What it takes: Notes on how to prepare for the unknown

You never know what crisis might strike, something that calls on the UN to act big and fast. If the world didn’t understand this before COVID-19, it does now. But an emergency can strike at any level.  

It can strike in the west African nation of Guinea, where I serve as the Resident Coordinator (RC).  

In 2014, a major Ebola epidemic originated in Guinea’s forest region and affected millions of people in the region. Just this year, while the country’s — and the world’s — attention was on the COVID-19 pandemic, the Ebola virus emerged for the second time in the forest area of N’zérékoré, raising fear that it might take the same toll on people’s lives and livelihoods as it did in 2014-2016, during the first wave, when 11,300 people died, among them more than 500 health professionals. 

Our experience facing Ebola and COVID-19 helps show how the UN and partners can help countries respond to public health emergencies — or any threat to peace and prosperity.  

Following are four things that can help UNCTs get prepared for the unknown: Coordination, Ownership, Speed, and Flexibility.  

COORDINATION 

When I took my post last year as the RC in Guinea, I wanted to learn about the work that NGOs and development partners in the country were already doing. They had done outstanding work in all areas of development, including during previous disease outbreaks. 

I wondered how the UN could complement their efforts. The UN has resources that can be valuable for other organizations. A reputation for promoting peace and freedom. Meeting space (mostly digital these days) and its convening power. Relationships with national authorities, technical and financial partners, civil society groups, local communities and the private sector throughout the country.  

With that in mind, my office connected with a group of representatives of NGOs to set up a platform and start getting ready for any potential disaster while strengthening the resilience of local communities. 

Things progressed. First, the UN updated the list of all the NGOs in country. Then, last year, we invited representatives to meet. Next, the full group developed a coordination platform structured around “clusters” that worked on floods, public health or other issues, and that are joined together by a Steering Committee. All this was made possible thanks to the guidance of OCHA, the Office for the Coordination of Humanitarian Affairs.  

Now having developed some trust, participants in this platform were better prepared to coordinate on long-term needs or in emergencies. Coordination is required at all levels, from UN headquarters to the grassroots level when an emergency — such as an Ebola outbreak — is taking place. The UN Country Team in Conakry can and must coordinate with its own agencies and partners, in alignment with the government response plan. Government coordinates the overall work. Fortunately, the government of Guinea has taken a strong leadership role in responding to COVID-19 and the new outbreak of Ebola. Based on its extensive experience managing the Ebola epidemic of 2014-2016, the government was ready to act fast.  

OWNERSHIP 

Shared ownership is extremely important. Communities must be and feel part of any development work, including in disease control, if it is to produce the best results.  

If they are not consulted, informed and engaged, then the measures are not accepted, and the response might be a failure. 

I saw this myself when I was in West Africa during the 2014-2016 epidemic of Ebola and observed the tensions within the community and the distrust towards health authorities and people coming from outside to help. 

As an example, because of the extreme danger of contracting the disease, public health workers told people not to touch the bodies of those who’d died of Ebola. But for some people, not to touch the bodies would mean denying the dead their proper burial rites. The living had to touch the dead. Sure enough, though, many of those people would get infected themselves, and die, and spread the disease still further. This could be prevented by delivering the right messages to the community through the right channels and co-creating the most acceptable solution together. 

In other words, stopping infectious diseases requires the expertise not only of doctors and virologists, but of psychologists, sociologists, anthropologists, artists, linguists, communications professionals, politicians and traditional health practitioners. And, perhaps most of all, it requires the participation of all people.   

The UN will continue to support the Government to ensure that grassroots communities feel ownership over a crisis response, through the engagement of community, religious leaders, youth and women’s groups.  

SPEED 

When dealing with an epidemic disease, time is of the essence. 

Guinea’s capital city, Conakry, sits on a peninsula that juts into the Atlantic Ocean. From there, it can take as long as 48 hours on bumpy roads to reach remote places such as N’Zérékoré, the country’s second-largest city.  

UN Humanitarian Air Service (UNHAS) flights from Conakry to N’Zérékoré had been suspended after the last outbreak of Ebola. But the desperate state of the roads made it unnecessarily hard to provide support to the inland region, whether in a hurry or not.  

The UN, through WFP’s UNHAS flight service, wanted to restore this flight route in order to be able to support projects, offer this service to the national authorities, NGO community and donors, and deliver people and supplies — whether food to address food insecurity, or possibly the COVID-19 vaccine when it became available. 

We decided to organize a “test” UNHAS flight to show the value to our partners.  

As it happened, the first flight coincided with the declaration of the Ebola outbreak, allowing us to deploy the necessary equipment the very next day. We also facilitated the deployment of National Health Security Agency experts, WHO public health specialists and NGOs such as Doctors without borders (MSF) or the French Red Cross. 

Flight time: 1.5 hours. 

That same week, we had called a meeting on short notice with our NGO partners on the development platform to coordinate about the Ebola response. Six months before, it would have taken much more time to get it organized. 

Having learned from the 2014-2016 epidemic, the UN response, led by WHO and UNICEF, was able to react quickly and to deliver the Ebola vaccine in record time. Nine days after the announcement of the outbreak, the vaccines arrived in the field and the vaccination campaign started. Funds were also mobilized through the UN Central Emergency Response Fund.  

FLEXIBILITY 

Another critical move during the Ebola and COVID-19 emergencies was to embrace the complexity of the situation and bring together the different pieces of the work the UN had been doing during the past decades at the peace, humanitarian and development nexus. 

In practice, working at this nexus means that we recognize how these three areas of work are inseparably connected — and that we respond as such. For example, the UN in Guinea has, in recent years, worked on preventing conflict, especially in the lead-up to the 2020 presidential elections. With support from the UN Peacebuilding Fund, trainings were held to teach women’s groups, young community leaders and moto-taxi drivers to spot the signs of conflict and nip it in the bud.  

With the recent Ebola outbreak, the UN team reoriented some of this work so that trainees could now convey messages on Ebola and help fight the disease in their communities. UN agencies immediately redirected some of their activities to help people earn incomes, protect their businesses, and retain access to basic health services despite Ebola and COVID-19.  

Preventing disease is valuable in and of itself, but it also helps prevent conflict. If there is misunderstanding about a deadly disease such as Ebola, then the disease is more likely to spread, tensions are more likely to flare, and conflict is more likely to erupt. Conversely, the more that people understand about Ebola and the more channels for communication are open, the less likely conflict is.  

The UN recognizes these connections, and UN reform has made it easier to work jointly across the areas of peace, humanitarian and development needs.  

WHAT THE U.N. DOES BEST 

A critical aspect here was being able to deploy rapidly. The UN’s fast action was made possible by laying the groundwork, getting prepared to any disaster months ahead, listening to communities, understanding their needs, and changing focus as circumstances demand.  

There will be other emergencies. Some of them will blindside us. But I believe we will be better off for having prepared beforehand and working at the peace, development and humanitarian nexus.  

That’s a lot of meetings and details and emails and meals shared. It’s behind-the-scenes. It’s workaday. It’s policy-oriented. But it’s so important, and it’s one of the things the UN does best.  

Vincent Martin is the Resident Coordinator for the United Nations in Guinea. To learn more about the United Nations' work in Guinea, please visit: Guinee.un.org