In response to the current Ebola Virus Disease (EVD) outbreaks in DRC, the Ministry of Health (MoH) through the Zambia National Public Health Institute (ZNPHI) put in place various mitigation measures for the identified health risks linked to EVD. The risk of EVD spread to Zambia remains relatively high considering the proximity of the affected area and the porous borders.With support from the World Health Organization (WHO), ZNPHI has embarked on training of rapid response teams (RRT) in all the districts in the 5 provinces bordering DRC; Northern, Lupaula, North-Western, Copperbelt and Central Provinces.
Honourable Minister of Health Dr Chitalu Chilufya, WHO Representative to Zambia Dr Nathan Bakyata, Hon Nathaniel Mubukwanu Minister of North-Western Province share a moment with the RRT team in training
Seven-member Rapid Response Teams per district in North-Western and Copperbelt Province were trained from 3-8 August 2018. Facilitators to the training include staff with technical expertise from WHO, Centers of Disease Prevention and Control (CDC), Africa CDC, University of Zambia school of Veterinary Medicine, MoH and ZNPHI. Prior to this training, other district teams have been trained in Northern and Luapula provinces considering their proximity to the DRC. The trainings are aimed at providing hands on training to RRT on important aspect of EVD including surveillance, infection prevention, isolation of patients, sample transportation, clinical management, reporting and communication. These skills are expected to empower the teams to respond rapidly in case of EVD threats, rumours and events. The trainings have additionally been used as platforms to provide understanding on the WHO checklist for field visits to clinics and ports of entry to access preparedness and make action points to resolve identified gaps.
Speaking during the training in Solwezi, the Minister of Health, Honourable Dr Chitalu Chilufya MP, MCC called for acceleration of preparedness actions. “I encourage you to raise the index of suspicion in the communities and ensure that all people coming into the country use the designated points of entry where surveillance measures have been put in place,” he said. He also thanked the partners and assured them of the government support in putting into practice the health security of the Zambia population.
The rapid response teams were sensitized on the need to establish incident management systems (IMS) with a command structure that will oversee public health emergency preparedness and response activities. In addition, they were equipped with skills in putting on and taking off the protective personal equipment (PPE) commonly known as donning and doffing respectively.
EBV is a highly contagious disease with a high fatality rate and the possibility of massive outbreaks within the region cannot be overemphasized. It commonly presents as fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, abdominal pain, unexplained bleeding. Symptoms may appear anywhere from 2 to 21 days after contact with the virus, and although a rare disease it is severe and often deadly.
MoH, ZNPHI and WHO leadership support the RRT training for Copperbelt Province in Ndola
Dr Mukonka, Director of the Zambia National Public Health Institute reiterated that Zambia’s health sector is concentrating on attaining universal health coverage by 2030 through health system strengthening with priority in service delivery through provision of primary healthcare. “This training is tailored to have team leads in the districts empowered with knowledge as we believe that 75% of decisions can be dealt with at district level,” he said.
A plan is in place to get all provinces in a preparedness mode through capacity building including training of responders. Other measures already in place include heightening surveillance, increased health monitoring at points of entry, accelerating community sensitization, diagnostic capacity preparations at the virology laboratories at the University Teaching Hospital (UTH) and University of Zambia (UNZA), stock piling medical supplies and RRTs placed on standby. At policy level, inter-ministerial liaison committee meetings chaired by the Secretary to the Cabinet have been activated, the 2017 national multisectoral plan by line ministries is in review and the construction of the Mwembeshi isolation facility is being facilitated.
Training facilitators from MoH, ZNPHI, WHO, UNZA, UTH, the US CDC and Africa CDC
The Government of the Republic of Zambia as host country of the Africa CDC Southern Africa Regional Collaborating Center is also supporting through the ZNPHI, member states in the SADC region in ensuring enhanced preparedness and response in case of an EVD threat in their countries as well as give support to DRC in mitigating the current outbreak. Regular video conferencing sessions using the Extension for Community Healthcare Outcomes (Project ECHO) platform for information sharing have been used for information sharing and preparedness planning.
- The Incident Management System (IMS) is an internationally recognized best practice that provides a standardized, yet flexible approach to managing response to the emergencies
- Trained and technically equitable Rapid Response Teams are important for timely and effective response
- Health care providers have an increased risk of being infected by EVD.
- EVD outbreaks can cause severe impacts on society (health systems, social disruption, economic).
- Early detection and isolation of new cases, and infection prevention associated with healthcare and contact tracing are essential to reduce and control the epidemic.
- Effective surveillance is a prerequisite for early case detection, interrupting transmission chain and eventually control of the outbreak
- Admitting a true Ebola patient to the ETC stops transmission; Not admitting a true Ebola patient can propagate infection; Admitting a non-Ebola patient place them at risk
- Data collection should be standardized with data collection tools whenever possible
Call to action
In the wake of the Ebola outbreaks in neighboring DRC, the rapid response teams are responsible for protecting and responding to health threats thereby providing health security to the Zambian population.
Mazyanga Lucy Mazaba (firstname.lastname@example.org)
Head Information Systems
Zambia National Public Health Institute