INTER-REGIONAL TRAINING COURSE ON PUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC PHEMAP 9 MODULE 3 HEALTH EMERGENCY MANAGEMENT CAPACITY

INTER-REGIONAL TRAINING COURSE ON

PUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC

PHEMAP 9

MODULE 3

HEALTH EMERGENCY MANAGEMENT CAPACITY

HEALTH EMERGENCY MANAGEMENT CAPACITYPHEMAP 9

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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


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Outline of the presentation:

I. Relevance of Risk Management to Health Emergency Management Capacity DevelopmentII. Elements of capacity to manage health risks of emergenciesIII. Elements of capacity for specific health service delivery functions

V. Roles of a health emergency manager in

developing health emergency management

capacity


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Challenges

Roles of HEM in DisasterRisk Mgt.

Risk Mgt. concepts

Risk mgt. services

Delivery of functions/Services:

PreparednessResponseRecovery

Health EmergencyManagementCapacity


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Risk = Hazard x Vulnerability Capacity

In managing Risk:

• Reduce Hazard• Reduce vulnerability• Increase Capacity

Relevance of Risk Management to HEM Capacity Development


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ANATOMY OF COMMUNITY RISK MANAGEMENT

hazard

communityvulnerability

readiness

multisectoral, 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


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Group Activity I

What do you understand by the term “capacity” in the context of health emergency management?


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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


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Defining Capacity

Sum of:• capability• resources• relationships

Within • community• organization• country• region• world

Aims• Reducing illness,

disability and death from risks

• Promoting health, safety and security


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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


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Disaster Risk Management Framework

Response

Preparedness Recovery

Prevention Mitigation

(Capacity utilization)

(Capacity building) (Capacity rebuilding for better)

(Capacity to Reduce/preventHazard)

(Capacity to Lessen Impact of hazard)


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ElementsOf capacityTo manageHealth risks of emergencies

OrganizationsSystemsPeople


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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


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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?


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Organizations

In the context of health emergency:

• Designated/organized body • Defined organizational structure• Clear roles and directions• United action or functions• Legal framework


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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)


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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

Gonzalo


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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

Gonzalo


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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


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ElementsOf capacityPerformFunctions

OrganizationsSystemsPeople


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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


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ANATOMY OF COMMUNITY RISK MANAGEMENT

hazard

communityvulnerability

readiness

multisectoral, 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


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EMERGENCY AND HEALTH

EMERGENCY

COMMUNITY

VULNERABILITIES CAPACITIES

DIRECT IMPACT

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

DAMAGE AND

NEEDS

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


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EPIDEMIC EMERGENCIES

OUTBREAK

Specific morbidity and mortality

- in the community

- in health facilities

- in health facilities

Risk for health and lab workers

Difficult access

Agent unknown

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

NEEDS


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Health Emergency Capacity Development Plan Matrix


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General or Cross-cutting Functions

• Risk communication

• Occupational health and safety

• Facility design

• Organization-based disaster planning

• Managing critical supplies and protecting infrastructure


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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


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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


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• 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)


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Hazard and Risk Reduction functionsPreparedness FunctionsRecovery & Response Functions

General and Cross Cutting Functions

Functions for specific services

CAPACITY

10 Elementsof

Preparedness

Service

Delivery


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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


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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


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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


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Group Activity V

In your group, address one of the following:

1. Environmental health

2. Communicable disease

3. Management of the dead and the missing

4. 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)


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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


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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


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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


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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


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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


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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


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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


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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


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Group Activity VI

In your group, discuss the role of the Health Emergency Manager in developing health emergency management capacity


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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


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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.


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THANK YOU

Documents

INTER-REGIONAL TRAINING COURSE ON PUBLIC HEALTH AND EMERGENCY MANAGEMENT IN ASIA AND THE PACIFIC PHEMAP 9 MODULE 3 HEALTH EMERGENCY MANAGEMENT CAPACITY