Using Continuous Quality Improvement in Community-based Programming During Disasters: Lessons Learned from the 2015 Ebola Crisis in Sierra Leone.

This paper describes the CQI (Continuous Quality Improvement) process of collecting and analyzing field level qualitative data in an ongoing cycle. This data can be used to guide decision-making for effective emergency response. When medical and community components are integrated from the earliest stages of the disaster, it allows for true collaboration and supports the CQI process to be responsive to evolving data.

Germs, Guns, and Fear in Disaster Response: A Rapid Qualitative Assessment to Understand Fear-Based Responses in the Population at Large: Lessons From Sierra Leone 2014-2015.

We set out to assess the feasibility of community-focused randomized qualitative assessment at the start of an emergency to identify the root causes of fear-based responses driving the pandemic. We used key informant interviews, focus group discussions, reviewing of government and non-government organization documents, combined with direct field observation. Data were recorded and analyzed for key-themes: (1) lack of evidence-based information about Ebola; (2) lack of support to quarantined families; (3) culturally imbedded practices of caring for ill family members; (4) strong feeling that the government would not help them, and the communities needed to help themselves: (5) distrust of nongovernmental organizations and Ebola treatment centers that the communities viewed as opportunistic.

Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone.

An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities.

Monitoring the tidal Delaware River for ambient toxicity.

This study assessed ambient waters in an urbanized area of the Delaware River, to determine whether river water samples exhibited chronic lethal or sublethal toxicity when measured in laboratory experiments. Toxicity was assessed at 16 fixed stations in the main-stem river and 29 stations in tributaries of the tidal Delaware River with salinities from 0 to 15 parts per 1000 (ppt) using Pimephales promelas, Americamysis bahia, Menidia beryllina, and Ceriodaphnia dubia in 7-d tests; Pseudokirchneriella subcapitata in a 96-h test; and Hyalella azteca in a 10-d water-only test. The toxicity tests measured organism survival, growth, and reproduction.