July 27, 2011 marked the midpoint of the weeklong Senegalese National Government Pandemic Disaster Response Tabletop Exercise. The day was dedicated to sessions two and three of this five-session tabletop exercise. This is a simulated exercise so nothing is real, but the exercise planners have ensured that the scenarios are realistic and accurately reflect a worse-case scenario for a pandemic outbreak. Session two marked the arrival of the new pandemic virus in Senegal and session three had the situation worsening. The day concluded with a simulated press event. The exercise participants are divided into five groups - operations, health, logistics, safety and communications. Some of the challenges they grappled with during session two were Senegal's first confirmed cases of the virus, a potential outbreak of meningitis in a school district, and food shortages in the initial outbreak area. The economy is being impacted as tourists cancel trips to Senegal and expatriate residents flee the country. Many airports, train routes and border crossings are either closed or impacted by required screening of travelers. By session three, the death toll in Senegal is at 2,400 and rising. The rainy season is causing massive flooding and has displaced 30,000 residents. Neighboring countries are also being impacted by the virus and flooding, straining their resources and impacting their ability to assist Senegal. Employee absenteeism is impacting government services, civil society and the Port of Dakar. Many residents have left the major cities and moved to the rural areas to stay with family. Gas stations and markets in the major cities are almost empty of fuel and other commodities. Senegal has exhausted its health resources and has requested international assistance. During the press event, journalists asked questions about the state of the emergency; the status of schools and other public gatherings; what was being done to address reports of violence, particularly in areas where displaced people were seeking refuge from flooding, and what was being done to provide respectful and proper burial for the thousands who had died. A five-person panel, with representatives from the Ministries of Interior, Health and Communication and the Senegalese Armed Forces, took on the media's questions. The participants were Colonel Mamadou Adjie, Senegalese Armed Forces; Dr. Moussa Dieng Sarr, Ministry of Health; Mar Lo, Ministry of Interior; and Papa Atou Diaw, Ministry of Communication; and Colonel Ouanza Ouattara, Senegal's Fire Brigade. The press event was done in all seriousness and the participants did a great job answering the questions and getting out key messages that had been drafted during the day by the communications and health cells. A critical link Two of the press briefing participants were familiar faces as they had been part of a panel discussion the previous day, during the academics portion of the exercise. The session was called "Logistical and Coordination Challenges in Providing a Multi-Sectorial Response to a Severe Pandemic." Of the five groups the participants are divided into for the exercise - communications, health, logistics, safety and operations - logistics is the only one that had its own dedicated panel discussion, which probably speaks to its importance. During the panel discussion, international, national, military and civilian experts discussed the critical role logistics serves during any emergency response, particularly a pandemic. The panel discussion was intended to get folks thinking about the different challenges they might face during the exercise and in real-world events. It was stressed several times that careful, thoughtful planning has to be done ahead of time and that coordination and communication needs to take place at all levels during the crisis. Participants Lo and Adjie, along with Dr. Amadou Diaite, an international expert in risk reduction and disaster management from the World Food Program, Pape Diop, head of the Operational Logistics Group of the ORSEC plan, which is Senegal's national plan for emergency response, and Lieutenant Colonel Wayne Benjamin, logistics representative from U.S. Africa Command (AFRICOM). Benjamin told the group, "It is said that logistics is not everything but you can't have anything without logistics." He told attendees that they needed to be adaptable and responsive in their planning and that the goal is "to get the right supplies, to the right place, to the right people, at the right time." He mentioned the difference between capacity and capabilities. "It is one thing to have the trucks - capacity," he said, "but you need drivers - capabilities." Benjamin stressed the supply chain and the importance of storing materials properly and maintaining accountability of all supplies. He also told the group that hard decisions would have to be made during a crisis about who gets what and when, and that those decisions would have implications and possible consequences that they need to be prepared for that eventuality. Adjie said that "without logistics, there is no successful operation." He highlighted the logistical capabilities the Army could contribute to the Senegalese government's national plan, which fits right into one of the exercise objectives. The Senegalese Government wants to identify how best the Senegalese Armed Forces might contribute to an emergency response and is using this exercise as a way to discover options. Adjie also mentioned that the Army could only intervene if requested to do so, as the response was under the management and direction of civil authorities. Lo described logistics as a chain, and if there is even one missing link, the whole chain suffers. For example, he shared that if the 'cold' chain is not managed correctly, and vaccines are not properly handled and stored, than the lifesaving vaccine would be made useless. "The logistical piece of any operation is critical," Lo added. The discussion lasted for more than an hour and brought up many more concerns. Transportation nodes, such as roads, bridges, rails and ports, could be impacted by the emergency. What alternatives exist? If there are food and fuel shortages, what then? What are alternate means of communication if traditional means fail? These questions and more are best asked and explored during an exercise as opposed to being faced for the first time during a real-world emergency. (PAO Note: This exercise is being hosted by the Senegalese government, organized by U.S. AFRICOM and supported by the Center for Disaster and Humanitarian Assistance Medicine and the U.S. Agency for International Development. The tabletop exercise will assist the Senegalese government in assessing their pandemic influenza preparedness and also identify and validate how the Senegalese Armed Forces can assist in Senegal's National Pandemic Response Plan.)