Anne Lynam Goddard visited Guinea and Liberia last month.

As the Ebola crisis in West Africa winds down, aid agencies such as ChildFund International are reflecting on their response.

During the crisis, Henrico County-based ChildFund set up temporary observation and care centers for children in hard-hit Liberia and Sierra Leone.

“They were for children who had somehow potentially been exposed to the virus, and mostly children of family members who had gotten sick from Ebola,” said Anne Lynam Goddard, ChildFund’s president and CEO.

Goddard traveled to Liberia and Guinea on May 11-15. The week before, on May 9, the World Health Organization had declared Liberia Ebola-free. Sierra Leone and Guinea continue to report new cases, though significantly fewer than when the crisis was at its peak eight months ago.

“The centers were technically still open, but in both cases there were no children there,” said Goddard, who visited two of the centers during her trip.

“People did not want to close the centers yet. Until all three countries are Ebola-free — really the whole region — cases can come back,” Goddard said. “It was a donor’s idea to keep them open for a while, just to make sure.”

ChildFund had more than 600 staff members and volunteers in West Africa, including 316 local volunteers, 113 locally hired staff members and 89 local partner staff members.

“It’s the government of those countries that got things under control,” Goddard said. “Really, what helped in all three countries were two things. One, proper burials for people who had been sick. The Red Cross in one country went in and handled all the burials. ... That cut down a lot of transmission. That brought the rising number down really quickly.”

“And then setting up treatment facilities and showing people that they could be treated if brought in early enough and survive,” Goddard said.

The survivors also turned out to be a resource. Because they had already been infected with the virus, they had immunity from reinfection unless the virus mutated. Caretakers for the child care centers were recruited from support groups for Ebola survivors set up by the government.

Goddard said she asked one care center worker why she wanted to help.

“She said she was lucky that she survived,” Goddard said. “She had a child at home who was healthy, and she couldn’t imagine other children whose parents had died, that there was no one to care for them.”

Children cared for at the centers were all ages — infants to teens — and they stayed for a minimum of 21 days, the incubation period for an Ebola infection.

Overall, the ChildFund-supported centers took in more than 300 children over the course of the epidemic. Eight developed symptoms and were transferred to health care facilities, Goddard said.

All the other children were able to return to family or extended family, she said.

According to the World Health Organization’s June 3 report on the Ebola situation, Guinea reported 49 new Ebola infections in the past 21 days and Sierra Leone reported 23 new cases. At the peak of the epidemic in October, Liberia had more than 450 new cases reported in a week’s time and Sierra Leone had more than 500.

“They are still doing health education,” said Goddard, recalling an impromptu session on a street corner in Guinea. A health care worker gathered a bunch of women together.

“One of the local health care workers had information that had been finalized with correct messages. Finally, they had the right messages,” Goddard said.

Recovery is expected to take two to three years.

“I think they missed a whole planting season in one country. You don’t get over this in a week,” she said. “We will be working with government to continue doing surveillance, working with children to ensure that children have recovered and are back in school, and also now looking at some of the weaknesses. I think it showed the weakness in the ministry of health at the community level, and seeing what can be done to strengthen that.”

The rest of the world is still on guard. The U.S. continues to monitor travelers from those regions.

When Goddard arrived back in the U.S., she was pulled aside when she got off of the plane at Washington Dulles International Airport and answered “yes” to a question about whether she had been in a country with Ebola in the past 21 days. As of June 1, the Virginia Department of Health had 100 travelers under its post-arrival active monitoring program for Ebola.

“They give you a mobile phone and a thermometer and book with all your material in it. You have to take your temperature twice a day. The Health Department follows up within 24 or 48 hours,” Goddard said. “I was contacted by someone from Virginia Department of Health. She called me and then sent me an email.”

“It is every efficient,” said Goddard, who traveled to Brazil for work during that 21-day monitoring period. She continued to report to her state Health Department contact who was, in turn, in contact with the Brazilian authorities.

“The Brazilian Health Office also contacted me when I was there,” Goddard said.

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