PUBLIC HEALTH EMERGENCY MANAGEMENT (PHEM) AND RCCE’S ROLE
Understanding PHEM
Public Health Emergency Management (PHEM) is a continuous cycle of activities to prevent, prepare for, detect, respond to, and recover from health emergencies.
Unlike disaster management (which focuses on natural disasters), PHEM addresses disease outbreaks, pandemics, bioterrorism, chemical exposures, and other health threats.
The PHEM Cycle
PHEM has 4 main phases—but they overlap and cycle continuously:
1. PREPAREDNESS (50% of effort should be here)
What it means: Building capacity, systems, relationships, and plans BEFORE emergencies hit.
Activities:
- Risk assessments (What could happen? Where are we vulnerable?)
- Emergency response plans
- Training health workers, VHTs, task forces
- Stockpiling supplies (PPE, medications, IEC materials)
- Establishing coordination mechanisms
- Conducting simulations and drills
- Building community relationships and trust
- Pre-positioning communication channels
RCCE in preparedness:
- Map community assets (trusted leaders, existing networks)
- Develop message libraries (pre-drafted, ready to adapt)
- Establish rumor tracking systems
- Train VHTs in community engagement
- Build media relationships
- Conduct community risk perception studies
- Develop multilingual IEC templates
Kampala example: The 2025 KCCA RCCE simulation was preparedness—testing readiness before a real outbreak.
Why it matters: Communities that invest in preparedness respond 3x faster and with 50% fewer deaths than those that don’t.
2. RESPONSE (15% of effort)
What it means: Immediate actions during an active emergency to save lives and contain threats.
Activities:
- Activate Emergency Operations Center (EOC)
- Deploy rapid response teams
- Conduct surveillance and contact tracing
- Provide medical care
- Implement control measures (isolation, quarantine, vaccination)
- Coordinate logistics
- Communicate with public and media
RCCE in response:
- Issue timely alerts and updates
- Counter misinformation and rumors rapidly
- Provide behavioral guidance (handwashing, isolation, testing)
- Engage communities in case finding
- Address fear and stigma
- Coordinate messaging across sectors
- Conduct social listening (What are people saying? What do they need?)
Kampala example: During a cholera outbreak, DMOs activate task forces, deploy VHTs, set up rehydration points—while simultaneously providing radio updates, WhatsApp alerts, and community meetings.
Common mistakes:
- Waiting too long to communicate (“Let’s confirm everything first”) → People fill information vacuums with rumors
- One-way announcements without listening → Communities resist or ignore guidance
- Technical jargon → People don’t understand what to do
3. RECOVERY (5% of effort)
What it means: Restoring health systems, supporting affected communities, and rebuilding trust after crisis ends.
Activities:
- Mental health and psychosocial support
- Livelihood restoration
- Health system strengthening
- Rebuilding community trust
- Reintegrating survivors (reducing stigma)
- Documenting lessons learned
RCCE in recovery:
- Support survivor reintegration (address stigma)
- Acknowledge community sacrifices and grief
- Rebuild trust if damaged during response
- Conduct After-Action Reviews (AAR) with communities
- Celebrate successes and honor frontline workers
- Prepare for next emergency (recovery → preparedness)
Kampala example: After COVID-19, some communities distrusted KCCA because enforcement was harsh. Recovery required rebuilding relationships through dialogue, apologies where appropriate, and demonstrating accountability.
4. EARLY WARNING / SURVEILLANCE (30% of effort)
What it means: Continuous monitoring to detect threats early, when they’re easier to control.
Activities:
- Disease surveillance (tracking cases)
- Laboratory testing
- Event-based surveillance (unusual health events)
- Community-based surveillance (VHTs reporting)
- Rumor surveillance (What are people saying?)
- Cross-border surveillance (regional coordination)
- Risk monitoring (environmental, animal, human health)
RCCE in early warning:
- Community-based surveillance networks (VHTs as eyes and ears)
- Rumor tracking systems
- Social media monitoring
- Community feedback mechanisms
- Regular community meetings (ongoing relationships)
- Toll-free hotlines
- School-based surveillance
Kampala example: VHTs in Nakawa reported unusual rashes to DMO → Turned out to be Mpox → Early detection enabled rapid response.
Why it matters: Early detection = faster response = fewer cases = lower costs. The 2003 SARS outbreak cost global economy $54 billion. Early detection could have reduced this by 80%.
RCCE EFFORT ACROSS PHEM PHASES
Most RCCE work should happen in PREPAREDNESS and EARLY WARNING—not just response.
Traditional approach (wrong):
- Preparedness: 10%
- Response: 80%
- Recovery: 5%
- Early warning: 5%
Result: Scrambling during crisis, communities distrust you, rumors spread unchecked, slow response.
Best practice approach:
- Preparedness: 50%
- Response: 15%
- Recovery: 5%
- Early warning: 30%
Result: Rapid activation, communities trust you, rumors detected early, coordinated response.
KCCA’s current reality (from simulation):
KCCA invested heavily in preparedness (simulation training, plans, drills). Result: Kawempe activated in 28 minutes. Rubaga (less prepared) took 45 minutes.
The gap: Rumor tracking scored 1.8/5.0 across all divisions. Why? Because rumor systems weren’t built during preparedness—divisions tried to create them during the simulation (response phase). Too late.
Lesson: Build RCCE systems during calm times, activate them during crisis.
KAMPALA-SPECIFIC PHEM/RCCE INTEGRATION
Preparedness:
- Annual RCCE training for all DMOs, VHTs, health facility staff
- Quarterly simulations (division-level)
- Rumor tracking systems established and tested
- Multilingual IEC material libraries
- Community leader relationships built
- WhatsApp coordination groups active
Early Warning:
- VHTs report to DMOs weekly (routine) and immediately (urgent)
- Rumor desks in each division
- Social media monitoring
- Cross-border information sharing
- Market-based surveillance (vendors as sentinels)
Response:
- EOC activation within 30 minutes
- Task forces convened within 1 hour
- VHTs deployed with pre-positioned materials
- Radio spots aired within 2 hours
- Community meetings within 6 hours
- Rumor tracking activated immediately
Recovery:
- After-Action Reviews within 2 weeks
- Community dialogues to address concerns
- System improvements implemented
- Documentation for learning
- Recognition of frontline workers