In today’s world, robust health systems are essential in ensuring the health and safety of populations, particularly in regions prone to disease outbreaks. According to the World Health Organization (WHO), a strong health system is key to achieving universal health coverage, and one of the pillars of such systems is the ability to manage health emergencies effectively. This is where Emergency Operations Centers (EOCs) come in, acting as crucial hubs for coordinating responses to health crises. In countries like Somalia and the Democratic Republic of Congo (DRC), where security challenges and infrastructure deficiencies are prevalent, setting up these centers is not just about logistics—it’s a herculean task that requires resilience, resourcefulness, and a deep understanding of local dynamics.
eHealth Africa is at the frontline of strengthening health systems through its Polio Outbreak Control Rooms (POCR) project. This initiative, supported by the Bill and Melinda Gates Foundation (BMGF), aims to equip governments across Africa with the tools needed to combat polio and other vaccine-preventable diseases. Over the past two and a half years (March 2022 – June 2024), eHealth Africa has successfully set up more than 24 POCRs across countries like Cameroon, Somalia, the DRC, and Niger, Tanzania among others. The scope of the project includes constructing or renovating facilities to become POCR, training government-assigned staff on basic EOC operations management, providing IT and GIS/mapping support, and offering assistance for high-level national meetings and public health campaigns. While this work is essential in peaceful nations, it takes on an entirely new dimension in fragile and conflict-affected regions like Somalia and the DRC, where insecurity and logistical difficulties have become part of the daily routine.
For eHealth Africa’s Operations Leads (OLs), setting up these centers in Somalia and the DRC meant facing these difficulties head-on. Abukhasim Salisu, who was part of the operations in these countries, highlighted how complex the process was: “The major challenge was security-wise because Somalia is a very fragile country with regard to security. We had to be extremely careful when dealing with vendors… We were very cautious to ensure we were not dealing with insurgent groups.”
In the DRC, the vastness of the country compounded logistical issues. “DR Congo is about two and a half times the size of Nigeria. Sometimes it could take two to three days just to get from one location to another. The logistical challenges, combined with the limited number of operational airlines, made transportation very difficult,” said Abukhasim.
Security issues in these regions inevitably impacted the timelines for project completion. In Somalia, movement restrictions delayed progress. “In Somalia, movement restrictions delayed the project. In the DRC, it was the logistics. Items could take up to two to three months to arrive, and some arrived damaged, which impacted our delivery timelines,” Abukhasim noted.
Atiku Haruna, another Operations Lead, echoed similar sentiments: “In Somalia, movement across cities requires a security clearance every time we go from point A to point B, always with a well-armored escort. The movement of services and goods to the sites is equally challenging.”
In regions of high-security risks, resilience is not just a desirable quality, it’s a necessity. Both OLs recounted incidents that tested their resolve and commitment to the project. Abukhasim shared a harrowing experience during a flight: “We crash-landed, and the aircraft stopped right on the runway. That incident made me think deeply about my life, my job, and the risks we face. But despite these dangers, the work had to continue.” Atiku, too, faced life-threatening situations: “One of the incidents that tested me was when our aircraft refused to fly after landing, and I had to witness the repair in my presence.”
While security was a major obstacle, engaging with local communities and authorities was equally crucial to the success of these projects. Both OLs emphasized the importance of cultural adaptation. “In DR Congo, my ability to speak the local language gave me a big advantage. I could identify as Congolese, which made it easier to navigate and gain trust from the local authorities and communities,” said Abukhasim. Atiku added: “Learning the basics of the Somali language was key. This language unlocks societal freedom and helps build rapport.”
Despite the daunting challenges, the rewards of setting up these EOCs are immeasurable. The OLs took immense pride in their work, knowing they were making a difference in regions that desperately needed health system support. Abukhasim reflected on the scale of his accomplishments: “Being able to lead the set up of 11 EOCs across different countries is a huge achievement for me. It’s something I’ll always look back on with pride, even after my time at eHealth Africa.” For Atiku, the most rewarding aspect was seeing the tangible results of his efforts: “The most rewarding part is seeing my achievements across locations that have proven to be difficult.”
Atiku also shared how significant the EOC project has been for Somalia: “In Somalia, it may seem like just a mere building, but it’s a turnaround, a whole ministry, and its staff were in a rented location with no idea how to develop their building. Shortly after, through eHA’s technical expertise and funding from the BMGF, we were able to build seven EOCs that can comfortably accommodate both the EOCs staff and the Ministry, strengthening coordination of public health interventions.”
Both OLs have valuable advice for those embarking on similar projects in security-challenged regions. Abukhasim advised: “My advice is to always develop security consciousness. No matter how much you prepare, the actual scenario can be very different. You have to be aware of your environment, and security must always be a top priority.” Atiku’s advice was simpler but no less critical: “Stay out of any form of trouble.”
Setting up Emergency Operations Centers in security-challenged regions is a task filled with complexities, risks, and challenges, but it’s a mission that eHealth Africa undertakes with commitment and resilience. The success of the POCR project in countries like Somalia and the DRC is a testament to the dedication of the teams involved, who continue to strengthen the health systems of these countries under some of the most difficult conditions imaginable. Through their efforts, eHealth Africa is helping governments build lasting public health infrastructure that can save lives and manage health crises more effectively.
