In today’s interconnected world, the rapid detection and containment of disease outbreaks have become paramount for safeguarding public health. Thus, World Health Organization serves as the sole agency to provide technical assistance in a comprehensive Early Warning Alert and Response system (EWARS) for disease surveillance in the countries. EWARS acts as an early warning mechanism for detecting potential disease outbreaks promptly. By gathering, analyzing, and disseminating data from various sources, including health facilities, and local health partners, EWARS enables the timely identification of health threats.
Photo: WHO personnel managing EWARS data for surveillance of outbreak prone diseases in Rakhine State
Myanmar, a country with a complex political landscape and sporadic conflicts, faces unique challenges in public health management. In such contexts, disease surveillance system like EWARS become even more critical. Myanmar's healthcare infrastructure may be strained or disrupted due to conflict or natural disasters, making the detection and response to disease outbreaks particularly challenging.
Combined to these pre-existing difficulties, the Cyclone Mocha that made a landfall to Myanmar on 14 May 2023 causes damage to the health infrastructure and poses significant challenge to people in Rakhine State in all 17 townships and Kachin State for receiving health care. At the same time, populations affected are continually at risk of epidemic-prone diseases and other public health hazards due to limited access to safe water, sanitation, mass displacement of people and increased risk of overcrowding.
EWARS provides a lifeline in these situations by enabling the rapid detection and reporting of disease outbreaks, even in resource-constrained environments. Since 2017, EWARS has been established in Rakhine State, followed by Kachin State in 2019. By using innovative and simple methods such as reporting via a mobile phone, the information helps health officials to mobilize response teams, allocate resources, and implement preventive measures efficiently. In May 2023 within two days after Cyclone Mocha, the national health authorities in Myanmar and partners have been able to resume their health care services and report on EWARS to capture any signal of public health threats for early detection and appropriate response, followed by health consultations through the mobile health clinics and rapid response medical teams.
WHO has been playing a key role in EWARS implementation through coordination with national health authorities and partners in Myanmar, enhancing capacity of public health staff and partners for data entry, epidemiological analysis and sharing the findings with relevant stakeholders. It allows minimize excess morbidity and mortality during emergency and continue surveillance of outbreak prone diseases. The extensive support of EWARS in other states and regions is currently being considered, while the challenges in telecommunications to reporting still remain due to the ongoing armed conflicts.
One of the partners from International Rescue Committee IRC Myanmar said “EWARS has been implementing in Rakhine firstly as pilot and currently it is at the stage of more systemic and regular reporting process. IRC Rakhine involves both in the pilot processes and regular reporting, after the pilot phase is fully implemented by mobile clinic team leaders (medical doctor). Relevant information is also delivered in a short time from the mobile clinic teams of implementing partners. Previously, IRC also had also the experience of handling Acute Watery Diarrhoea AWD outbreak action responses in camp areas very well after EWARS was fully implemented. With thanks to EWARS, the beneficiaries can also get follow up investigation within short duration.”
In countries like Myanmar, where displaced populations are often more vulnerable to disease outbreaks, EWARS serves as an essential tool for monitoring health conditions in refugee camps and host communities. It helps identify potential disease hotspots, implement targeted interventions, and prevent the rapid transmission of infectious diseases in these settings.
