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When we’re in the midst of a crisis, it’s tempting to find someone to blame. Where COVID-19 is concerned, we’re laying the blame for mistakes at the feet of people who are trying to manage something they have never experienced before.

Stephen Kemp, Senior Consultant at McCartney Healthcare Associates, uses his experience of being thrown into mass migration and a cholera outbreak in Africa to show how we can use our own experience to guide us and why it’s essential for us to learn from our mistakes.

Fresh out of Law school, Stephen visited Zaire in 1994, hoping to make a positive impact and improve lives.Stephen told us:

“I volunteered to teach nursing in the Institut Technique Medical in Boga, Zaire. A trickle of refugees from the unfolding civil war in Rwanda were arriving, ravaged with bullet and machete wounds for us to treat. This was just a taste of the horrors to come in Africa during that difficult time.

“A Rwandan bishop begged me to go to his country and help his people. I wasn’t sure how we could do this because the country was a no-go zone and we didn’t have the resources to treat the tens of thousands of affected citizens who desperately needed help.”

In at the deep end

Wondering how he could do more to help, Stephen met Pat Nickson, a Senior Advisor to the World Council of Churches. Pat advised Stephen to return to the UK, join the aid agency Tearfund and return as an aid worker to Rwanda. Stephen recalls this experience:

“I had a little knowledge of the country, passable French and a basic idea of the situation, but no idea what to expect. Romford on a Friday night is no preparation for the aftermath of a genocide. I was recruited as a nurse and logistician. My recruiters reassured me that I’d be working with people with plenty of experience, so I had no need to worry.

“By the time I flew into Goma on a C130 transport plane in September 1994, the refugee numbers had swollen to a million. These people we so desperate that they’d fled to one of the most unforgiving landscapes in the world. Goma sits at the northern tip of Lake Kivu and nestles under Mount Nyiragongo, an active volcano.

“A cholera epidemic had struck the camps that summer. The disease had spread rapidly, initially claiming about 1200 victims per week and at its peak, was estimated at 6000 per day. That’s ten times the ferocity of the UK’s peak of the Coronavirus outbreak in the spring of 2020. Things were tough, and people were desperate for help.

“I was met by an excited team who were looking for a leader. The experienced leader I’d expected to be working with was stranded in Tanzania and not expected anytime soon. I quickly realised that I was expected to lead this team.

“I met the United Nations High Commissioner for Refugees (UNHCR) to discuss what Tearfund had to offer. I’d only met the Tearfund team 20 minutes before this meeting and had no idea of their capability. My passable French wasn’t as good as I had thought, and I struggled to understand the rapid-fire questions of my inquisitors.

“As a last resort, I reverted to English, apologised, and said, ‘Tell me what your most pressing need is, and we will solve it for you.’ Their priority was stabilizing the refugee camp population by removing the heavily armed ex-combatants who were garnering support for revenge attacks. We needed to move the armed groups to a separate camp and disarm them in return for food, water, shelter, health and hygiene. As a team, we set to work constructing a camp and began disarming the first of 8000 ex-combatants.

“Although the camp was relatively small and attracted some criticism from larger agencies, it was a successful project which saved thousands of lives and minimized violence. We made mistakes as we went along, but quickly learned from them, found solutions, maintained clarity of purpose and continued to focus on the end goal.”

Stephen was managing a dangerous situation that he’d never experienced before. He had no knowledge of mass migration, no military experience or understanding of what drives citizens to take up arms against neighbours, colleagues and teachers. He had never built a refugee camp, a health centre or a water treatment plant. Stephen was there to teach nursing care, which he was qualified to do and had researched and prepared for.

He didn’t ever want to find himself in this position again and so he looked for the training and expertise he would need to respond in future. To this end, he studied at the Centre for Development and Emergency Planning at Oxford Brookes University and worked at the Oxford Centre for Disaster Studies before going on to successfully run emergency health operations in response to war, disease and natural disasters around the world.

So where was the preparation by experienced professionals and Government ministers for a viral pandemic? Where is the evidence that they have applied learning from previous pandemics and global health threats? It would be good to know what preparedness was in place for a deadly virus and to understand exactly what informed their decisions-making throughout its course.


Stephen Kemp is a Senior Consultant at McCartney Healthcare Associates.

He has more than 20 years’ experience in emergency, urgent and primary care. Stephen helps healthcare organisations to implement better workflows, systems, roles and services in an ever-changing, fast paced environment.

Stephen has been keynote speaker at the Open Forum Transforming Urgent Care conferences, and regularly writes about current healthcare issues. Find out more about Stephen and get in touch on LinkedIn. Find out more about McCartney Healthcare Associates.