Planning for Health Emergency Management

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

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

Hyogo Framework for Action Building the resilience of Nations and Communities to Disasters

Five Priority Actions:

1. Make Disaster Risk Reduction a priority – ensure that DRR is a national and a local priority with strong institutional basis for implementation

2. 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

Hyogo Framework for Action

Five Priority Actions:

3. Build understanding and awareness – use knowledge, innovation and education to build a culture of safety and resilience at all levels

4. Reduce risks – reduce the underlying risk factors

5. 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

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

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

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

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

Form Planning Group

Hazard Analysis

Develop Strategies andSystems

Describe ManagementStructure

Describe Roles andResponsibilities

Emergency Planning Process

Define the plan

Analyze resources

“Hospital Emergency Preparedness, Response and Recovery Plan Development ‘08”

Vulnerability Analysis

Risk Analysis

Problems/Gaps Analysis

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

Emergency Preparedness, Response and Recovery Plan

1. 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

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

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

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

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

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

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

Hazard Vulnerabilities Risks Services CapacitiesOrganization System People

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

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

Hazard Vulnerabilities Risks Services CapacitiesOrganization System People

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

ANATOMY OF COMMUNITY RISK MANAGEMENT

hazard

communityvulnerability

readinessmultisectoral, all hazards

Community risk

indicators: indicators:indicators:indicators:probabilityscale/magnitude/ strength/intensityspreadduration

biological hazards: season, infectivity, latency, transmission resistance, etc.natural phenomenafaminediseases of epidemic potentialevents/crowdsintoxificationinfestationstransport accidentsstructural failuresindustrial accidentschemical accidentspollutionrefugeeswarterrorism

Prevention & MitigationProgramme

=

=

People:access to health

caremeasles

vaccinationunder 5 nutritionunder 5 mortality

access to clean water

access to sanitation

adequate housingemployment/

incomefemale literacy

Property:health

infrastructurevehicles

medical supplies

Services:curative care

servicesambulance

servicespublic health

serviceshealth info system

Environment:water/soil/air

quality

Vulnerability Reduction Programme

policy, plans, proceduresknowledge, skills, attitudesresources

legislationnational & sectoral policyadministrative proceduresresponse & recovery planspreparedness planstechnical guidelinesmanagement structureinstitutional managementsinformation systemswarning systemshuman resourcesmaterial resourcesfinancial resourcessimulations & trainingeducationpublic informationcommunity participationresearchpublications

Emergency PreparednessProgramme

risk of:death

injury (mental/ physical)

disease (mental/physical)

loss of lifedisplacement

loss of propertyloss of income

secondary hazardsbreakdown in

securitydamage to

infrastructurebreakdown in

servicesContamination

Community Risk Management

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

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

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

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

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

• Category 5 tropical typhoon ( > 250 kph winds) struck Country X• associated with heavy rainfall

Report 2 (9: 00 AM)

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

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

• 20 injured needing surgery • 20 deaths; • 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

Report 4: at 11:30 AM

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

• two hospitals flooded till 2nd floor,• 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

Report 4: at 11:30 AM

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

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

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

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

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

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

Response Plana. Activation of Early Warning and Alert System

b. Activation of the Plan

c. Activation of the ICS

d. Activation of the Operation Center

e. Implementation of the RESPONSE Standard Operating Procedures/ Protocols Emergencies

f. Implementation of existing Standard Operating Procedures/Guidelines for systems developed

g. Initiation and Maintenance of Coordination andnetworking for referrals of cases

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

Response Planh. 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

k. Provision of the Public Health Servicesl. Management of the Dead

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

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

Recovery/Rehabilitation Plan

HospitalPeoplePropertyEnvironmentServicesLivelihood(Vulnerable)

Hazard RisksPeoplePropertyEnvironmentServicesLivelihood(Damages Needs)

Recovery/Rehabilitation

EmergencyDisaster

Capacities used to manage Risks

Capacities Utilized, lost

Damaged

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

Next Actions1. Write the Plan and 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 plan to 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”.

3. 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

4. Implement the plan. 5. Monitor and evaluate the implementation of the plan6. Review and update the plan regularly.

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

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

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