Emergency Response For Cholera Outbreak In Yemen – Risk Management Plan

Background of the Chosen Project

Discuss about the Emergency Response for Cholera outbreak in Yemen.

In recent times, Yemen has faced one of the most severe cholera epidemics in the world. After coming into control in some time, the outbreak again resurged claiming the lives of a huge number of people and affect the health of few million people of the country. As a result, a project was authorized to provide emergency medical response to the cholera affected areas. The project based on setting up health camps, sending medical staff delegates in the regions to treat the patients and others. In addition to the appointment of medical stuffs, the project required a constant supply of medicines and medical equipments so that the medical staffs and nurses could be able to treat the patients and provide them with sufficient dosage of vaccination and medicines. Due to the large scale of the outbreak, the medicine supplies in the country was completely exhausted and hence, the medicines and vaccines were needed to be imported from other countries that resulted in the increase of the project costs and overall time.

In this report, a risk management plan has been developed based on the risks associated with the emergency response project.

The chosen project is based on emergency response for Cholera outbreak in Yemen that took place within the period of May to October 2017. In the last quarter of 2016, a massive cholera outbreak took place in Yemen that reached an alarming level during April-May. As per an overall WHO estimated, nearly 900,000 people were affected with cholera with further rise in the value was projected for the next few weeks. The huge outbreak also claimed a large number of lives with almost 1% of the affected people reached fatality due to lack of timely and proper treatment of cholera. The outbreak was not limited to a single area – it spread over more than 150 districts of the country that were included in 16 Governorates of the country. While the cholera slowly came under control during March-April 2017, a resurgence of the cholera occurred in late April 2017 that claimed even more lives than the previous outbreak. The fatality rate also increased significantly to 1.6% of all the affected people and the cholera spread over an even bigger area – 180 districts in 18 Governorates.

In order to bring the cholera under control and treat the infected people, an emergency response project was initiated by appointing a large number of human resources including helpers, physicians, nurses, logistics assistants and others. The main objective of the project was to move from place to place and provide immediate medications to the affected people in the area. In addition to the healthcare support staffs, the medications and medical equipments were also needed to be carried from place to place in the areas of the outbreak. However, when the healthcare staffs were carried from place to place, it was needed to be ensured that the staffs are healthy and do not catch cholera during the treatment processes. Hence, sufficient amount of medical protection was to be provided to the patients as well as the healthcare staffs sent there for treatment of cholera. The project also required regular supply of medicines and medical equipments so that the physicians could be able to treat the patients and provide them with sufficient dosage of vaccination and medicines. Due to the large scale of the outbreak, the medicine supplies in the country was completely exhausted and hence, the medicines and vaccines were to be imported from other countries that resulted in the increase of the project costs and overall time. The project also required setting up field hospitals and health camps where the cholera struck most severely. The staffs in these camps did not need to move from place to place for providing services. Medicines, food and water had to be supplied from outside as the existing water sources were contaminated with cholera bacteria. The emergency response drive was continued till October 2017 when the outbreak slowly came within control and there were ample supply of cholera vaccine in the country.

Identification of Associated Risks

Due to the severity of the case and the epidemic situation of the country, there are a huge number of risks associated with the project. These risks are discussed as follows.

Health Risk – By far the most serious risk associated with the project is the health risk of the support and medical staff. Cholera is one of the most contagious diseases and hence, in spite of taking suitable amount of precautions and medications, the disease can easily spread from the patients to the physicians. This risk is further aggravated by the fact that it has taken the form of an epidemic and can easily spread on the healthcare staffs. Other support staffs like logistics assistants, health camp managers and others may also catch the disease easily. If the healthcare staffs are affected by the disease, the project cannot be continued further and emergency evacuation will be required for the healthcare and support staffs.

Supplies – Another major risk associated with the project includes the supply of food and medicines for patients as well as the medical staffs. While the Government is entitled to provide safe food and water to the common people, the food and water for the medical staffs and medicines for the patients are to be delivered from outside. Due to extensive nature of the epidemic, all the cholera vaccines are used up and most of the water sources are contaminated with the cholera bacteria. Any person coming in contact with these water sources can easily catch cholera. Hence, the medical staffs are strictly banned from eating local food and coming in contact with the local water. Their food and water are to be delivered through supply vans that travel from place to place for delivery in the health camps. During the delivery as well, the food, water and medicines can get contaminated and hence, extra-precautions like anti-germ delivery vaults, disinfectants and hand sanitizers are to be used to prevent contamination during delivery.

Budget – Budget is one of the major risks associated with the project. Due to the nature and scale of the project, no proper budget can be estimated accurately. The treatment processes depend on the extent of the disease in the patients, number of patients in the area, availability of the medicines and others. Due to the repeated recurrence of the disease in Yemen within a period of few months, all the stocks of medicines and vaccines are completely exhausted and hence, it is needed to import the required medicines from other countries. As a result of the epidemic, the prices of the medicines and vaccines have also sky-rocketed and this solely makes a huge negative impact on the project itself.

Inaccessibility – Another risk associated with the project is the inaccessibility of certain cholera affected areas of the country. Some of the extreme rural areas of Yemen are affected by cholera and the medical staffs depend on the land transport to reach these places and deliver healthcare measures. Furthermore, there will be also significant inconvenience of delivery of food, water and medicines in these areas that may delay the treatment processes of the affected people.

Dumping of Dead Bodies – Due to the outbreak of cholera, many people have already died and some more people are expected to die in the near future as well. However, in the rural areas, the dead bodies are simply dumped anywhere near water sources and other locations from where the cholera spreads as well. Hence, the medical staffs need to ensure the bodies are dumped at a suitable place that is far from water or food sources in order to avoid further contamination.

Outrage from Local People – This is a possible risk that might be faced from the medical and healthcare staffs especially in the rural areas. Due to continuous infections of cholera without sufficient treatment and prompt healthcare services provided by the governments resulting in deaths of the patients, the local people may turn hostile against the healthcare staffs when they arrive at the sites for providing treatment. It is needed ensure that the local people are calmed down and treatment is provided to the patients as fast as possible.

The risk evaluation is done for this project using what-if analysis as follows.

The mitigation strategies and contingency plans are determined using risk register matrix as follows.

For the risk monitoring and control plan, an estimated time schedule has been prepared as shown in the following table.

The costs are estimated based on the following resource usages.

Additionally, the total costs for the risk management process will incur costs as shown in the following table.

Conclusion

Finally, it can be concluded that there are a number of risks and issues that are associated with the project. While this project is based on emergency response to the cholera affected areas in Yemen, the most serious risk associated with the project is the health risk of the support and medical staff. In addition to the existing medical staffs, the support staffs like logistics assistants, health camp managers and others may also catch the disease easily due to extreme contagious nature of the disease. The main problem is that if the healthcare staffs are affected by the disease, the project cannot be continued further and emergency evacuation will be required for the healthcare and support staffs. Another major risk identified for the project includes lack of the supply of food and medicines for patients as well as the medical staffs. Again, due to the extensive nature of the epidemic, all the cholera vaccines are used up and most of the water sources are contaminated with the cholera bacteria. This also spreads disease among the medical staffs. Finally, budget is one of the major risks discussed in this report and also associated with the project. Due to the nature and scale of the project, no proper budget can be estimated accurately. The treatment processes depend on the extent of the disease in the patients, number of patients in the area, availability of the medicines and others and for these cases, the budget can significantly vary. Hence, all plans are to be made before proceeding with the project.

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