Ebola Virus Disease table-top simulation exercises

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Early in October 2014 at the Rwizi Arch Hotel in Mbarara District in Western Uganda, the East, Central and Southern Africa Health Community (ECSA-HC), the East African Community (EAC) and the Ministry of Health of the Republic of Uganda (through the EAPHLNP) convened a cross-border meeting between the bordering districts of the Republic of Rwanda, the Republic of Uganda and the United Republic of Tanzania.

The exercise was conducted to assess the level of emergency preparedness and response capacity for Ebola and Viral Haemorrhagic Fevers (VHFs) outbreak in the EAC Partner States and North & South Kivu provinces of the Democratic Republic of Congo (DRC.

In addition, the exercise would be used to identify gaps so as to strengthen the surveillance and response system within the region.

The simulation exercise was facilitated by experts from the Food and Agriculture Organization of the United Nations (UNFAO) and the Department of Veterinary Services, University of Nairobi.

The specific objectives of the table top simulation exercise were to;

Assess the level of preparedness and ability to detect VHF and contain a VHF outbreak at the cross-border areas;

Raise awareness of the roles, responsibilities and immediate emergency response actions of the participants in surveillance, laboratory testing, confirmation and risk communication;

The table-top simulation contained three scenarios with different levels of complexities beginning with simple to more complex moves and table-top demonstration of downing and doffing personal protective equipment (PPEs).

The first scenario contained three moves (from simple regular clinical case to confirmation of initial cases of Ebola). The second scenario contained two moves (increase in Ebola cases from contacts requiring improved clinical support and communications to the communities) and the third scenario contained three moves (cases requiring establishment of burial teams to final control and outbreak control).

The moves assessed the responses of various stakeholders involved in outbreak management including disease surveillance and the laboratory (diagnostics); case management (clinical staff); risk management; coordination (policy makers and heads of programs) and supportive services (communication, immigration; security officials etc). The different stakeholders were expected to develop response actions appropriate for their functional areas and to coordinate, as would be necessary, with other groups.

This methodology proved to be effective in identifying response actions and providing participants with an opportunity to develop command, control and coordination of their action plans necessary for a meaningful response to an Ebola outbreak within their countries. It also identified gaps in the systems that would need to be addressed to improve the response systems and processes.

The simulation exercise was considered very successful by the participants, evaluators and observers. The participants’ evaluation report was positive regarding processes and outcomes. The participants were also grateful for the hospitality from the Ugandan hosts.

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