Standing up emergency coordination in Sierra Leone

The context

On 5 November 2021 a loaded fuel tanker collided with a lorry at PMD Junction in Wellington, on the eastern edge of Freetown. The tanker leaked before it ignited. In that window people came with jerricans, because a stream of free petrol in Wellington is not a hazard but a windfall. By the time the count closed, 154 people were dead — 87 at the scene, 67 in facility care — and more than three hundred were injured.

Deployed by Africa CDC and working alongside the Ministry of Health and Sanitation’s Public Health National Emergency Operations Centre, the immediate task was to help stand up the incident coordination centre.

What the work involved

Three hospitals were counting differently and no one could say with confidence how many patients were in the system. Establishing a single line list came first. Then the daily reporting rhythm — a situation room tracking health outcomes not only at the moment of impact but over the following weeks, as burn patients who survived the first night did not survive the second.

Holding the distinction between died at the scene and died in facility care mattered more than it appears. Those two numbers point to entirely different failures and entirely different fixes: 87 is a mass-casualty scene-management problem, 67 is a burns-care capacity problem. A country that records only “154 dead” learns nothing.

Beyond the incident

The deployment ran from April 2021 to September 2022. In that period Sierra Leone worked through multiple COVID-19 waves including the Omicron-driven fourth wave, a measles outbreak, Lassa fever, anthrax, vaccine-derived poliovirus, Ebola preparedness triggered by reports across the Guinea border, and Marburg.

The durable output was documentary. Contributions to the National Public Health Emergency Operations Plan, the National One Health Policy and the National Public Health Personnel Deployment Plan; cross-border protocol harmonisation with Liberia; new traveller screening procedures and trained health workers at points of entry and ground crossings.

None of that is photogenic. But a personnel deployment plan is the reason that, the next time something happens at 8pm on a Friday, somebody knows who is authorised to move, where they are going, and who pays for the fuel.

What it demonstrates

Emergency systems are built in the quiet months. The pathogen changes; the system does not. That conviction is what Celenara’s consulting division now sells — and it was learned somewhere specific.