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Planning for and response to Ebola - Is Malawi Ready?

IFRC Treatment Centre Kenema, Sierra Leone, Sept 2014

This article begins to highlight some of the key areas of preparedness needed to prevent Ebola Viral Disease from occurring in Malawi through measures to keep it out (border management) and addressing the consequences and effects of the disease by stamping it out (cluster control). This working paper is also aimed to serve as an impetus for action and is intended to complement the preparedness efforts currently being prepared by the Ministry of Health. This article is highlighted by Kuluka as topical to improving Malawian healthcare and covering a critical issue

Author: Dr. Evanson Sambala


Acknowledging that Ebola Virus Disease (EVD) is frightening invokes concern over the slow progress the Government of Malawi is making towards the planning for, and response to Ebola Virus Disease. Since the first cases of Ebola were notified in March 2014 in Guinea, it has been unclear whether Malawi is ready to deploy its plan to respond to the threats of Ebola Virus Disease. While it is acceptable that planning is a continuous process, the public are yet to see the finalised proposal of the Preparedness Plan or be notified of any Ebola drills, exercises and simulations. Preparedness and responses to the avian H5N1 in 2006 and pandemic influenza H1N1 in 2009 in Malawi were not as slow, but they were clumsy and incomplete, raising serious concerns whether Malawi is able to be prepared for the current Ebola outbreak. There is a great deal more to preparedness than just acquiring resources. Planning should be about responding effectively in preventing and mitigating the disease threat with the means available. The effectiveness of preparedness is not just a matter of having a plan, but of having one that maps out core issues and finds legitimate solutions in their own context. Such plans need to be fully supported by political and social structures. If Malawi is to respond effectively, the “know-do gap” between what gets planned and gets done must be connected with evidence of what works effectively. To fight Ebola in the event an outbreak occurring, and in order to bend the “epi curve” in the right direction, we need to strengthen the health operation systems. Ebola outbreak will make additional demands on health facilities and any response actions in the implementation plans must provide the best ways to minimize costs and maximize health service benefits. The practical elements, such as shortage of doctors, nurses and volunteers to work at the frontline, must be addressed. Communicating the response plan prior to the outbreak is not only good public health practice but also helps overcome the problem of social order, panic, fear, myths and staff absenteeism. If Ebola preparedness plans are to illicit successful responses it will be necessary to delve more into participatory approaches that address cultural problems associated with increased risk of Ebola transmission. National and local decisions ought to be well informed with epidemiological and public health information so as to address practical difficulties, such as ethical problems, priority setting hiccups and collaboration riddles. All Ebola actors should play a key role at the community level in providing essential services to ensure business continuity and public order. The National EVD Preparedness Plan needs to consolidate and identify the alternative care sites for the delivery of health care in the event that hospitals are overwhelmed with scores of patients.

Please read the pdf for the full article

Image thanks to International Federation of Red Cross and Red Crescent Societies