Member voices: David Adams reflects on outbreak response training

David Adams, an experienced aid worker from Northern Ireland, reflects on a recent outbreak response training – where he joined as comms lead.

Ordinarily, you’d be hard-pressed to find a connection between the tranquil, stunningly beautiful Lake District in Cumbria and the numerous disaster-stricken areas of our world. Yet recently, for a few days at least, there was indeed a tenuous connection.

Even aside from the number of lives that it will initially claim or forever alter, an outbreak will have a terrible and long-lasting impact on an affected country. Health and education systems and local and national economies will all come under enormous strain, and may well collapse. Countless livelihoods will certainly be lost in the disruption, whilst the poorest and most vulnerable communities will invariably be the worst affected. The challenges faced by governments and the global humanitarian community in responding to an outbreak situation are enormous. UK-Med is working with partners to improve outbreak preparedness and response, which is why – from September 25-29 – more than 35 members of UK-Med’s Outbreak Response Team (ORT) were at Derwent Hill in the Lake District National Park to undergo an intense training programme specially designed to make the them ready to disease outbreaks overseas.

The dedicated members of the Outbreak Response Team are a diverse group of people, by profession as well as background. While the majority are, unsurprisingly, medical professionals – nurses, doctors, paramedics – a significant number are programme support staff, without whom any emergency intervention would be well-nigh impossible. Doctor Caroline Bwango from London is in no doubt about this: “Support staff are vital to everything we do. Logisticians, programme managers, human resources, finance people, security experts and so on. Without them nothing can happen. It would be like trying to drive a vehicle without any fuel in the tank.”

In the event of a disaster, whether natural or man-made, a largely helpless local population will invariably be faced with an extreme medical emergency of one kind or another: be it infectious disease, malnutrition, physical trauma, or a combination of these. At the earliest possible opportunity, UK-Med will send members of its outbreak response team to provide critical support to such populations. But, of course, you cannot send people to live and work in a hostile environment without first preparing them for the various dangers, hardships, and problems they might face. While some outbreak response team volunteers have many years of experience in responding to disasters, they still welcome the opportunity of a “refresher” course at Derwent Hill. As Carrie Garavan, a Public Health Specialist from Ireland, puts it: “These training programmes are excellent, and very necessary. No matter how much field experience you have, there is always something more you can learn. And it is always helpful to have much of what you have learned before refreshed and reinvigorated in your mind.”

There is no such thing as a safe disaster zone. Each has its own particular set of dangers. Some obvious, and others not so much. It is critical, therefore, that first-responders are trained in all aspects of security-awareness before travelling. Field Epidemiologist specialist, Caroline Maxwell, says of security training: “If you’re about to travel to a country, the need for general security training and briefings on the overall security situation, is self-evident. But it’s critical that you’re also briefed on risks particular to the area where you’re going to be living and working. What are the crime levels and types of crimes in the area? And what local customs do I need to know about? Essentially, you need to know how to avoid putting yourself and your colleagues in potentially dangerous situations.”

Less critical than security training (but extremely important, nonetheless) is team-building. And not just to have people working together as a cohesive and productive unit. Outbreak Response Team team members will often be away from home for weeks or even months at a time – working long hours in highly-stressful situations, often having to live together in poor conditions. Tempers can easily become frayed and real or imagined slights exaggerated until they threaten the harmony and cohesion of an entire group. Team building, as it applies to first responders, is about learning to live together as well as work together. When you’re living together with a group of people in a trying situation, you need to be flexible and thoughtful of others. From the outset you need to be accepting of other people’s little quirks, and they of yours. Small things can easily destroy group cohesion if left unaddressed. For instance, no one should ever have to ask, ‘whose turn is it to do the dishes?’ Or ‘whose clothes are these scattered about the room (or tent)?’. Learning to team-build is vital to harmony and cohesion where you’re living as well as where you’re working.

Incidences of infectious diseases continue to rise and outbreaks have become more common. In the past decade alone, the World Health Organisation has declared five Global Health Emergencies. Three of these were in the past five years: the Ebola epidemic in West Africa; the Zika outbreak that spread through the Americas; and more recently the Ebola Outbreak in the Democratic Republic of Congo.

Viruses, bacteria, and fungi spread around the world with greater effectiveness and speed than ever before. When they turn up in unexpected places, they catch doctors, health systems (and people’s immune systems) off-guard.

You can read the full WHO Global Preparedness Monitoring Board Annual report 2019 here.

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