TRAINING REPORT ON

EPIDEMIC CONTROL FOR

VOLUNTEERS (ECV)

December 1 – 3, 2013 Vientiane, Lao-PDR

Introduction

Communicable diseases continue to kill millions people every year throughout the world, mostly of

who are vulnerable populations in developing countries. To support the national societies whose

roles is to respond to save lives during an epidemic or any other health emergencies, International

Federation of Red Cross and Red Crescent (IFRC) developed The Epidemic Control for Volunteer

(ECV) Toolkit was developed to reinforce the IFRC Community-based Health and First Aid

(CBHFA) Toolkit, a comprehensive training and resource package for volunteers in community

health development and health risk reduction programming. The toolkit ensures that volunteers have

the proper training and essential communication tools (among other materials) before they are

engaged in outbreak and epidemic response in their communities. It is designed as practical and

action-oriented, simple, and easy-to-follow tools considering that volunteers have limited time to

remember everything they have learned during trainings or to develop effective response materials

in the middle of an outbreak.

Southeast Asia Regional Delegation (SEARD) financially supported Lao Red Cross to review,

translate, adapt and print ECV manual and toolkit in Lao text - 100 units of training manuals and

toolkits. Again, with the financial and technical support of SEARD, IFRC, Bangkok, ECV training

was conducted by health department of Lao Red Cross.

The training was organized from 1 – 3 December, 2013 at Lao Red Cross – National Headquarter,

Vientiane, Lao- PDR. The total 17 participants1 from 15 different provinces and 2 from national

headquarter participated in the training. Representative of Lao-PDR ministry of health gave an

overview of disease outbreak situation and surveillance system of Lao-PDR.

Objective

To build and strengthen capacity of health focal persons from 15 different provinces, and enable

them to contribute in epidemic response and control in their communities.

The training as a whole focused on:

1. Build on existing CBHFA disease prevention and health promotion knowledge and skills by

focusing on understanding of common diseases that has a potential of an outbreak epidemics;

2. Selected health focal persons to use evidence-based actions and approaches to prevent the

spread of communicable diseases in the communities and provide appropriate care for the

sick and reduce the number of deaths;

3. Enhanced capacities of health focal persons to act quickly and effectively in the event of a

disease outbreak/epidemic.

1 Annex 1: Participant List

Day to day Sessions

Agenda One: Opening Remark

The training was officially open at 8:30 a.m. on 1st December, 2013 in Lao Red Cross (LRC)

Meeting Room, presided by Mr. Laoly Phaiphengyua, LRC President. Mr.Laoly started his opening

remark by announcing compensation leave for those who are attending the training as the training

started on Sunday due to some unavoidable conditions. He said this training will increase capacity of

technical officer at provincial level and in future this needed to be trickle down to volunteers. He

emphasized there are several diseases affecting Lao people and every year several cases of malaria,

Dengue and diarrhea, etc. are common for Lao people. If we can do timely prevention many disease

outbreaks can be prevented, even we cannot prevent an epidemic we can save many life with proper

response. He said it is important to develop good coordination with provincial health authorities and

other stakeholders. He appreciated International Federation for developing such tools for volunteers

and bringing it down to Lao Red Cross in their native language. At the end he requested everyone to

gain as much as possible during these three days.

Following the opening remark participants were requested to write down the expectation2 from the

training. Dr.Bounma (head of health, LRC) then groups the expectations. He then introduced the

objective of the training and agenda3 to the participants. Ground rule was also set for the entire three

days of the training

Agenda Two: Presentation from Ministry of Health

Day one was fully occupied with a brief updated of current diseases and national surveillance

system from the Ministry followed by Module 1.

Ms. Viengsavanh Khittiphong, from Disease control division Ministry of Health gave an overview

of most common diseases in Lao-PDR. She informed currently there are only 17 diseases but next

year this list will be updated as there are many more diseases affecting Lao people than ever before.

She mainly emphasized on the surveillance system that Ministry of health, is doing to detect new

cases and report. She emphasized that a good partnership with provincial health authority and Red

Cross at provincial level will help to detect more cases so that adequate and timely response can be

planned.

She also highlighted disease trends in Lao for last five years. The analysis was quiet evident

showing increase number of cases in malaria, dengue, typhoid and diarrhea.

Agenda Three: Module 1: Introduction to the epidemics

The training started with an initial pre training test, which was reviewed by the facilitators straight

after it was completed. It helped the facilitators to understand the knowledge of participants in

regards to key contents of the course.

2 Annex 2: Summary list of expectation

3 Annex 3: Agenda

ECV module 1 as introduction to epidemic composed of some essential definitions, diseases that can

cause epidemic, special issues in epidemic. In the session more time was allocated for infection

cycle and the spread of disease as well as basic tips how we can prevent an epidemic by adopting

some healthy behaviors. Role play was introduced to make participant aware that how quickly an

infection can cause epidemic in presence of suitable environment, and host.

A special focus was given on dead bodies and epidemics. Participants were made aware of

precautions need to be taken before handling dead bodies. Some of the participants were surprised to

know that dead bodies are not the source of an epidemic and poses small risk to the public.

Agenda Four: Module 2: Principles of epidemic control

Day 2 started with recap of day one where one of the groups made the summary of day one and

presented to all other participants.

Module 2 as principle of epidemic control composes of understanding an epidemic, epidemic

response cycle, understanding risk, volunteer and epidemic control. In this session emphasis was

given on various stages of epidemic response cycle. The

participants were divided into groups and were asked to

come up question they think are needed for any

epidemic assessment. Later on the facilitators added

questions that were not highlighted by the participants.

A group exercise was followed to whom they would ask

their questions in an emergency. The participants came

up with target groups, which were practically done by

giving the groups a scenario. It was also discussed with

the participants what can increase and decrease the risk

of an epidemic outbreak.

Participants were also made aware how to develop and deliver health promotion messages.

Participants were divided in groups and were asked to come up with innovative ideas to deliver

health messages on Malaria, Diarrhea and Measles. Two groups came up with song on malaria and

hand washing and one group a poster on measles campaign.

The later part of the session focused on the work of volunteers in such emergencies. Participants

also brainstorm on the advantages of having skilled local volunteers in the communities.

Agenda Five: Module 3: Actions in epidemic control

Module 3 as the actions in epidemic control highlights key action to be taken before, during and

after epidemic including alert phase. It was made very clear by the facilitator that developing proper

plan, capacity building and prepositioning materials, and equipment are key activities during before

epidemic phase. It was also discussed that the country varies immensely from north to south hence

having a provincial or district level plan can be more helpful for epidemic management.

Participants also identified that partnership and coordination are very important before, during and

after an epidemic. Coordination during an epidemic

draws the attention of many participants and was

recognized as an area to focus in future planning. It

was emphasized the large volunteer network of Red

Cross can play vital role in case identification, health

promotion, etc. during an epidemic.

Participants in their group identified various

activities that can be done as a Red Cross in various

stages of epidemic response. In addition, facilitator

also supplemented the list of activities presented by the participants.

Agenda six: Module 4:

Day 3 started with recap of day two where one of the groups made the summary of day two and

presented to all other participants.

Module 4 which is all about using the epidemic control toolkits emphasizing on the introduction and

practical usage of the toolkits such as disease tool, action tool and community message tool. All the

participants were given a set of toolkit.

In this session the facilitators explained the different tools and later the participants were divided in

different groups and were given a particular scenario to work on using the different tools from the

toolkit. At the end of the group discussion participants presented the epidemic response as role play

using the toolkit.

Some minor adjustments were made from the original session plan to maximize learning:

Provide more time for the delivery of Module 1 to ensure participants understand the basic

concepts. An exercise was also conducted at the start of session 1 to realize the fact how

quickly an epidemic can spread even when one person in the community is affected.

Fitting all participants coming from different background/experiences, and translation to

local language, it take some more time for Modules 2, 3 and 4 for an attempt to deliver the

topics in a bit slower way. In particularly for a scenario-based group exercise to consolidate

their learning during the 3-day training and to allow them more time to practice as on the job

training, focused on the community assessment, the assembly and use of disease, action, and

community messages tools.

Surveillance portion was omitted as it was presented by representative from ministry of

health.

Pre and Post finding

Table 1: finding from pre & post-test

Contents Very good Good Fair Poor

Pre-test 0% 18.75% 62.25% 18.75%

Post-test 5.88% 88.23% 5.88% 0

Remark for range of score:

Very good: 9-10

Good: 7-8

Fair: 5-6

Poor: score<5

Summarizing daily evaluation, over 90% of participants found the sessions very useful and they also

appreciated the participatory methodology applied by the facilitator with minimum PowerPoint

presentations and more time for group work, role play, plenary sessions, etc.

Ways Forward

LRC headquarter to distribute the ECV training manual and its toolkits to all provinces in

Lao-PDR, for the continuation for volunteer training at branch and community levels.

Provide technical support from NHQ and IFRC to branches as needed

Find local/international partners for resource mobilization to trickle down the training at

provincial level.

Further strengthening the capacities of branches in epidemic response and preparedness by

addressing cross cutting issues like psychosocial support, etc.

Conclusion

Training ran smoothly according to the set agenda and managed to reach the expectation of the

participants. The epidemic control for volunteers manual and toolkit proved to be very easy to

follow and provided the participants with tools to prepare their volunteers adequately for future

epidemics. The manual and toolkit is self-explanatory enough for volunteers to refresh their

knowledge on an ongoing basis or upon the alert of an epidemic.

Summarizing of daily evaluation, the participants regarded the training as very useful. They also

expressed that with the translated ECV materials, they will be able to re-echo their learning to their

provinces, districts, and communities. Facilitator’s team do felt that the training was well organized

through the collective efforts of Lao Red Cross health department team, selected experience branch

staff, IFRC representatives from regional delegation in Bangkok, Thailand and enthusiastic

participants. The finding of pre and posttest had shown that knowledge; capacities of majority of

participants improved and are able to disseminate their knowledge to their colleagues and volunteers

in provinces.

Facilitators and participants agreed even though training has lot of positive aspects, there were some

difficulties in planning and delivering the training as well as planning for further roll out in

provincial level.

Good points

Close direction from LRC President/LRC leadership

Availability of manuals and curriculum from IFRC (translated into Lao).

Facilitators’ were well prepared and have experience.

Technical officers from 15 provinces, responsible for health promotion from and

central level participated in the training.

All participants were active, enthusiastic in study, discussion, group work; and strictly

follow training regulation.

Financial and technical support from IFRC SEA, Bangkok.

Difficulties

LRC lacks experience on this work as this was the 1st time for LRC.

Facilitator’s face to face preparation with translator was short due to limited time.

Training time is short and no time for field stimulation.

Limited budget.

No concrete financial commitment to roll out at provincial level

Recommendations

Organize ECV training at provincial level as there is a need to trickle down such training to

benefit more volunteers and staffs of the provinces.

Enhancing partnership with government for epidemic detection and control

Develop epidemic preparedness plan for some high risk provinces in Lao-PDR

Mainstreaming epidemic preparedness with other health programs

Enhancing capacity of Lao red Cross Staff and volunteer on Psychosocial support