Preparedness of Response to Deadly Outbreaks: Lessons Learnt From Zambia's Deployment to the 2014 African Ebola Outbreak

Abstract

Background: West Africa experienced the largest outbreak of Ebola in 2014 in history involving three Mano River States of Sierra Leone, Liberia and Guinea. The World Health Organization (WHO) coordinated an emergency response from WHO Country Offices in many areas, including human resources for health services. WHO Zambia deployed human resources (HR) focal persons to Sierra Leone and Liberia to strengthen operations. The purpose of this paper is to document the contributions made by WHO Zambia human resources staff that were deployed for more than six weeks during this outbreak and areas of value of this exposure experience.
Methods: A review of standard operating procedures (SOPs) in an Ebola setting and experiences gained during the deployment of staff in Sierra Leone and Liberia were recorded systematically. Comparisons were made between experiences gained in the WHO offices situated in the Ebola outbreak setting and one outside such a setting. Lessons learned from this deployment were documented and where appropriate documentation adapted by staff upon return from the Ebola setting. The staffs were in an emergency setting for over six weeks in either Sierra Leone or Liberia.
Results: There were major similarities in settings affected by Ebola. Both the local and international staff members that visited the Ebola affected areas worked as a team towards the goal of ending the epidemic quickly. At these sites, staff members discharged a variety of duties which involved facilitating recruitment, deployment, appointments, Special Service Agreements (SSA), Consultancies and Agreements of Performance of Work (APW). The HR staffs were also responsible for travel and logistics of international staff and consultants on duty travel and entitled for rest and recuperation. Recruitment processes were shorter with HR waivers being applied where necessary unlike in a WHO country non-Ebola office setting. Working hours were longer including weekends and it was normal for staff to be found working at the WHO office after office working hours, weekends and official holidays. People working at WHO compound avoided bodily contact, including a specified contact distance, to minimize the risk of exposure.
Discussion: The participation or exposure of staff to an Ebola setting during an outbreak built a strong culture of staff enabling them to work under harsh conditions which were characterized by long hours and constant recognition of the threat of disease enabling a quick adaptation to different culture and lifestyle which had a positive impact. Some of the lessons learnt included improved work efficiency, built staff resilience to work long hours under stressful conditions and consciously managing aseptic techniques.
Conclusion: Exposure to some adverse conditions such as managing work operations in the midst of a deadly outbreak such as Ebola may have a positive impact on the work culture of the individual exposed to this setting and the organization as a whole.