Preparing to confront Ebola – just in case

December 2014

Countries in Africa have been working on improving their preparedness in the event of an Ebola outbreak. The WHO teams have provided simulated exercises in hospitals and technical training, for immediate emergency response and communication.

WHO-led training on Ebola infection control, Sierra Leone
WHO/N. Alexander

Mamo Jatta is a Regional Public Health and Surveillance Officer in The Gambia and, like many people living near Ebola affected countries, he is concerned the disease will enter his own country, “I recently visited the town where I grew up and wondered what would happen if Ebola were to hit us here, would we be ready for it?”

Experts at WHO have the same concerns – and they are transforming these into action. Ebola has already been exported, albeit resulting only in small outbreaks, from the three most-affected countries to the neighbouring countries of Mali, Nigeria and Senegal. Now, because of their geographic location or trading and migration patterns, 14 additional countries are considered as priority countries, in terms of risk of Ebola importation: Benin, Burkina Faso, Cameroon, Cote d’Ivoire, Central African Republic, Ethiopia, Ghana, Guinea Bissau, Mauritania, Niger, Togo, The Gambia, South Sudan and the Democratic Republic of Congo.

“The Ebola outbreaks and response in Nigeria and Senegal showed the world that the disease can be stopped if a country is adequately prepared from the outset,” observed Isabelle Nuttall, Director of the Global Capacities, Alert and Response department at WHO. “WHO is now working with all countries on the at-risk list to help them meet the same standards for preparedness.”

WHO teams help prepare for Ebola

"The Ebola outbreaks and response in Nigeria and Senegal showed the world that the disease can be stopped if a country is adequately prepared from the outset. WHO is now working with all countries on the at-risk list to help them meet the same standards for preparedness."

Isabelle Nuttall, Director, Global Capacities, Alert and Response, WHO

The WHO teams provide simulated exercises in hospitals and technical training, for immediate emergency response and communication, to help countries identify opportunities for improvement in order to strengthen their preparedness in the event of an outbreak. Mamo participated in the training and says that, “The mission is timely, as The Gambia prepares for Ebola. It has revealed a lot about our strengths and weaknesses and what we can do better, particularly in the area of coordination.”

Mamo is talking about the first component of the Ebola preparedness checklist, developed by WHO, that calls for overall emergency coordination- designating roles to all national and international agencies in case of an outbreak. The teams are using the checklist in their workshop to review with doctors, government officials, and border guards, among others, the first steps that need to be taken when a case of Ebola appears in the country. The comprehensive checklist follows WHO’s International Health Regulations and is used to identify concrete actions for countries and how they will be supported by the international community.

Lessons learned

The checklist further helps teams to make recommendations on community engagement, infection prevention and control, case management, Ebola Treatment Centres, safe dignified burials or safe alternatives, epidemiological surveillance, contact tracing, laboratory capacity, and border crossing preparedness. The recommendations of the teams can vary- from implementing rapid response teams that carry out infection, prevention, and control measures to identifying diagnostic laboratories that can efficiently test for Ebola and safely transport samples to the laboratory.

The team works closely with the country’s Ministry of Health and international partners, including the UN Mission for Emergency Ebola Response, to best incorporate the recommendations according to each specific country context.

Putting theory into practice

All 14 countries have unique health systems, and WHO is conducting training sessions in each of them to help key actors complete the tasks on the check list. In part, the training sessions involve simulated exercises – for example in hospital settings, where participants seek to meet the gold standard for infection control. There are also table-top sessions where participants do the concrete work needed to determine how national authorities will coordinate their actions with partner organizations and the UN Mission for Emergency Ebola Response.

At present, the training missions represent a race to help countries ready themselves to quickly stamp out any further Ebola outbreaks, but there are broader implications. The exercise is giving countries an opportunity to take a closer look at the functioning of their health systems overall. “Preparedness efforts in Ghana brought sharper focus on the health system and revealed strengths and weaknesses,” says Dr Magda Robalo, WHO Representative to Ghana, where a training session recently took place. “The country’s Ministry of Health will capitalize on the lessons learned during the training.”