Planning for Health Emergency Management

1. Planning for Health Emergency Management First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

2. Hyogo Framework for Action Building the resilience of Nations and Communities to Disasters Five Priority Actions: Make Disaster Risk Reduction a priority – ensure that DRR is a national and a local priority with strong institutional basis for implementation Know the risk and take action – identify, assess and monitor disaster risks and enhance early warning First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

3. Hyogo Framework for Action Five Priority Actions: Build understanding and awareness – use knowledge, innovation and education to build a culture of safety and resilience at all levels Reduce risks – reduce the underlying risk factors Be prepared and ready to act – strengthen disaster preparedness for effective response at all levels First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

4. Risk Management is a comprehensive strategy for reducing threats and consequences to public health and safety of communities by: preventing exposure to hazards (target = hazards) reducing vulnerabilities (target group = community) developing response and recovery capacities (target group = response agencies) First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

5. Emergency Management Plan An agreed set of arrangements for: responding to, and recovering from emergencies First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

6. Emergency Management Plan A plan containing description of: • Responsibilities • Command & coordination mechanism • Management structures • Resource management • Information management and communication • Training and exercises First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

7. Preparedness • measures to build capacities to respond to, and recover • from emergencies Capacity ability to manage risks by: • reducing hazards • reducing vulnerabilities • reducing consequences by responding to, and • recovering from emergencies • In terms of: • Organization; systems; resources and partnership First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

8. Emergency Planning Process Analyze resources Define the plan Describe Roles and Responsibilities Form Planning Group Hazard Analysis First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Describe Management Structure Vulnerability Analysis Risk Analysis Develop Strategies and Systems Problems/Gaps Analysis “Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”

9. Emergency Preparedness, Response and Recovery Plan • Emergency Preparedness Plan consists a Programme for: • Hazard prevention • Vulnerability reduction • Emergency preparedness First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

10. Case Study: Country X • Category 5 tropical typhoon • ( > 250 kph winds) struck Country X • associated with heavy rainfall and flood • Landslide from the lava of previously • erupted volcano First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

11. Impacts to the community • 450 injured; 86 deaths; 820 missing • 15 drowned; 7 electrocuted • 1,500 displaced families • two hospitals flooded till 2nd floor • All health Centers flooded • Immunization services disrupted • Pre-natal check ups halted • Private clinics closed down First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

12. Impacts to the community • Damaged houses, flooded buildings, • Damaged telephone and electrical lines • Impassable roads • Electrical brown outs, no water supply • Damaged vehicles and roads • Closed stores and businesses • Damaged schools • Damaged crops • Snake bites First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

13. Impacts to the community • Garbage collection halted • Flood water stagnated • Human wastes everywhere • Toilets flooded and overflowed • Mud covered all streets First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

14. Evacuation Site Scenario • Damaged lifelines • Overcrowding • Poor environmental sanitation • No access to safe water • No community surveillance system • Inadequate sanitary toilets • Health workers are direct victims • Disrupted basic health services • Severe depression of the bereaved • and other health workers First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

15. Exercise: Emergency Preparedness Prog. • Group the participants > Develop the Emergency • For country X Preparedness Program • Identify the hazards • Identify the vulnerabilities of people, properties, • environment, services, and livelihood • Identify the risks to the community as to people, properties, • environment, services, and livelihood • Identify the services needed • Identify the capacities needed First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

16. Exercise: Emergency Preparedness Prog. • Group the participants > Develop the Emergency • For the Evacuation Site Preparedness Program • Identify the hazard • Identify the vulnerabilities • Identify the risks • Identify the services needed • Identify the capacities needed First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

17. ANATOMY OF COMMUNITY RISK MANAGEMENT Community risk readiness community = hazard  vulnerability multisectoral, all hazards indicators: indicators: indicators: indicators: probability scale/magnitude/ strength/intensity spread duration biological hazards: season, infectivity, latency, transmission resistance, etc. policy, plans, procedures knowledge, skills, attitudes resources legislation national & sectoral policy administrative procedures response & recovery plans preparedness plans technical guidelines management structure institutional managements information systems warning systems human resources material resources financial resources simulations & training education public information community participation research publications People: access to health care measles vaccination under 5 nutrition under 5 mortality access to clean water access to sanitation adequate housing employment/ income female literacy Property: health infrastructure vehicles medical supplies Services: curative care services ambulance services public health services health info system Environment: water/soil/air quality risk of: death injury (mental/ physical) disease (mental/physical) loss of life displacement loss of property loss of income secondary hazards breakdown in security damage to infrastructure breakdown in services Contamination natural phenomena famine diseases of epidemic potential events/crowds intoxification infestations transport accidents structural failures industrial accidents chemical accidents pollution refugees war terrorism First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Prevention & Mitigation Programme Vulnerability Reduction Programme Emergency Preparedness Programme = Community Risk Management  

18. 2. Emergency Response Plan to use built capacity to manage risks, includes : • Policies for direction and plans to be activated • Systems and Procedures to be activated/implemented • Organized team to respond to emergencies • Available logistics and funds for the operation • Established networks for emergency management First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

19. Emergency Response Plan • use existing capacities to deliver relief or response • mobilization of resources • use of developed systems for emergency management • actual implementation of guidelines/proedures for the • developed systems First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

20. Activities during Response Phase • Utilization of capacities built • Activation of plans and systems developed • Activation of OPCEN • Mobilization of resources • Management of emergency cases • Validation and constant monitoring of the event First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

21. Case Study: Country X • A destructive cyclone is coming with landfall after 24 • hours was aired in the TV and radio Report 1 First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

22. Report 2 (9: 00 AM) • Category 5 tropical typhoon • ( > 250 kph winds) struck Country X • associated with heavy rainfall First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

23. Report 3 (11:00 AM) • Flood starts to build up • Landslide from the lava of previously • erupted volcano starts to roll down • the villages First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

24. Report 4: at 11:30 AM • 20 injured needing surgery • 20deaths; • 15 drowned; 7 electrocuted needing to • to be revived • 2 snake bite needing treatment • 1,500 families needed to be evacuated • 50 missing with mothers screaming First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

25. Report 4: at 11:30 AM • two hospitals flooded till 2ndfloor, • non- functional Operating Rooms • Non-functional ambulances • All health Centers flooded non functional • Health workers are direct victim • Immunization services disrupted • Pre-natal check ups halted • Private clinics closed down First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

26. Report 5: 12:00 PM • 600 houses damaged, flooded buildings, • No telecommunication • Electrical brown out • Impassable roads • No water supply • Damaged vehicles and roads • Snake bites First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

27. Report 5: 12:30 PM • Closed stores and businesses • Damaged schools • Damaged crops • Snake bites First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

28. Impacts to the community • Garbage collection halted • Flood water stagnated • Human wastes everywhere • Toilets flooded and overflowed • Mud covered all streets First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

29. Evacuation Site Scenario • Damaged lifelines • Overcrowding • Poor environmental sanitation • No access to safe water • No community surveillance system • Inadequate sanitary toilets • Health workers are direct victims • Disrupted basic health services • Severe depression of the bereaved • and other health workers First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

30. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

31. Response Plan • Activation of Early Warning and Alert System • Activation of the Plan • Activation of the ICS • Activation of the Operation Center • Implementation of the RESPONSE Standard Operating Procedures/ Protocols Emergencies • Implementation of existing Standard Operating Procedures/Guidelines for systems developed • Initiation and Maintenance of Coordination and networking for referrals of cases First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

32. Response Plan h. Initiation and Maintenance of Mental Health and Psychosocial Support Services for casualties, patients, hospital staff and other responders, bereaved i Management of Information j. Activation of plan in the event of complete isolation of hospital/CHD/community for auxiliary power, water and food rationing, medication/ dressing rationing, waste and garbage disposal, staff and patient morale • Provision of the Public Health Services l. Management of the Dead First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

33. 3. Recovery and Reconstruction Plan • A plan to restore services and replace lost as well as damaged elements of the community First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

34. Recovery/Rehabilitation Plan Emergency Hospital People Property Environment Services Livelihood (Vulnerable) Risks People Property Environment Services Livelihood (Damages Needs) Hazard Disaster First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman Capacities Utilized, lost Damaged Capacities used to manage Risks Recovery/ Rehabilitation

35. Next Actions 1. Write the Planand have it approved by the head of the agency. The Plan is not a plan until written and approved by the head of agency 2. Disseminate the planto all the stakeholders and staff. Everyone needs to know the plan so that in emergency no one would ever say, “he does nothing cause he knows nothing”. • Test the plan. The plan is believed to be effective only when it is tested, be able to know its functionality, acceptability, and doability in the hands of the implementers. Update the plan • Implement the plan. 5. Monitor and evaluate the implementation of the plan 6. Review and update the plan regularly. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

36. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

37. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman

38. First National Course on Public Health Emergency Management 12 – 23 March 2011. Muscat, Oman