USING DATA TO CURB EPIDEMICS

When there is an outbreak, project teams look to epidemiologists to learn where and how fast a disease is spreading, and how it can be stopped. That information is drawn from data that is carefully recorded by clinical staff, health promotors, or outreach teams and then processed by an epidemiologist and his/her team. Epidemiologists are therefore crucial in understanding what is happening in the population and how to leverage this information to help individual patients.

Belgian epidemiologist Neil Saad just came back from his second mission and explains his passion for the field.

Where did you hear about MSF as a potential employer?

When I was studying public health in London, I went to the MSF scientific days and I liked what I saw. In academia, you apply concepts to inform changes in policy or changes in methodology usually on a timescale of years if not decennia. It was refreshing to see the concepts I was learning being applied by MSF to populations in need with a very direct impact. After getting my degree in epidemiology, I specialized further in the analysis of infectious disease data and this convinced me even more that I wanted to work for MSF.

What does the job of an MSF epidemiologist entail?

An epidemiologist designs studies or data collection systems and analyses the data to better understand what is happening in a population. At MSF, this entails writing protocols, which outline the planning and set-up of a study, developing and managing all the forms that are used to collect the information, training individuals in how to record information, maintaining the database systems, supervising correct entry of the data and conducting the analysis of the data.

Data gathering and analyses are crucial to try to understand what is happening, who the individuals affected are, where it is happening and what the trends are on the short and long term.

For example, there is an increasing number of cases coming from a certain area. The epidemiologist will liaise with the health promotors, the outreach team, and the Ministry of Health who gather data to understand why those cases are coming from that area and why the number of cases is increasing. The health promotion team and you could then decide to send the outreach team to sensitize the local community on not only what the symptoms of a particular disease are but also on general hygiene practices such as open defecation, water and hygiene or hand washing techniques, and encourage people with symptoms to seek care.

But you also need to think long term: what is driving the epidemic? What are the wider dynamics and the root causes and why is it persisting? This needs to be fed into the larger strategy for planning. Basically, epidemiologists crunch the numbers, find patterns and translate the data to clear explanations of what is going on and what they think should be done. This is important in order for our colleagues to use this information for decision-making or awareness-raising.

You went to Cambodia and Bangladesh. Can you tell us about one of your missions?

In Bangladesh I was posted in Cox’s Bazaar where the Rohingya refugee settlements are. My task was to help with the diphtheria outbreak among the Rohingya refugees and the Bangladeshi host community. Diphtheria is a bacterial disease that is spread through droplets, sneezing or coughing. It can be very lethal if not treated and it mostly affects children and women.

It is hard to prepare yourself for the sight of such a huge refugee camp. The circumstances in the refugee camps are dire. The area is hilly and not suited for such a high population density, they have limited access to clean water, clean toilets and there is a high risk of flooding and landslides. These close quarter conditions, combined with heavy rainfall and shabby housing are the perfect breeding ground for the spread of disease.