PROTECT YOURSELFPROTECT YOUR FAMILYPROTECT YOUR SCHOOLPROTECT YOUR COMMUNITY from Ebola

Training on the School Safety Protocols

February 2015

Training Workshop Ground Rules

• Introduction•Ground rules• Expectations

Workshop Objectives:• Participants are familiar with, and fully understand, the

Protocols for Safe School Environments in the Ebola Outbreak in Liberia• Participants’ experiences from this workshop can influence

how future trainings are conducted• Participants are ready to replicate this training for school

staff and members of the Parent Teacher Association in their respective districts

What are the Protocols for Safe School Environments in

the Ebola Outbreak in Liberia? The minimum requirements to ensure that every school is safe for all students and staff from a health, water, sanitation and hygiene point of view.Later, they can be updated to support early warning and rapid response to new outbreaks, and to maintain good hygiene practices in schools.

Pre-opening: Putting Structures in Place for the Safe Reopening of Schools

Registration and Exposure Risk

Before reopening, for every student and staff member, the school will collect:• Information on any exposure to

Ebola during the 21 days before school reopens• Contact details of parents/family

to be contacted in case of illness

What is Exposure?

A person is considered to have “contact” if, in the last 21 days, they were exposed to a suspected or confirmed Ebola patient through:

• Direct physical contact • Contact with their blood, urine, vomit, feces, sweat, saliva • Sleeping in the same household • Touching his/her clothes or linens • Attending a funeral

Registration and Exposure Risk: Role Play

Now it’s your turn to try out the forms!Find a partner in the group. 1) One of you will pretend to be the school administrator and one of

you will be the student. 2) Go through and fill out the form together. 3) The two of you switch roles. One person play the school

administrator and the other will play the staff member. 4) Go through and fill out the form together.

Be sure to read and explain why this form is important.

Roles and Responsibilities

We all have a role to play in

ensuring schools are safe and

protective spaces for learning!

Simplified messages on the Protocols

• Simplified messages are available based on the Protocols• One-pagers for:

• Parents• Students• Teachers• Communities

Example: Simplified messages for parents

School Ebola/Health Safety Committee

• Establish School Ebola/Health Safety Committee (4 or 5 people: school staff, community members, students) before school reopens• Ask people to volunteer for the role and/or invite people

you trust to join – link with PTA• The committee might be asked to:

• Support pre-registration • Manage communication with County Health Team • Support someone with a fever until family is contacted • Accompany someone with a fever to the isolation area• Help to monitor school safety

• After the Ebola outbreak, we recommend the group continues to support school health and hygiene

Fever Monitoring Team• The Fever Monitoring Team should be

established before school reopens• Team members do not have to be health

professionals • Team members may be asked to:• Take temperatures at the school entrance • Escort a student displaying Ebola

symptoms to the isolation area• Carry out other tasks linked to the School

Ebola/Health Safety Committee• After the Ebola outbreak, members could

join the School Health Safety Committee

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Using an Infrared Thermometer Step 1: Turn on thermometerStep 2: Allow 10 minutes for thermometer to warm upStep 3: Ensure thermometer is on the correct setting Step 4: Ask the person to push back hair, remove hat or

glasses and wipe off sweatStep 5: Aim for the middle of the forehead or the temple,

as per included instructions and hold the thermometer 3 - 5 cm from the person

Step 6: Take the person’s temperature Step 7: If lower than 35 °C RETAKE temperatureStep 8: If 38°C or higher, the person has a fever

Activity: Now You Try!

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Divide in groups of 3Each participant now has an

opportunity to be the student, the member of the Fever Monitoring

Team, and an observer

Activity Instructions:Screener:1. Follow the steps described. 2. Take the student’s temperature.3. Repeat this process three times

to ensure accuracy.4. Move to the next role.

Student:5. The screener will take your

temperature three times. 6. Move to the next role.

Observer: a. Provide feedback after each

reading.b. Which steps were done well?

Which steps need improvement? c. Were the readings accurate?d. Was there variance across the

readings?e. Did the screener touch the

patient?f. Could anything have been

changed/improved?

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Managing Ebola Symptoms at School

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Establishing a Referral System

• How should a school work with the County Health Team to develop a referral system for the school ?

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Setting up the isolation/holding areaEach school must have a separate area where people

with Ebola symptoms can wait for family/guardians and referral

The space should be accessible, easy to clean and must have drinking water

As a group, discuss and identify a space in schools you know - Do you have a space? If not, please identify a space.- How will you communicate information about the

space? - What will you include in the space and who will

be responsible? 19

Everybody must have their temperature taken at school entry point each day.Access to school is not permitted for any person who: Has a fever of 38°C (100.4°F) or higher

Has two or more symptoms of Ebola: Headache Red eyes Joint and muscle pain Weakness Diarrhea Vomiting Abnormal bleeding Had contact with an Ebola patient or a person who died of Ebola in the past 21 daysDoes not respect the measures put in place

Remember: Text the word “School” to 8737 for more information on how to keep your school safe

Daily checks at the school entry point

Fever or Ebola Symptoms: At School Entrance 1. Fever Monitor escorts person with

symptoms to isolation area keeping a distance of 1 meter

2. School Administrator contacts parent/guardian and follows referral system agreed with County Health Team/District Health Officer

3. Health center keeps School Administrators and parent/guardian informed

4. If Ebola confirmed by laboratory : Record in school register Contact DEO and CEO County Health Team creates list of

contacts and follows up

Fever or Ebola Symptoms: During School Hours 1. Teacher informs School Administrator who contacts parent/guardian and follows

referral system as agreed with County Health Team

2. School Ebola Safety Committee member escorts person to isolation area keeping a distance of 1 meter

3. If a school staff feels unwell: Notify School Administrator, go to isolation area and follow referral system School Administrator contacts staff’s family

4. Health center keeps School Administrators and parent/guardians informed

5. If Ebola confirmed by laboratory : Record in school register Contact DEO and CEO County Health Team creates list of contacts and follows up

Activity: Managing Potential Cases of Ebola

Role play: The facilitator will provide you with a scenario and one group will act out the scenario while the others watch and provide feedback.

When you provide feedback, look at these four areas:1. Temperature taking - was it carried out properly?2. Escort to isolation area – was this done properly? 3. Contact with County Health Team – did the school

administrators have the right information?4. Reducing stigma – do you feel the way this was carried out

made the potential patient feel comfortable, embarrassed, ashamed, scared?

Maintaining School Health and Hygiene

Preparing Schools for Reopening

Locations to clean:

External compoundInside the classroom Office, staff lounge and kitchen

Sanitation facilities

Step 1: Remove from the campus:• Any visible waste: dig a pit and burn it• Drain any stagnant water

Step 2: Dry sweep with a broom: • Around the compound including classrooms,

offices and other spaces• Latrines and urinals

Step 3: Use a soap and water solution to spray:• All doors and window sills • All classroom walls up to 1-meter high

Step 4: Wipe down: • Tables, chairs, benches, and seating areas

Use of the Back Sprayer

If Cleaning Spills, Follow These Steps: 1. Put on protective equipment 2. Clean visible waste:

• Remove all visible waste with a towel sprayed with 0.5% chlorine solution

• Place soiled towel in a bucket and cover with 0.5% chlorine solution

3. Disinfect:• Pour 0.5% chlorine solution on the area, do not splash• Let chlorine sit for 15 minutes then wipe up with a towel • Put soiled towel in a bucket and cover with 0.5% chlorine

solution • After 1 hour, towels may be washed with soap and reused

once dry

4. Let the surface dry5. Carefully remove protective equipment and wash

hands

Proper Chlorine Preparation for Cleaning:

Wait 30 minutes before use

10 level or flat TABLESPOONS chlorine powder

Label the bucket:“0.5% chlorine for CLEANING”

Proper Chlorine Preparation for Hand Washing:

. Wait 30 minutes before use

1 level or flat TABLESPOON chlorine powder

Label the bucket“0.05% chlorine for HAND WASHING”

Safe Chlorine Preparation

If you don’t mix the chlorine well, it will look like this:

• Chlorine is a strong chemical. Always wear heavy duty gloves when handling chlorine and strong solutions.

• Make new chlorine solution every day

• Keep chlorine buckets closed and away from sunlight

• Do NOT dip dirty towels into a bucket of chlorine

Activity: Make Chlorine Solution

Participants will divide into groups and practice making 20 Liters of strong (0.5%)

chlorine solution

Once the School Reopens…

Raising Clean Hands!

Proper Hand WashingThe following 2 locations in the school must have hand washing facilities:

The school entrance: hand washing with chlorinated water (0.05% chlorine solution) or soap and water or alcohol-based hand sanitizer

The bathrooms: hand washing with water and soap

Any additional hand washing stations on the school premises should use water and soap.

Hand Hygiene When Washing with Chlorine or Soap and Water

When washing with chlorine or soap and water, wash hands for 40 - 60 seconds!

Activity: Promoting Hand Washing

Think about activities you can do with students, especially young students, to

promote hand washing Example: Make up songs that last 40 – 60

seconds children can sing while they wash!

Ensuring a School Water Supply

Water Access

If a school does not have a reliable water supply, School Administrators have to organize the provision of water from a source in the community.

The minimum requirements for drinking and hand washing are:

3 liters of water per student per day for day students

20 liters of water per student per day for boarding school students

Activity: Water access in your community

Work together with a WASH a colleague from your district or a resource person at the

training to find solutions for the provision of water for hand washing in schools that do

not have water

More School Health and Safety

Eating and Drinking at School • School administrators should:• Ensure the area where food is prepared or sold is clean.• Prohibit the preparation or sale of bush meat

• Food vendors should:• Be authorized by School Administrators and the PTAs• Follow the same procedures for school entry when entering school premises• Wash hands before starting to prepare food and after every interruption.

• Students should not:• Eat food that has touched the ground.• Share the same cup or utensils for eating or drinking.• Leave the school yard to buy food if food is available at school.

Additional Safety Precautions

• Every school should have a first aid kit • At least one school staff member should be trained in first aid• Immediately rinse cuts and scrapes with soap and water while

wearing gloves, cover all cuts and abrasions with dressings.• If contact with blood occurs wash with soap and water.• Every school should have a catch up campaign for health activities:• Immunization• Deworming• Micronutrient supplementation

3 Simple Psychosocial Support Messages

LISTEN Take time for deep listening: nod and agree without

judgment or advice.

PLAY

REPEAT

Give children opportunities for recreation each day.

Create routines (including listening and play) so children can feel control each day.

Reporting, Monitoring and Compliance•School Administrators and PTAs must make sure all items on the protocols checklist are in place before school can re-open.•School Administrators have to report monthly to their DEO and CEO on Ebola and other health related matters in their school.•The MoE will monitor compliance with these Protocols by all education personnel, parents, students and school visitors. School administrators who do not ensure compliance can face suspension, dismissal, and/or prosecution.•Students who do not to follow these Protocols may be expelled immediately.

IMPORTANT: Make sure all School Ebola/Health Safety Committee members text the word “School” to 8737 to help keep your school safe

Next Steps

Where do we go from here?Planning the next steps