Outbreak preparedness requires strong health systems, but conflict disrupts health systems and poses additional constraints on implementing preparedness and response.

Conflict started in Tigray, North Ethiopia in November 2020, displacing people from rural to urban areas, and disrupting the health system.  In the town of Shire, displaced people found shelter in schools, in conditions of poor sanitation, limited water supply and food insecurity.  As an area endemic for Cholera, emergency preparations were made in an anticipation of an outbreak.

Outbreak preparedness and response involves a cycle of prevention, detection, confirmation, response and evaluation.  These principles and the constraints encountered in the Tigray context are discussed.