On the morning of August 14, after 3 days of excessive rainfall, devastating floods and mudslides occurred in and around Sierra Leone’ capital city of Freetown. Many areas in the districts of Western Area Urban and Rural were affected, including the partial collapse of Sugarloaf Mountain and complete submergence of numerous houses and structures. With 499 confirmed deaths and over 1,000 reported missing, this disaster marked one of the worst in Sierra Leone’ modern history. In addition, more than 3,000 survivors were left internally displaced due to evacuation of risk-prone areas.
The disaster initiated a timely response from Office for National Security and the Ministry of Health & Sanitation (MoHS) were engaged to launch a public health response. In response, the Public Health National Emergency Operations Center (PHNEOC) was activated to a level two with the surveillance pillar set for preparedness mode and surveillance teams at both national and district level were established in Western Area Urban and Rural.
Sierra Leone’s FETP Response
Since June 2016, Sierra Leone has strengthened its public health workforce by partnering with the US Centers for Disease Control and Prevention (CDC) to establish the Field Epidemiology and Training Program–Frontline with the aim of building the capacity of its public health workforce in outbreak investigation and response. Following the 2014-2015 Ebola outbreak in West Africa, the FETP was set up with the major aim of developing Sierra Leone’ public health workforce ability to apply epidemiological skills to reduce the threat of public health emergencies. To date, the FETP has graduated 81 frontline public health officers, who are able to effectively analyze surveillance data, and conduct case- and outbreak-investigations. In the past year, these graduates have conducted more than 50 case or outbreak investigations in all 14 districts, improved timeliness in reporting, conducted assessments on country’s surveillance systems, and presented their epidemiological findings at an international scientific conference.
The program has allowed Sierra Leone to establish in-country capacity to prevent and control diseases of public health importance and develop leaders within its health system. At the time of the disaster, the Government of Sierra Leone and MoHS leadership were able to call upon its own public health officers, the FETP graduates, to take charge of the situation. Twenty-four Frontline FETP graduates were deployed to provide critical field support in identifying and monitoring potential diarrheal disease cases, carrying out rapid assessments, and collecting morbidity/mortality data. Two graduates, Fatmata and Musa, were given the responsibility of characterizing the disaster in terms of person, place, and time – helping the authorities to respond appropriately and effectively.
While sharing her experience in responding to the disaster, Fatmata said: “When I heard on the radio that people had been buried by earth, I knew I needed to be there … to identify who was affected, where it occurred, when this occurred, and why this terrible thing had occurred…. I knew this information would be very vital in understanding the disaster if we were going to respond more appropriately”