Dr. Qudsia HudaWHO EMRO

.1Risk Management

Risk assessmentRisk reduction planningRisk CommunicationPolicy developmentCapacity developmentPrioritizing

.2Operations Management

Needs assessmentHealth surveillanceOperational ResearchCapacity developmentPrioritizing

3 .Early Warning and Alerting System4 .Training Needs Analysis and

development5 .Monitoring and Evaluation6 .Response Coordination

`Mass casualty management Logistics and supplies Prioritization of Need

Info. Needs Analysis Tools Development Reporting Flow Design Data Quality Assurance

Data Storage Data Retrieval Data Analysis Info. Dissemination

Health Service Planning Resource Allocation Monitoring & Eval. Policy Formulation

COLLECTION SHARING UTILIZATION

Figure 1 – Information Management Processes

Information Dissemination

To whom? In what form? How frequently? Public information; filtering/sifting

information for release to general public

Feedback mechanism Update

Collection objectives- identify managerial, coordination

and organisational gaps, overlaps and problems

-identify gaps and problems in meeting urgent medical needs

-identify existing and potential public health needs

-assess environmental risk factors-assess resource and logistics needs

Analysis objectives - set priorities for response / relief -set priorities for information dissemination

and communication -identify resources needed to meet priorities –

external and internal -identify additional information needs for the

response and for planning recovery and reconstruction

Office of the WHO Representative in the Philippines

The assessment involves the collection of three key categories of information:

Analysis of the damage to:critical resourcescritical infrastructure and fixturescritical services

Analysis of the needs of the response agenciesimmediate needs arising from the situationfuture needs arising from damage/disruption to

services/infrastructureAnalysis of the needs of the victims

immediate needs arising from the situationfuture needs arising from damage/disruption to

services/infrastructure

Office of the WHO Representative in the Philippines

Health Needs in an EmergencyStage Time-frame General Needs Health Sector Responsibilities

Immediate first 24 hours search and rescue first aid

evacuation / shelter triage

food primary medical care

water transport/ambulances

public information system acute medical and surgical care

emergency communication, logistics and reporting systems (including injury and disability registers)

Short-term end of security emergency epidemiological surveillance for VBD, VPD, DEP

first week energy (fuel, heating, light etc.) control of diseases of public health significance

environmental health services for: control of acute intestinal and respiratory diseases

* vector control care of the dead

* personal hygiene general curative services

* sanitation, waste disposal etc. nutritional surveillance and support (including micronutrient supplementation)

(measles vaccination and Vitamin A)

Medium termend of protection (legal and physical) (re) establishment of the health information system

first month employment restoration of preventative health care services such as EPI, MCH, etc.

public transport restoration of priority disease control programmes such as TB, malaria etc.

public communications restoration for services of non-communicable diseases/obstetrics

psychosocial services care of the disabled

Long term end of education reconstruction and rehabilitation

3 months agriculture specific training programmes

environmental protection health information campaigns/health education programmes

disability and psychosocial care

Conclusion compensation/reconstruction evaluation of lessons learned

restitution/rehabilitation revision of policies, guidelines, procedures and plans

prevention and preparedness upgrade knowledge and skills, change attitudes

The first task is to assess function of all the health facilities in the area

(hospitals, clinics, laboratories, warehouses, blood banks,

administration):.aStaff – dead, injured, missing, absent.bAccess – can staff/people reach the facility.cBuildings – damages, safety, loss of

electricity/ gas/water, loss of fuel (diesel).dSupplies and equipment damaged or lost,

including vehicles

The next task is to assess needs arising from loss of function:

.aTemporary services needed?

.bRepairs needed?

.cReplacements needed (staff and materials)?

The next task is to assess urgent medical needs of the population:

Overview of actual and potential causes of morbidity and mortality,

and numbers of cases

The final report will make recommendations on: Resource

needs, Management and Organisational needs and Logistics

and Communication needs

It is not necessary to go to the field to collect detailed information from other

sectorsAt the daily coordination meetings,

reports and assessments from other sectors are shared – these can be sent

as ANNEXES to health sector reportsThe Emergency Reporting System

should take over from assessments as soon as possible

Set the assessment objectives, team skill needs and time frame

Collect the data:reviewing existing informationinspecting the affected areainterviewing key peoplecarrying out a rapid survey

Analyse and interpret the findings

Issue orders and instructions

Disseminate the report and communicate the findings

What information should I collect before going to the field?

What collection methods are appropriate given:

the specific context of the emergency, andweather, security, time, logistics, technical,

cultural constraints?What will the main sources of

information? Is an interpreter needed?

What is the composition of the team and the role of each team member?

What are the security, logistics and communication needs of the team?

What equipment to take – maps, contact information, forms, specimen bottles,

paper/pens, personal items

any existing national, provincial or district emergency profiles

local risk assessments

local capacity assessments

inventory of resources and deficits

maps

directory of local staff and experts (government and NGO)

lists of emergency materials and supplies

logistics arrangements for emergencies

standing orders and administrative guidelines

No policy or guidelines on assessmentNo standard collection formatsNo training in assessment skillsDifferent sectors use different terms and

methodsData cannot be consolidatedToo much irrelevant or duplicate data

collectedToo much time taken – accurate is better

than preciseThose collecting the data don’t know how it

will be used and don’t have opportunity to improve the assessment system

80% of what we do in emergencies is generic – we do it for every

emergency – the all hazards approachNo need to wait for field information to do

this15% is specific to the hazard

Much can be done before field data is available but an assessment is needed to

provide the quantitative data5% is unique to the event – the

people, the place and the timeThe assessment will provide all of this data

Disaster Management is:80% generic 15% specific 5% uniqueto all disasters to the hazard to the event

1. Organisation

EOC earthquake timecoordination large numbers of trapped and injured placecommunications large numbers of homeless and displaced weathertransport large numbers of dead and missing

logistics and supplies geographyinformation and media dead, injured and missing staff climatereporting and surveillance damaged critical infrastruture/resources (hospitals, vehicles)

loss of water, gas, electricity, phone, transport, fuel networks security2. Response loss of road, sea, air, rail infrastructutre / access

search and rescue politicsevacuation long period of SAR, victim extraction economymass casualty management high demand for FA, stretchers, triage, medical transport governancemanagement of dead and missing high demand for beds, surgery, blood products, referral

security wound infections, amputations, tetanus, dust inhalation emergency management capacitytemporary shelter, clothing and utensils high demand for orthotics, prosthetics, disability, dental logistics capacityemergency water, sanitation and energy demand for specialised spinal and head injury care disposal of inappropriate donationsemergency food supplies high demand for temporary shelter, food, utensils, stoves,

emergency public and environmental health water, energy, clothing, tents, blankets leadershipemergency engineering and public works high demand for psychosocial support of victims and staff solidaritymanagement of donated supplies/foreign teams morale

3. Recovery few outbreaks of communicable diseases corruptionvariable demand for medicines and equipment crime

curative and public health care (acute/chronic injury care - high, infectious disease - low, lootingeducation potentially unstable chronic disease - medium)

agriculture compensation claimstrade and commerce contamination of water, air and soil insurance claims

toxic chemical, sewerage and gas leaks/spills

4. Rehabilitation and Reconstruction urban fires, explosions ownership disputespeople contaminated, infested and unsafe foods property disputesproperty increased vector breeding

serviceslivelihoods loss of livelihoods, markets, distribution networks

environment

THIS IS WHAT WE PLAN FOR ….

prepared for the people who need to use the information (managers, decision makers)

controls what kind of information is collectedstandardised protocols for data collectionstandardised terminology, technologies, methods

and proceduresenforces “Zero” reporting

facilitates preparation of consolidated reportsfacilitates rapid analysis and dissemination

prepared by the people who need the information

those collecting the information have no input into design

controls what kind of information is collectednon standard information cannot be included

standardises the terms usedqualitative information might not be

captured

National committee

Overall commander

Zone commander

Site commander

Team leaders

The Command Structure

A DCB

Reporting

Office of the WHO Representative in the Philippines

Thank Thank youyou

Thank Thank youyou