The Uganda Ministry of Health declared an outbreak of Ebola virus disease (EVD) in the Western and Central region of Uganda in September 2022. By October 20, 2022, 65 EVD cases were confirmed, 27 people had died, and 1,636 contacts of cases had been listed, with new cases continuing to be detected.
While the Ugandan government declared a three-week lockdown as of October 15 in two high-risk districts, surrounding nations remain concerned about possible cross-border spread of EVD, which is highly transmissible and has an incredibly high death rate. South Sudan borders Uganda and is considered by the World Health Organization a Priority 1 country, meaning it is at particularly high risk of experiencing EVD cases as a result of the outbreak in Uganda. The impact of an EVD outbreak left undetected and uncontained could be severe in South Sudan, whose health infrastructure continues to recover from years of conflict.
ICAP at Columbia University in South Sudan is preparing communities and health facilities for such a potential outbreak, catalyzing risk communication, community engagement, surveillance, infection prevention and control, and lab strengthening in counties most at risk of EVD spread.
“Every day, thousands of people travel in between Uganda and South Sudan; the risk of importing EVD is very high if we don’t act quickly,” said Susan Michaels-Strasser, senior director of Human Resources for Health Development at ICAP. “Our highest priorities are identification of the virus, containment, and protection of health care workers and communities. The preparedness work we are doing in South Sudan to reach these priorities is a good example of ICAP leveraging time and resources we have already invested over many years to affect the future. Because we have already been training teams at the border of the two countries on EVD response, we are able to hit the ground running even faster with this current response.”
A major component of curbing the spread of an EVD outbreak before it arrives is establishing awareness. ICAP in South Sudan has developed and distributed numerous visual guides to health and isolation facilities, including guidance on infection prevention and control, as well as EVD symptoms, transmission, and prevention. ICAP has also distributed standard operating procedures on surveillance, case management, and lab preparedness, among other critical virus response mechanisms. At border crossing points, within Juba health facilities and Juba International Airport, ICAP is supporting joint supervision visits to boost monitoring efforts of major points of entry.
During the 2014 outbreak of EVD in West Africa, the health care workforce experienced immense losses. In Sierra Leone, it is estimated that as many as one in five of the country’s health workers died from EVD. To prepare health workers for managing a potential outbreak in South Sudan, ICAP is supporting EVD incident management training and EVD communication and community engagement workshops in high-risk areas and is supporting the Ministry of Health in conducting training on international health regulations and cross-border collaboration within the country. In collaboration with the United Nations Development Program (UNDP), ICAP reprogrammed its COVID-19 Response Mechanism (C19RM) project in South Sudan – supported by the Global Fund – to assist in the development of an EVD preparedness, readiness, and response plan. The plan specifically outlines pathways to improved testing capabilities, use of personal protective equipment, and health worker training, to name a few.
“To assist the Ministry of Health leadership in making informed decisions on EVD preparedness and possible response, ICAP has led development and adaptation of EVD data collection and reporting tools, case definitions, and standard operating procedures,” said Kennedy Muni, senior epidemiologist at ICAP in South Sudan. “These documents are necessary for harmonized and standardized data. We are also supporting the Ministry of Health with developing regular EVD situation reports as well as maintaining a database of all reported EVD alerts.”
Key to preparing for a potential EVD outbreak in South Sudan is leveraging lessons learned from ICAP’s EVD response in previous years. When West Africa experienced rapid community spread of the virus in 2014, many countries hit hardest confronted the epidemic with scarce resources, limited infrastructure, and health care worker shortages. Learning from this, ICAP is supporting health facilities to address physical infrastructure problems that could hamper infection control, including installing more hand-washing stations and repairing washrooms. Laboratories in South Sudan that provide vital EVD testing are also receiving support on improving their information management systems, workflow, and receipt of the latest guidance from the laboratory technical working group.
“ICAP, through the C19RM project, is preparing a pool of future frontline public health emergency responders across South Sudan,” said Kibebu Kinfu, senior public health emergency preparedness and response advisor at ICAP. “I am very confident that the capacity building in the incident management system, point of entry disease surveillance, and cross-border collaboration training will enhance the knowledge and skills of health workers in public health emergency management. In addition, the ongoing frontline field epidemiology training supported by ICAP will increase the number and quality of trained health workforce to respond to future public health emergencies.”
A major global health organization that has been improving public health in countries around the world for nearly two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in nearly 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies.