands to avoid contracting the disease.
• Families can eat better: In Sierra Leone’s Rapid Social Safety Net and Economic Recovery Project, 91% of people were satisfied with CARE’s Ebola response, and 84% of people are eating more meals a day.
• Health systems got stronger: In Yemen’s Joint Response Project, 29,836 people received health services from trained health workers. In Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program, the national supply chains for critical drugs got stronger, so health centers are 5 times more likely to have medications for women coming in for pre-natal visits. They are also 58% more likely to have the supplies and equipment they need. In Ecuador and Peru’s Zika Response, 60% of local governments in Ecuador, and 95% of local governments in Peru budgeted extra money for Zika prevention, monitoring, and response.

How did we get there?

• Build emergency alert systems: All of the projects worked with national and local governments, and community leaders to share accurate information that would help people take action. This included T-shirts, posters, dramas, and radio shows, and call in numbers with local health centers so they could get immediate alerts about suspected cases.
• Connect health centers to communities: Most projects worked with a network of local volunteers who functioned as go-betweens between centers and communities. They could share health tips with communities, and alert the health centers when communities needed extra support and attention. A key learning from In Ecuador and Peru’s Zika Response was that projects should pay health volunteers for their time—both to ensure longer-term engagement and to give families some much-needed support in an emergency
• Do your homework: All of the projects conducted rapid assessments so they could adjust project plans based on the immediate needs.
  Be efficient and flexible: Sierra Leone’s Rapid Social Safety Net and Economic Recovery Project, originally spent over $70,000 on a mobile money transfer system that didn’t work for the communities we were serving. In the second phase, they saved $39,000 by going back to more traditional distributions in places without mobile coverage.
• Focus on supply chains: In Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program, community volunteers conducted supply audits at health centers to track which centers were having trouble keeping enough medicine available to treat patients, and develop a plan to fix it.
• Make data visible: Sierra Leone’s Epidemic Control and Reinforcement of Health Services (ECRHS) Program helped health centers track patient and supply data so they could track supply and demand patterns and order medicines. It also made it easier for health inspectors and communities to hold centers accountable.
• Think about the whole portfolio: The most successful project teams used a combination of donors and projects so they could bring in money to fill in gaps from other programs and avoid duplicating effort.
• Focus on gender: Many projects focused on gender, using tools like Rapid Gender Analysis, gender mainstreaming trainings for all staff, and CARE’s Gender Marker as a way to measure progress towards quality gender programming.