Rationale: as UNHCR prepares to respond to a potential outbreak of COVID 19 in refugee, internally displaced persons (IDP) settings, the Evaluation Service offered to do a quick extraction of key findings and recommendations emerging from independent assessments of similar responses – with specific reference to Ebola (other outbreaks may also be relevant but are beyond the scope of this first review). 1 The main audiences for this review are Division of Emergency Security and Supply (DESS) and Division of Resilience and Solutions (DRS). Some Key Take-Aways
1. Over-arching findings
Ebola response evaluations noted that the humanitarian system does not always easily understand the health system as led by the WHO. Actively seeking to understand a) the global health system, responses and structures and b) the national health structures and response plans will help to close the “gap” between the two systems. A political-economy analysis specific to health authorities and government could help anticipate the effectiveness of state institutions in addressing the epidemic - for example assessing public trust in specific government bodies such as the health service and the overall executive, and the likelihood that the public will follow government’s advice. An analysis of who is trusted by the public in general and by specific groups may help organisations to understand how effective governments' responses may be and where and when other influential thought leaders may need to play a role.
Epidemics have a high likelihood of spillover affecting key markets and private sector supply lines. While starting as a health crisis, Ebola mitigation measures had a substantial negative impact on local economies and livelihoods – and required significant post-crisis recovery support.
Everyone is busy reacting. It is important to ensure adequate spaces of reflection during the emergency, whether at an operational, strategic, or response governance level.
Gender analysis was noted as particularly weak during the Ebola response. For example, there was limited sex and age disaggregated data and limited attempts to understand the protection issues that might arise in the context of infection mitigation measures. Quarantine was a form of isolation that was particularly psychologically difficult for children. School closures and suspension of education further negatively impacted children’s well-being and their future prospects. Quarantine was also linked to an increase in sexual exploitation and abuse.