Training in EpiInfo 6 in Palau
In September 2002 Dr Narendra Singh from the Fiji School of Medicine and Dr Tom Kiedrzynski from SPC carried out training sessions for Palau Area Health Education Center (AHEC) students in Koror. The AHEC students are all trained medical doctors, ex-students of the Pacific Basin Medical Officers Training Program (PBMOTP) specialising in Family Practice. As part of their community health training, the doctors learned how to use EpiInfo 6 to collect and analyse data from a community-based survey.
The doctors also received information on the PPHSN and use of the Internet, especially the PPHSN and Distance Education in Health websites developed by SPC. Dr Singh and Dr Kiedrzynski also ran a session for nurses on public health surveillance and outbreak investigation.
Bioterrorism preparedness workshop in Palau
Dr Mark Keim
Director, Emergency & Disaster Public Health Services
Centers for Disease Control and Prevention (CDC)
In 2000, the Centers for Disease Control and Prevention (CDC) established the Pacific Emergency Health Initiative (PEHI) with the mission to “strengthen the capacity for emergency health preparedness and response among Pacific island nations”. The objectives of PEHI are: 1) to measure and assess emergency preparedness among developing health and medical systems of Pacific island nations; 2) to facilitate the development of emergency operations plans among developing health sectors of Pacific island nations; and 3) to develop a sustainable indigenous source for emergency health training and education in Pacific island nations.
The Palau Community College Center for Emergency Health, in Koror, was founded by the CDC in partnership with the Palau Community College and the Republic of Palau Ministries of Health and Justice in September 2001. In keeping with the third objective of PEHI, the mission of this centre is to provide a sustainable indigenous source for emergency public health and medical education and training in the region.
Recent world events like the bombing in Bali have implicated international terrorism as a real and present threat to the public health of people in the Pacific. Bioterrorism, or the use of disease as a terrorist weapon, also threatens to be a low probability yet high impact event for island societies and nations. Epidemics and outbreaks occur in the Pacific with relatively high probability and in some cases also high impact. By building capacity for response to the most likely emergencies of regular epidemics, we are also preparing for the (hopefully) less likely event of bioterrorism. PEHI emergency preparedness follows an “all-hazards approach”, meaning it identifies, prioritises and prepares for the full range of all hazards that a nation may face. These hazards may be natural, like cyclones, earthquakes, epidemics and volcanoes, or may be man-made, like airline and marine crashes, oil and chemical spills and, now, terrorism.
The Palau Community College Center for Emergency Health and the CDC hosted a workshop for the development of public health preparedness for bioterrorism, epidemics and other public health emergencies in October 2002. About 35 public health officials of six Pacific island jurisdictions attended the workshop, representing American Samoa, Commonwealth of Northern Marianas Islands, Guam, Republic of Palau, Federated States of Micronesia, and the Republic of Marshall Islands. The public health officials included the Bioterrorism coordinators and the focal point of the EpiNet teams of each jurisdiction.
Territorial legislators from Guam, the Marianas and American Samoa also attended as part of a coordinated effort with the National Conference of State Legislators. Other organisations participating in the conference included the World Health Organization, the Red Cross, the Secretariat of the Pacific Community, and the Hawaii Department of Health.
The bioterrorism workshop included two forty-hour-long weeks of training. The first week involved mostly lectures on the public health consequences of disasters, including bioterrorism and measures for planning and responding. The second week involved a closed meeting of the public health officials, who developed regional plans for coordination and international cooperation.
Training in epidemiology and outbreak investigation, Federated States of Micronesia
SPC together with WHO and PIHOA were asked by the Federated States of Micronesia (FSM) Ministry of Health to run a workshop in epidemiology and outbreak investigation. The workshop was held in Pohnpei from 4 to 8 November 2002, for EpiNet team members from FSM, Palau and the Marshall Islands, following the Bioterrorism workshop (see text above) and was funded by FSM (for the FSM participants), WHO (two participants from Palau and two from the Marshall Islands), and Palau (for two more participants from Palau). This was a very good example of pooling resources, not only in terms of facilitation but also in terms of funding.
Although SPC has run training sessions in outbreak investigation before, this was the first time a training focusing nearly exclusively on this topic was run. The evaluations by the participants were very positive. For example, one of the participants wrote: “Excellent workshop. It was the best I have ever attended in the past. Being very interactive, allows participants to think and actually see their role in the surveillance activities. Thank you!”
Health professional attachment at SPC
The training sessions for the year ended with a three-week attachment at SPC for Mr Jackson Appo from Papua New Guinea. Mr Appo completed the two basic and advanced training modules in Public Health Surveillance and the Use of EpiInfo 6 Software, and part of the Analytical Epidemiology module. Although this was a short attachment, it allowed the Public Health Surveillance and Communicable Disease Control (PHS&CDC) Section of SPC to offer ‘à la carte’ training tailored to personal needs. But, let’s read Mr Appo’s feedback below!
Firstly, I congratulate Pacific Public Health Surveillance Network (PPHSN) for developing Inform’ACTION.. It was through Inform’ACTION that I learnt about the PHS&CDC section of SPC, and thus established contact that resulted with this arrangement of my attachment programme.
My attachment was from 22nd November to 12th December 2002. Although timing was short, it was an exciting and very enjoyable experience learning new skills and methods of counte acting major public health issues (communicable disease outbreak/surveillance) in developing countries, of which South Pacific Island nations are no exception.
The attachment programme focused on four main areas:
- Basic principles of public health surveillance
- Selecting the communicable diseases and priority health indicators of surveillance
- Designing an operational plan for:
- Surveillance of communicable diseases
- Performing various stages of case and outbreak investigation
- Computer and technological (EpiInfo 6 software) tools for public health surveillance (including e-mail, PacNet and internet use)
The content and the materials provided during this training were relevant and very beneficial to my areas of duties and responsibilities, as I directly deal with public health surveillance and communicable diseases control.
The very friendly staff at PHS&CDC section were very supportive and assisted me very well during my attachment period under the watchful eyes and guidance of Dr Tom Kiedrzynski.
I have strongly recommended in my report to the Ministry of Health (PNG) to plan and conduct a similar training workshop in PNG for all Provincial Disease Control Officers from our twenty provinces, to be facilitated by experts from the PHS&CDC Section of SPC.
I found this training very useful and personally gained a lot in the areas of public health surveillance, epidemiology, and particularly EpiInfo 6 software, which is a very vital tool in public health surveillance and outbreak investigations.
The training was a success and I’m confident whatever I gained I will put into practice and share knowledge with colleagues to improve public health surveillance activities and the communicable disease control programme in my province (Eastern Highlands Province) and PNG as a whole.
Jackson Appo and
(SPC Data Processing Officer)