An IDS programme partnership, the Social Science in Humanitarian Action Platform (SSHAP), has recently launch its Central and East Africa Regional Hub to connect academics, humanitarian responders and public health practitioners primarily working in the Democratic Republic of Congo, South Sudan and Uganda. In this blog, partners of the hub explain the importance of South-South collaboration.
Uganda was recently faced with another Ebola outbreak. Likewise, the Democratic Republic of Congo (DRC) has confronted outbreaks, the latest of which was in Beni in August 2022. Meanwhile, South Sudan was plunged into a preparatory mode while Ebola was spreading in Uganda in early 2023. While there are contrasting contexts that influenced the nature of preparedness and responses in these three countries, in this blog we answer the question: how can collaborative academic research activities contribute to improved performance of health and other institutions involved in Ebola and other crises preparedness and responses? The question is relevant to the establishment of the Social Science in Humanitarian Action Platform (SSHAP) Central and East Africa Regional Hub, under which academics, humanitarian actors and public health practitioners working in DRC, South Sudan and Uganda will collaborate on sharing social science perspectives on health and disease outbreaks and related issues. This South-South collaboration, supported by partners in the UK with funding from the Foreign, Commonwealth and Development Office (FCDO) and Wellcome Trust, builds on linkages between institutions in the three countries.
In this blog, we provide context on Ebola and the benefits of collaborating to tackle it. We then explore a case study from Sierra Leone that discusses the technical expertise provided by Ugandan health professionals during the Ebola in Sierra Leone. Finally, we reflect on knowledge and expertise transfers in South Sudan, illustrating how vital these cross-border and cross-institutional linkages manifest.
The context of collaborations on Ebola research, preparedness and response
Since its appearance in the DRC in 1976 and subsequent outbreaks in numerous countries, Ebola has been a significant public health challenge, and the subject of many studies. Academics and health organizations, WHO in particular, have documented on several aspects of the disease, including both the medical dimensions as well as the socio-anthropological matters. Collaboration has been a key element of better understanding, preparing for, and responding to Ebola – and hence is the focus of our blog, as well as the Central and East Africa Regional Hub.
Mobilising Ugandan expertise in the Sierra Leone Ebola Outbreak
An example of cross-border health response is the deployment of Ugandan clinicians to the containment of Ebola in Sierra Leone. One of the co-authors of this blog interviewed Ugandan clinicians who responded to the Ebola outbreak. A clinician currently leading Uganda’s epidemic containment expressed surprise that pre-set MSF guidelines prohibited rehydration of patients, as this was an effective response he had used in Uganda. A Ugandan nurse also returning from Sierra Leone could not hide her shock at finding that the MSF Standard Operating Procedures banned administering fluids or rehydrating severely dehydrated patients. She said: “We had to draw people’s attention to basics in clinical practice. We argued that we had extensive experience in treating Ebola, cholera, dysentery and even HIV/AIDS patients. All a clinician needs to do is to adhere to disease-prevention procedures, but ensure that rehydration is done.” The Ugandan team applied their experience of rehydrating patients who had lost plenty of fluids due to virulent epidemics in Uganda. As a result, many Sierra Leone Ebola patients survived. This story underscores the importance of South-South collaboration, as learnings can be transferred across contexts.
While the Uganda-Sierra Leone collaboration made significant contributions, this was also in a context where finances, scientific ideas, and other standard operating procedures originated from the global North. Traditional clinical practices such as rehydrating patients, which are often ignored or prohibited by Western countries and actors, were revived by Ugandan clinicians. Such knowledge could only be transferred in this precarious setting because Ugandan clinicians had experience with successfully managing such virulent conditions.
This brought the co-author to another important component of partnerships, financing. One clinician interviewed argued, “We Ugandans were horrified by the figures originating from the West African Ebola outbreak, but we could not immediately finance our trips to help our brothers there. Fortunately, the African Union and some well-wishers secured some funds for this cause.
This experience illustrates the importance of not only South-South collaboration, but also the vital support that partners in the global North brings, for example in financing cross-border collaboration. It is exactly why the Central and East Africa Regional Hub, supported by partners in the global North, will be an effective way to share knowledge and learnings.
South-North and South-South Collaborations in South Sudan
Universities in South Sudan, Uganda and DRC as well as institutions in the global North have collaborated under various funding schemes. A telling example is the ongoing Norwegian Higher Education Development (NORHED) programme, a multi-year scheme which has enabled universities in South Sudan, Uganda and other countries to collaborate with academics in Norway. This programme illustrates that traditional North-South collaborations can be extended to also facilitate South-South collaborations.
There is already substantial collaboration between South Sudanese institutions, including the Ministry of Health, with institutions from other countries. In fact, the health sector in South Sudan is largely bankrolled by external actors. There are also experts from Uganda and other countries serving in the South Sudan health sector. Experts from neighbouring countries are able to adapt to working in South Sudan, as the context is not too different. Even the prevalent disease challenges in the countries of this region are similar. This illustrates that South-South collaboration can be an effective as actors can better relate to the contexts which may be similar to their own.
In a similar vein, Uganda is a major training ground for health personnel serving in South Sudan. Under the NORHED programme, for example, academic staff from University of Juba gained access to training and research programmes offered by Ugandan institutions. Like DRC, Uganda is nearby and so easily accessible. Indeed, many South Sudanese travel to Uganda for medical attention. The launch of the Central and East Africa Hub builds on existing fruitful South-North and South-South collaborations.
Conclusion
Often people allude to either a South-South collaboration or a North-South collaboration, but we argue that a more important collaboration would be a South-South-North collaboration in which the South-South component is accorded equal importance. Multifaceted collaborations which mobilise linkages and expertise across and within continents and promote synergies of experience, knowledge and competence lead to more effective responses to health and humanitarian crises. Drawing on this agenda for better collaboration and knowledge-sharing, the Central and East Africa Hub brings together academics, humanitarian responders and public health practitioners with this goal in mind.
This blog was originally published by the Social Science in Humanitarian Action Platform (SSHAP). To keep up to date with SSHAP’s regional hub activities and latest outputs, follow the programme on Twitter.
