‘Tiny Iceland’ preparing for Ebola in a globalized world

Abstract

Background : The Ebola epidemic in West Africa caused global fear and stirred up worldwide preparedness activities in countries sharing borders with those affected, and in geographically far-away countries such as Iceland. Objective : To describe and analyse Ebola preparedness activities within the Icelandic healthcare system, and to explore the perspectives and experiences of managers and frontline health workers. Methods : A qualitative case study, based on semi-structured interviews with 21 staff members in the national Ebola Treatment Team, Emergency Room at Landspitali University Hospital, and managers of the response team. Results : Contextual factors such as culture and demography influenced preparedness, and contributed to the positive state of mind of participants, and ingenuity in using available resources for preparedness. While participants believed they were ready to take on the task of Ebola, they also had doubts about the chances of Ebola ever reaching Iceland. Yet, factors such as fear of Ebola and the perceived stigma associated with caring for a potentially infected Ebola patient, influenced the preparation process and resulted in plans for specific precautions by staff to secure the safety of their families. There were also concerns about the teamwork and lack of commitment by some during training. Being a ‘tiny’ nation was seen as both an asset and a weakness in the preparation process. Honest information sharing and scenario-based training contributed to increased confidence amongst participants in the response plans. Conclusions : Communication and training were important for preparedness of health staff in Iceland, in order to receive, admit, and treat a patient suspected of having Ebola, while doubts prevailed on staff capacity to properly do so. For optimal preparedness, likely scenarios for future global security health threats need to be repeatedly enacted, and areas plagued by poverty and fragile healthcare systems require global support.

Community health workers for pandemic response: a rapid evidence synthesis

“…30 CHWs in LMICs are volunteers with no permanent base-pays and are paid small amounts (in cash or kind) on the basis of actual service delivery. The high-income country evidence pertained to pandemic preparedness in Iceland 9 ; USA, wherein a new CHW program was initiated during a pandemic wherein CHWs were integrated as staff; and the UK where potential availability of volunteers for CHWs was studied. 14 41 As such, the evidence from high-income countries is very limited, and unless otherwise stated, evidence in subsequent section pertains to LMIC contexts.…”

Community health workers for pandemic response: a rapid evidence synthesis

“…Policies related to CHW task/roles - Policies and guidance related to specific roles and tasks for CHWs were reported in many studies. (9, 21, 30, 34, 37, 38) These policies largely aimed to distinguish tasks as essential (routine activities that need to be continued but with modifications for decreased transmission risk), non-essential (nonessential activities that could be postponed) and additional (activities that need to be carried out additionally owing to the pandemic) to bring accountability and enhance trust in health systems. CHWs have been involved in various pandemic control activities, including community engagement, community sensitisation, awareness and promotion and use of appropriate preventive practices.…”

“…Information Management Systems for CHWs in Pandemics - Operational support using information management systems and digital health technology had been used for supporting and monitoring CHW programs. Honesty, transparency of communication and reciprocity of information with CHWs was noted to be beneficial (9, 14, 21).…”

“…CHWs and their supervisors required appropriate training and supportive supervision for community sensitisation, awareness and risk communication during pandemic outbreaks and the lack of these was noted as a significant barrier to effective service delivery. (7, 9, 13, 16–18, 20, 21, 25, 29, 32, 34, 37, 38, 40) In most of these studies, it was reported that appropriate training in skills and knowledge related to disease outbreaks led to an improvement in awareness of the disease, screening and reporting. In qualitative studies, it was reported that there was a change in perceptions of CHWs, leading to more proactive involvement in disease prevention and control.…”

Technology Infrastructure in Public Health System: Mediating Role of Public Trust in Government Disaster Preparedness

“…Thus it can be seen, previous natural disasters can help nurses and front-runners to gain preparedness measurement and experience from a former epidemic before Ebola was SARS and HINI. There was a connection between healthcare players around the world for global healthcare assistance and following frontier guidance (Gunnlaugsson et al, 2019).…”