NATIONAL SIMULATION REPORT 2014

LUBULINI AND TIKHUBA INKHUNDLA

Coordinated by the National Disaster Management Agency (NDMA)

Deputy Prime Ministers’ Office (DPMO)

Technical and Financial support from UNDP in collaboration with JICA

KINGDOM OF SWAZILAND

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Table of Contents

Acknowledgements ................................................................................................................................... iii

1.0 Introduction ........................................................................................................................................... 1

2.0 Justification/rationale ........................................................................................................................... 2

3.0 Purpose ................................................................................................................................................. 3

4.0 Objectives ............................................................................................................................................. 3

5.0 Stakeholders Responsibilities ............................................................................................................ 3

7.0 Pretesting of the practical exercise ................................................................................................... 4

8.0 Hazard Scenarios ................................................................................................................................ 4

8.1 Malaria ............................................................................................................................................ 5

8.2 Cholera ............................................................................................................................................ 6

8.3 Floods .............................................................................................................................................. 7

8.4 Storms and Fires .............................................................................................................................. 8

8.5 Road traffic accident ....................................................................................................................... 9

9.0 Lessons Learnt Event ....................................................................................................................... 10

10.0 Conclusion ........................................................................................................................................ 12

11. Recommendations ............................................................................................................................. 13

Annex 1: National DRR Stakeholders ................................................................................................... 14

Annex 2: Simulation Flyer ....................................................................................................................... 14

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Acknowledgements

The Office of the Deputy Prime Minister would like to acknowledge the effort of all

stakeholders whose inputs resulted to the production of the National Simulation Report

for Disaster Preparedness and Response. Special thanks go to the Core Technical

Task team comprised of Joseph Mutsigwa, Technical Advisor UNDP-DRM Project;

Leonard Dlamini, HEA Officer-WVS; Victor Mahlalela, DRM Manager-NDMA; Cebsile

Kunene-Dlomo, DRM Manager-NDMA; and MoH-EPR team: Brian Cindzi, Xolisiwe

Dlamini and Khanyakwezwe Gama who coordinated the simulation exercise including

the preparation of this report.

We are grateful to the Japanese Government and the United Nations Development

Programme who provided technical and financial assistance to the DRM Project under

which this activity was carried out.

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1.0 Introduction

Swaziland, like the rest of the world is not immune to the impact of natural and man-

made disasters. The United Nations Environment Programme (UNEP) lists notable

hydrological related disasters in recent years as incessant lightning during rainy

seasons, cyclone Domonia in 1984, drought in 1991 to 1996 and 2001 to 2005, and

torrential rains and floods in 2000. Hailstorms and strong winds are also common

hazards which tend to destroy crops and property such as houses, telephone lines and

motor vehicles. Food insecurity is very high in Swaziland due to persistent drought, HIV

and AIDS and poverty. The lowveld and lower middleveld regions of the country which

typically experience low rainfall even in normal rainy seasons are at high risk of drought.

Over the past decade Swaziland has experienced an increase in the occurrence of

natural hazards such as storms, incessant rains, flash floods, drought, extreme

temperatures, wildfire, disease outbreaks resulting in significant damage to ecosystems,

threats to agriculture production and food security. These hazards have become more

frequent and intense in recent years.

The country should be capacitated to better prepare, respond and mitigate the adverse

effects of natural and man-made hazards. Several national contingency plans (CPs)

were developed with variable levels of success with regards to their implementation.

The National Multi Hazard Contingency Plan (MHCP) was developed given the

multiplicity, magnitude and frequency of occurrence of natural hazards in the country.

It is vital that such plans when developed are simulated/ tested in order to better

prepare emergency responders during real hazard events. It is against this background

that the national simulation exercise was conducted at Lubulini and Tikhuba Inkhundla.

Both tinkhundla fall under the Lubombo region which is among the country’s most

vulnerable rural regions after the Shiselweni region.

In the past three years simulation exercises were conducted in other regions of the

country. However, these simulation exercises were prepared and conducted

impromptuly without a systematic and coherent plan for stakeholder and resource

mobilisation strategy. This year’s exercise was conducted in the context of the National

Simulation Plan 2014-2018.

The Deputy Prime Minister’s Office (DPMO) through the National Disaster Management

Agency (NDMA) in collaboration with Disaster Risk Reduction (DRR) National

Stakeholders drawn from Government, the United Nations (UN) System and non-

governmental organizations (NGOs) organised the simulation. A Technical Task Team

comprised of stakeholders from the NDMA, United Nations Development Programme

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(UNDP), World Vision Swaziland (WVS), and Ministry of Health- Emergency

Preparedness and Response (MoH-EPR) coordinated the entire exercise. Financial

support was provided by UNDP in collaboration with the Japanese International

Cooperation Agency (JICA), WVS and MoH-EPR. The inkhundla leadership and

communities played a critical part in role-playing the simulation scripts. The hazard

scenarios that were simulated in this year’s simulation are: (1) Fires and Storms; (2)

Floods; (3) Cholera; (4) Malaria and (5) Road Traffic Accidents.

The simulation exercise was conducted in four communities within Lubulini Inkhundla at

Mcathuvane, Lusabeni, Bekezela, and Lubulini from the 5th to the 08th May 2014 and at

Tikhuba Inkhundla on the 9th May 2014. A series of participatory and consultative

meetings involving stakeholders and communities were held prior to the actual

simulation exercise.

At Tikhuba Inkhundla his excellence, the Deputy Prime Minister, honourable Paul

Dlamini handed over houses built for survivors of storm hazards that hit the country

between November 2013 and January 2014. Following the simulation exercise, a

lessons leant workshop involving all DRR national stakeholders including Lubulini

Inkhundla leadership held at Riverside Hotel on the 5th June 2014. The purpose of the

workshop was to reflect and draw lessons that will inform future simulations.

2.0 Justification/rationale

Communities are the first to suffer and first real-time responders in any disaster

situation. It is communities that constitute “disaster fronts”. Being at the forefront,

communities need to have capacity to respond to threats themselves. It is for this

reason that communities should be involved in managing the risks that may threaten

their well-being. Community is the ultimate target of any disaster preparedness and

mitigation plans. The emphasis of disaster management efforts should focus on

communities and the people who live in them. Unless the disaster management efforts

are sustainable at individual and community level, it is difficult to reduce the losses and

scale of the tragedy. It is against this background that the simulation exercise was held

at Lubulini and Tikhuba Inkhundla with the aim to raise awareness on natural hazards

and DRR/EPR national service providers/stakeholders who the communities can access

for service provision. There are a number of stakeholders who respond to natural

disasters when they occur. Therefore there is a need to harmonize and coordinate the

stakeholders with the aim to promote better preparation and coordination before, during

and after real disaster events.

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3.0 Purpose

The purpose of the national simulation exercise was to assist the country and target

communities to better prepare, respond and mitigate the effect of natural hazards and

disasters when they occur. The exercise was also meant to test stakeholder

coordination in the context of the Multi Hazard Contingency Plan (MHCP); a national

framework for emergency/ disaster preparedness and response.

4.0 Objectives

The objectives of the simulation exercise were to:

a. Strengthen capacity of the NDMA to coordinate Inter Cluster Disaster Preparedness

and Response.

b. Strengthen capacity of the cluster lead agencies to coordinate the development of

cluster disaster/emergency preparedness and response plans including their

implementation.

c. Strengthen capacity of emergency service providers in emergency preparedness

and response to natural and man-made hazards.

d. Build capacity of first responders to better prepare and respond to disasters/

emergencies.

e. Sensitize communities about disaster preparedness and response service providers

and their respective roles and responsibilities.

f. Create awareness on disasters to communities and their role in prevention and

response measures during disasters.

g. Facilitate lessons learnt workshop/s including publication of lessons learnt results

from simulations.

5.0 Stakeholders Responsibilities

All stakeholders were expected to bring relevant equipment that they need when

preparing and responding to a disasters/emergencies.

Personnel attending the incidents were to be relevant, adequate in numbers and

have the necessary required skills and knowledge.

Discipline in form of cooperation, adhering to stated rules and maintaining order in

terms of the nature of that disaster/emergency.

Train community members on the different roles they are to play in each

scenario/script.

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6.0 NDMA Role

Lead, coordinate and manage all national disaster management programmes

Ensure effective coordination of all stakeholders in their different functions in

disaster management i.e. in preparedness, response, mitigation and recovery

Promote and facilitate the inclusion and participation of all key players in DRR

programmes

Support logistics functions in preparedness and response

7.0 Pretesting of the practical exercise

The pretesting of the simulation scenarios was conducted per each script a day before

the actual simulation event including a preparatory session that was held on the 2nd of

May 2014. On this day, members from the participating communities took part in the

pretest of the scenarios/scripts to be simulated. About 150 people including the

community members and the stakeholders involved in disaster management

participated in the rehearsals.

8.0 Hazard Scenarios

As earlier stated, the simulation exercise was conducted at Lubulini Inkhundla involving

all the constituent’s seven communities at four venues and one event at Tikhuba

Inkhundla. In overall, each community had about 300 to 500 people from the local area.

At Tikhuba close to 1000 people from Tikhuba community including government,

regional administration and UN dignitaries participated in the simulation event. The

simulation had four episodes that were role played by both the stakeholders and the

communities. In some episodes like road traffic accident and drowning, school children

were also included as they are the most vulnerable in these hazards.

The first episode was Malaria, followed by Cholera, Floods (drowning), Storms and fires

(including live electricity cables) and road traffic accident (RTA). These episodes were

played in succession. In every episode, stakeholders were then narrating what was

happening in that scenario and the different roles of stakeholders to mitigate the effect

of the hazard at hand. On what to do before, during and after hazard and disaster

events were disseminated including hotline telephone numbers for alerting emergency

service providers.

Community members were also given a chance to interact with different stakeholders by

asking questions and giving feedback and comments to make them more prepared for

disasters. Each stakeholder mentioned above had brought with them necessary

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equipment’s and personnel that they usually need when responding to disasters. The

following section presents summaries of the hazard scenarios that were simulated.

8.1 Malaria

It is the summer season, the country has received a lot of rains – dams are full. Mr.

Matse, from Lubulini area, is off from work for the weekend. He works on the

construction of a water canal in the community. On Saturday, his wife notices that he

vomits the meals prepared for him. He complains of painful joints, backache, fever,

chills, and a severe frontal headache. His wife, who is 2 months pregnant, quickly

suggests that they visit the nearest health facility because she suspects malaria. Her

husband feels that his condition is “food poisoning” or “slow poisoning” by his wife. His

wife then calls the Rural Health Motivator (RHM) for help. When the RHM arrives Mr

Matse still refuses to go to hospital and he wanted to go to the local traditional healer Mr

Malaza. So Mrs. Matse takes him to the traditional healer who gave him herbs (imbita)

and incision him with a razor and applied a traditional mix (wamgata).

On the following day, the condition become worse, he was hallucinating and twitching a

lot and they again took him to Mr Malaza first before they came to the health facility.

They felt he was “seeing people”. His skin has lost its elasticity, his jaws were tight and

his eyes are open having a fixed gaze. The hands are turned out as if twisted on

purpose. You also notice that his posture is twisted and no matter how straight you

place him, the chest is pushed forward and the back arched. His body is “hot on touch”

suggesting a fever. Mr Malaza made him smoke incense (wambhunyisela) and because

of the severity of the condition, he suggested they send him to Good Shepherd Hospital.

EPR ambulance is called to pick him.

At GSH, Mr Matse is diagnosed and confirmed he has malaria. Thereafter he is

admitted and treated. While he was still at GSH, his wife complained of fever,

headache and fatigue. The nurses promptly tested her for malaria too. The results came

back positive. She was also given treatment.

Furthermore, his two sons showed signs of fever and headache in the evening after

their father was admitted, they were all taken to Lubulini clinic in the morning where they

were also diagnosed and confirmed with malaria.

In conclusion, on the 3rd day, Lubulini clinic, reported 5 more cases of confirmed malaria

to 977 from the community of Lubulini. Teams from malaria programme, regional

epidemic task force went down to Lubulini, started investigation and more cases were

found, then the national support from relevant stakeholders was summoned by

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The pictures above show malaria victims being attended from the community to a

temporal/makeshift clinic. Malaria victims being attended in a temporal clinic.

chairperson of Regional Epidemic Task Force (RETF) to Lubulini. Local authorities are

notified and they call urgent meetings. Malaria program plus health teams from national

level do active surveillance/ detection and investigation, residual spraying, provision of

treated bed nets and Lubulini clinic will provided chemoprophylaxis.

8.2 Cholera

In this episode the community was made to be aware of a communicable disease like

cholera. Cholera is a diarrheal disease manifested by excessive loss of body fluids

through passing of rice watery stools, vomiting, and loss of strength and sudden

collapse of body systems resulting in instant death if emergency assistance is not

solicited. Key messages on cholera were that communities need to have properly built

toilets and that are kept clean all the time. Unsafe water must be purified through

boiling and use of jik (5mls in 25 litres of water), proper hand washing after toilet use.

Community was educated that when one is infected by vibrio cholera, it does not mean

that the person is bewitched as that is a usual belief in their community but it is that the

person has lost fluids and needs urgent medical attention. Emergency Medical

Services (EMS 977) were called by rural health motivator. EMS dispatches an

ambulance for that incident with an Advance Life Support team in full Personal

Protective Equipment (PPE) for their protection. On arrival the team conducted a patient

assessment to confirm the suspected cholera case. IV line, oxygen is administered to

the patient at the scene. Whilst transporting the patient to the hospital the team

continuously monitors his or her vital signs. In addition response actions are mounted

in that community to give assistance in form of safe water, temporal toilets, health

promotion and other necessities that are needed to combat the outbreak.

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Cholera patients being collected by paramedics wearing PPE

Health Team visited the family for funeral arrangements. Health education continued in

the community and they were prepared on the anomaly they will see in this funeral so to

allay anxiety and maximization of cooperation

Health Talk/Health Education

The corpse is taken straight from mortuary to the burial site.

No food preparation is allowed to funeral attendants. Food preparation is

only for those staying in the family and it is under strict scrutiny from the

health team.

RSP and USDF continue to be in the area till no cases reported and also

to assist the community by all means and to keep safety and security.

Emphasis is made on preventive methods and early medical/health

seeking behaviors

8.3 Floods

The local radio station SBIS was continuously issuing warnings from the MET

department about possible flooding due to the severe rains being experienced. Five

herd boys are coming from looking after cattle from the grazing land and find the nearby

stream flooded. They removed their clothes and tried crossing the river. They debated

whether they should cross or wait for an elderly person, but Sipho insisted that they

cross and warned that they not be cowards. They started crossing and two of them

were swept away, and disappeared. Two of the boys rushed home to report the matter

and the elderly people rushed to the scene. Meanwhile the local rural health motivator

called the emergency number 999 to report the drowning. The local police called their

diving unit (scuba divers), and they also called Fire 933 and 977 EPR unit. All actors

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RSP-scuba divers searching for children who had drowned and loading a corpse from the river

with the assistance of the USDF, Scouts and SNFES.

rush to the site and the boys who were present are used to make a statement and also

show the exact point in which the others disappeared. Then the divers start their search

for the bodies. The EPR ambulance on the side was helping the other boys who had

drank a lot of water while crossing the river and rushed them to Lubulini clinic. After 2

hours of search the divers retrieved the two bodies and were taken by police van to the

nearest hospital where they were certified dead

8.4 Storms and Fires

There was a heavy storm where electricity poles were brought down with the live

cables. The community controlled the herd boy from driving cattle across the live cables

whilst calling SEC toll free no: 8009000 to attend. SEC arrived and controlled the

situation. In this scenario the key message was that live electricity wires must not be

tempered with because it can cause death. Instead communities must immediately

report to SEC.

In the second scene a household had made an illegal connection which resulted in fire

outbreak causing loss and damage to property. Two children had fume inhalation when

the houses were burning and the other two sustained 2nd degree burns.

Police were called through (999), the police called the relevant stakeholders, fire

(933), EMS (977) and SEC (8009000).

SEC cuts off the power lines.

Fire service put out the fire.

EMS (paramedics) applied dressing on the burns and resuscitated the children who

had inhaled smoke before they were transported to hospital.

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SNFES fighting a buring house. Cattle at risk from live electricity cables

NDMA responds with temporal shelter (tent) to fire survivors

8.5 Road traffic accident

In this pisode, the meteorological services had previously reported that there shall be

heavy rainfall the following day and that children must be careful when crossing rivers

especially footbridges. A head teacher gave a lift to school children overloading the car.

Unfortunately the overloaded car overturned resulting in P1,P2, P3 and P4 causalities. .

A community member called the toll-free line 977. The EMS Call Centre also called the

relevant stakeholders, the police 999 and fire (933).

Police on arrival conducted a scene safety.

Paramedics (EMS) conducted a triage (patient survey) applied Basic to Advance life

support to the patient on scene, by practicing pre-hospital medicine of “golden hour

approach” as well as applied dressing and mobilize fracture on the patient, calling

nearest hospital for immediate referral.

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SNFES conducted rescue to the trapped patient from the vehicle, removed the

vehicle from the road.

The area of the hand over of the survived person to the paramedics (EMS) for

advance life support and the dead were then handed over to the police.

NB: All patients were transported to hospital under serious care.

Demonstration of an RTA scene during the simulation at Tikhuba Inkhundla

9.0 Lessons Learnt Event

Lessons learnt workshop was held at Riverside Hotel on the 5th of June 2014. The

purpose of the workshop was to reflect and draw lessons on the simulation exercise

conducted at Lubulini and Tikhuba Inkhundla with the aim to inform future simulation

programming. It was attended by all DRR national stakeholders including Lubulini

Inkhundla leadership, Traditional leadership and community members.

Lessons Learnt Workshop

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From the lessons learnt workshop the following were the key issues raised as best

practices and lessons learnt (areas of improvement):

9.1 Malaria

Best practices

Active response and surveillance was evident

Audience was made aware that malaria is curable

Awareness on how and where a case should be reported.

Fast reporting and response prevent eventual death.

Lessons learnt

Spraying/fumigation was done after the outbreak which is not normal practice or

not the key message as the ministry has a prevention programme

9.2 Cholera

Best practices

Person suffering or having died of cholera should not be touched by anyone

except experts

No food preparation during funerals of cholera victims

Key messages were well communicated,

Dress code showed that the disease is easily transmitted from one person to the

next

Lessons learnt

Some responders who came to the scene were not well protected as those from

the epidemic department which means they will also contact the disease

9.3 Floods

Best practices

Audience were made aware that some victims manage to come out alive while,

some die

Audience learnt the importance of wearing PPE during a search and rescue

mission

The scenario was well planned and coordinated

Lessons learnt

Scenario should be realistic to audience (talk about dams if area has dams)

At times narration was not done by a technical person in the field (diver).

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9.4 Storms, live wires and Fires

Best Practices

Personnel’s response was timeously

Displayed great skills in putting out fire and ensuring there is no fire protruding to

others

The team was well equipped and their response was recommendable

Lessons Learnt

Fire and Emergency services should be brought closer to the community in order

to improve the response time during fire outbreaks. Presently the fire and

emergency services far from this community (lubulini), making it impossible to

promptly respond to emergencies.

At times narration was not done by a technical person in the field (fire personnel).

9.5 Road Traffic Accidents

Best practices

Response numbers were clearly visible

Co-ordination was good between stakeholders at the scene

Handling of victims was shown as the critical thing for recovery

Key messages were well communicated

Lessons learnt

Communication between stakeholders at the scene is important to be shown/

evident

Stakeholders should meet and discuss scene before acting

Improve on the narration of the scenario

10.0 Conclusion

Communities were educated on disasters/emergencies and the role they can play when

disasters strike. Communities as first responders should be well capacitated in order to

prevent compounding effect of emergencies. This exercise enabled communities to

know the different key stakeholders in disaster management, their various roles and

how to get in contact with them using their toll free numbers. Moreover, the

stakeholders had an opportunity to educate the communities about the services they

provide and how the community can access them. Stakeholders had the opportunity to

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test and strengthen their coordination capacity during emergencies. It is therefore

commended that such exercise should be rolled out to all Tinkhundla centers for the

purpose of strengthening community resilience.

11. Recommendations

The following recommendations were suggested by stakeholders during the lessons

learnt workshop:

General Recommendations

Accommodation should be closer to the operational area so that stakeholders

have ample time to prepare communities

There is need to incorporate special groups like people living with disabilities on

the scripts

Safety/precautions should be ensured in some scripts e.g. fire on a windy day,

swimming of children on a cold day etc.

Stakeholders should come chronologically when responding at the scene in order

not to distort the message on the different roles of stakeholders

Community should be informed and well prepared, (more time need to be

invested by stakeholders on preparation and rehearsals).

Malaria

The script should emphasize on prevention by starting on the national fumigation

programme, whereby those who don’t allow it in their households become victims

instead of fumigating after the outbreak

A training of the community on the different types of mosquitoes and the use of

PPE must be incorporated

The script should include education of the Traditional Healers and Pastors on

symptoms/signs of malaria

Cholera

For education purposes more water must be available with soap on site which

will be used by the community for education purposes during the simulation

Stakeholders and key partners must bring more live/real equipment/teaching aids

to use

Floods

More divers are needed, so that they are spread throughout the regions

The training must be reviewed for divers to include swift water rescue, big

dams/deep water bodies.

The script should include cases whereby divers’ assistance is used in crossing of

flooded rivers rather than sticking to drowning only.

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Artificial dams/rivers should be made bigger to make scenario closer to reality

Storms, Electricity cables and Fire

Improve on visibility of 933 and 8009000 to the community

There is a need to emphasize that Emergency lines should be respected

Fire stations should be brought closer to communities for meaningful assistance.

Road Traffic Accident

Decentralization of services to be closer to the communities is important

A Central/ harmonious response number for disaster team is needed who will

contact all response numbers (NDMA Toll Free Number).

More time is needed for practicing prior to the actual play of the scenario

Annex 1: National DRR Stakeholders

EXPANDED LIST OF NATIONAL SIMULATION TECHNICAL TEAM-June 14.docx

Annex 2: Simulation Flyer