International Medical Corps has a long history of responding to outbreaks of disease—from Ebola to COVID-19 to cholera, and more.
When Ethiopia declared an outbreak of Marburg virus disease (MVD) in mid-November, we mobilized to respond to this dangerous hemorrhagic fever, which was Ethiopia’s first ever outbreak and was contained in the southern part of the country. Our teams provided case-management support, infection prevention and control (IPC), and water, sanitation and hygiene (WASH) services. We deployed program leads, epidemiologists, public health surveillance experts, clinicians, and IPC and WASH experts who conducted rapid need assessments, designed evidence-based interventions aligning with local-government priority areas and began interventions based on directions from the authorities and MVD command system.
Over the course of our response, we screened more than 9,300 people in five health facilities and helped construct the Marburg treatment unit in Arba Minch, which included triage, areas to don and doff personal protective equipment (PPE) and admission areas for suspected/confirmed cases. We also donated supplies and medicines to five healthcare facilities, as well as Gazer Primary Hospital and Jinka General Hospital.
But our attention wasn’t just on IPC and case management. Marburg, with its severe symptoms and high mortality rate, has no cure, and there are currently no antiviral drugs to treat it—leading to immense stress and anxiety. In response, our Mental Health and Psychosocial Support (MHPSS) team provided training and support—funded with the generous support of the United States government through the LEARN Project—to help frontline MVD responders stay calm and manage their fears.
“It’s common that healthcare professionals engaged in the Marburg response have psychological reactions that include anxiety, depression, acute stress, PTSD, guilt and fear of contracting the disease,” says Ethiopia MHPSS Coordinator Gebresilassie Gebreegzhibhier. “To prevent burnout, vicarious trauma and PTSD, we helped them manage their stress levels and strengthen their emotional regulation.”
The team started by adapting MHPSS training curriculums and customizing basic psychosocial support services specifically to the needs of those responding to the MVD outbreak, including these updates in a manual addressing how healthcare workers can be resilient in times of high stress, maintain self-care practices and come up with individual wellness plans.
The updated training manual also:
- stresses the importance of providing clear communication, since a lack of information can be a stressor to MVD patients and their families;
- gives guidance on how to help patients maintain connections with their relatives while in isolation;
- helps healthcare providers understand how to communicate effectively and compassionately with their patients while wearing layers of PPE; and
- provides hope and reassurance based on cases of recovery.
These components equip first responders with the skills required to support affected community members, strengthening community well-being and resilience in areas affected by the Marburg outbreak.
The MHPSS team provided basic psychosocial support and emotional resilience training for healthcare workers in Jinka town, where the outbreak originated. They also provided instructions for stress management techniques, such as deep breathing, progressive muscle relaxation and visualization practices. After seeing the work we did in Jinka, the government asked the team to provide emotional resilience training in Arba Minch, followed by additional training in Jinka.
We reached 126 MVD frontline responders with these training sessions. We also integrated two hours of MHPSS training—focused on self-care and stress management—into our IPC training for another 158 frontline MVD responders in Arba Minch and Dasenech.
“It is only when healthcare professionals and other frontline emergency responders have good mental health that they can support others,” says Dr. Kinfu Manzura, MHPSS Program Manager. “If they’re burned out, there’s a good chance they could make a mistake. Self-care is not about being selfish; it’s about protecting yourself and others.”
After the Outbreak
The MVD outbreak was declared over on January 26, after 14 cases led to nine fatalities, three of whom were healthcare workers. Today, the Ethiopia MHPSS team is continuing activities that will help affected people, patient families and communities through the recovery phase.
International Medical Corps is continuing to play a key role in the Ethiopian government’s recovery plan, which includes a survivor-care program that will provide clinical, psychosocial and counseling services for the outbreak’s five survivors—in addition to addressing community stigma towards those survivors. In collaboration with the South Ethiopia Regional Health Bureau and Public Health institute, we are evaluating the needs of families of survivors and of those who died from MVD, to identify the services they require.
We also are continuing our work with frontline emergency responders who went through the MVD outbreak, helping them with self-care, stress and burnout management, and we are evaluating and providing services to those who have developed mental health conditions such as anxiety or depression.
Finally, we are strengthening the existing health system through capacity building, mentorship and supply prepositioning, to ensure that anyone affected by future outbreaks of disease can continue to receive MHPSS services.
“Building a resilient community and a system that can appropriately respond to and withstand future emergencies requires working on recovery—and MHPSS plays a crucial role in that,” says Dr. Kinfu.