In 2013, roughly 10 years after the end of the civil wars in the region, Sierra Leone, Liberia and Guinea were again ravaged, this time by the largest Ebola crisis in history. The significant psycho-social disruption associated with this multi-level emergency created challenges for Ebola response and contributing greatly to the suffering of affected communities. A torture treatment center, the Liberia Association of Psycho social Services (LAPS) rose to the challenge of re purposing their skills and programs to respond to the new enemy, the Ebola virus.
LAPS participated in Ebola response coordination meetings and developed an Ebola screening form which was adopted by the government for widespread use. LAPS increased and reorganized their staffing in order to provide training in psychological first aid for school settings, broadcast public health announcements, offered stress management tips to the fear driven population and, manage a hotline to respond to questions from the community. Counselors provided 10 sessions of group counseling to 117 people previously identified as suffering longer-term emotional effects of torture and war trauma. LAPS adapted the counseling model to encompass the impacts of the Ebola crisis on this group already suffering the effects of war.
Quantitative impact data comparing intake and follow up assessments produce strong effect sizes on key psychosocial indicators including social support, post-traumatic stress symptoms, depression symptoms, anxiety symptoms, as well as difficulties with daily functioning. These results demonstrate the effectiveness of small group counseling processes for people affected by Ebola, including people who are still struggling to recover from the impact of war and torture.
We reflect on the possibilities and challenges in repurposing torture rehabilitation knowledge, skills and programming to respond to further humanitarian crises such as a deadly epidemic. These reflections encompass the advantages of flexibility in organizational structure, the importance of local and international networks in coordinating and supporting work in times of crisis, the need for good assessment and information management, and the fundamental requirement of ongoing training, supervision and support at all levels of programming.
Funding & No Conflicts Declaration
Work aspects were funded by USAID, Concern Worldwide, Dignity, African in the Diaspora and UNICEF. The authors are not aware of any conflicts of interest.