Empowering St Helena to enhance their Emergency Preparedness
April 2024
In this blog, Kathy Wainwright, Senior Emergency Preparedness Manager, shares what she learned from a recent visit to St Helena.
In January, I went with colleagues from the National Response Centre and UK Overseas Territories (UKOT) Programme to St Helena to conduct a comprehensive After-Action Review (AAR) of the island's response to the COVID-19 pandemic. The visit was part of the UKOT Programme's commitment to supporting health security and emergency preparedness overseas. Our focus was on empowering the island's workforce to independently undertake future debriefing activities—a crucial step in building local capacity and resilience.
We started the journey with three days of introductory AAR training for 40 dedicated colleagues from across St Helena Government. I was so impressed by the enthusiasm and engagement during these sessions, and it set a promising tone for the whole visit.
The AAR itself proved to be a valuable forum for reflection and collaboration. Bringing together representatives from various sectors, including Health and Emergency Planning, we delved into thematic areas essential for effective response and recovery. From country-level coordination to community engagement and logistical support, each aspect was scrutinised to identify best practices and address challenges, deriving proposed actions for continuous improvement.
The challenges of emergency planning in a small island
Throughout our stay, we had the privilege of engaging with a diverse array of St Helena colleagues, including the Director of Health and Social Care, the Minister for Health and Social Care and the Emergency Planning Team. I learned a lot through these interactions, particularly the challenges of working within a small island context, where limited resources and staffing allocations pose ongoing challenges. For example, emergency planning colleagues who navigate a demanding schedule of training and exercises, despite constraints in resources in the island. Recognising the importance of reinforcing response skills, we discussed opportunities for enhancing the island's incident management system and providing peer support in developing end-to-end response mechanisms.
The St Helena visit helped us to identify how to make the most of overseas visits next time. We experienced challenges in planning and session organisation which highlighted the importance of streamlined coordination, particularly in resource-constrained environments.
The visit also highlighted the challenge of ensuring comprehensive stakeholder engagement and participation in AAR sessions, where key players in the given response were either unavailable to attend, or no longer in post on island.
The importance of UKHSA's role in global emergency response
Despite these challenges, the experience reaffirmed the importance of open and honest debriefing, even within close-knit communities where personal relationships may influence feedback dynamics. While the AAR sessions provided a platform for constructive feedback, I was conscious of potential barriers to candid dialogue and strive for inclusivity in future events.
As we compile our findings into a formal report and action plan, the journey doesn't end here. We remain committed to supporting our colleagues in St Helena, providing ongoing guidance in plan implementation and response refinement. Together, we continue to strengthen resilience and readiness, ensuring that communities are better prepared to face future challenges.
Visiting colleagues in St Helena provided invaluable opportunities to immerse ourselves in the unique contexts of small islands, fostering deeper understanding and empathy. Through the sharing of knowledge and collective efforts, we paved the way for a safer and more resilient future on the island.
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Reducing the impact of antimicrobial resistance in the Caribbean
November - December 2023
Antimicrobial resistance (AMR) is a particular issue in the Caribbean region, which is home to six UK Overseas Territories (UKOTs). It has high AMR rates and considerable gaps in data. To address this, the UKOTs Programme hosted an innovative, three-day Antimicrobial Stewardship (AMS) Workshop in Anguilla, in December. The Workshop aimed to address AMR and facilitate AMS by using a cooperative and wider systems approach, to educate and assist health care professionals in adhering to evidence-informed guidelines on prescribing and dispensing antimicrobials.
The UKOTs Public Health Programme, situated within Global Operations in Health Protection Operations Group, has been expanding its work around AMR through technical support, the development of peer networks, and supporting increased capacity and capabilities around diagnostics and surveillance.
Antimicrobial Stewardship Workshop
The AMS Workshop was attended by 16 multidisciplinary professionals from across the Caribbean UKOTs (Anguilla, Bermuda, British Virgin Islands, Cayman Islands, Montserrat, and the Turks and Caicos Islands). There were also representations from the Pan American Health Organization (PAHO), the Caribbean Health Agency and UKHSA.
The workshop delivered two workstreams to cater to the different audiences in attendance. There were practical laboratory sessions that focused on the detection of AMR; and professional development sessions that focused on AMS and AMS accreditation, diagnostics, the use of the Microguide in prescribing, and surveillance approaches.
The rollout of the ‘Microguide application’ has been a substantial component in enhancing territory capabilities. This free mobile application allows clinicians and prescribers to access internationally recognised prescribing guidelines with ease, ensuring continuity and quality of care.
The workshop topics were primarily delivered by UKOT Programme members: Matthew Dryden, Consultant in Microbiology and Infection, and John Lee, the UKOTs Laboratory Technical and Quality Manager. The laboratory sessions were also supported by Geoffrey Benjamin, a Senior Biomedical Scientist from the St Helena Government, who provided expertise from a similar small island context, and a representative from the Washington office of PAHO, who discussed their role in supporting AMS in small island states.
Matthew Dryden said:
“AMR continues to be a major global public health threat and addressing it remains a key international priority. Tackling AMR is one of our strategic priorities: to reduce the impact of infectious disease and antimicrobial resistance.
“Feedback from the workshop was incredibly positive and signaled a renewed motivation to tackle AMR in the Caribbean region. The workshop will serve as a catalyst for greater collaboration and a platform for the UKOTs Programme to build on this work over the coming year.”
