70 trained specialists in Botswana ready to be deployed and intervene in health emergencies

A group of 70 representatives from different governmental agencies and institutions in Botswana were trained between 20 and 29 June 2022 to strengthen their skills and capacities to effectively coordinate emergencies with public health impact using a functional public health emergency operations center (PHEOC) to enable an all-hazards and multisectoral approach.

WHO continuously works with the Member States, Africa Centers for Disease Control and Prevention (Africa CDC) and other partners to build the capacity of the region to reinforce core competencies for the implementation of the International Health Regulations (IHR 2005). The aim is to ensure countries are better positioned to respond to all public health emergencies including the ongoing COVID-19 pandemic.

In this context, WHO developed an emergency response training programme to equip a national multisectoral and multidisciplinary team of experts to manage emergencies within their borders and beyond to support other countries in the region if required. The training programme falls under pillar one (workforce development) of WHO AFRO flagship initiative Strengthening and Utilizing Response Groups for Emergencies (SURGE). Botswana is one of the first five countries where SURGE is implemented in the region.

“As the public health emergencies are on the rise, this comes at the right time. Health emergencies do not only concern health professionals, but other sectors as well, because we have to be ready to intervene as one within 48 hours in an emergency here in the country or wherever our strengthened skills are needed in the entire region” says Dr Thebeyame Macheke from the Ministry of Health (MoH), participating at the training sessions.

The specific objectives of the training were to:

• Update participants on the Public Health Emergency Operations Centers (PHEOC) framework, tools, standards, and guidelines as per IHR 2005;
• Provide key concepts of emergency management using the incident management system principles as the model for preparing for and responding to public health emergencies;
• Describe the functions of PHEOC operations and management during all phases of the emergency management cycle for effective emergency response;
• Provide an overview of the WHO emergency response framework (ERF);
• Discuss multi-sectoral coordination, communication, and planning approaches to plan for and respond to public health emergencies using an all-hazard approach;
• Conduct tabletop simulation exercises to test emergency management capabilities in the country.

A Monkey Pox outbreak and a flooding disaster were the themes for the tabletop simulation exercises during the SURGE training in Botswana. All the sessions were facilitated by a team of Emergency Operation Center (EOC) experts from the Gambia, Ethiopia, Liberia, Namibia, Sierra Leone, and Nigeria, in addition to emergency experts from the WHO Regional Offices for Africa and the Eastern Mediterranean.

Senait Fekadu, EOC Lead at WHO AFRO, one of the key facilitators, was impressed with the engagement of the participants. “There was a zero rate of drop-out despite the long and intensive sessions. From an average score of 50% before the training, I noticed important progress to over 70% in understanding public health emergency management, and even more in certain skills at the end of the programme”, she said.

Tiny Rammika, Health and Safety Environmental Coordinator at the Ministry of Agriculture, one of the trainees said “As my Ministry plays an important role in animal health emergencies, it is critical to be part of this training. What we are learning here makes me better understand the importance of the One Health approach within PHEOC and prepares me to intervene in emergencies in synergy with other sectors”.

“As the health emergency architecture must be driven by specific country needs, the Government of Botswana through its critical ministries plays a significant leadership role in this initiative. Earlier in March, during the SURGE scoping mission, a Memorandum of Understanding and a unique roadmap were developed by the Ministry of Health and WHO and this capacity-building exercise is one of the key components agreed upon, among several others” said Dr Pamela Smith-Lawrence, Director of Health Services at MoH.

Through this initiative, the national experts will be registered in the WHO Regional database and acknowledged as emergency response experts ready to be deployed within 24-48 hours to support emergencies in their country and beyond. In addition, logistical support will be provided for use by the expert teams to decentralise the storage of emergency supplies, facilitate alert investigations and initiate an emergency response, particularly in remote areas. This support will include an ambulance, seven hard top vehicles, interoperable stock systems and refurbishments of existing structures to sub-national warehouse hubs and support for developing and implementing a risk communication and community engagement strategic plan for health emergencies.

*WHO’s African Member States face a broad range of emergencies resulting from various hazards and differing in scale, complexity and international consequences. These emergencies can have extensive political, economic, social and public health impacts, with potential long-term consequences sometimes persisting for years after the emergency. They may be caused by natural disasters, conflict, disease outbreaks, food contamination, or chemical or radio-nuclear spills, among other hazards. They can undermine decades of social development and hard-earned health gains, damage hospitals and other health infrastructure, weaken health systems and slow progress towards the Sustainable Development Goals (SDGs). Preparing for and responding effectively to such emergencies are among the most pressing challenges facing the international community as can be witnessed by the current COVID-19 pandemic.

Risks to public health have increased due to globalization, and international travel and trade. Such risks might be transmitted by people (e.g. COVID-19, SARS, influenza, polio, Ebola), goods, food, animals (e.g. zoonotic disease), vectors (e.g. dengue, plague, yellow fever), or the environment (e.g. radio-nuclear releases, chemical spills or other contamination). In all types of emergencies, the poorest and most vulnerable people suffer disproportionately. These negative impacts are complicated by the enormity of the resulting economic costs. The appropriate and timely management of these risks requires effective national and international capacities, intersectoral collaboration, the promotion of equity, the protection of human rights, and the advancement of gender equality.*