Disease early warning, alert and response in emergencies
Humanitarian emergencies increase the risk of transmitting disease. Disease outbreaks, such as malaria, measles and cholera, are often a major cause of illnesses and death during crises.
The global Early Warning and Response System (EWARS) project is a WHO initiative to catch disease outbreaks early on to be able to contain them in emergencies. It supports Ministries of Health and health partners by providing technical support, training and field-based tools.
EWARS is committed to supporting disease surveillance, alert and response even in the most difficult operating environments. “EWARS in a box” is a kit of durable, field-ready equipment needed to establish and manage surveillance or response activities in field settings.
This photo essay illustrates how the first “EWARS in a box” was set-up in Mingkaman, an internally displaced persons (IDPs) settlement, in South Sudan.
The first priority area in South Sudan was identified with the Ministry of Health, as Mingkaman IDP settlement. Here participants from all health partners in Mingkaman, and the local County Health Department, received training on how to report cases of disease using mobile phones.
A single kit costs approximately US$ 15 000 and can support surveillance for 50 fixed or even mobile clinics, or roughly 500 000 people.
In Mingkaman, the “EWARS in a box” kits arrived by UN helicopter. Due to poor road conditions access to more remote areas or those in conflict is only possible by air, especially during the rainy season.
Health services are provided by the Ministry of Health as well as nongovernmental organizations: Health Link South Sudan (HLSS), International Medical Corps (IMC), Sudan Medical Care (SMC) and Comitato Collaborazione Medica (CCM).
Julius collects disease data from patients every day during routine consultations. If any diseases are seen that require an urgent response, such as measles, the County Health Department can be notified immediately using the mobile phone. Then the County Health Department can consider next steps, such as alerting colleagues to respond immediately, investigate further or take laboratory samples.
Previously, the reports were submitted on paper and took a lot of time to reach the state and national levels. Reporting by mobile phone speeds up the process and makes the information available to the Ministry of Health and WHO staff in real-time.
Lasu Robert Martin works with Kenyi Nason Felix, a laboratory technician from a health facility in Mingkaman, to review the actions needed if an outbreak alert is received on the phone.
The performance of EWARS is regularly monitored to identify where support is needed. At 3 to 6 month intervals, in-depth evaluations are used to document successes and challenges, and to obtain feedback from frontline users.