Transcript Cameroon Defence during disease outbreaks

ROLE OF THE MILITARY DURING
DISEASE OUTBREAKS
Col MAMA Ambroise, MD
Director of Military Health
LCol MPOUDI NGOLE, MD MPH
Head Pandemics Unit/HIV Focal Point
Department of Military Health, CAMEROON
APORA, 20/04/15 in Accra, GHANA.
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Humanitarian action is not specifically part of the
mission assigned to the Cameroonian Defense and
Security Forces. Involvement is not formal.
In practice, military health and non health personnel
commonly take active part in outbreak management in
support to the MOH, especially in non urban areas.
Major partner to the MoH in disaster management and
strategic planning in pandemics (i.e HIV, Ebola).
Main contributions are found in provision of care and
logistics.
Strategic planning
HIV and Ebola responses
With coordination of the MoH. Other stakeholders
include Interior, Communications, Environment, fishing
and animal industries, NGOs and international
partners
Led early response to HIV
Contribute to the IMS (in development). EOC located
in mil buildings.
Detection of outbreaks
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Surveillance focal points in mil. health facilities located in
endemic areas. Report surv. data to Mil health and regional
health authorities. Routinely done for HIV, less effective for
other diseases.
In remote areas and borders: Gendarmerie (Military police)
staff are often the only authorities available. Routinely
provide regular reports to their hierarchy. Readily available
means of communication and liaison vehicles.
Frequently the first to notice and/or report unusual changes
in their environment including upsurges in fatalities/sick
where they are posted. Commonly informed by communities.
They alert health authorities when unusual outcomes are
observed
Early response:
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The gendarmerie (mil. police) is trained to
quarantine areas where potentially transmissible
infections are suspected by restricting movements of
populations.
They lack training for infection control and
sometimes get contaminated.
They assist local health authorities in the early
response as requested by the Ministry of Interior,
usually triggered by the Ministry of Public Health
Management of outbreaks:
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Mil. health network: 126 health facilities nationwide,
75 leaded by a military physician.
Hospitals and health centers are open to civilians;
commonly involved in management of disasters and
outbreaks when located in affected area.
Provide care +/- Lab Diagnostic
to walk-in patients or when requested by MoH.
Regularly provides logistics support (informal
arrangement MOD-MOH)
Logistics
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Most of the mil-civ collaboration is achieved through
logistics support, especially outside major urban areas.
Making use of the high mobility, fast communications
chains and nationwide deployment of the military, the
MoH via Interior have requested support from the MoD
for issues related to transportation of patients, security
(borders, quarantined areas), buildings/sites and
communication.
Examples: cholera with communication and provision of
potable water in Far North region or Ebola with IMS
structure and isolation units offered by the MOD.
Care provision
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Mil health staff
provides medical care
when mil. heath facility
is located in the area
affected by the
outbreak.
Frequently receives
equipment/intrants
support from the MOH
in these cases.
Prevention
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Mainly applies to mil
health personnel,
except for
Screening for diseases
at entry points.
No post crisis nor
recovery measures
In a nutshell:
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Contribution of Defense and Security Forces in Cameroon
: not clearly defined.
Involved as requested by the MoH through leadership of
MoI or unpredictably as caught in frontline.
Health services, Engineering, communications
Organisation, training, celerity and equipment in the
military provide a strong potential to more efficiently
contribute to outbreak management, should mission and
expectations be clearly spelled out and supported.
GAPS…
Healthcare system strengthening
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Reliable stockpile of PPE/reliable channels to
secure PPE.
Access to appropriate shipping containers/safe
specimen handling . IATA trained personnel
Lab available but not equipped for diagnostic and
shipment.
Isolation units not available
SOPs
Military-friendly visuals/brochures
HR capacity building (1/2)
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Additional personnel training needed for :
Surveillance ; adequate reporting of data
detection of outbreak and management/action
during outbreaks
Epidemic management and rapid response teams
Importance and use of EPI
Shipping of infectious substances. IATA trained
personnel.
HR capacity building (2/2)
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Training needed in:
Handling of blood, infectious specimen.
Resources and knowledge to establish isolation units
Staff training for infection control, esp handwashing.
Appropriate measures in place to isolate and
transport suspect travel-related cases to the ETU
Risk Communications
THANK YOU!!!