WHO and international partners are rallying to support Lao PDR as it responds to the arrival of COVID-19 cases in the country. A coordination system was activated for NGOs, UN agencies, development partners and donors wishing to support the response to COVID-19. More than 50 international and local organizations are now coordinating their efforts via WHO.
“We have known since January that COVID-19 would arrive in Lao PDR. It was always a question of “when” rather than “whether” this disease was going to arrive.” explained Dr Reiko Tsuyuoka, WHO Health Emergencies Lead for Lao PDR. “WHO has supported the Ministry of Health in preparing across a whole range of areas – from disease surveillance, to medical treatment and public communication. We have been lucky in that the Ministry of Health, with support from WHO and international partners, has developed a rather strong emergency response capacity over the past few years.”
Though Lao PDR already has a strong system for responding to epidemics, WHO and the Ministry of Health have had to prepare for some of the specific challenges posed by COVID-19. This is a new disease caused by a previously unknown virus. The laboratory tests to confirm that someone has COVID-19 are all new technology, and there has been a worldwide scramble to get hold of the materials needed to test for it. Low-and-middle income countries such as Lao PDR are not necessarily at the front of the queue for these test materials.
“This is an unusual emergency. Development partners and donors have been very generous in providing funds. The government and its partners have made good use of these funds. The health system, in particular, has ramped up its preparedness dramatically. But, unfortunately, some of the equipment we need – particularly the materials for testing for COVID-19 – arrives only little by little rather than all at once.” said Dr Reiko.
Dr Howard Sobel, who arrived in late March as acting Head of WHO’s Country Office in Lao PDR agrees with Dr Reiko’s assessment. “Overall, I believe the government of Lao PDR has made the right decisions. It is taking aggressive action now, while it only has a small number of cases, to stop COVID-19 spreading. The Ministry of Health is stepping up and showing leadership. It has some amazing staff who are working incredibly hard. I am proud to be working with such a great group of people.”
However, Dr Howard, who worked on the response to the SARS epidemic in 2003 and was the acting Head of WHO’s Country Office in the Philippines when 4 million people were displaced by flooding, is clear about the scale of challenge that COVID-19 poses to Lao PDR.
“The Ministry of Health, with our support, needs to ensure every health center in every district knows what to do when they receive patients with COVID-19 like symptoms, such as fever and cough. It needs to mobilize community-level groups across the country to make sure our risk communication messages reach every village, so everyone is empowered to protect themselves. And while doing all this, it needs to maintain other essential health services such as ensuring safe births, providing routine childhood vaccinations, and treating people with TB and HIV.”
WHO experts are assisting the Lao Ministry of Health in all aspects of preparedness and response. These include:
- Working with the Ministry and development partners to source medical equipment (e.g. ventilator machines and laboratory equipment) and medical supplies (masks, eye-protectors and other protective equipment for health workers plus the materials needed to test for COVID-19)
- Providing guidance and training on how to use the medical equipment and supplies
- Technical support for preparedness planning
- Technical support for detection of COVID-19 cases, contact tracing and laboratory testing of samples from suspected cases.
- Supporting preparedness of individual hospitals to be used for treating COVID-19 cases
- Technical support to develop Lao guidelines on clinical management of COVID-19 cases
- Technical support, in cooperation with partners, in developing and disseminating effective risk communication on COVID-19
Much of the support WHO is giving to Lao Ministry of Health needs to be coordinated with other partners and stakeholders, such as other UN agencies, international NGOs, development partners and donors. Coordination with these partners takes place in a forum known as the UN Health Cluster.
If you represent an organization that would like to assist the COVID-19 response people contact Dr Jana LAI, Partnership Lead for COVID-19 Response, at the WHO Country Office for Lao PDR. Dr Jana’s email is [email protected] . If your specific interest is Risk Communication then you can apply to join the private Facebook group of partners in Lao PDR working on this area.
A difficult journey ends in home quarantine in Vientiane Capital
Dr Howard Sobel was working in Manila at the WHO Regional Office for the Western Pacific when he was asked to go to Lao PDR to become acting Head of the WHO Country Office in Vientiane. It was Friday 20 March 2020 when Dr Takeshi Kasai, WHO Regional Director for the Western Pacific, decided to deploy him. But the usual route of flying from Manila to Bangkok then onward to Vientiane (a trip of around 6 hours, including transfer times) had already closed down, and international air routes were closing on a daily basis. Dr Howard spent 6 days with his bags packed and his passport ready, complete with an emergency visa issued to him on the Saturday by the Lao Ambassador to the Philippines, ready to go to the airport at an hour’s notice. After two false starts – being put on an hour’s notice to go, only for the flight to be canceled – Dr Howard managed to board a flight to Haneda Airport, Japan on Thursday 26 March. “Manila airport that day was like an end of the world party. There were lots of people there, nearly all wearing masks, and Filipino party music blaring from the loudspeakers. On the runway were a group of 10 planes that never moved the whole time I was there.” From Haneda, Dr Howard was booked to fly the Bangkok then onwards to Vientiane. However, first he had to negotiate his way past anxious health officials in first Japan then Thailand. Luckily, with the help of a team in Laos providing necessary additional documents to the numerous ones he had already, they let him pass to the next stage of the journey. In Thailand, though, he was warned that he was not allowed to leave the airport. Dr Howard’s flight from Bangkok to Vientiane on Saturday 28 March was the last one before Thai Airways closed the route. His journey from Manila to Vientiane has taken 40 hours (compared to 6 in normal times). A WHO driver met him at Wattay International Airport and took him to his rented apartment where he began his self-quarantine for 14 days. Reflecting on life in quarantine, Dr Howard says “I have had to dive straight into working on the COVID-19 response. I haven’t had time to get bored.”