Rwanda hosted its first pandemic disaster response tabletop exercise on the shores of Lake Kivu July 11-15, 2011. Using a scenario involving the international spread of a hypothetical avian virus called "H5N1," civilian and military authorities sought to identify gaps in existing national crisis plans.

"We must take a whole of society approach," said General Marcel Gatsinzi, minister of Disaster Management and Refugee Affairs for Rwanda, during opening ceremonies. He stressed that a pandemic crisis can overwhelm far more than the country's health sector, extending to virtually all aspects of society as more and more people become ill.

"We're trying to get all sectors to be aware," he said. "It's a wake-up call."

Simulating the span of nine months during which massive flooding, a refugee crisis, and civil uprisings compound the pandemic problem, the scenario forced local and international health, security, and planning agencies to test their procedures under extreme conditions. Over three days, Rwandan authorities formed into operations, logistics, health, security, and communications groups in order to examine solutions to very real problems such as limited resources and the spread of misinformation.

The exercise was part of an effort by the U.S. Agency for International Development to assist African countries in developing detailed contingency plans for pandemic preparedness. Representatives from neighboring countries who have participated in similar exercises were on hand to assist and observe the exercise.

"We must go beyond thinking about health," said retired Colonel Vincent Anami, director of Kenya's National Disaster Operations Center. "The social and economic impacts may be very great, and one single organization cannot handle everything."

Because the military will certainly play a major role in any pandemic crisis, U.S. Africa Command was on hand to support those aspects of the exercise.

"This pandemic response plan exercise in Rwanda exemplifies our command's message of building the capacity of our African partner nation militaries to become self-sufficient," said Brigadier General Stayce Harris, mobilization reserve assistant to the commander of U.S. Africa Command. "The synergies created through understanding how each sector can work together and serve the population in the event of a pandemic disaster will better serve the population as a whole."

Several areas of improvement were identified, such as the requirement for better preparedness plans involving all aspects of government and civilian sectors, proper training, and the development of a National Disaster Center.

"I feel very good about what we've achieved here this week," said retired Lieutenant General Joseph Inge, who facilitated the exercise on behalf of the Center for Disaster and Humanitarian Assistance Medicine. "I'm impressed by the Rwandans' sense of professionalism and encouraged about the way forward."

"Disaster respects no boundaries," said Agnes Binagwaho, Rwandan Minister of Health, during concluding ceremonies. She praised the work done toward forming a "multi-sector approach" to both planning and execution of basic services such as health, energy, security, and food distribution during a pandemic crisis.

"We should start to think about a regional contingency plan," she said, in which essential service sectors from several neighboring can work together. "It's something to think about for the future."