GLOBAL HEALTH
APHL Mozambique Responds to Cyclone Idai
By Elizabeth Toure, MPH, senior specialist Global Health; Palmira Mangae, specialist Global Health
and Solon Kidane, senior technical advisor, APHL Mozambique
On the night of March 14, 2019, Cyclone
Idai made landfall near Beira, one
of Mozambique’s largest cities. The
damage caused by one of the Southern
Hemisphere’s most powerful cyclones
was catastrophic, with thousands of lives
lost and millions affected by the flooding.
Much of the infrastructure in and around
Beira was severely damaged, including
the central hospital, many health facilities
and laboratories.
The Ponta Gea Health Facility in Beira is
the main reference laboratory for HIV viral
load (VL) testing for two entire provinces.
VL testing is critical for monitoring the
treatment regimen of people living with
HIV and is a major focus of the President’s
Emergency Plan for AIDS Relief (PEPFAR)
and the UNAIDS 90-90-90 initiative.
Dozens of health centers across two
provinces refer VL samples to Ponta Gea
and receive electronic results using an
electronic test order and result return
system maintained by APHL.
When Cyclone Idai made landfall,
the Ponta Gea Health Facility was
severely damaged. The roof on parts
of the building—including part of the
laboratory—was blown off, resulting in
heavy rains pouring directly into the
building. In the main laboratory, the
server and many other electronics were
damaged. Patient results that had not yet
been sent back to the referring sites were
seemingly lost, and the two provinces had
nowhere to refer VL samples for testing.
As a result of APHL Mozambique’s back
up and data recovery system, staff were
able to immediately take action to ensure
that no data was lost and that HIV VL
testing could continue uninterrupted. The
Ponta Gea server went down at 7:45 pm
on March 14 and APHL was able to recover
all patient data up to the last registered
sample minutes before the server
went offline. Results that had not been
electronically sent back to referring sites
were printed at the APHL office in Maputo
and securely distributed back to the sites
by road.
Additionally, in coordination with the
Mozambican Ministry of Health (MoH)
and CDC-Mozambique, APHL modified
the electronic referral system to refer
Cyclone Idai’s path across Africa. Photo: UN Office for
Coordination of Humanitarian Affairs
electronic sample data to VL testing labs
in two unaffected provinces, Nampula
and Quelimane, while the Ponta Gea lab
is being repaired. PEPFAR clinical partners
are assisting with the physical transport
of the specimens between health facilities
and reference labs. APHL is monitoring
data from the two referral labs closely
to identify any testing backlogs that
could result from the sudden influx of
additional specimens. As a result, APHL
has already mitigated a backlog at one lab
by re-routing samples to a third VL lab in
Maputo.
The unprecedented damage caused by
Cyclone Idai tested the laboratory backup
systems that the MoH and APHL had built.
The fact that no patient information
was lost from the damaged server
at the Ponta Gea laboratory and that
patients can continue to receive results
from critical VL tests demonstrates the
resilience of the nation’s laboratory
systems and the importance of a fully
functioning electronic laboratory
information system. n
The Ponta Gea Health Facility in Beira, Mozambique was badly damaged by Cyclone Idai in March 2019.
20
LAB MATTERS Summer 2019
PublicHealthLabs
@APHL
APHL.org