Participants at the training
Zambia has experienced a number of cholera outbreaks since 1977. The most recent outbreak in 2017/2018 affected over 5,000 people, claimed 114 lives and cost the country large sums of resources including money, human resource and health systems. Under this background, cholera was prioritized as the one of the hazards facing the country during the vulnerability risk assessment mapping (VRAM) exercise sponsored by WHO that was addressing a gap identified in the 2017 joint external evaluation (JEE).
In the recent 77th World Health Assembly, Zambia sponsored a resolution to eliminate cholera globally by 2030 and further determined a national legacy goal to eliminate it in Zambia by 2025. In response to this declaration, a multisectoral costed cholera elimination plan is in development. This plan focuses on interventions aligned to coordination, surveillance, water, sanitation and hygiene (WASH), social mobilisation as well as prevention through the use of Oral Cholera Vaccines (OCV). This has prompted the country to be on high alert for cholera outbreak.
Currently, the cholera outbreak in neighboring Zimbabwe declared on 6th September 2018 affecting Harare suburbs with 8,786 cases and 54 deaths recorded as at 10th October, poses a risk to Zambia considering the trade relations and population movement between the two countries. In this regard, Zambia has heightened surveillance, and emergency preparedness; to ensure preparedness and response capacity is in place, training for rapid response teams is ongoing with a team in Lusaka trained between 8th and 12th October 2018. The participants drawn from various Lusaka sub-districts converged to learn and share best practices as well as challenges in outbreak preparedness, response and recovery following a three-day training in Ebola Preparedness and Response. Lessons learnt in previous outbreaks were also shared and through table top exercises the Rapid Response Team (RRTs) used case studies and applied learning to develop participants’ knowledge and skills in response.
Honourable Minister of Health Dr Chitalu Chilufya MP (centre) with fully donned RRT members and other stakeholders and partners (ZNPHI, WHO and US CDC)
The Honourable Minister of Health Dr Chitalu Chilufya MP, MCC gave high level support to the trainers and trainees, emphasising that the Public Health Security in Zambia is a top priority agenda. In his remarks, Hon. Chitalu Chilufya reaffirmed the government support in ensuring that all preparedness efforts are put in place including surveillance at ports of entry.
Speaking during the opening of the training, Dr Victor Mukonka, the Director of the Zambia National Public Health Institute (ZNPHI) noted that the institute is keen to provide health security in a strategic manner together with other targeted plans in health to keep the Zambian population safe and healthy.
Dr Victor Mukonka, the Director of the Zambia National Public Health Institute (ZNPHI) at the training
“We have adjusted this training program to focus on both cholera and Ebola for Lusaka district so as to build the necessary capacity for health care workers as it is an integral part of public health responses and interventions,” he said.
The training has been facilitated with various resources including financing, Human Resource, equipment, tools and consumables from the Ministry of Health, World Health Organisation, Zambia Centers for Disease Control, Africa CDC Southern RCC and the Zambia National Public Health Institute. The main aim of this training was to offer hands on training to the RRTs and form teams that will be able to respond rapidly in case of any threats/rumours/events. Participants had a chance to work on case definitions of cholera, contact tracing processes including Global Positioning System (GPS) mapping. Demonstrations on laboratory diagnosis including sample packaging and transportation was also covered in detail.
The legal components with particular focus on the public Health Act (PHA) and enforcement of statutory instruments, guide on the provisions in PHA on disease outbreaks and during watch mode was interpreted. Other key areas of focus were risk communication, oral cholera vaccine (OCV) as a preventive measure, as well as data management and linking data from all sources like electronic integrated disease surveillance and response (eIDSR), laboratory, contact tracing and the environment.
Practical sessions included, setting up of a cholera treatment centre (CTC) and disinfection using chlorine mixing exercises. The use of incident management system (IMS) as a best practice was highlighted as it enables coordinated response among various agencies by establishing common practices for planning and management of resources as well as allowing for integrated approach during response.
Group work on simulation exercises on chlorine mixing
The call to action for the teams was to hold the responsibility of protecting and providing health security to the population from disease outbreaks.
Acknowledgements:
Ministry of Health (HQ, University Teaching Hospital and Kafue District Health Officer)
World Health Organisation
Zambia Centers for Disease Control and Prevention
Africa CDC Southern Africa RCC
For more information contact: Mazyanga L Mazaba Liwewe, Head Information Systems, Zambia National Public Health Institute. Mobile: +260 977879400; Email: mazyanga.mazaba@znphi.co.zm