The UK Department for International Development (DFID) and the Sierra Leone Ministry of Health published a “lessons learned” report in 2012, reflecting on that year’s cholera epidemic. The report focused on ensuring that national risk reduction strategies accounted for the threats posed by communicable diseases. In the face of the burgeoning Ebola epidemic, DFID brought this report to the attention of multiple stakeholders (from the President of Sierra Leone and the WHO, to the UN and NGOs).
Some of the areas that James Shepherd-Barron felt were not adequately translated from the 2012 Cholera Report to execution amidst the 2014 epidemic include:
1. Weak coordination;
2.) Inadequate national resources (i.e “The national Ebola Operations Center” was undermanned); and
3.) Inexperienced leadership
In his discussion of the ways in which the 2012 report can be incorporated into thoughts and lessons resulting from the Ebola outbreak, Shepherd-Barron poignantly writes that “…learning by dying is not an option.”
I find Shepherd-Barron’s criticism of translation efforts (the application of previous reports on lessons learned from epidemics) to be important and timely. How is it that we can ensure that future reports are internalized and applied (ideally before any sort of outbreak)? How do we ensure that lessons learned from the Ebola epidemic are not lost? Are we taking steps to ensure that learning by dying is not an ongoing approach?
We are surrounded by natural hazards, and a zoonotic disease of epidemic potential is only one in a list that includes earthquakes, landslides, tsunami, and hurricanes. When hazards like these collide with poverty and human indifference, disaster normally ensues. The eruption of the Ebola virus from the jungles of Kenema in early 2014 was no different. Here was a naturally occurring biological hazard which superstition, fear, fragile health systems, poor leadership, and dysfunctional management spent much of 2014 turning into a global crisis. It did not have to be like this.