Featured case: Médecins Sans Frontières and
the 2014 Ebola Disaster in West Africa

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The case

Who – the protagonists

Dr Joanne Liu, Medecins Sans Frontieres (MSF) International President.

What?

MSF was initially the only international humanitarian organisation working to stop the spread of Ebola in West Africa. MSF was taking much of the blame and the criticism while there was endless procrastination and denial by governments and other aid agencies.

Why?

An exasperated Dr Liu was addressing the United Nations in New York in September 2014, as the world was failing to contain Ebola.

Deaths were continuing to surge, riots were breaking out and Ebola treatment centres were reduced to places where people were going to die alone. Little more than palliative care was offered.

Dr Liu was seriously concerned. Her colleagues had cared for more than two thirds of the officially declared infected patients. Even though she doubled her staff in the space of the month, they were completely overwhelmed.

When?

Ebola first emerged in the 1970s in the Democratic Republic of the Congo, Central Africa.

Between outbreaks the disease is usually confined for long periods, deep in the remote forested areas of Central Africa.

The index patient in the 2014 outbreak is believed to be Emile Ouamouno, a two-year-old boy, who died on 28 December 2013.

Where?

It is thought Emile contracted the disease by playing in a hollowed-out tree containing a colony of bats, near his home in Meliandou, Guinea.

Worryingly, this was the first time Ebola had ever been recorded outside of the Central and East Africa zone.

Unfortunately, an investigation by the Guinea authorities didn’t detect Ebola, leading many people (including MSF) to remain sceptical at first of the likelihood of an outbreak in Guinea.

Key quote

“Last week, the World Health Organisation (WHO) projected as many as 20,000 people infected over three months in Liberia, Sierra Leone, and Guinea. We are in uncharted waters.” – Dr Joanne Liu, speaking in September 2014.

What next?

The 2014 Ebola outbreak was a game changer in medical humanitarianism and taught humanitarians and logisticians some important lessons about dealing with disasters of this type and magnitude.

It raised questions such as: is enough understood about E2E supply chain management? Is the entire E2E visible by people working in the field? Do appropriate procedures exist for use during the emergency phase?

The B case goes in to more detail on MSF's supply chain and operations.

 
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Médecins Sans Frontières and the 2014 Ebola Disaster in West Africa (A): In Uncharted Waters
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Teaching note

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Médecins Sans Frontières and the 2014 Ebola Disaster in West Africa (B): Medicines, Materials and Mobilisation: The MSF Supply Chain
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Teaching note

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The author

author

Jamie Rundle

Jamie discusses his students’ appetite for learning about a whole range of topics through cases, and producing a case using both field research and published sources.

Thinking outside the box

Jamie said: “Ebola is a very powerful topic and one which has sadly recurred in recent months.

“In the past decade, I have witnessed my students increasing interest in contexts outside the traditional business and management boundaries, and a craving to comprehend how the management disciplines can interact with, say, non-profit and third sector operations. 

“I became interested in humanitarian operations around 10 years ago and think that much more can be done to develop materials for teaching management aspects. For example, in recent decades we have emphasised zero inventory/zero waste business models (for good reason) in research and commercial practice, yet this case study – and another I wrote on disaster relief in 2013 – enables students to challenge this ‘one-size-fits-all’ assumption.

“It is important that students are given the chance to think about alternative models, and apply the consequences in areas other than the typical textbook examples of consumer products in high-consumption economies.”

Motivations for writing the caseMotivations for writing the case

He continued: “Soon after I became interested in humanitarianism, the quick succession of large-scale disasters, from the earthquake in Haiti, Typhoon Haiyan, the Ebola outbreak, really made me take notice of the importance of the work being done in the sector. 

“Despite the serious humanitarian emergencies in the previous decade, the Ebola disaster was a game changer for MSF in much the same way that the Haiti earthquake had been in 2010 for other organisations; yet people outside the sector may not necessarily realise this. 

“No matter how well-intentioned people may be in donating funds and following the events unfold in the media, society is still largely unaware of the challenges faced by NGOs; the reality, however, is that these challenges don’t disappear when the cameras stop rolling.

Combining field research and published sources

He added: “This is an enormous topic and in this instance, as the background research progressed, I came to realise that introducing a topic as complex as a humanitarian supply chain in extremely difficult circumstances, and balancing this with the sensitivities of the situation on the ground, needed a supporting (‘A’) case to introduce students to the topic and help them understand the wider context. 

“The ‘A’ case, therefore, is developed from publicly available secondary sources and helps to ‘set the scene’ for the situation. The ‘B’ case is focused on the supply chain challenge and is mixed with some direct quotes from MSF Supply. But, even this needed some historical context in order to introduce, for example, the organisation culture. 

“However, the bulk of material in both cases is from published materials available in the public domain.”

The need for a lengthy caseThe need for a lengthy case

Jamie concluded: “As the case research progressed, I allowed the case to grow. 

“Other cases written about the Ebola topic in The Case Centre collection are mostly of an equal or greater length, which may illustrate the difficulty of condensing this complex subject, but certainly indicates the importance of telling it in detail. 

“However, my experience of teaching the disaster relief case I authored in 2013 following the Haiti earthquake, ShelterBox: A Decade of Disaster Relief, whether to executive MBAs or undergraduates, has taught me that despite the assumptions teachers may make about students’ reluctance to read and prepare from written materials, these are sometimes wrong. 

“If the students are inspired to learn about a topic with a powerful hook to grab their attention, then the class discussion will be a success.”

About the authors

Jamie Rundle is a Researcher and Lecturer in Strategy at Sheffield University Management School.
jamie.rundle@sheffield.ac.uk
tw @JamieRundle

William Vannier is an agile innovation consultant and the former Supply Chain Director at MSF Belgium.

 

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