Saving Lives in a Time of Cholera

Having spent a number of years combatting Ebola and Marburg viruses, officials in Uganda were able to quickly set into a motion a series of proactive strategies such as restriction of movement, surveillance strategies, and widespread testing to help contain the coronavirus outbreak. Although the approach isn't without its limitations – many are stockpiling groceries out of fear – the rapid and aggressive measures have kept the country's caseload low compared to that of other African nations.

Weeks before the coronavirus outbreak was declared to be a pandemic, Seoul, and other parts of South Korea set into motion a combination of "prevention and mitigation programs" that are now being touted as lessons for other countries struggling to contain the virus. Using technological advancements such as a national mobile phone alert system and mobile phone applications along with increased transparency around data collected, new reports of cases have slowed allowing the country to prepare for a potential surge later on.

"Poor man Instagram" is how vets at Chiang Mai University describe their system of pandemic preparedness and emergency prevention. Recruiting community members throughout the region to be disease detectives, the scientists train these volunteers to use a mobile app that allows them to document dead animals that may have been sick with an illness that could pose a threat to humans. When scientists are alerted of cases, they are then able to investigate and intervene if the situation merits danger.

With climate change, population pressures and mobilization epidemics will occur more frequently, and past ones have proven to be disastrous and expensive. The Center for Epidemic Preparedness Innovations (CEPI) is focused on developing vaccines to viruses such as Ebola, as well as creating a fast approval path for future vaccines and helping increase global preparedness for future epidemics.

Teams of Community Direct Distributors (CDD) are leading drug distribution campaigns to prevent and eliminate neglected tropical diseases in hard-to-reach, rural areas. These CDDs are members of the community they serve and are trained to educate the locals on disease prevention and administer the drugs themselves. With the CDDs’ help, several states have already eliminated some diseases and greatly reduced the spread of others.

Kano State in Nigeria has implemented a strategy to increase the likelihood of children receiving necessary vaccinations to reduce cases of polio. The strategy, which included enhanced training on administering the vaccinations, taking the vaccines directly to homes and "collaboration between policy makers and traditional leaders," has resulted in no cases of polio for the last five years.

Cold storage supply chains improve the reliability of vaccine delivery. In Nigeria’s Kano State, the establishment of zonal cold stores has increased immunization coverage. Local nodes equipped with solar powered refrigeration provide storage for vaccines, which are then delivered to supply smaller health centers in the area. The initiative came from a partnership between the Nigerian state and nonprofits, such as the World Health Organization (WHO) and the Bill and Melinda Gates Foundation.

Kaduna State in Nigeria hasn't seen a case of poliovirus since 2016 due to a series of approaches that aim to stop any potential spreads before they even begin. Between data monitoring, distributing tasks to increase efficiency and continuous oversight, the region has successfully increased immunization and stands as a region to learn lessons from.

Local public health infrastructure makes monitoring and responding to epidemic outbreaks possible. In Nigeria’s Kebbi state, The Nigerian Centre for Disease Control (NCDC) operates Public Health Emergency Operation Centers (PHEOC), which serve as local nodes in the country’s battle against infectious disease. Each PHEOC coordinates with a local committee of leaders in identifying, isolating, and treating cases of infectious disease.

A nonprofit in Haiti called SOIL with a business arm called EkoLakay is bringing back the old-fashioned idea of a container-based sanitation system. Customers rent toilets with containers in them, use them, and return them to EkoLakay to then be converted into highly nutritious compost. Piloted in 2011, the program has been successful serving more than 1,000 households (growing by 40 every month) with a staff of 58 mostly local workers. They attribute their success to using "applied resilience thinking", having many actors at different levels, and constantly adapting to new solutions and knowledge.