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Au centre opérationnel d'urgence
du Liberia, de lutte contre Ebola

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en compagnie de mon collègue 
Mosaka Fallah.

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Votre lutte contre Ebola est primordiale
puisque vous êtes aujourd'hui responsable

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des traceurs de contacts ici à Moravia
- Oui.

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Alors dites nous... Pourquoi est-ce
si difficile de suivre ces contacts ?

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Pour deux raisons principales.

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La première est une question de confiance.

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De confiance dans les traceurs eux-mêmes

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Ils ont de moins en moins confiance en nous
et c'est dû au fait que

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to them in time.
also there is an issue of... our non-Ebola

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health services is not developed , in case
they don't have Ebola, how do they get the

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best treatment?
That means if they have malaria, pneumonia

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or other sorts of diarrhea... they can't find
any treatment.

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Exactly. Since Ebola our health care system
collapsed on the wake of the emergency

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So they don't have an alternative to go
So they see their relatives go before... they don't

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have any alternative, so they are distrustful.
Why should they tell us? They don't have an

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alternative.
And the third thing is the issue of feedback.

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They have seen their relatives go to ETUs
and maybe die

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and they didn't have the feedback in a timely
fashion.

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And ETU is the abbreviation for the Ebola
Treatment Units

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that are the hospitals or tent hospitals specially
for Ebola.

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Yes, Dr. Hans.
But I mean... is it 8 monitors you have now?

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Oui.
Qui supervise cela…

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They are really wise.
When I have been in the morning meetings,

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they understand all the dynamics
and realities of people. Some of which are

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very poor.
So when you now became in charge of this;

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What is the most important? I know that you
are fixing the food now.

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Yes.
Because they need food the same day that they

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became a case, a contact,
so they can't go out and buy themselves.

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How are you planning to change or improve
the system?

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Because it's already good!
Because you took it from a catastrophe.

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You took it from a 100 a day down to 10 a
day.

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What are the next things you want to change
now?

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First I want to restore the confidence and
I hope in building trust.

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Engaging local communities.

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Engaging lots of stakeholders. And ensuring
that they'll have a response

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in a timely fashion.
And we are talking about making

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practical field decisions.
Moving case-investigators, contact-tracers,

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psychosocial together.
Generate full list.

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Have the full list returned to the family
in a timely fashion.

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Providing the psychosocial support.
Working with local leaders.

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Supporting the local leaders building the
transport.

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Working on a feedback system where we now
gonna have

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case investigators working closer with us
and a data unit

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ensuring that they'll feedback in a timely
fashion.

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As of the status of; their relatives;
those in the ETU; and the lab results.

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Your people, the tracers, how many are they?
How many people do you have who go and visit

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these contacts?
In Montserrado county we have 305 tracers

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22 supervisors
currently in the two zones of the Montserrado

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county.
And they have to be like detectives almost.

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But then you say they have to be kind also.
They have to think about the family.

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Yes, so it's always a critical issue, because
they see them as representing the system.

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Because they are the ones that the first time,
if there is a death in the family, someone

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has to come see them first,
and they have to be the ones who go there

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everyday for 21 days.
So, yes they have to be empathetic.

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But also they have to be detectives.
They have to be able to see through them

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and know; those who have been honest
and those who are not saying the truth

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and after follow up investigation to find
all contacts.

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In this epidemic there is no room for errors.
You need to find 100% contacts.

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So they have to do the both.
Be kind, at the same time as being a detective,

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to find out all of the contacts.
And you never use force?

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I mean you don't threaten people.
It's just their free will?

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Yes, Sir! We encourage the free will,
even when deciding the concept of quarantine.

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We always say quarantine should be done by
the communities.

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You shouldn't get the police involved.
It should be done... it should be involved

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for discussion.
There's a consensus building.

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It's so important because the fear we always
have is that:

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if we use force, they could escape.
If we put them under huge pressure.

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It has to be a friendly approach; a comunity-based
approach

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You look like a very tough guy! That's what
has impressed me you know.

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I've seen you almost rush out from the morning
meetings.

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And then when you argue, you talk like a nun.
You are very kind to people!

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This is probably the most important
to be empathetic, you say?

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I think so. Yes!
But you have two types of problems. One is

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that you don't get the contacts listed.
They are hidden some of them.

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And the other is that the contacts who get
sick, they leave

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because they don't want to be identified as
sick.

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What is the reason why they don't get listed
in the beginning?

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In the beginning of the epidemic there was
a couple of factors.

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One of them was that the burial team picked
up

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the body and we would not have the contacts
coming to us in a timely fashion.

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Some of them road commercial vehicles probably
ambulances, and went to ETUs.

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And those who did that without collecting send
back as a feedback

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and line then was sent to begin contact tracing.
That means that the list for them…

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and of course when they had someone who had
died at home

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that was a very emotional, and very sad moment
it's not an easy time to remember them.

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Exactly, and the exam of contacts and all
those kind of questions.

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It's an emotional period. That stage is critical
you can build friendship, you can build empathy

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and then they can reveal to you, by that time
when they are in the though period.

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So now you are going to have a system where
by

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those which we call "case investigators",
who just take care of the information of the

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sick
and your contact tracer, with a list of contacts

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and ambulances and the burial cars
they will be one system?

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Yes, we're hoping yes.
So there can practical field decision.

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Because most of the time we lost a contact
in the time past when the case investigator

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does the investigation and line listing,
between that and the data unit and coming

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back to the tracer,
there was a delay in time.

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So some of the contact listing got lost.
If there is a field level decision

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where the investigator does the investigation
the contact tracer takes the line listing

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and initiates investigation immediately.
In that case I'll be very confident that every

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case we've seen,
we've gone through that. We have the contacts

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listed and that we have followed up!