Disasters and Health: Understanding the International Context

1. Disasters and Health:Understanding the International Context John Scott  Patricia Bittner Center for Public Service Communications “Empowering competent enthusiastic people to do good things”

2. Good Afternoon! • Agenda for the next two days • Using the ‘chat’ function • Background material and references in the Moodle classroom at: http://mla.mrooms.org/course/view.php?id=48 This project is funded by a contract with the Disaster Information Management Research Center, Specialized Information Services Division, National Library of Medicine.

3. Moodle Site for this Course

4. Objectives • Increase awareness of disaster risk reduction (DRR) and disaster risk management (DRM) practices in ‘international’ (a.k.a. ‘other national’ and ‘multinational’) disasters and public health crises. • Increase awareness of the breadth of the field and the variety of ‘constituents’ you may have.

5. Our Assumptions about the Participants • You are a librarian or an information professional • You are part of an academic health center, private/not-for-profit hospital/medical facility, local or state government health department, NGO, etc. • Your constituents may be administrators, public health or medical professionals, academics or the public.

6. Day 1 6 September 2012

7. What’s the Most Common Typeof Disaster? • There is more than one correct answer…

8. The difference between a disasterand an emergency…

9. The Ability to Respond Makesthe Difference EMERGENCY DISASTER The crisis exceeds the local capacity to respond Local resources are sufficient to manage the crisis

10. Importance of Defining Terms

11. ReliefWeb Glossary of Humanitarian Terms • Find these publications in the Moodle classroom under General Information.

12. Some Definitions

13. An overly simplistic history of tipping points in ‘disaster management’ 1 • “The Old Days” (c. 1970): National Security/Emergency Preparedness -- focus on preparedness for nuclear events and “big ones”; earthquakes and hurricanes • 1984: Chemical explosion in Bhopal, India • 1986: Chernobyl nuclear accident in Ukraine and the US 1979 Three Mile Island • 1990 - 2000: International Decade for Natural Disaster Reduction (IDNDR)   • 1990: AT&T long distance network crash in the U.S

14. An overly simplistic history of tipping points in ‘disaster management’ 2 • 1991: Break up of the Soviet Union • 1992 United Nations Conference on Environment & Development (“Rio”) • 1993: Somalia (and former Yugoslavia, Rwanda in similar timeframe) • 2001: “9/11” • c. 2005 Avian Influenza (Bird Flu)

15. Other Types of Health Emergencies? PHEIC: Public Health Emergency of International Concern http://www.who.int/whr/2007/media_centre/07_chap5_fig01_en.pdf Immediate global action is needed to provide a public health response to prevent or control the international spread of disease.

16. Common Problemsin Most Disasters 1 • Water supply and sanitation • Communicable diseases • Mental health

17. Common Problemsin Most Disasters 2 • Damage to health infrastructure • Food and nutrition • Population displacement to water and sewage systems

18. Moodle Site for this Course

19. Health Impact ofSelected Natural Hazards

20. Who’s Who inEmergencies and Disasters U.N. Agencies • World Health Organization (WHO)www.who.int • Pan American Health Org. (PAHO)www.paho.org/disasters • World Meteorological Org. (WMO)www.wmo.org • Office for the Coordination of Humanitarian Affairs (OCHA)www.unocha.org • U.N. Development Program (UNDP)www.undp.org • UN Children’s Program (UNICEF)www.unicef.org/ • World Food Program (WFP)www.wfp.org/ • UN High Commissioner for Refugeeswww.unhcr.org • UN Environment Program (UNEP)www.unep.org • Int’l Telecommunications Union (ITU)www.itu.org

21. World Health Organization

22. Pan American Health Organization

23. Example: Tropical Storm Isaac

24. UNDP

25. Other International Partners • IFRC www.ifrc.org • ICRC www.icrc.org • IOM www.iom.int • MSF www.msf.org • Handicap International www.handicap-international.us • OFDA (U.S.) • CIDA (Canada) • SIDA (Sweden) • EU-ECHO • Japan • World Bank • Regional Banks • Foundations

26. IFRC

27. More on Who’s Doing Whatin Disasters

28. Interaction 1

29. Interaction 2

30. Interaction 3

31. Follow these Agencies on Social Media • NLM DIMRC: http://twitter.com/NLM_DIMRC • USAID - http://twitter.com/theOFDA • PAHO Disasters: http://twitter.com/PAHOdisasters • WHO/PAHO EOC: http://twitter.com/pahoeoc • ReliefWeb: http://twitter.com/reliefweb • USGS: http://twitter.com/usgs • NOAA: http://twitter.com/NOAA • Natural Hazards Center – http://twitter.com/HazCenter • CDC Emergency: http://www.facebook.com/cdcemergency • IFRC: http://www.facebook.com/pages/IFRC-IDRL-Programme/197688860525 • PAHO Disasters: http://www.facebook.com/PAHOdisasters • UNOCHA: http://www.facebook.com/UNOCHA • Doctors without Borders: http://www.facebook.com/msf.english

32. Good Sources of General Information • Natural Disasters: Protecting the Public’s Health. Pan American Health Organization. http://paho.org/disasters/ • NLM Resource Guide for Disaster Medicine and Public Health http://disasterlit.nlm.nih.gov/ • Health, Disasters and Risk. UNInternational Strategy for Disaster Reduction. http://www.unisdr.org/we/inform/publications/3816 • Technical Guidance. World Health Organization http://www.who.int/hac/techguidance/en/index.html • Prehospital and Disaster Medicine (Journal of the World Association of Disaster Medicine) http://pdm.medicine.wisc.edu/ • Health and Safety Concerns for all Disasters. Centers for Disease Control and Prevention. http://emergency.cdc.gov/disasters/alldisasters.asp • Disaster Risk Reduction and Response at the International Level: Global Trends in a Changing Environment

33. 2004 Southeast Asia TsunamiA “Tipping Point” • The earthquake that triggered the Indian Ocean tsunamis on 24 December 2004 was the world's largest natural disaster in 40 years. • It led to destructive tsunamis that left approximately 227,000 people dead, missing and assumed dead. • Fourteen countries were affected, with Indonesia, Sri Lanka, India and Thailand the hardest hit in terms of loss of life.

34. Members of the Tsunami Evaluation Coalition UN Agencies FAO OCHA UNDP UNFPA UNICEF WFP WHO Donors AusAid (Australia) BMZ (Germany) CIDA (Canada) Danida (Denmark) DfA (Ireland) DfiD (UK) IOB/MFA (Net‘lands) JICA & MoFA (Japan) MFA (France) MFA (Luxembourg) NORAD (Norway) NZAid (New Zealand) SDC (Switzerland) SIDA (Sweden) USAID (United States) NGOs and RC ActionAid Int’l AIDMI (India) CAFOD CARE Int’l UK Cordaid IFRC Oxfam GB RedR Save the Children (UK) Tearfund UK World Vision Int’l World Vision Canada Research Networks ALNAP DARA Int’l Feinstein Int’l Famine Center Groupe URD HPG/ODI ICMH (Migration & Health)

35. TEC Findings • Poor coordination due to: • Proliferation of agencies (all types) • Funding fueled competition • Lack of NGO field representation mechanisms • Poor coordination skills • Aid was supply-driven, resulting in inappropriate aid in some cases.

36. OneResponse: Cluster ApproachA Paradigm Shift The Cluster Approach aims to strengthen overall response capacity and effectiveness of the response http://oneresponse.info/GlobalClusters/health/Pages/default.aspx • Ensure sufficient global capacities maintained in all main sectors/areas. • Ensure predictable leadership based on agreed standards and guidelines (Cluster leads also act as the “provider of last resort”). • The concept of partnerships/clusters (avoiding situations were governments have to deal with hundreds of uncoordinated international actors). • Strengthens accountability (IASC Generic Terms of Reference for Sector/Cluster Leads at the Country Level). • Improve strategic field-level coordination.

37. Health Cluster Functions at the Country Level • Formulating strategies and plans in collaboration with Ministry of Health and UN agencies • Monitoring health trends, activities and outcomes • Joint decisions and follow-up • Collation, preparation and dissemination of health information • Resource mapping (Who, What, Where) • Response to needs / gaps • Advocacy and resource mobilization • Inter-cluster linkages

38. Cluster System in Haiti • Agriculture • Camp Coordination/Management • Early Recovery • Education • Emergency Telecommunications • Food • Health • Health Cluster Surveys • Logistics • Nutrition • Protection • Shelter and Non-food Items • Water and Sanitation

39. Health Cluster in Haiti PAHO/WHO led the Health Cluster in Haiti, which consisted of the following sub-clusters: • Mobile Clinics • Hospitals • Disability and Rehabilitation • Health Information Management • Disease Surveillance • Reproductive Health • Mental Health and Psychosocial Support

40. Main challenges related to Information in Haiti • Pressure to provide accurate/transparent information • The “We don’t have time to read” syndrome • Information gaps — often filled by unvalidated sources • Lack of searchable information • ‘Players’ searching for visibility • Poor or insufficient information, rumors • Poor ‘institutional sharing’ of information

41. Information Specialists in Disasters: What was Needed in Haiti • Abilitytoknowwhatinformationismostneeded and relevant at any time and in dynamicenvironments • Abilitytounderstand, process and presentinformation in a pertinentwayfordecisionmaking • Excellentcommunication and writingskills • Abilitytomakedecissionsonbesttoolsfor IM • Ableto be on-call 24/7 • Use of Web 2.0 and “social media”technologies

42. In the words of the experts… 1 • Process of setting up systems—even relatively simple ones like the ‘WWW’ (who does what, where, when?)—is cumbersome. • Information management is central to managing the Health Cluster. WHO information manager is part of core team that is deployed. • It is very difficult to sift through and analyze the large volume of reports and updates -- especially in the first week of an emergency. • There are very few systematic repositories of disaster information and even with such systems in place populating them is difficult. Dr. RodericoOfrin, WHO Regional Office for Southeast Asia Member of the tsunami health response team.

43. In the words of the experts… 2 • The challenge was collecting two types of information: information for the ‘outside world,’ such as donors and agencies, and information for purely operational purposes. • Social media was used in Haiti during the first days of the emergency, but was very limited, as phone and Internet service was spotty. It also may have contributed to the spread of rumors that later needed to be verified. • The use of social media in response has not been well exploited or optimized – experiences from Haiti was the last in-depth study on this. Dr. Dana Van Alphen, PAHO/WHO Health Cluster Lead Earthquake in Haiti

44. Scenario Consider a major disaster such as the earthquake or cholera outbreak in Haiti or the Fukushima nuclear power plant accident in Japan, resulting from the earthquake/tsunami(or choose another disaster that claimed international attention). Try to anticipate what type of information your constituents may be looking for. Why might they be asking for this information? From your experience, or using your imagination, consider the supportive role you and your library might play in providing information about these events (you might choose to focus on response, recovery or preparedness). Research trusted sources identify some practical advice or guidance that you can give to one or more of your constituents.

45. Exercise Some information sources Homework for Day 2 Give some examples of information you have found, what sites you have used and why this might be useful to your constituents. (This can be on any aspect of the disaster). • Email your completed exercise to mlapd3@mlahq.org • In the email subject line, please add the following: [your last name]_INT_Homework • (e.g.,) Smith_INT_Homework Use the Moodle classroom:http://mla.mrooms.org/course/view.php?id=48 Health Cluster (Haiti) http://www.hai.clustersante@paho.org Pan American Health Organization. Health Response to the Earthquake in Haiti. http://www.paho.org/disasters WHO/Western Pacific Regional Office http://www.euro.who.int/en/what-we-do/health-topics/emergencies/disaster-preparedness-and-response/publications (search on Fukushima) NOAA http://www.tsunami.noaa.gov/index.html International Atomic Energy Agency http://www.iaea.org ReliefWebhttp://reliefweb.int/ Interaction http://www.interaction.org/