MODULE 3 HEALTH EMERGENCY MANAGEMENT CAPACITY

1. MODULE 3HEALTH EMERGENCY MANAGEMENT CAPACITY

2. Learning Objectives By the end of this module, the participant should be able to: • Describe the elements of capacity to manage health risks of emergencies • Identify key elements of capacity for specific health service delivery functions • Describe the role of a health emergency manager in health emergency management systems and in developing health emergency management capacity

3. Outline of the presentation: • Relevance of Risk Management to Health • Emergency Management Capacity Development • Elements of capacity to manage health risks • of emergencies • Elements of capacity for specific health service • delivery functions • Roles of a health emergency manager in developing health emergency management capacity

4. Challenges Roles of HEM in Disaster Risk Mgt. Risk Mgt. concepts Risk mgt. services Health Emergency Management Capacity Delivery of functions/Services: Preparedness Response Recovery

5. Relevance of Risk Management to HEM Capacity Development • Risk = Hazard x Vulnerability • Capacity • In managing Risk: • Reduce Hazard • Reduce vulnerability • Increase Capacity

6. 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 Prevention & Mitigation Programme Vulnerability Reduction Programme Emergency Preparedness Programme = Community Risk Management  

7. Group Activity I What do you understand by the term “capacity” in the context of health emergency management?

8. Defining Capacity • System definition of capacity • Capacity includes capability (or capacity) of the • component parts, the resources (financial, • equipment) which support the system, and the • relationships which together form the system. • Capacity is a quantitative measure • Measurement of human and material resources • i.e. number or volume or size. For example, the • capacity of the hospital is 500 beds

9. Sum of: capability resources relationships Within community organization country region world Aims Reducing illness, disability and death from risks Promoting health, safety and security Defining Capacity

10. Health Emergency Management Capacity Capacity to perform the following functions: • Reduce hazard • Reduce vulnerability • Respond to reduce and manage consequences • Recover and reconstruct to reduce and manage consequences

11. Disaster Risk Management Framework Response Preparedness Recovery Prevention Mitigation (Capacity utilization) (Capacity building) (Capacity rebuilding for better) (Capacity to Reduce/prevent Hazard) (Capacity to Lessen Impact of hazard)

12. Elements Of capacity To manage Health risks of emergencies Organizations Systems People

13. In Risk Management Module: Capacity is directly associated to health emergency preparedness • 10 elements of Health Emergency Preparedness: • Legal framework • Policies • Guidelines • Procedures • Resources • Plans • Knowledge • Attitude • Skills Organizations Systems People

14. Group Activity II What do you understand by organizations, in the context of health emergency management? Give examples. What are systems in health emergency management? Give examples. How does people contribute to organizations and systems?

15. Organizations In the context of health emergency: • Designated/organized body • Defined organizational structure • Clear roles and directions • United action or functions • Legal framework

16. Systems Definition: • a “regularly interacting or interdependent group of items forming a unified whole” (Merriam Webster Dictionary) • an orderly grouping of facts, principles, or methods in a certain field; any formulated method or plan; a manner of arrangement or procedure (The Random House Dictionary)

17. Systems to Manage Health Risks of Emergencies Systems • systems operating at each administrative level • systems in specific sectors • systems to manage specific types of risks (hazards and vulnerabilities) • systems for specific functions or services

18. Systems to Manage Health Risks of Emergencies Systems • Logistics Management • Information Management • Coordination and Networking • Surveillance System • Human Resource Development • Communication and Public Information • Mass Casualty Management

19. People People contribute to organizations and systems by providing: • skills, knowledge and attitudes • Competency People may be: • Career (or paid), volunteer and community • Managers, coordinators, operators or responders

20. Elements Of capacity Perform Functions Organizations Systems People

21. Group Activity III What are the health risks expected from the hazard assigned to your group? What are the roles and function of the ministry of health in response to the hazard?(You may identify your organization or identify the level of administration) What capacities must they have in place in order for them to perform their roles and functions

22. 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 Prevention & Mitigation Programme Vulnerability Reduction Programme Emergency Preparedness Programme = Community Risk Management  

23. EMERGENCY AND HEALTH HEALTH RESPONSE Search and rescue First Aid Triage Medical evacuation Primary care Disease surveillance and control Curative care Blood banks Laboratories Referral system Special units (burn, spinal) Evacuation centers Shelter and Water Food and nutrition Energy and Security Environmental health Primary Health Care Care of the dead Psychosocial care Disability care Recovery and Reconstruction COMMUNITY VULNERABILITIES CAPACITIES DIRECT IMPACT DAMAGE AND NEEDS EMERGENCY INDIRECT IMPACT ASSOCIATED FACTORS Climate/ weather/ time of the day Location Security situation Political environment Economic environment Socio-cultural environment Morality, solidarity, spirit Competence, corruption

24. EPIDEMIC EMERGENCIES HEALTH RESPONSE Case definition Admission criteria Case confirmation Case management Discharge criteria Contact tracing Vector control Environmental controls Surveillance system Referral system Professional education Public Information and awareness Laboratory plans Hospital plans Supplies and equipment Borders control Quarantine Animal culling Commerce/ trade Specific morbidity and mortality OUTBREAK NEEDS - in the community - in health facilities - in health facilities Risk for health and lab workers Difficult access Agent unknown

25. Health Emergency Capacity Development Plan Matrix

26. General or Cross-cutting Functions • Risk communication • Occupational health and safety • Facility design • Organization-based disaster planning • Managing critical supplies and protecting infrastructure

27. General or Cross-cutting Functions • Communication and transport • Information management • Health surveillance • Mental health • Reproductive health • Environmental health • Food safety, emergency feeding and nutrition • Water supply management • Waste management

28. Specific Emergency Response and Emergency Recovery Functions • First aid, self-aid and first-responder health assistance • Incident site management • Assessing needs • Mass-casualty management • Decontamination • Epidemiological investigation

29. Specific Emergency Response and Emergency Recovery Functions • Forensic investigation • Management of the dead and the missing/ fatality management • Shelter and temporary accommodation (including evacuation shelters) • Community support • Longer-term issues (health effects, recovery, rehabilitation, reconstruction)

30. Specific Emergency Response and Emergency Recovery Functions Hazard and Risk Reduction functions Preparedness Functions Recovery & Response Functions General and Cross Cutting Functions Functions for specific services CAPACITY 10 Elements of Preparedness Service Delivery

31. Evacuation Site Scenario • Damaged lifelines • Overcrowding • Poor environmental sanitation • No access to safe water • Inadequate sanitary toilets • Health workers are direct victims • Disrupted basic health services

32. Group Activity IV As Health Emergency Manager, what could be the priority service that you could deliver to reduce the possible secondary health risks in the evacuation site? Name just one. What capacities must you have to be able to deliver such health services to manage the risk? • People • Organization • System

33. Evacuation Site Scenario: Typhoon • Poor environmental sanitation • No access to safe water • Inadequate sanitary toilets • No community surveillance system • Disrupted basic health services • Foul smell of decomposing bodies • Severe depression of the bereaved • and other health workers

34. Group Activity V In your group, address one of the following: • Environmental health • Communicable disease • Management of the dead and the missing • Mental health and psychosocial support Assess the risk and identify capacity needed in terms of organization, systems and people. Write your answers on a flip chart for presentation. (20 minutes)

35. Health Emergency Capacity Development Plan Matrix

36. Environmental Health in Evacuation Center Environmental health risks are assessed, including: • Water supply services • Waste handling and disposal • Food safety • Garbage disposal Local Capacity ( laboratory services, sampling, diagnosis and analysis; equipment etc.) Inventory of organizations with environmental health roles and responsibilities (laboratories, surveillance, chemical industries, water supply services, waste disposal services, fire service, etc.) Availability of supplies, reagents, medicines

37. Environmental Health in Evacuation Center Environmental health risks: • Food and water borne diseases Environmental Capacity • Environmental assessment, surveillance • Environmental teams • Environmental logistics including systems of distribution • Laboratories and other confirmation devices • Reporting, monitoring, evaluation

38. Communicable Disease Communicable health risks are assessed including: • Diseases of Epidemic Potential • Vaccine Preventable Diseases • Vector Born Diseases • Diseases of Public Health Significance Considerations: • Health status • Local capacity, program implementation • Inventory of Organizations • Availability of health services, facilities • Availability of drugs, medicines, supplies, vaccines

39. Communicable Disease Communicable health risks: • Epidemic and Outbreak Communicable Disease Capacity • Surveillance System in place in evacuation centers • Surveillance teams available • Case definition etc.. • Epidemiological investigation • logistics including systems of distribution • Laboratories and other confirmation devices • Reporting, monitoring, evaluation • Networking and referral system

40. Management of the Dead and Missing MDM Issues: • Identification of the Dead • Cultural Considerations • Final Disposal of the Dead • Management of the Relatives Considerations: • Legal framework, functioning coordination mechanisms and organizational structure in place for health emergency preparedness and response • Local capacity • Inventory of Organizations • Mortuary System

41. Management of the Dead and Missing MDM health risks? • Myths and realities about dead bodies • Mass burial MDM Capacity • Organizational/Institutional Arrangements; roles and responsibilities; management structures • Procedures (identification, keeping of records,fingerprinting, dental records, DNA and photographing) • Provisions for notification of relatives (next of kin) • Logistics • Reporting, monitoring, evaluation • Networking and referral system

42. Mental Health and Psychosocial Support Psychosocial health risk assessment: • Coverage • Silent victims, Family displacement • Medical Responders/Leaders • Early identification and referral Considerations: • Local capacity for emergency provision of essential services and supplies • Inventory of organizations, health facilities, • Availability of drugs, medicines, supplies, • Availability of training modules and trainers

43. Mental Health and Psychosocial Support Psychosocial health risks: • Long lasting; affects rehabilitation and recovery (children, responders, etc.) Psychosocial Capacity • Policies and Plan • Training modules, pool of trainers ; range of services • Advocacy and awareness through education, information management and communication • Health facilities, drugs and medicines • Reporting, monitoring, evaluation • Networking and referral system;Inter and Intra sectoral coordination • Local capacity for emergency provision of essential services and supplies

44. Group Activity VI In your group, discuss the role of the Health Emergency Manager in developing health emergency management capacity

45. Role of the Health Emergency Manager • Determine the risk and plan to manage it • Identify the capacity needed in terms of Organization, Systems and People • Determine strategies to reach the goals set • Determine resource requirements (Compare from what is available to what is required and what is the gap) • Look for resources, identify partners, co share • Determine a point person, time frame and indicators • Monitor and evaluate

46. Health Emergency Capacity Development Plan Matrix

47. Learning Objectives By the end of this module, the participant should be able to: • Describe the elements of capacity to manage health risks of emergencies • Identify key elements of capacity for specific health service delivery functions • Describe the role of a health emergency manager in health emergency management systems and in developing health emergency management capacity.

48. THANK YOU