Outbreak prone diseases are a public health challenge in Indonesia. During the COVID-19 pandemic, outbreaks of communicable diseases such as measles, diphtheria and dengue caused a double burden on the health sector. Meanwhile, a number of emerging infectious disease (EID) outbreaks, including monkeypox and variants of COVID-19, indicate an ongoing need for countries to improve their detection and response capabilities for outbreak prone diseases to contain them at the source and prevent further spread.
Rapid response teams (RRT) are at the front line to conduct field investigations and respond to outbreaks. An RRT consists of a surveillance officer, a clinician, a laboratory technician, a risk communication officer, a point of entry officer and other relevant disciplines, such as an animal health officer for zoonosis. The RRT needs sufficient knowledge and skills to investigate and respond rapidly to an outbreak.
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Demonstration of and exercise on sample collection and packaging in RRT training from 18-24 September in Makassar. Credit: WHO/Endang Wulandari
In September-October 2022, WHO supported RRT training for 60 participants from 12 provinces. Another 59 participants from 16 provinces attended two additional RRT training sessions funded by the Ministry of Health (MoH).
The MoH Human Resources Bureau accredits the training. The training module covers material on outbreak prone diseases; early detection and response to outbreak prone diseases at Points of Entry; EID case management and infection control; risk communication; sample collection and shipment; deployment of RRTs; and a practical exercise.
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A WHO-facilitated exercise during the rapid response team training in Makassar, 18-24 September 2022. Credit: WHO/Endang Wulandari
The participants exchanged experiences and highlighted challenges during outbreak field investigations, including the need for community empowerment based on the specific local context, socio-cultural behaviour, and challenges in accessing remote areas. At the end of the training, participants actively engaged in the monkeypox scenario-based simulation exercises. A debrief “hot wash” at the end of the simulation identified areas for improvement.
“The training has improved and updated our understanding of emerging infectious disease detection, prompt response and the need for team work the among multiple disciplines of RRT members. And the training served as a platform for learning and share experience among RRTs from provinces in different contexts”, stated Dr Arun Rumenum, head of the disease control division from the Provincial Health Office in Papua.
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Donning and doffing PPE as part of the RRT training in Bali, 2-8 October 2022. Credit: WHO/Endang Wulandari.
Upon completing the training, the participants determined follow-up actions to implement the training material at their workplace and maintain RRT coordination. In addition, for sustainable capacity-building efforts, MoH has institutionalised the RRT training in collaboration with the MoH training centre with a standardised training curriculum for provinces, districts and primary healthcare.
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The training was supported by the United States Government and the Australian Government.
Written by Dr Endang Widuri Wulandari